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                      AN


            ESSAY

                    ON THE

       THEORY  AND  TREATMENT

  OF FEVER  AND INFLAMMATION,

ACCORDING TO THE BOTANICAL OR REFORMED SYSTEM OF PHYSIC AND
  SURGERY, TAUGHT AT THE REFORMED MEDICAL INSTITUTIONS OF
        NEW YORK  CITY, AND WORTHINGTON, OHIO.

                   ALSO, AN

      EXAMINATION AND  EXPOSITION

                OF THE EFFECTS  OF

  BLOOD-LETTING,  MERCURY AND ANTIMONY,

         UPON THE HUMAN SYSTEM, AND OF THE

IMPROPRIETY  OF  USING THEM  IN THE

       TREATMENT OF DISEASES.

                TO WHICH IS ADDED,

   A FEW OBSERVATIONS  ON CHOLERAv 6^^


                                    ■-•■■= \ V."Y .?

                ____.___    '.^flV'Qy

             BY DR. D. L.  TERRY, ^'3/H^tOf. iv*

 Practitioner of the Reformed System of Medicine, and Member of
      the Reformed Medical Society of the United States.
          DAYTON:

VAN CLEVE & COMLY, PRINTERS.

            1834. 
                           DISTRICT OF OHIO, to wit :
 Be it remembered, That on the 30th day of November, A. D. 1833,
D. L. TK.RYofthe said District, hath deposited in this Office, the
title of a book, the title of which is in the words following,'to wit: "An
Essay on the Theory and Treatment ofFever and Inflammation, accor-
ding to the Botanical or  Reformed System of Physic and Surgery,
taught at the Reformed Merlcal Institutions of New York city and of
Worlhington, Ohio.  Also, «m examination and exposition  of the
effects of Blood-letting, Mercury and Antimony, upon the human sys-
tem, and of the impropriety of using them in the treatment of diseases:
to which is added,afewobservations on Cholera.  By Dr. D. L. Terry
Practitioner of the Reformed System of Medicine, and Member of the
Reformed  Medical Society of the United States."   The right where-
of he  claims as Author and Proprietor, in conformity with an act of
Congress, entitled "an act to amend  the several acts respecting copy
nShu- '                    Attest,WILLIAM MINER,
                                         Clerk of the District. 
CONTENTS,
Chapter I.	
a	II.
u	III.
a	rv.
a	v.
d	VI.
it	VII.
«	VIII.
«	IX.
        On Sensibility  and Contractility.
         Of the Nature and Uses of the Blood, in the
           Human  System.
         Of the Physical Sympathies.
         Of Fevers.
         Of the Different Kinds of Fevers.
         Cause of Fever.
         Of the Symptoms of Fever.
         Of Inflammation in General.
         Treatment of Inflammatory Diseases, or of
           Diseases attended with Local Fever.
"   X.   An Examination into the Effects of Mercury,
           Bleeding and Antimony, in the Treatment
           of General and Local Fever.
"  XI.  Of Blood-letting.
" XII.  Of Mercury, and its Effects upon the Human
            Constitution.
" XQI.   Of Antimony—its Use and Effects  upon the
            System.
« XIV.   To the Reader.
"  XV.   Address to  Physicians—especially  to the
            young.
" XVI.   Observations upon the Nature and Treatment
            of Cholera. 
 
PREFACE.
   The Science of  Medicine is so extensive and intricate,
rthat no one need expect to obtain a knowledge of it,  except
 by a long, persevering, and regular course  of study.   It
 is not therefore, the design of the following pages to qualify
 persons for the practice of medicine; but to make them ac-
 quainted with some of the most important general princi-
 ples of practical medicine.   To  develope some  of these
 great truths in medical science,  which have been  buried
 for centuries  past in the depths of false science and fash-
 ionable prejudice; to expose, if possible, more clearly than
 has been done heretofore, the many dangerous errors which
 have so long existed, to injure the practice, to prevent useful
 improvement, and to oppose'all attempts for a  reformation
 in this important science; to set forth some of the  leading
 principles and peculiarities of the Reformed System of Med-
 icine ;  to correct some of the many misrepresentations and
 erroneous impressions in relation to this system; and to en-
 courage improvement in medical science.  These  are the
 motives which have  induced me to undertake the task
 of writing this  Essay.  I do not give all the principles and
 ideas as being sanctioned and approbated by every Reform-
 er.  Some of them  are  peculiar to my own  mind,  and
 I hold myself responsible for their correctness and  support.
 But in general, they are such as are taught by  the founder
 of the Reformed System, and sanctioned by all true Reform-
 ers. In so short a work as  the following, it cannot be ex-
 pected that the different subjects treated, should be discussed
 with as much minuteness as even their importance demands;
 yet, if I have  presented them in a light calculated toenlist
 the attention of the public in their investigation; if this work,
 which claims  no high pretensions, shall serve as a pioneer
 to another upon the subject, from an abler pen; and  finally,
 if it shall result in any real good to mankind, a consciousness
of the same, will be the author's highest and best reward.
                                     D. L. TERRY.
                          *1 
 
INTRODUCTION.
  Any deviation from long established opinions upon im-
portant subjects, is not only forced  to undergo the ordeal
of public scrutiny, but is, in general, met by all the  obsta-
cles,  which  an unqualified attachment to  pre-conceived
notions,  a love of popularity, the prejudice  of early edu-
cation and the selfish propensity of monopolizing  all im-
provements, can suggest.  These may be reckoned among
the most efficient causes, which have combined in all ages
to clog the wheels of the car of Science, and thus materially
to retard its onward march.  It appears  also, to have been
more especially the case in the  science of medicine; for no
sooner had the genius and talents of some one in the profes-
sion ventured beyond the known boundaries of any branch
in the science, and built some new and splendid theory, or
discovered some unnoticed  principle in  the economy and
government of the human system;  no sooner had any one
exhibited sufficient courage and independence, thus to rend
iho chains of  mental despotism and oppression, than the
indignation, the slander and ridicule of hundreds of his pro-
fessional brothers were levelled at him, to bring him to yield
allegiance to their opinions and prejudices, or to effect his
exile from the field of medical science.   This was the spirit
which opposed the doctrine of Doctor William Harvey, in
relation  to the  circulation of the blood;  but  in spite of all
opposition, his  efforts were crowned with the attainment of
their noble object, and it is now received as  an  invaluable
acquisition to the science of medicine.  Such is the ignoble
spirit of jealousy and envy, that it  is not the usual fate of
novel doctrines, however important, to be received  without
opposition; accordingly, we find there   were some, whor 
VIII.
 biaased by passion and interest, had the boldness to deny the
 facte so  fairly  proved, and to calumniate the name of the
 truly ingenious ard illustrious Harvey.  It is observed by
 a judicious writer, that "the books ofllarvey present us with
 many indications of a great mind, acute  discernment,  un-
 wearied  application,  original remark, bold inquiry, and a
 clear, forcible, and manly reasoning."
   The very brilliantand important discovery of the vaccino
 disease by Doctor Edward Jenner, a celebrated English
 physician, for a time met with a similar fate: it was treated
 as chimerical;  but the discovery  is  now looked upon as
 an incalculable blessing to mankind,  and for which the  au-
 thor deserves lasting and universal respect and gratitude.
  Medical  science  is progressive,  and  the  melancholy
 triumph  of disease over  its victims  clearly evinces,  that
 the combined stock of both ancient and modern learning is
 greatly insufficient to perfect our science.  It is very evident
 that, in order to give permanency to the theory and practice
 of medicine, this theory mud be founded upon true philo-
 sophic medical  logic; it must be supported  by pl_in facts
 derived from actual demonstration und practical experience.
  Had  medical theories  been  built upon such basis, his-
 tory would not present us that numerous list of revolutions
 in the science, which it now does.   We find, by adverting to
 the pages of medical history, that the theories in physic have
 been extremely numerous and fleeting.  Many of them
 were no more than visionary hypotheses, arising from per-
 verted imaginations, totally unconnected with facts, and alto-
gether repugnant to the plainest dictates of observation and
 experience.  AH ages have teemed with the  controversies
 of the learned; and while ambitious  projectors  imagined
 they had attained to perfection, their  cotemporaries or im-
 mediate successors contested their principles, and triumphed
 over their errors; hence we see theories, which scarce sur-
 vive their authors,  give place  toothers as transient and  un-
 substantial as themselves; but all this fluctuation in theoreti-
 cal medicine may be  traced to erroneous premises—to mere
 metaphysical speculations and imaginary conjectures.
  The plain and determinate operations of the  laws which
 govern  living animal matter had been overlooked- the\ 
IX
were too humble in themselves to attract the observation of
those whose vanity had flattered them with the idea that they
had penetrated so far into the labyrinths of knowledge, as to
place thtm beyood the reach of nature's  instruction.  The
common popular routine of medical practice, notwithstand-
ing the improvements which are pretended  to have  been
made in it by its adherents, is, it must be confessed, still
fraught with deficiencies, far indeed beneath the standard
of perfection, and altogether inadequate to our desires.  To
disable the destroying arm of disease,  how often  are the
efforts of medical skill entirely inefficient!
   To what extent the frail condition of our nature is capable
of being meliorated and existence prolonged by the timely
and judicious application of correct principles of medicine,
must still  be reserved to the wisdom and industry of future
generations to determine.   It is nevertheless a duty incum-
bent upon every physician at least, to consecrate his talents
to the advancement of this science; duly to appreciate and
exalt its merits; to cherish its dignity; to  stud}' and improve
its principles; and to cultivate a due sense of the inestima-
ble blessings which mankind should derive  from its influ<
ence.  It is to be regretted that so many causes have existed,
and that so many still exist, to retard  the improvement of
medical science.  For  ages, its progress was  obstructed
by the edict of sovereigns and legislatures.  The Emperor
Charles V. in the sixteenth century, although addicted to
crimes of the darkest stain, ordered an assembly of divines
to deliberate, whether it were lawful, in point of conscience,
to dissect a dead  body.  During the same  reign, a violent
controversy subsisted  respecting the question, whether in
a pleurisy blood should  be drawn  from the arm  of the
affected side, according to Hyppocrates, or from the opposite
side.  The university of Salamanca, in Spain, decided by
a decree, that no  one should dare to let blood, but from the
contrary arm, alleging that the other method was of no less
pernicious  consequence to medicine, than Luther's heresy
had been to religion.   Haller, that eminent and indefatiga-
ble physiologist,  was obliged  to  flee the city of Paris, to
avoid prosecution for dissecting dead  bodies.  In  some
aountries,  yes, even in our land of professed liberty, laws 
X.
have been enacted, having a direct  tendency to suppress
the spirit of freo inquiry and learned investigation, which
the improvement of this highly important science demands.
These laws have said  to the friends  of  medical improve-
ment, "thus  far shalt  thou go, and here thy inquiries shall
end;" they have prescribed the limits and declared non-pro-
tection to him who shall dare exceed them.   But we are
happy  to add, that, by the democratic influence of progres-
sive  knowledge, these most despotic and  oppressive lawi
have generally been repealed—leaving the medical practi-
tioner no further aid than that which his skill, his knowledge
and virtue shall merit.
   Another cause, which  has proved almost an insurmoun-
table barrier to the growth  and  improvement of practical
medicine, is that illiberal feeling, existing in the  minds of
physicians of different opinions, towards one  another, as
denominations, and sometimes even as individuals.  There
is a want of mutual confidence—of unity  of action, in promo-
ting the welfare of the science. It will be admitted by every
intelligent and liberal physician, that the field of medical
science is an extensivoone—that now discoveries have been
making ever since it was first entered into—that much of it
must even yet remain undiscovered. If  this be admitted,
why need one physician condemn another, because he has
had the curiosity and courage to explore  some of the fields
which had never been before discovered; and if in his trav-
els he  should find some new remedial agent, or imbibe some
fresh principle, should he not have the  privilege of making
known the same, and thus  indulge the  virtuous and  pleas-
ing  hibit of doing good?
   It is an advantage of no  ordinary moment, that we live
in a Republican Government;  a government which toler-
ates freedom of thought, the liberty of speech and of the
 press; where  every one  may present to the world whatever
 useful or important knowledge he may  have discovered.
   As  Reformers in the science of medicine, we profess to
 have made  new and important discoveries in some of its
 departments.   We believe that many  errors exist  in the
 common  practice of  medicine; nor are these errors  alone
 confined  to the practice; errors in theory lead to errors in 
XI.
practice; hence to expose these errors, both theoretical and
practical, and to establish a consistent system of theory and
practice, which shall be in accordance with correct physio-
logical principles, and which shall apply to all cases of fever,
is the principal object of these pages, and should we attain
our object we shall gain the reward which is indispensably
connected with the consciousness of doing good.
  In the profession of medicine, as well as in that of the-
ology, many controversies have been raised and continued,
merely from a misunderstanding of terms and an ignorance
of opposite doctrines, or controverted points.   It has been
a subject of warm discussion, whether life be depending
upon organization, or organization  be depending upon life.
The question is  supposed to have been ably discussed on
both sides, each party  claiming men of distinguished abili-
ties and profound  erudition; and each party in turn claim-
ing the victory.   But if we follow the  arguments on both
sides, we shall  be convinced that neither party is able to
establish its position; we shall discover that simple organ-
ization, abstractly considered, has no power of producing
life; nor can life  exist independent of organization.  The
simple and  undeniable fact then is, that they are mutually
and equally dependent upon each other.  Life resides only
in the structure or body of its own forming; so it may be
said,  that life and organization grow up out of each other,
and are inherently and necessarily  united.   The vital prin-
ciple, or the indescribable something, which  seems to be
the main-spring  of all the actions  which take place in the
human machine, has been  differently explained by  those
whose knowledge was too limited to lead them  to confess
their ignorance upon subjects which they could not compre-
hend; yet all  these  have tacitly and unintentionally ac-
knowledged the truth: yes, they have acknowledged thetruth
from  unyielding  necessity—they  have failed to describe
this vital  principle; still they must submit to the humble
admission which we are reduced to: that it is, "are indescri-
bable something," only  known to us by the  phenomena
which it presents in  the animal and vegetable kingdoms. 
 
ESSAY  ON  FEVER,  &c.
                  CHAPTER   I.

      ON SENSIBILITY AND CONTRACTILITY.

   The physiological principles, or properties in the animate
world, which appear to be the primary discernible effects
of the vital principle,  are denominated Contractility and
Sensibility;  these  are  properties, without which  life can-
not exist in any being, animal or vegetable.   Contractility,
in a peculiar sense, is a property of all matter,. In inanimate
matter, it  is commonly  denominated  attraction of gravita-
tion -or in a more limited sense, the attraction of adhesion.
But that kind of contractility, which is more especially the
subject  of our present inquiry,  we shall denominate vital
organic contractility;  and this is divided into that kind
which exists in animals, and that which is found in vegeta-
bles.  Contractilitv, when applied to animal matter, signi-
fies that property which  holds together  the various parts of
the animal body;  which keeps  the particles in  contact;
which brings together the parietes of the heart's  ventricles
and diminishes the calibre of the arteries and  veins, and
produces all other  actions in the animal body, which con-
sist in lessening the magnitude of the organs; in bringing
the particles in close contact with one another.
   Sensibility is a property belonging generally to animate
matter.   It exists in vegetables to a certain extent, and  m
some  more than in others. Almost every one has observed,
in what an astonishing  manner the sensitive plant recedes
                           2 
14
from the near approach of the finger.   In this example, we
discover the effect of vegetable contractility and sensibility.
  The sensibility of plants renders them susceptible of the
stimulus of those materials, by means of which  they sub-
sist ; such as heat, air, moisture, light, &c.   Animal sensi-
bility may  be considered under two divisions or heads.
  First.  Simple organic sensibility; by the aid of which,
combined with  contractility,  the vital animaliunctions are
performed.  This species of sensibility supplies those organs,
the functions of which are performed involuntarily; that is,
independently of the will or the act of volition.
  Second.   Sensibility,  through which  the  impression*
made upon any  of the  senses are conveyed to the centre of
reflection and thought—this  species of sensibility  is com-
monly  called perceptibility.  It supplies those organs, the
actions of which are voluntary, that is, under the control and
direction of the will.
  Contractility, as has been  already  observed, is a gen-
eral  property of all matter; but in living matter it  is modi-
fied and strengthened by the influence of the vital principle.
This property varies in different organs and structures in
the human system. The muscular fibre appears to be highly
charged  with it.  In the osseous system, it appears to be
but little different from what it is in  vegetables.   There
is sometimes mention made of a property of animal matter,
termed elasticity; but it would appear  that  this  is only a
modification of contractility.  Sensibility in  animals is con-
sidered to be dependent upon a system of delicately organized
cords,  which have their origin in the brain and spinal mar-'
row, and which are sent off from thence to every part of the
body.   These are called nerves, and are supposed by some
tocontain an extremely subtile fluid, termed the  encephalo-
spinal fluid.   The  various  organs  or  parts of the  body
differ very materially in regard to the different degrees of
sensibility  which they naturally possess; each organ and
system of organs  being endowed with  that  quantity and
quality of sensibility which is best  calculated to attain the
 object of its creation.   In order that a perfect state of health
 may exist in  the human system, there must be  an exact
 equilibrium maintained between the  properties of contrac- 
15
tihty and  sensibility, throughout the different organs  of
which the body is composed.   The vital principle must be
at its standard.  It never can deviate from  this, except by
sinking below.  Thus far we deem it necessary to go into
the  examination of these important principles of the science
of life.   In these observations, we do not pretend to  have
advanced any new ideas; or any with which the scientific
medical gentleman is not familiar.   Our object in treating
upon these physiological subjects, is to aid those who  may
peruse these pages and  who are not acquainted with medi-
cal  science, in comprehending our peculiar doctrine of fe-
vers and the propriety of the course we  pursue  in  their
removal. 
CHAPTER   II.
OF THE NATURE  AND  USES OF  THE  BLOOD  IN
               THE  HUMAN  SYSTEM.

   The blood is a red  homogeneous fluid, of a saltish taste
and glutinous consistence, which  circulates in the cavitiei
of the heart, arteries and veins.   Its quantity  is estimated
to be about twenty-eight pounds in an adult;  of this four
parts are contained in the veins, and a fifth in  the arteries.
Some anatomists  and physiologists regard the blood as a
fluid possessed of life.   Mr  John Hunter, in  speaking of
the blood,  asks the following  question: "How could the
blood impart life to the various organs of the body, if it pos-
sesses no life in itself?"  The specific gravity of blood
is a little,more than  that of water.  Blood,  upon being
drawn and permitted to stand for a short  time,  forms a soft
mass, which separates spontaneously  into two parts; the
one liquid, yellowish,  transparent, called scrum; the other
soft, of a deep brown red, entirely opaque; this is the cruor
or clot.   This occupies  the bottom of the vessel; the serum
is placed above.   The  spontaneous separation of the ele-
ments of the  blood  does not take place quickly, except
where it is in repose.  If it is agitated,  it remains liquid,
and preserves its homogeneity much longer.   Mr Hunter
divides  the blood into  the coagulating  lymph, the serum,
and the  colouring  matter, or the red globules.  All phys-
iologists are agreed in attaching great importance to the
blood.  It is the most essential fluid in the human system.
It is called the vital fluid, the pabulum of life.  All parts
of the system are made  out of it; we grow up out of it,  and
are  entirely supported  by  it.   It distends the cavities of
the heart and blood-vessels, and prevents them from collaps-
ing; it  stimulates to contraction the cavities  of the heart 
                          17

and blood vessels, by which  means the circulation of the
blood is performed; it generates within itself, by the friction
of its  particles, animal heat, which it propagates through-
out the body; and lastly it is that source from which every
secretion of the body  is separated.  Whatever the  vital
principle may be, it is continued and supported by the blood.
This fluid is formed  from the aliment which is taken into
the stomach, after this aliment has undergone the chemico-
vital process of digestion.  Hence we must admit with Mr
Hunter, that during disease the quantity of blood is dimin-
ished, from the fact that it is constantly expended in the sup-
port of the vital functions, while the process of making  more
blood is mostly  suspended for the time.  The blood,  from
various causes, may become mechanically, but not chemi-
cally, deteriorated; for  whatever extraneous  matter may
combine with the blood, still the constituent particles of this
fluid are unaffected; no chemical  union having taken place
between the blood and the foreign matter.
                         *2 
CHAPTER  III.
        OF THE PHYSICAL SYMPATHIES.

  That reciprocal dependency, which  is known to exist
between the different  members or organs  of the human
system, is expressed in medical science, by the term sympa-
thy.   The  particular  or specific nature of this  principle
has never been clearly ascertained.   It appears to form
that  beautiful  and invisible chain, which encircles and
unites all the parts of the body; the medium of vital commu-
nication between them; the principle by which  one organ
becomes the mutual bearer of the sufferings of another.
It enables each member of the system, to "feel  for others
wo, and patiently endure its own."
  Were we to take a limited view of this principle in human
nature, we might even be led to conclude, that  "nature is
not wise in all her works."  For we should sec organ after
organ becoming involved in disease through  this medium of
sympathy.   We should see original or idiopathic disease
of the liver, extending itself to the lungs, stomach, and fi-
nally to all parts of the  body,  involving  even  the mind
itself in consequences of the most  deplorable and  melan-
choly character.   But when we survey the whole system of
physical sympathy, we shall discover abundant cause to
admire the Author of nature, as much  in this, as  in the rest
of his works.  By sympathy, the united strength of all the
organs of the system are brought to resist the attacks of the
many causes which operate upon the  body to  produce dis-
ease.  The unassisted strength of any one individual organ
of the system, would, in all cases,  where any considerable
cause of disease should exist, prove totally inadequate to
eradicate or remove this cause; but when a  union of all the
forces of the system make  a simultaneous attack upon any 
19
morbid cause, it must generally yield.  The general sym*
pathy of the human system may  be compared to the gener*
al government of the United  States.  Each State, for ita
own safety and for the welfare of the others, has voluntarily
entered into a social compact with  all the others, and has
pledged herself to aid in preserving ihe liberty of the whole.
She still reserves the privilege of enjoying the liberty of
her own conscience, and of forming her own laws  for her
individual government.
  The various organs of the svstem are under the truly
republican  government  of universal  sympathy.  This
union seems to have been  formed with a strict regard to the
well being of the whole body; as ifevery organ was sensi-
bleof the truth of the motto, "united we stand, divided we
fall."  The individual laws which govern each organ have
some peculiarities of a specific nature, adapted to the par-
ticular function which it performs in the animal economy.
The sympathy existing between the body and mind, or the
physico-mental sympathy presents  to the philosophic mind
a field of curious and interesting speculation.  That diseases
of the body affect the mind, no one of experience  and ob-
servation can deny; nor are the  affections of the body from
diseases of the mind less conspicuous.   The actual exer-
cise of the mind is depending in a certain degree  upon the
vital energy imparted to it by the body.   So, the functions
of the body are in some degree under the special  influence
of the mind.
  The modus operandi, or the manner  in which many
medicines produce their effects upon the human system, is
only explicable  upon the principle of physical sympathy.
Some medicines, upon being taken  into the stomach, affect
the whole system almost instantaneously.   This  must un-
doubtedly take place through the medium of nervous phys-
ical sympathy.  No one part of the body can be materially
affected, for a considerable length of time,  without affecting
the other parts.  Hence when an organ receives an injury,
which produces inflammation in it, the heart and arteries
takeon an increased.action, giving  rise to what is termed
in  medical language, sympathetic or symptomatic fever.—
But a more admirable and exalted principle of sympathy- 
20
 liian has yet been noticed is that which exists between
 mind and mind.   This is depending upon virtue and knowl-
 edge.  The extensive exercise of it is congenial to every no-
 ble principle of the soul.  It contributes materially to the
 health of the body, and to the happiness of the mind.   It is
 that which causes us to weep witli  those who weep, and  to
 rejoice with those who rejoice; it is by the  exercise  of it,
 that we may learn that there is a joy  in grief.
   But to return again to the subject of physical sympathy.
 We find  it exerting  itself in all diseases; distributing
 strength and vital energy to those parts, whose peculiar sit-
 uation at the time may demand a more than  ordinary de-
 gree of vitality.   Before we proceed to a further examina-
 tion of the phenomena  produced by sympathy, it may not
 be improper to observe, that the  sympathy of the body  is
 sometimes  divided by  authors into "sympathy of equilibri-
 um," and "sympathy  of association."  The  sympathy
 of association is produced suddenly and for a short time;
 that of equilibrium is produced  more slowly, and continues
 inoperation  during a much longer time.  The sympathy
 of equilibrium is seen  in the effects produced on any one
 organ from the inflammation of another; an example of
 which we have in  case of gastric inflammation,  or inflam-
 mation of the stomach, where the brain is very  sensibly
 and materially affected.
  We have  an instance of the sympathy of association in
 the mutual  increase of action of the skin and liver; but if
 this increased action is continued long, then this association
 is set aside by  a stronger and more general principle of the
 e^iilibrium of action, and the sympathizing part  is weak-
 ened.  Upon this principle may  be explained  the preva-
 lence of affections of the liver in warm climates.   As the
 warm season approaches, the  vigilant  eye of nature per-
 ceives the gradual rise  of the animal heat; it sees the neces-
 sity of instituting some  process, to prevent the temperature
 of the system from rising above its healthy standard.  By
 observing the actions of the different parts of the system, we
 shall discover the  process of reducing animal heat to be an
 accelerated action of the  perspiratory system.  Every one
knows that he sweats more in warm weather than in cold ;
and it is for this reason, viz. to reduce the animal tempera- 
21
 ture.  In southern  climates, nature is obliged to push this
 process to a great extent; and as the skin and liver are sym-
 pathetically connected, the latter organ becomes weakened,
 upon the principle of the sympathy of equilibrium; the ac-
 tion of the liver is first increased, but  it being the sympa-
 thizing part, is finally subjected to the laws of equilibrium
 of action.  The liver, then, being in a debilitated condition,
 at the time when the autumnal season sets in, is but  illy
 prepared to meet the frequent attacks made upon it, through
 the medium of cutaneo-hepatic  sympathy, by the sudden
 transitions of atmospherical temperature, so  common in
 southern  climates, especially at that  season of the year.—
 The perspiration, by some slight exposure, is checked;  giv-
 ing  rise  to obstruction of the liver, or  preventing the excre-
 tion of the bile.  This gives rise to the bilious appearance
 observed in  those fevers denominated yellow and bilious
fevers.  To a cause, though opposite  when abstractly con-
 sidered, yet similar in effect, may be attributed the general
 prevalence of pneumonic affections, or diseases of the  lungs,
 in northern latitudes.
  In order to maintain a proper and necessary consistency
 in the fluids of the body, nature  has several chemico-ani-
 mal processes, by which she produces this effect.  One of
 these is that of natural insensible perspiration.  But in  cold
 weather the action of the skin is diminished, in order  that a
 due degree of warmth may be supported in the system; but
 to effect the object before mentioned, viz. to prevent the flu-
 ids from becoming too much attenuated, the pulmonary  sys-
 tem takes on an increased action.   This action being con-
 tinued, must of necessity, to a  certain extent, give  rise to
 weakness of the lungs,  rendering  them  less  able to with-
 stand the attacks of a severely cold  air, to which they con-
 tinually  present such an extended surface.   The doctrine
 of sympathy is one of great moment to  the practitioner of
 medicine, both in a pathological and practical pointof view.
 It is upon this principle,  or through this medium, that he is
 enabled to bring  about many of those desirable results,,
 which follow the exhibition of his medicine, and which  are
 his  best reward, for the anxiety and deep  responsibility
 which is imposed upon his mind, by the exercise of his pro-
 fession. 
CHAPTER  IV
                    ON FEVERS.

  The term fever, in its vague and indefinite sense, includes
a very numerous and diversified class of diseases, common
to both sexes, to every period of life, and to all climates and
countries.  In the most extensive signification of the term,
itissaid to be the most  general  of  all the morbid states to
which the human constitution is liable.   Doctor Sydenham
has said, that it constitutes in its various forms two-thirds of
the diseases  of mankind.  We agree with a celebrated
medical author, when he says: "It  must  appear obvious,
that, for the practical purposes of the physician, the general
application of the term  fever is too vague and indefinite."
To avoid this difficulty, authors have  distinguished fevers
into two great classes.   Such as arise  from general causes
and operate upon the body at large, are denominated prima-
ry, or  idiopathic fevers:  while  those  which depend  upon
inflammation  or some other local affection of particular or-
gans, are called  secondary  or symptomatic fevers.   The
division which is now generally adopted,  is into the  three
orders of intermitting, remitting and continued fevers, which
are again distinguished into  synocha, or inflammatory fever
synochus, or simple continued  fever,  and typhus, or low
nervous fever.
   Each of these general divisions is sub-divided  into othersr
which are named from some peculiar symptoms, or the ob-
vious affection of some particular organ or setof organs, in
each case.   Thus, where, in addition  to the  usual febrile
symptoms, there is a redundant secretion and vitiated state
of the bile, occasioning frequent evacuations by vomit or
stool, the fever is called bilious.  In fevers of thecontinued
kind, attended with great prostration  of strength, general 
23
torpidity of action, diminished arterial action and  delirium
or corna, the term typhus is commonly used to distinguish
them.   The sympathetic or irritative fever, which usually
attends in the late stages ofphthysis pulmonalis or consump-
tion, is denominated hectic.   That which  arises from the
habitual use of ardent spirits is termed febris cerebralis, or
brain fever, &c.
   That which is accompanied with a peculiar yellowness
of the  skin, is termed  pestis  tropicus, typhus icterodes or
yellow feyer.  That, which is accompanied with  bilious
appearances, combined with affection of the lungs, is called
pneumonia  billiaosa, or typhoid pneumonia.  And many
other terms are applied, by some authors, to febrile affections,
which merely designate some prominent symptoms in each
case.   If we will condescend to adopt the division marked
out by nature in all  febrile diseases, we shall find that  all
affections of the human system,  attended with those symp-
toms,  which, according to the common acceptation of the
term,  constitute what is called  fever, are  naturally   and
specifically divided  into two entirely separate and distinct
heads.
   The general affection is to be considered as being  made
 up of, first, a morbid  or  diseased  action;  secondly, of a
 salutary  or restorative action.  By  the first, or morbid ac-
 tion, we  mean that  loss of the balance  of sensibility and
 contractility, which balance is indispensable to  the health
 of the svstem: that is, whenever this equilibrium is destroy-
 ed, the well-being of the system is endangered, the general
 health is disturbed.  This state of the system is generally
 overlooked by common observers; yet the one who is thus
 affected is very conscious of it.  He is alternately affected
 with chills and flashes of heat; he is dull and languid; he
 feels,at different times, pains in different parts  of the sys-
 tem; he has no disposition to eat; he is averse to all action;
 his mind is torpid and  much depressed; and finally,he feels,
 knows, and declares himself to be "sick."  This is the only
 term by which his indisposition and state  of feelings can
 be expressed at this time.   This state of things  continues,
  with some slight variations, for  two, three, or  more days,
  when a different state of the system is felt; the action of the 
24
 heart and arteries is  accelerated; the temperature of the
 surface is elevated; a general dryness and thirst is experi-
 enced throughout the system; a disturbance in the  system
 of thought is manifest; a total  aversion to food, a sense of
 debility and incapacity of physical and mental exercise is
 painfully felt.   The individual, as well as all around  him,
 now knows what is the matter with him.  He has a fever.
 He is alarmed and very naturally sends for the doctor.—
 The doctor tells him he has a fever.  All agree as to his dis-
 ease.   We would not wish to be understood as considering
 the application of the term  fever, to the  above described
 state ofthe system, improper or unphilosophical.  The term
 being derived from the latin/erpco, signifying "to burn,"
 not inaptly points out a prominent feature  of the  patient's
 condition and feelings; I mean the real and  sensible in-
 crease of temperature.   It is the construction that is gener-
 ally given to this term that we consider unreasonable, un-
 medical, at war with  common sense,  and plainly contra-
 dicted by all experience and  observation.  It is the method
 of treatment, erected upon this erroneous view of fever, that
 we, conscientiously, and from  the strongest evidences, are
convinced is  entirely  wrong in itself,  subversive of those
salutary laws and operations of nature, by which the animal
machine is governed, both in disease  and health, and the
practice of which consigns thousands of our fellow beings to
an early and premature  grave.  O that a subject of such
 vast importance as the present might be duly and seriously
 reflected upon by every  intelligent mind!  O  that  kind
 Heaven would avert this evil from the world!
  We do not  pretend to say that temporal  death,  which,
according to the laws of physical fitness, must be  the  final
and inevitable fate of all, is to be regarded as an evil.  By
no means.   It is the pathognomonic symptom of a perverted
understanding and an unphilosophic mind, that pretends to
discover aught of evil or aught that works not for admirable
ends, in the  innumerable  events  which  take place under
the direction of a kind and benevolent Providence.   So we
are to consider the natural dissolution of our bodies rather
as a blessing than otherwise;  but we are also to regard that
 portion of existence which is allotted to  us  in the present 
25
 world as a blessing, and any cause which may be the  re*
 sultof our own ignorance or folly, which shall tend to abre-
 viate the period of our existence in this world, is justly  re-
 garded as an evil.  It is the increased heat, the quick pulse,
 and the flushed face of the patient, that alarm the friends,
 and all who are particularly interested in the welfare of the
 individual sick.
   Those very  symptoms which are  viewed as dangerous
 and prejudicial to the patient, by common observers and by
 the self-styled regulars themselves, are looked upon by us
 and by medical Reformers in general, as salutary and hav-
 ing a direct tendency to restore health to the constitution.
 The symptoms, of which we now speak, are increased  ac-
 tion of the heart and arteries, with an elevated temperature
 of the whole surface.
   These are the symptoms which constitute fever, accor-
 ding to the specific and derivative meaning of the term itself,
 and according to the common acceptation of the term.   As
 we have already said, affections \uhich are usually termed
 febrile are naturally divided into the morbid or diseased  ac-
 tion, which is primary or idiopathic,  and the sanative or
 restorative,  which is subsequent  or symptomatic.
   Now, what we have just called fever and wh"t is gener-
 ally admitted to be fever comes under  the second  head of
 the natural division, and, so far from its being adiseaseor a
 diseased action, it is actually necessary, salutary, and tends
 directly to remove the first state or diseased action,and con-
 sequently to restore  health.  We  are well aware, that
 some will  say, this  is  Thompsonianism, and  that  we are
steam doctors.
   As it respects the first, or the idea that fever is a necessa-
 ry and salutary action of the system, it is very immaterial
 whose doctrine it is, so long as we are fully convinced that
 it is true.   A truth is none the less so and none the less val-
 uable, because it is understood and believed by a steam
 doctor.  But in respect to our being Thompsoniansor steam
 doctors, we must be candid, and declare that we never par-
 ticularly studied that mode of practice; that we never prac-
 tised it at all; and that  it forms  no part of  the  reformed
 medical practice, established by  the  learned and benevo- 
26
 lent Doctor W. Beach, and taught by himself and other
 regular bred physicians, in the Reformed Medical Colleges
 of the city of New York, and of Worthington, 4Ohio.  The
 idea, which we have already expressed concerning fever,
 is fully proved by a close examination into the operations
 of nature, by experimental facts, and medical logic, and it
 is we think, essentially true, notwithstanding it is believed
 by Thompson.   We would ever wish to be delivered from
 that state of mind, in  which we could relish  an error from
 the mouth of some great man, better  than the truth from
 even Thompson himself.  If any one should  be led to con-
 clude that  we Reformers, are steam doctors, because we
 entertain correct notions in relation to fevers, we could men-
 tion a tolerably respectable number of eminent physicians
 of the old  order,  who entertain and published  the same
 doctrine of fevers, though not in the same words;  among
 these are  to be reckoned Mr John Hunter, the celebrated
 English surgeon; Doctor Johnson,  an English physician,
 and author of great merit;  Doctor Gregory  has expressed
 this doctrine; Stahl  and Hippocrates the  same  notion of
 fever.  If these were all steam  doctors, we should not feel
 that  it were any disgrace to medical reformers to be classed
 among them.
  Let those self-sufficient and arrogant pretenders in medi-
 cine consider the learning and talents of the authors which
 we have  mentioned, and let them reflect, that it is the opin-
 ions of these learned and noble minded  men, that they are
 opposing, as well as those of Reformers, and they may then
 be less profuse with  their abuses.   We are ready to prove
 our positions, not only by plain reasoning, but  from the very-
 words which have fallen from  the  lips  of the ablest ana
 best authors in the science of medicine.
  But to return to the inquiry of the doctrine of fevers; we
 contend that what we and what all agree to be fever, is a
 avorable and necessary symptom.  It is present sooner  or
later in every disease of any extent to which the human
system is lmble, if there is sufficient  strength to excite and
support it.  Whenever the health of a person becomes de-
ranged from any cause  whatever, this state of the system
cannot remain long without giving rise to what is termed a 
27
reaction—a fever.  This is nature's process of curing a
disease; this is the way that nature removes  obstructions;
relieves oppressed organs; restores impeded functions and
establishes the reign of health where it has been subjugated
by any morbid cause.
  In fevers the disease for the removal of which the fever is
established may be situated in any part of the system, and
it may be of different specific natures.   But in most cases
of fever, especially of that kind called idiopathic, the system
is generally affected throughout; the brain, the  stomach,
the kidnies, the intestinal canal,  the  liver and the skin all
show at different times manifest signs of disorder.   The se-
cretion and frequently the excretion of  the bile is partially
or wholly suspended; the skin, in consequence of the regur-
gitation of the biliary matter into the circulation, becomes
tinged with a yellow hue; this cast is frequently observable
in the external coats of the eye; the action of the stomach is
so much diminished, as to disqualify it for the work of di-
gestion.   This gives rise to the loss of appetite; sickness of
stomach, furred tongue, &c.  which are common in cases of
fevers.   The action of the skin is also very torpid, by which
a large quantity of the perspirable matter is retained in the
circulating mass; this  renders the blood irritating, and is a
source of disease  in the system;  yet, as is said by Mr Hun-
ter,  this matter does not enter into a chemical union with
the blood, but admits of a separation by a chemico-vital pro-
cess, which shall leave the blood  in its usual healthy state.
  It is worthy of notice in this place, that a larger quantity
of worn out and  sparable matter is removed from the system
by insensible perspiration, through the system of the cuta-
neous exhalents, than by any other vital or animal process.
  To illustrate our peculiar views of the nature of fever, we
will take for example a case of common intermittent fever,
or ague and fever; which, by the by, is pretty well known
from experience  by most who have resided long in the West-
ern country.  An individual, after having been exposed to
the influence of marsh miasmata or some other efficient cause
begins to feel dull and languid; his appetite diminishes, his
skin is unusually dry and  husky—a peculiar bitter taste
is observable in the mouth; he  feels  pains in  his head,
s 1 
26
  shoulders and back; after a short time elapses, he is affected
  with a general sensation of chilliness.   So much for the
  symptoms which point out a diseased action; now  for the
  stage of  reaction—the salutary effort of the Constitution;
  the restorative  action—the fever.   When the cold stage
  shall have continued for a longer or shorter time, according
  to circumstances, the action of  the heart and arteries  is
  much accelerated;  we say much, but we mean in proportion
  to the constitutional strengih, and the extent of the morbid
 cause.  The pulsations at the wrist become fuller, stronger,
 quicker and  more frequent;  the temperature of the surface
 raises, the face is flushed, and the blood appears to be rush-
 ing to the surface.
   This is an exhibition of  the second natural division, of
 which we spake; this is that necessary action  which nature
 institutes  for therelicf of herself; she seems to be conscious
 of her own suffering, and of the necessity of the  course
 which she pursues.   We will now  inquire what is the ulti-
 mate design of nature in making  this effort?  Though this
 question is already  answered sufficiently plain, in a previ-
 ous consideration of this subject, yet it may be expressed in
 this  place with a peculiar bearing to the present case.  We
 answer then, thai the design  of this, is to restore that equili-
 brium throughout the system, which has been and is disturb-
 ed through the agency of some external and morbid cause-
 and  as a proof of the truth of this position, we need onlv
 mention the result of this action, called fever.   At the time
 when it commences, we see that  there is coldness of the
 surface and extremities, a dry skin, a furred tongue, a de-
ficient appetite, &c.   After it has continued for a longer or
shorter period according to the necessity and particular cir-

oZtnT   thr Ca3\a general  moistl,re " ™eat break-
out upon the surface; the temperature of the skin is reduced

its coating the action of the stomach  is restored, in conse-
quence of which, the appetite returns; the due balance of
 he circulation and excitability of the system  is restored.

™T£rtL°T "^L^6 d°Si=n  °f »'"«" '£:
compnshed   Here then,  we have traced the various nU
nomoaa wh.ch present Wlvesduring,»££_£_ 
29
of intermittent fever.   We have shown that from external
causes, the individual became morbidly affected, diseased,
or in common language "sick;" and that by the reaction or
fever, he becomes well.  Now however strange this may
appear to some, it is nevertheless true; and we love truth,
for its own intrinsic goodness.  Ye professedly learned, and
great  doctors in medicine, is not this correct doctrine? We
appeal to your sense and judgment for  an answer.   We
know that in order for you to be qualified to appreciate the
correctness of the doctrine, you must come out from  the re-
gions of fanciful and fictitious speculations—of baseless fab-
rics and sophisticated  theories, into which you have been
led by reading authors,  who spurned the  idea of confining
themselves to plain and philosophical facts; who were led
by imagination, (the ignisfatuus of the human mind, w'.iich
always shines brightest, and influences  those minds most,
which are least enlightened by true  philosophy and self-
knowledge,)  to disregard the instructions of nature, and
arrogate, to themselves the prerogative of deciding all points
of medical knowledge.   It will not be sufficient for you to
ridicule the doctrine, or to endeavor to put it down by mere
assertions.  Such a course might suit the prejudiced and ig-
norant mind, but it will never convince or satisfy the intel-
ligent, the philosophic and liberal mind;  and such minds,
we are happy to say  are becoming too numerous  for the
well-being of impostors, or the growth of superstition,bigotry
or aristocracy.
   We therefore, call upon you to acknowledge the truth of
the doctrine, or else prove by philosophy—by true medical
reasoning, and by experience andobservation, that it is
false.  Ifyou do either of these, you will act the part  of
honest men; you will discover your zeal in the doctrine in
which you profess to believe; you will prove that you love
li<*ht and truth more than darkness and error, by the recti-
tude of your  conduct; you will save your own doctrine
from the grave of oblivion, and confer an important favor
upon your humble writer,  and upon  many of your fellow
men who think in this matter as he does.
   That man  who shall  remove an error  from  our mind,
shall ever be looked upon as having rendered us a kindness
                          3* 
30
—he shall be considered as our benofactor, and an addition-
al seed of gratitude Shall  be  sown and cultivated in our <
mind for him; for we cannot conceive how any one could do
us a more important  favor than to divest our mind of an
error, and establish in the place ofit,*ttruth. 
CHAPTER   V.
      OF THE  DIFFERENT KINDS OF FEVERS.

  According to the true signification of the term fever, any
 terms used to qualify it, other than such as  specify differ-
 ence in degree, are improperly applied.  Fever signifies ac-
 tion and heat; hence it is improper to say, "bilious fever,"
 which in reality would be to say, bilious action and heat.
 The bilious appearance is a symptom of the  disease, not of
 the fever.  In those cases of disease which are usually, but
 unscientifically called bilious fevers, the action of the liver
 and its appendages, is so much diminished, that the bile is
 not excreted, but it is taken up by  the hepatic absorbents
 and carried into the sanguineous circulation, and thence to
 all parts of the system; and finally in attempting to be dis-
 charged from the  system, is, in consequence of the loss of
 action in the perspiratory system, deposited under the skin,
 in  the coats of the eye, &c, and this gives rise to the yel-
 lowness which has caused it to be called  bilious or yellow
fever.  It would be much more in accordance with correct
 pathology and true science, to say "a disease of the biliary
 system,  attended with fever."  Nor is it strictly proper to
 say, "typhus fever;" the word typhus being derived from a
 Greek word signifying stupor, does not properly qualify the
 term  fever.   We have not a very  clear conception of the
 peculiarities of stupid heat, nor does the word stupor apply
 well to any action, which, comparatively speaking, is accel-
 erated in the slightest possible manner.   It would be more
 philosophical to say,  "a disease of general debility of the
 system, attended  with fever of a low degree."  The term
 intermittent, is very correctly applied to that state of the
 system in which there is fever, which intermits at regular 
32
 periods; there is not the least impropriety in saying  that a
 suspension of increased action has taken place.  The same
 may be said of  the terms remittent and continued, when ap-
 plied to fever.   But we cannot say  the samo  of the term
 scarlet, which is applied to a disease in which there is a
 peculiar eruption and redness of the skin.  There is no rela-
 tion or qualifying sense existing between the  term s-arlot
 and fever, or action and heat.  We know nothing ofcolored
 actions, or colored caloric.   So of spotted or  putrid fever.
 Wc therefore, have no objections to a regular  system of
 nosology, wherein each particular disease  is marked out by
 one or more prominent and leading symptoms: such a course
 appears quite nocessary  to facilitate the acquisition  of
 knowledge in the highly important science of  medicine.
   It is to such a  use of terms as is calculated to mislead the
 rnind and  prevent it from arriving at truth, that wc object.
 Wearefarfro:n thinking that yll diseases have their origin
 from ono and the same cause, or that they  are to bo treated
 invariably with the same medicine and in the  same  way.
 But we do believe that  fever is the same thing in every case
 and in every disease, admit.ing of no comparison, except in
 degree of violence, or strength of action; and that it is the
 natural and only way whereby the system could be relieved
 from that state of disease, for the removal of which the fever
 is excited.  It is probable that the precise  degree of fever,
could it be ascertained,  would be found not to  agree in any
 two individuals laboring under similar diseases.
  According to the view which we have taken of fever, it is
very evident that its degree, strength or intensity, in any
particular case, must be aftogethcr modified  by individual
circumstances; as for instance, the extent and obstinacy of
the cause,  the length of time  which the disease  has contin-
ued, the natural energy of the constitution, the particular
seat of the diseased action, 6_c.  It appears then not to be
of so much importance to learn what kind of fever it is, as
to learn the natuie and seat of the disease, and to learn the
way whereby we  can be most useful to nature, by  assisting
her in her efferts to overcome disease, to re-establish health
In every case of disease to which the attention of the physi-
cian is called, there  is opened an extensive field for the ex- 
S3
ercise of his judgment and skill, in the investigation ©f its
causes, the probable manner of its termination, the  best
remedies to facilitate a cure, and the most judicious mode of
administering them. 
CHAPTER  VI.
            CAUSES  OF  FEVERS.

  In treating of the causes of fevers, we shall in som«
measure depart from the beaten track, and take that more
consistent and pleasant path prescribed  by nature.  We
shall divide the causes of fevers into external and internal,
remote and proximate, natural and artificial.  By external
causes, we mean all those agents or  circumstances by
which  we  are surrounded, and by the influence of which
the animal functions are at certain times deranged.   By
internal causes, we understand such as operate within the
system, in such a manner as to disturb the equilibrium of
the nervous energy and excitability of the system. Remote
causes, are those which produce their effects previous to the
commencement of actual fever; as contagion,  marsh efflu-
via, cold, humidity and atmospherical vicissitudes.   Proxi-
mate  causes, are such  as operate immediately upon the
system, in such a manner as to call for and actually excite
fever.  Natural causes include all external or internal causes
which produce disease,  and which are entirely out of our
agency or control.   Artificial  causes,  are such as arise in
consequence of medicine or medical treatment; as from the
irritation and debility produced by mercury and some other
mineral poisons;  also from the shock and weakness which
the system undergoes by the loss of blood.  Other causes
of the  artificial kind might be enumerated, among which
none would appear more prominent than that of the exces-
sive use  of ardent spirits.  Did the world know the real
amount of pain and misery that it brings  upon  itself by the
use of spiritous liquors,  intemperance would  be banished
from our land—the cause of temperance would be acknowl-
edged to be the cause of virtue and humanity. 
35
  That debility is a predisposing cause of disease, and con-
sequently of fever, we presume no one will hesitate to  ac-
knowledge.  This is the cause of those irregular distributions
of vital energy and nervous excitability,twhich invariablj
precede the real formation and establishment of all diseases,
whether  chronic or acute.  This state, or a state of debilhy
may be produced artificially, either directly by the abstrac-
tion of blood, or indirectly by excessive stimulating; but it
is to be noticed, that in the former case the weakness is ab-
solute  and of longer continuance; in the latter, the debility
being  that of over-action, if not carried to a very great ex-
tent, is soon obviated by rest.  It is a weakness similar to
that which the laborer experiences, after  having endured
the heat and toil of the day.  This  is effectually  obviated
by  the tonic effect  of sleep  and rest.   But the debility
brought on inconsequence of bleeding, is of a more danger-
ous kind, and that which is much dreaded by every judicious
practitioner  of the  healing  art.  It  is  what has slain its
thousands, and what has doomed as  many more to drag out
a miserable existence, in the midst of pain and disease.—
This is a subject which  demands the attention and seriouj
deliberation of every intelligent mind—of every one  who
regards his own safety and happiness, or the well being
 of his fellow men.
   We have therefore, arrived at the conclusion, that  there
 are a multiplicity of causes tending to disturb those laws of
 natural order,  upon the regular application and perform-
 ance of which, the health and life of the human system are
 kept up and maintained; that these causes operate upon the
 system primarily, in a manner incomprehensible, and con-
 sequently  inexplicable to the human understanding; that
 all we know, or the first we know, concerning their mode of
 operation, is the effect which they  make  on the system.—
 We can then trace one effect to another, ascribing each pre-
 ceding effect to be the cause of that which immediately suc-
 ceeds it;  so that what we call  the cause—the  proximate
  cause of fever, is but the effect of some other cause, which
  itself might be traced in like manner. 
CHAPTER  VII
          OF THE  SYMPTOMS OF FEVER.

   Sp extremely various are the characters of (he affec-
tions  which give rise to fever, that it is hardly possible to
include in any one enumeration the many symptoms  aris-
ing therefrom.   Wo can do no more  than  to  adopt the
common system of generalizing, by the advantages of which
ive may designate classes and orders of symptoms, which
iro common to all cases, but we cannot descend into genera   ;
ind species which murk out particular or individual cases;
for as variety seems to be one of the first laws of natural
order, we not only see it in plants and animals of inferior
frades, but  we find it equally conspicuous  in  the  highest
order  of the animal creation.  N >r docs it seem  to be con-
fined alone to materiality, except it be contended  that mate-
riality is applicable  to mentality.  There appears to be as   |
much dissimilarity  in  minds as in bodies,  yet  each  are
alike governed by the laws of universal sympathy. Hence
similarcauses, acting upon structures and organs possessed   J
of individual and specific differences, must of necessity pro-
duce different results; and when  this1 proposition, (which
we consider selfcvident,) is applied to certain  states of the
human system, which give rise to a necessity for fever, it
teaches us why the  symptoms of diseases  are so variou?.
   In this place, and to accomplish our present purpose, it
will be sufficient to mention some of the leading and com-
mon symptoms attending such diseases as are followed with
what  is termed fever.   They are such as chilliness—alter-   I
nating with flashes of heat, dull and  oppressive  pains iu
differeut parts of the system, impaired digestion, acid eruc-
tations, cardialgia or heartburn, costiveness, dryness of the
skin,  attended with an unusual paleness,  sleepiness, and 
37
 pain in  the head of a  heavy kind, weak and  contracted
 pulse, sometimes regular, and at others intermitting, &c.
   When these symptoms have  continued as long as  the
 safety of the system will  allow—nature makes a°sensible
 and manifest effort  to rid the system of all the difficulties in
 which it is involved.   This gives rise to  what is generally
 known under the term of  fever.   We mean accelerated
 action of the heart  and arteries, and as a necessary result
 of the same, increase of the animal temperature.   At this
 time, we generally observe the tongue to be covered with a
 coating,  termed fur, in regular medical language; and it is,
 we believe, what is termed  canker by Thompson.  It is
 undoubtedly a combination of mucus, and the secretion nat-
 ural to the p-irt, which from loss of action in the part, have
 become inspissated, or in other words,  have degenerated
 into the peculiar substance called fur.   We have no  hesi-
 tancy in saying that the whole internal surface of the stom-
 ach  would exhibit a similar appearance  with that of the
 tongue, could  it be examined; this we infer from  the doc-
 trine of similar and  continuous  sympathy.  To  explain
 which, we need only  observe that the  membrane, which
 lines the tongue and mouth is continued along (he course of
 the pharinx and msophagus to the  stomach; differing  un-
 doubtedly in eachof these parts in the  particular  structure
 and sensibility, yet  retaining sufficient similarity to be  the
 medium  of similar and  continuous sympathy.    So that
 when the action of this membrane is diminished in one part,
 it must be in every other part.  This is  alspproved by the
 loss of appetite, which is always concomitant with a furred
 tongue.
  It may be remarked, that in cases of fever, there is a gen-
eral suspension of  the secretions, and that a restoration of
all the secretions is the natural result of fever, and when
this result is not produced by fever, either chronic disease
or death is the consequence.  Hence,  we see that  people
do not die of fever; but of disease, which the fever  fails to
eradicate.  Ifany one can overthrow this doctrine and es-
establish a belter and more consistent one in its stead, we
shall consider  him guilty  of neglect of duty, if he does not
doit.
                            4 
CHAPTER  VIII.
       TREATMENT  OF FEVKRS IN GENERAL.

  Thk indications to be answered in our attempts to remove
the proximate cause of fever, arc to be drawn from  the
symptoms present; as the skin is dry, and the mouth and
tongue parched,  we would at once come to the conclusion
that something should be administered, which would have
a tendency to  restore the action and  natural  secretion of
these parts.  To this end the efforts of nature are most evi-
dently tending; by the accelerated action of the heart and
arteries, the blood is urged forwards into the  small vessels
of the surface, accompanied with heat and the influx of vital  '
energy to all the surfaces of the body.   By this means  the
action of the perspiratory system is aroused, sweating is ex-  ■
cited and the  action of the heart gradually sinks to its com-
mon standard.
  It ought always to be understood that in the cure of dis-
ease, nature takes Ihe lead and points out the way, and it is
the height of presumption, for the physician to  attempt to
take the rcinifrom her hands; he should feel himself suffi-
ciently honored, if he is so much respected by nature, as to
be  permitted to be her  hand-maid, to stand ready at  her
call,  to obey  her command.   No physician can  do more
than  to assist nature in her efforts to cure; he who presumes
or attempts to do more, will be sure to do  less.  Then if
 nature is laboring to produce sweating in cases of fever,all
 that  we can do  With propriety is to administer  such med-
 icine, as is best calculated  to determine the  circulation to
 the surface, and thut to induce  perspiration; by doing this,
 we effect several important objects in  the cure of the dis-
 ease; for it is to be observed, that the internal living mem-
 brane of the  stomach and  bowels, is but a continuation of 
39
the skin, and consequently  the action of this membrane is
increased simultaneously with that of the  skin, upon  the
principle of continuous sympathy.  Every physician must
admit this from actual experience and observation.
  It is not  common that we observe much emaciation or
wasting away of the flesh, until there begin to be evident in-
termissions or remissions of the fever.   This circumstance
may be explained in  the following manner.  During  the
time of health, nature,  (as  if conscious of the accidents
which may and frequently  do befall the system) prepares
a greater quantity of animal materials than  necessity  re-
quires for the present  support of the system; this supera-
bundant matter having undergone  the process of digestion
and become incompletely animalized, is deposited in such
parts of the system as shall  give rise to least inconvenience
and best answerthe immediate designs of nature; it is known
by the term adeps or fat.   In  cases of disease where the
stomach is so affected  as to disqualify  it  for the process
of digestion, and when the  powers of the system begin to
languish and faint; nature avails herself of this her admira-
ble  provision.  She  commands the heart and arteries to
diminish their action, that the action of the  absorbents may
be increased, in order to take up a portion of the fat, the al-
ready partially animalized matter, and carry it into the cir-
culation, to support the vital functions, and  to enable nature
to persevere in her efforts to relieve the system of disease.
When this is understood, it will no longer be looked upon
as matter of astonishment that patients frequently  live for
several weeks without  any, or with but  extremely little
nourishment  from any kind of food; during this time the
patient is living upon the substance of his own body.  It
requires but little exertion on the part of the constitution to
reduce this matter to its own substance, and still less, to ren-
der it subservient to the requisitions of the vital organs.
  How admirable are the laws of nature, and how infinitely
wise and good is He who framed them!   These are useful
lessons to man, calculated  to make him  humble  and in-
cline  his mind to goodness.
  When there are symptoms of particular disorder of the
stomach, such as total loss of appetite, thick coating of the 
/
                          40

 tongue, with nausea and vomiting; this last symptom should
 bo promoted l>v the exhibition ol an active and efficient, yet
 gentle and silo emetic; it may be considered that we here
 recommend what is impracticable; that is, an emetic which
 shall be both gentle  and active.  But  we  would  remark
 that these properties in any medical preparation, arc by no
 means incompatible, but  very  consistent  and natural.—
 Whenever these preparations are formed of vegetables we
 niav apply the terms active and gentle upon  the authority of
 actual experience andobservation.   It is a well known fact
 that the action  of tartarized antimony, or as it is commonly
 called tartar ai:ctic,\s many times distressingly violent,when
 taken into the stomach as an emetic.  It is extremely liable
 to produce spasms and cramps of the stomach, and sometimes
 so far produces organic lesion in thisorgan, ns to give i i.-e to
 inflammation and death.  On this account we  exclude it from
 the list of our remedial agents, and  give it a place among
 the incompo ibles; that is,  we regard it as a violent miner-
 eral puis.in, whose action is incompatible with the safety of
 the human system.   The  beneficial  effects, produced  by
 the operation of emetics  in cases of fever, are by no means
 to be wholly ascribed to their evacuation of the  contents of
 the  stomach; lor it is  very evident, their operation upon the
system is extensive; they powerfully  determine the circu-
 lation to the surface,  and thus excite perspiration.   By the
contraction of theabdominal muscles  in theact of vomiting
the  viccra of the abdomen, especially the liver, is compress-
ed,  and in  this  way  measurably relieved of conges ion; a
general shock is imparted to the whole system, whi :h  not
unfrequently  has a highly favorable effect in res:..ring an
equilibrium of action.  In an indirect manner, they increase
the action of the absDrben's by lessening in the natural and
proper way, the action of the arterial  system.
  T; is propr r here to observe, tint theah's- r eat and arterial
sys'ems of vessel vireaningonizirig powers;  that when the
action of one of these  systems is increased, the action of the
other is invariably diminished.   Hence, we oLsprve that in
cases ofdropsy, the process ofabsorptiun is suspended when-
ever there is hLh arterial action.  Upon  this  principle may
also be explained, the fact, that patients laboring under high 
41
 fever, retain their flesh in a remarkable manner for a long
 time, even though they take little or no nutriment.
   Owing to a loss of action throughout the whole alimen-
 tary canal, in cases of fever, we find that in such cases,
 costiveness is a prevailing  symptom.  Thorough and ac-
 tive purgatives are necessary and very plainly indicated to
 obviate this state.  Injections,  though they serve many
 times, as useful and excellent auxiliaries are not sufficient-
 ly extensive and  powerful in their action,  to  accomplish
 what is  required of cathartics.   The curative  powers of
 cathartics, like  those of emetics, are not  entirely  con-
 fined to  their evacuant effects'; for besides unloading the
 bowels of their morbid contents, by increasing their vermic-
 ular or pcriestaltic action, they stimulate the mouths of the
 intestinal exhalente, causing them to discharge large quan-
 tities of serous fluid,  which  cleanses and  renders  more
 healthy the state of the blood; they arouse the action of the
 liver, in the first instance, by stimulating the mouth of the
 ductus communis choledochus or common biliary duct which
 impression being carried to the liver along the duct, through
 the medium of continuous sympathy, increases the actions
 of the excretory ducts.
   2. They  arouse  the portal circulation of blood, restoring
 the secretion of bile.
   3. They obviate congestion of the brain, by producing a
 determination from this organ to the abdominal vicera.
 This action or effect of cathartics can be explained.by taking
 advantage of the principle of remote sympathy, and of that
 principle inthe animal economy universally  acknowledged
 by  physiologists; viz ubi iritatio, ibifluxus,  that is, where-
 ever an irritation is produced upon any organ of the  body,
 there will be a flow, or flux of the fluids to that organ or part.
 This is obvious in cases of external wounds or bruises; as
 for example—a weight fells upon, and bruises the hand, in
 a short time  there will be an unusual flow of blood to the
 part, the hand swells, appears^red, and feels warmer than
 natural, a peculiar pulsation, or5 throbbing is experienced in
 the part, &c.  These symptoms indicate that state of the
 part denominated inflammation; a necessary and natural
 consequence of any violence done to the body which pro-
t                            4* 
1,
 duces organic lesion, or a breach in the continuity of the
 solids.
   4. Cathartics  diminish the unusual action of the heart
 mid arteries,  by  removing the causes which gave  rise to
 this action.   Here, it is proper to observe, that no unusual
 action or effort takes place in the human system which is
 under the Goverment  and direction of the  laws of nature,
 other than such as is indispensibly necessary in order to
 restore regularity and health to the body.
   We take the liberty, to make use of the  phrase laws of
 nature, from the authority of  philosophy;  presuming  that
 the use which we have made of it, will be fully sanctioned
 by every enlightened, liberal and philosophic mind.
   5.  Cathartics excite a gentle moisture of the mouth  and
 tongue, and of the  skin; they seem to do this by stimula-
 ting the mucus membrane of the intestinal  canal which ef-
 fect, or impression  is made indirectly upon  the external
 surface, through the medium of continuous sympathy.
   Considering these effects of Cathartics upon the system,
 their utility in the treatment of febrile diseases must  be ob-
 vious to all who have a correct knowledge of the pathology
 of this class of diseases.
   We believe that the same arguments  which go to  estab-
 lish the utility of emetics in the treatment  of febrile diseases,
 may be used with  equal propriety, in vindication of the pro^
 priety of the use of cathartics in the same kind of diseases.
 The propriety and correctness of administering emetics in
 cases of fevers, arc  urged  upon i he evident facts, that the
 action of the  stomach is quite lost or very  much diminished-
that not unfrequently it contains an unhealthy matter which
should be thrown off; and in common  language it is -ud
(and that very justly too) that emetics cleanse the  stomach
 I hey also promote  perspiration.   Now  the lining  mvw-
brane of the stomach ,s continued  throughout the  whole
track of the intestinal  canal.   Its  action must of course
sympathize with the action of the same membrane in  the
stomach so that the action of the  bowels  is  lost or Lin
 .shed.  Cathartic* restore  this  action-remove no  bid
 contents-promote perspiration, and i„ common lan^i™
 "they cleanse  the  bowels."  I, would be well Lhim who 
43
 rejects their  use, to study the subject well, for we  believe
 we might with equal and perhaps more propriety, lay aside
 the  use of emetics!
   In all diseases accompanied with fever, we may observe
 as a  universal and leading symptom, diminished  action.
 and consequently dryness of the skin, that much harm  will
 accrue from  the long continuance of this state, cannot ap-
 pear otherwise than  very obvious  to  every  one  at all ac-
 quainted with the office of the perspiratory system.   The
 cutaneous  exhalents may be called  the scavengers of the
 human body; which carry off that portion of the circulating
 fluids, the retention of which, would soon produce disease.
 It is an essential and  well established point in  physiology.
 that the constituent particles of the human body,  after  hav-
 ing remained in a state of organization and animalization
 for a certain period  of time, become "worn out," to use a
 common phrase, or in other words, they are so  far changed
 as to render them unfit for a longer continuance in  the sys-
 tem; hence they yield to the  action of the absorbents,  quit
 their post to make room for new particles, which nature has
 provided fo supply their place.   These worn out particles,
 being taken up by the absorbent  vessels, are carried  into
 the general circulation, and thence, through the kidnies and
 perspiratory  vessels of the skin,  discharged from the  sys-
 tem.  In  this manner it is supposed by some physiologists,
 that the entire body is changed for a new one, once in seven
 years.
   By a consideration  of what has  now been said concern-
 ing the use and necessity of perspiration, it will  easily be
seen how important it is, that the action of the skin should
be aroused in all cases where it has been checked from the
influence of morbid causes.   As an auxiliary to effect  this
purpose, the warm bath is many times used, and when used
at proper times, is undoubtedly of singular service.   But
the alkaline bath appears to possess much superiority over
 the simple tepid  bath, and  perhaps it may  be explained
rationally  as follows:  It is well known  to anatomists that
 there are many small glands situated in the skin called se-
baceous glands; these  secrete a fat, or  oily substance,
 which is thrown out upon the surface, probably to soften 
44
 the skin and protect it from receiving injury from the air,
 and other agents.  A superabundance ol this natural oint-
 ment is prevented from remaining on tho Mirl'ace by the ac-
 tion of the sweat upon it, but when the process of perspira-
 tion is suspended, as it usually is in cases of fever; ihisoily
 matter accumulates arid becomes inipisi tiled or dried and
 hardened upon the skin, presenting no inconsiderable obsta-
 cle to the desired process of sweating; by thcuscofthe sim-
 ple tepid bath, this  sul stance is not much  affected, but by
 the chemical action and union which takes place  between
the animal oil and thealkali, the substance may be removed;
 besides  the alkali has a stimulating action  upon the skin
 itself, which tends to promote perspiration by calling the
fluids to  the surface.  Where there is too much debility  to
permit of using this bath by immersion;it may bo used with
nearly or quite  as  much  advantage  by  dipping flannel
cloths into the alkaline mixture and applying it to the body
by way of embrocation or ablution.  Friction upon  the
 surface, even with  dry flannel will be  found useful; also
rubbing the  surface with  cloths wet with common spirits,
where there are symptoms  of local ci ngestion as  of the
brain  or liver;  warm fomentations or   warm  draughts
made  of pulverized  mustard  and corn   or rye  meal,
should be applied to the soles of tho feet and  in case of con-
gestion of the brain, to tho back of the neck, and over the
right hypochondric regim in cases of congestion of the liv-
er.  In regard to the patients common drink while laboring
under febrile  disease, such teas  as  are  made  of some
kind of diaphoretics, w ill in general be most proper.   Sage,
peneroyal, common  min\ peppermint, may  weed,  balm or
some other article ot similar properties may  be infused in
 water and drank freely either warm or cold, as may best
suit the  taste of the patient.   Where there is high fever and
 great thirst, and heat of the surface, cold  water may  be
 drank, not only  without danger, but with  much advantage.
 Experience has proved the  truth  of the  above statement,
 nor is it difficult to be explained upon | hysiological princi-
 ples.  The good effects arising from the use of the cold bath,
 are ascribed to its secondary effect upon  the body, viz: that
 of reaction.  Those who are in the habit  of bathing in cold 
45
 water, know very well, that when the water first comes in
 contact with the body, they experience a sensation of cold-
 ness, which is sometimes so great, as  to almost take their
 breath, but in a short time the water feels warmer, and when
 they get out of it, and get their garments on, a very agreea-
 ble and general sensation, or glow of warmth is feltoverthe
 surface, which is not (infrequently followed immediately by
 a gentle and healthful  perspiration.
   In the case of the cold bath,  the following will  00 to ex-
 plain the phenomena or the effects produced by it, as alrea-
 dy described.   The temperature of the water l eing consid-
 erably lower, than that of the surface of the body;  immedi-
 ately upon submitting the body to the contact of the water,
 a large quantity of heat is  abstracted, which causes the ex-
 treme  branches of the arteries terminating on the  skin, to
 contract; the blood contained in them, recedes towards the
 heart,  or is thrown upon  the  internal organs;  this is what
 gives rise to the sensation of coldness, and to the momenta-
 ry interruption of breathing; but as the  temperature of the
 surface is reduced neareito an  equilibrium with that of the
 surrounding water, the sense of coldness  diminishes, till at
 length no inconvenience is experienced.   In a short lime
 the internal  organs I eg in  to exhibit signs of oppression
 from the revulsnn of the blood from the surface, upon them.
 Nature, who ever stands as a faithful sentinel to guard  the
 health of the system, excites the heart and arteries to an
 increased action, producing for a short time a  real fever,
 which  terminates in a  glow of warmth  over the surface,
 and gentle moisture; this is what  is  meant by  a reaction,
 and what is really  and  properly termed  fever, is  nothing
 more nor less, than a reaction of the heart and arteries.—
 The action of cold  water upon (he  internal  surface  of  the
 stomach is in all respects similar to its action upi n the skin.
 When the water first comes in contact with the in'ernal coat
of the stomach, it gives rise to  an immediate sensation of
coldness, and reasoning  from analogy, it produces contrac-
 tion  in the small  arterial   branches  teiminuting upon the
 internal surface of the st. n.ach; but after a li t e time elaps-
es, an equilibrium is established between the temperature of
the water and  the internal surfaceof the stomach.   In this. 
46
-.so, as in that of the cold bath, a  reaction is  demanded
to obviate the effects of the primary  impression, this takei  j
place, and not unfrequently is carried to such an extent, as
to produce a general perspiration.
  In order to a clear understanding of this phenomenon in
the animal economy, it  will be  necessary to call to mind
the fact that the internal living membrane of the  stomach i3
but a continuation of the skin, at tho  same time it must be
remembered that there is a sympathetic connection existing
between the skin and stomach, known in medical language
by the  phrase, cutaneo-gastric sympathy.
  It is considered improper to use the cold bath as a reme-
dial agent in cases where there is sogrcat debility or weak-
ness of the constitution as to prevent this fever or reaction
from taking place.   That is, it is  said by  physicians of ex-
perience and learning, that whenever a  person uses the cold
bath and does not experience the glow  of warmth,  before
mentioned, it may be regarded as having been  productive
of injury; hence  very  weakly persons  should be cautious
how they risk the cold bath, since it may be possible  that
nature is not competent with the feeble energies of the  con-
stitution, to counteract  the effects of the first impression.—
From what has been said of the cold bath in cases of great
debility,  it will appear obvious that  large draughts of  cold
water taken into the stomach in cases of low fevers depend-
ing upon debility,  cannot  fail to produce injurious if not
fatai results.  It is only when the fever is high and there ia
sufficient strength  to produce reaction, that cold water is
admissible in such  diseases.  It is indeed, only when this
is the case that the  patient craves cold  water, and it is cer-
tainly  an act of prudence and humanity to grant his request.
   We shall now bring our remarks upon the reformed treat-
ment of fevers to a close, after merely observing that the
different means described as most proper  for removing the
disease which is the proximate cause of  fever, are to be
changed or varied and repeated,  according toihe particular
circumstances  and necessities of each respective case.__
For as every case has something in it peculiar to itself, it is
impossible for uh  to anticipate the natures of these peculiar-
iiies, so as to give particular prescriptions for each; this 
47
must be left to the judgment and skill of the physician under
whose charge the case may be confided.
  For  the  general success of the mode of treatment here
laid down, we can  appeal to hundreds of living witnesses,
who have experienced the treatment upon themselves; and
we  only ask of those who have not seen this treatment test-
ed, to suspend their  decision of condemnation, till experi-
ence shall  give to  them its evidence.   We are fully con-
vinced that if there is any truth  in medical science, our
treatment of fevers is based upon it, and will stand the test
of thorough investigation. 
CHAPTER  VIII.
         OF INFLAMMATION IN GENERAL.

   The term, from which the word inflammation is derived,
has the same signification as that from which is derived the
term fever.   Inflammation  is drived from  the latin word,
"injlammo" which signifies "to burn," fever is taken from
Ihe latin word, "fcrvco," which als:> signifies "to burn."
   Fever is defined by Hooper,  as follows: "A  disease
characterized by an increase ol heat, an  accelerated pulse,
a foul tongue, and an impaired state of several functions of
the body.  The same author in defining inflammation, says:
It is a disease characterized by heat, pain, redness, attended
with more or less of tumefaction and fever.   According to
thedeiivation and definition of inflammation and fever as
given above, it will be discovered that they are one and the
same affection, differing only in sirnc points of secondary
or minor importance.   A fever of high  degree of action,
accompanied with a peculiar appearance and certain chang-
ed state of the blood, is denominated a general inflammato-
ry fever; which would be, according to ihe definition alrea-
dy given, a diseasa characterized by heat, pain, redness,
attended with more or less of tumefaction and fever, which
is again characterized by a disease which consists in an in-
crease  of heat, an accelerated pulse, a foul tongue, with an
impaired state of several functions of the  body.   This is a
fair definition of the disease denominated in the books, "gen-
eral inflammatory fever," and it shows how much inconsis-
tency and absurdity can be, and  frequently are concealed
under the specious garb of science and high sounding words.
   It is in this way that so much error and such gross ab-
surdities are imposed upon mankind.   The abettors of such
doctrines appeal to the convincing voice  and all protecting 
49
arm of science, for the truth and soundness of their theories.
But let these theories be submitted to the test of true and
unsophisticated science, and their falseness will be develop-
ed; they are based upon false science—upon the imagina-
tions of a bewildered mind, and a perverted understanding.
   All true science is founded upon facts which have a real
and material  existence  in nature and in  nature's laws.
These facts are made manifest to the mind, through the me-
dium of the senses, by observation  and experience.   What-
ever, therefore, in speculative theories, are  found to come
into collision with these facts, must be regarded as -inconsis-
tent with true science, or in other words as super-scientific.
   We shall now attempt to give a definition and theory of
inflammation, which we regard as having facts for their ba-
sis, and observation and experience for their superstructure.
By inflammation we understand an increased action  of the
arteries of the part inflamed, which increased action may or
may not extend to the production of an increased action of
the heart, according to the nature and extent of the disease
of the part.  This increased action of the  arteries of the
inflamed part, is attended with heat, pain, redness and swel-
ling as so many natural consequences.  Agreeably  to this
definition of inflammation, it will be  discovered to be noth-
ing more nor less than local fever, which has already been
shown to be a sanative or necessary  action to remove dis-
ease and restore health.
   We cannot see how it can be proved to be any thing other
than this; and to prove that this is  a correct understanding
of the term inflammation, we have only to resort to the tes-
timony of observation and  experience to convince the un-
prejudiced and impartial reader; and tosatisfy such as build
their faith upon the  opinions of authors, we shall make a
few extracts from some of the most learned and noted, of
which the medical science can boast.
   In case that a wound is made upon the body, if it be to
any considerable extent, there will be experienced in:
pa*rt,aftera certain length of time which cannot be defined,
but in individual  cases, an evident increase of the action of
the vessels of the part; a sensible elevation of heat—a per-
ceptible swelling and redness, attended with throbbing and 
:>n
pain.   This will bo confirmed by the experience of almost
every individual who has been so unfortunate as to be the
subject of wounds and  bruises of any kind.   After the
wounded part shall have  remained in the condition above
described, for the necessary  length of time, the inflamma-
tion terminates in  adhesion or resolution of the parts in su-
puration or in mortification.   The first of these terminations
is most common, and of course most to be desired, and the
last, least  common and most to be dreaded.
  There are many remote causes which may operate upon
the body, or upon some particular part, or organ of the body,
in such way as to produce either lesion of function, or or-
ganic lesion, which is a state of a part designated by the
term disease.   This diseased state of the  part is the proxi-
mate cause of that increased action, which wc have defined
to be inflammation.
   It may not be improper here to observe that by organic
lesion, is  meant a  breach ofthecontinuity of parts, a solution
of the solids, or a tearing asunder of structures.  By a le-
sion of function, is to be understood, a disturbance produced
in the action of any organ.   Functional  lesion precedes
and is the immediate cause of organic lesion, except in such
cases as  arise from the instantaneous effects of chemical or
mechanical agents; such as violent  mineral poisons, heat,
electricity, and such  instruments and substances as may
be violently applied to the body.
   An unhealthy or diseased action cannot exist in any organ
for much time without producing a morbid  change in the
solids of tho part, which changed state is designated by the
 terms organic lesion.  What wo have here called functional
lesion,  Mr. Abernethy has called disorder of  a part; and
what we have called organic  lesion,  he has termed disease
of a part, but we cannot discover any advantages which his
 terms have over ours;  and indeed it would seem that the
 terms disorder and disease are synonymous, both according
 to the common use of the words, and the real signification of
 them.   By disorder in a part, we would  understand, a de-
 viation from that regular order in the action  of a  part, which
 deviation constitutes disease; that is, a state of uneasiness
 and painful sensation; so that Mr. Abernelhy's terms do not 
51
express what he designed to have understood; viz: function-
al and organic lesion.  It is not because we entertain any
feelings of disrespect towards Mr. Abernethy, that we here
question the propriety of his opinions, for we regard him as
a gentleman, highly  distinguished for  his deep researches
into the surgical department of medical science, and  as a
true philanthropist; we mention his opinions, which we con-
sider  as having a particular bearing upon the subject now
under consideration; to enforce ours  by contrast, and to
show  that the opinions  of even  great  men should not be
adopted, without being submitted to the test of truth.
   If what we have already said  upon the nature of inflam-
mation, united to the concurring testimony  of common ob-
servation  and experience, shall fail to convince the reader
of the propriety and truth of our doctrine, we would ask him
to read, with candid and unprejudiced  attention, the follow-
ing extracts,  from the best and  most respected authors,
which are in unison, and go to substantiate  our own views
upon the  subject of fever and inflammation.
   Mr. Abernethy says: "That the improvement of the pa-
tient's health, is  a principle object in the  treatment of all
chronic diseases, more especially, those which  have pecu-
liarly morbid characters."
   This expression goes to establish our doctrine of fever
 and inflammation, since it  holds  forth the  idea, that the
 probability of a favourable  termination of any chronic dis-
 ease, will be in proportion to the strength and health of the
 constitution.  For it is not possible that the necessary actions
 for the removal of disease,  should take place in the system,
 if there be not sufficient vital power to support them.
    While speaking of inflammation, Mr. John Hunter ob-
 serve*, that "all inflammation  attended with disease, have
 some specific quality which simple  inflammation has not;
 and  in such  cases, it is the specific  quality, which is the
 disease, and not the inflammation."   Again the same au-
 thor remarks: "Before we attempt to check inflammation,
 we should have reason to suppose it is going farther than is
 necessarv for a natural cure."                         ,
    It is evident from the above remarks, that Mr. Hunter did
  not regard inflammation as a disease.  He would not tell us 
w
 that before "wc attempt to check a disease, we should have
 reason to suppose it is going further than is necessary tor a
 natural cure." Any action in the system, whoso effect is a
 natural cure, must  be considered a salutary  action.   We
 have already said that wc consider inflammation and  fever
 as one and the same thing,  differing only in some  points of
 minor consideration.  Inflammation signifies increased ac-
 tion and heat; and this is tho true definition of fever, as has
 been shown.  The principle  difference between them is,
 that that increased action and heat, which is usually called
 inflammation is local, that is, it is circumscribed or confined
 to a single organ or part of the body; or else  the principle
 increase of action is manifested in some individual organ,
 while but little increase of action is observed in the general
system.  What is therefore, commonly termed inflamma-
tion, should  be called local fever; so that fevers could then
be said to differ only in extent and degree.
   From Doctor James Johnson, a celebrated English phys-
ician, and author of a treatise on derangements of the liver,
internal organs and nervous system; also of a work, entitled
"Influence of tropical  climates on  European  constitutions,
 we have the following observations:
  "In fulfilling the indications in the treatment of dysentery,
we are under tho necessity of keeping a strict  watch on the
operations of nature, and the ravages of the disease.  Thus
the symptomatic frier in dysentery, and indeed, in all other
diseases, is,  I am fully convinced, a sanative effort of the
constitution, to overcome some morbid or diseased impres-
sion—to restore some impeded function, or  to  relieve  some
oppressad  or labouring organ."  He then  adds,  "that he
 who studies  the ways of nature most attentively, will be
 the m )st fortunate practitioner."
   The term  dysentery, is a compound of two Greek words,
the one signifying difficulty, the other bowels; so  that the
literal sense  of the word would be, "a difficulty, disorder or
disease of the bowels."   In this sense we understand it, and
from the extract which is given above,  it will be seen that
 Doctor Johnson regarded it in the same sense; and from this
 view of it, he recommends that we keep a  strict watch on
 the  operations  of nature, and the ravages of the disease. 
53
 By the ravages of the disease, he  undoubtedly meant, that
 morb.d alteration which is going on in the mucus membrane
 of the bowels! while laboring under dysentery; and  bv the
 operations of nature he tells us that he means the symptom-
 atic fever, which in dysentery as well as in all other diseas-
 es, he considers "a sanative or salutary effort of nature or
 ot the constitution to remove some morbid impression, to re-
 storesome impeded function, or relieve some labouring or-
 gan.   It will be seen  that according to the view which we
 have taken of fever and inflammation; they must be looked
 upon as being symptomatic in every case.   That is most
 easily proved, the evidences of which are most unequivo-
 cal and nearest at hand.  That fever and inflammation  are
 symptoms of disease, and  that  effects or symptoms cannot
 be antecedent to the causes or diseases of which  they  are
 the effects or symptoms, appear to our mind in the light of
 self-evident propositions.
   There never was a case of fever or inflammation in which
 disease had not a prior existence; or  in which disease was
 not the immediate or proximate cause of the fever or inflam-
 mation.   If this assertion be true, (and we are fully per-
 suaded that the combined forces of the medical world cannot
 prove it to be otherwise,)  then the unscientific and unphi-
 losophic doctrine of idiopathic or primary fever and inflam-
 mation, must be classed where  it really belongs, among the
 ideal world  of immaterialities  and  non-existents.   For
 as has been said before, whatever of speculative  theories
 are found to come  into colision with the only true science,
 (we  mean that which is based upon  facts drawn from ex-
 perience and observation,) whatever  does not harmonize
 with this kind of science, will not be regarded as  sound and
 scientific, by men of intelligent minds.
   We are aware that reformers will be considered by some,
as confiding to much in  the efforts of  nature for the cure of
disease, but it is to be recollected that they are not on this
account, led to believe, that they are to remain merely pas-
sive  spectators of the efforts of nature; but on the contrary
they are to use such means  as appear most likely to assist,
and run parallel with the steps of nature in the cure of dis-
ease.  In mentioning the principles of treatment of fevers,
                            5* 
54
 Dr. Gregory says: "The most important feature in this view
 of the subject, is the natural tendency in all febrile diseases,
 to run a certain course, and to terminate in the  restoration
 of health;" and further, he says: "The natural tendency of
 fever, to come to a crisis, or to work its own  cure,  maybe
 often kept m view, with the best advantage.   Tho spiritof
 this doctrine should never be disregarded."
  Had Doctor Gregory considered  fever as a disease, he
 certainly would  not  have discovered its natural tendency
 to terminate in the restoration of health.  Has disease anv
 natural  tendency to terminate in the restoration of health?
 If it has,  the physician  may lay aside the practice of his
 profession, lor ifdisease itsclfhas a natural tendency to work
 its own cure,  and  the efforts of nature are operating to pro-
 duce the same ell'ect—there can be no longer need of phys-
 icians; especially of such as  employ means directly oppos-
 ed to the operations and efforts of nature.
  Let every in [uirer after truth in medical science, reflect
 candidly upon the opinions of the great and  learned Doctor
 Gregory, that be may learn whether there be any truth  in
 them.   Mr. Hunter says that "fever is a good symptom
 when equal to ihe injury."   Now in this expression,  Mr.
 Hunter admits, yes even affirms two truths, tor which we
 have been contending, viz: that  the increased action, which
 takes place m injured parts, commonly called inflammation,
 is a Jeer r  and a good symptom, when equal to the in-
jury.   We presume that he  means by the phrase "equal
 to the injury" an  increased  action  having sufficient sup-
 port from the constitution to continue till the injured part  is
 restored.   It is weakness of the  svstem which gives rise to
 an inequality between  the fever and the injury or disease
 for the removal of which, the fever  was induced.   Nature
 cannot be .barged with performing  any  work of superero-
 gation; that is, she does not excite  a  higher degree of fever

 ShP.trT'011  thln iS neCCSSary  to the  restoration
 of health;   hence in those  cases, where it is said that the
 fever or   inflammation istoo high,'this  being a  natural
 effort, we are constrained to ascribe the opinion to error in
 the understanding, rather than  to any imperfection i„iff*
 undisturbed administration of the laws of nature 
55
  As in fevers, so in inflammations—many different kinds
have been mentioned by authors.  The first division of in-
flammation is into two species—phlegmonous and erysipe-
latous.  The term phlegmonous is a derivative fromphleg-
mon,  which latter  word is taken from the Greek, (phlego.)
signifying "to burn."   Thus phlegmonous  inflammation is
a disease  characterized by heat added to another disease
which is also characterized by heat!   But in truth, phleg-
monous inflammation is no disease at all; it is only a  local
fever—a salutary and necessary effort of the constitution to
restore the part to health; so says some of the best authors;
so says the correct signification of the terms, and so also say
experience and observation.  The term erysipelatous, is a
secondary of erysipelas, which, is derived from, oris a com-
pound of the Greek terms ereo, to draw, and pelas, adjoin-
ing—from the neighboring parts being affected by the erup-
tion; so that the term  erysipelatous  does  not specify anv
quality of the inflammation itself, but merely expresses the
fact, that the adjoining parts are affected.
   We do  not object to the use of such technical terms as are
calculated to point out any important circumstance in rela-
tion to disease; on the  contrary, we  say  technical  terms
should be used to designate the characters  and  locations  of
diseases.   It is to  that pompous parade  and insignificant
connection of such terms, that we object.  To that unscien-
tific union of words, which, though from their terminations
 have the  semblance of grammatical  correctness; yet when
their real meaning is obtained they are found to possess no
significant affinity to each other; which proves the fact that
many have learned from experience that  such  a  use  of
 hio-h sounding words, only "leads to bewilder, and dazzles to
 blFnd!"
   This is more especially the case with the young mind,
 which is  very apt to put a false estimate upon words  from
 attending to "their  sound, and neglecting their sense.  In-
 flammation or local fever has no  other modification, than
 that of degree and place.  The accompanying  symptoms
 of a disease which gives rise to inflammation, may vary  in
 many particulars, that is, the swelling; redness and pain
 mav be more or less marked or  perceptible, according to 
50
 'die extent of die remote cause, tho specific state of the part
 at the time it was first subjected to tho cause, the particular
 organ  affected, the constitution of  tho individual and the
 mode of treatment adopted for the cure.   The  swelling ob-
 servable in an inflamed part, is caused by an unusual quan- t
 tily of fluids in the part.   The redness is owing to a dilata-
 tion of the small arterial branches and the adinisssion of the
 red globules of blood  into those small vessels of the  part;
 which do not carry red globulus while  in the natural state.
 This pain,  experienced in an inflamed part  is produced in
 tue following way-.  as has been staled, wherever there is
 unusual irritation, there  will be a corresponding increase in
 the fluids of the irritated  part, on account of the increased
 quantum of vital or nervous energy in the part, the sensibil-
 ity is heightened, and the o'ver distension of  the small ves-
sels gives rise to an  unpleasant sensation, which  is called
 pain; but this is one of those natural  or unavoidable evils,
 which will  finally be productive of good. 
CHAPTER  IX.
 TREATMENT OF INFLAMMATORY DISEASES, OR OF
    DISEASES ATTENDED  WITH LOCAL FEVER.

   It is unnecessary to particularize the general course to
 be pursued in the treatment of local fever, or of a combina-
 tion of general and local fever; since it would amount to
 no more than a repetition of what we have already said,
 while speaking upon the treatment of general feberile dis-
 eases.  But as local fever or inflammation has some pe-
 culiarities  which distinguish it from general fever, it is
 proper that these differences should be taken into the ac-
 count, while  laying out the course of treatment.
   In treating  disease,  we should apply our remedies in
 such manner as is best calculated to act upon the diseased
 part.  If,  for instance, a wound  has been inflicted upon
 the hand, so as to excite local fever or inflammation in that
 organ, our remedial agents, as  far as may be, should be
 brought to act immediately upon that part; although in this
 case, some distant organ of the system may be  sympa-
 thetically affected, yet this slight derangement from sym-
 pathy, will be adjusted so soon as the health of Ihe prima-
 rily diseased part shall be restored.   If there  be a diseas-
 ed state of any of the internal and vital organs, of sufficient
 intensity to give rise to local fever, the functions of the ad-
joining organs will be  more or less involved in the disease
 through the medium of nervous sympathy;  hence a general
 reaction or fever will take place; which  symptom is de-
 nominated  in the books, symptomatic  or  sympathetic fe-
 ver;  but these terms would be more applicable to the gen-
 eral derangement consequent upon the original disease.
   The idea which we  form of sympathy, carries in itself,
 the presupposition of sensibility;  but an action  is void of 
58
this  properly; so fever  in  itself, cannot be sympathetic,
vet an organ of the body, endowed with the  principle of
sensibility or excitability, may with  the strictest propriety
be said to be  sympathetically affected.  Since then,  any
local derangement of much magnitude, cannot long  exist
in the system without giving rise to general disturbance,
the propriety of combining general with local  treatment in
such cases will  appear obvious.
  The means used in the general treatment of inflamma-
tions are  similar to  thoso recommended in general fever.
Such as  emetics, cathartics, diuretics  and diaphoretics;
that  is, such medicine as will act locally or specifically
upon the stomach, to evacuate  its morbid contents,  and
restore its healthy action.   Such as produces its effects by
stimulating the inner membrane  of the bowels, giving  rise
to increased secretion of serum and frequent  alvine evac-
uations.   Such as exert a direct influence upon the  kid-
nics, causing  them to  separate  larger quantities of the
irritating acrid parts from the  blood;—and  such as act
specifically upon the  heart and  arteries, producing a de-
termination of blood and heat to  the surface, which results
in a general  perspiration.  The quantity and frequency
of exhibiting  these different remedies, must be left to the
judgment and skill of the practitioner,  who is supposed to
be sufficiently versed in medical science to adapt his means
in all respects to the special circumstances of each individ-
ual case  that may come under his treatment.
   In many cases of general  disease, but more especially
in those  confined  to particular parts or organs, much  ben-
efit  may be derived from external  and  local treatment.
When any of the external parts  of the body are inflamed,
the cause of the inflammation, may be effectually removed
or very materially diminished by the frequent  use of the
medicated local vapour bath,also  by the application of warm
fomentations and poultices to the part; these should by no
means be neglected in such cases. Their apparent simplic-
ity is but a weak argument to urge against their utility.__
Their effects are not those of a charm, but they will admit of
a physiological and rational explanation.   In cases  of in-
flammation of internal organs, as the stomach, lungs, bow- 
59
els, liver, &c, much benefit may be derived from the ac-
tion of rubefacients; that is, such medicines as when applied
to the skin, produce irritation and redness without blistering;
also fomentations applied immediately over the region of the
affected organ, will be found to produce admirable effects.
  Those cases of inflammation or local fever which are ex-
cited by the application of heated substances to the body  as
is the case in the burns and scalds, may  be benefitted by
cold applications, as  cloths wet in cold water and laid upon
the injured part; here the permanent utility is derived from
the reaction produced by the cold application, as  is the case
with the cold bath; but  where the  burn ©r scald is so exten-
sive as to produce great debility or diminution of the pow-
ers of 1 ife; it would be improper to  apply cold, as the consti-
tution would not be able to bring on the necessary reaction,
Then in severe  and  extensive scalds  and burns, warm poul-
 tices  should be applied, and  the strength of the system,
 should be supported by  the judicious administration of tonics
 and stimulants.
   It is necessary that we bear in mind this fact, in the treat-
 ment of diseases, viz: That by relieving pain, we do not in
 all cases, weaken disease, for though the pain will always
 cease when the cause or disease,  of which it is a symptom,
  is removed, yet the disease is not always  removed  when
  the pain ceases or  is diminished.  This is a consideration
  of vast  importance   to the physician, it will caution him
  ao-ainst  placing much  confidence in those means which,
  wdiile they momentarily relieve pain, seriously interrupt the
  efforts of nature, and thus indirectly strengthen the disease.
    From this view,  we shall discover that  it is not those
  means  which most  speedily relieve pain, that we are to re-
  gard in all cases as most permanently useful in the treatment
  of disease.  We think this idea should be seriously revolv-
  ed in the minds of those physicians who deal liberally in the
  narcotics, and the  lancet; and who at the same time, indis-
  criminately, condemn all those who  conscientiously differ
  with them in opinion on this particular subject.
    In local fevers, as well as in general, it is frequently ne-
  cessary to administer that kind of medicine which imparts
  tonicity to the muscular fibre, and strength to the general 
60
 system.  For though there may be  a sufficient degree of
 strength in the constitution to enable nature,  assisted by
 proper medicine, to affect an equilibrium of the circulation
 and excitability of the system; yet from deficiency of vital
 power, each organ may not possess that tonicity  which is
 requisite to enable it to retain its due portion of vitality, or
 which is indispensiblo to the  continuance of the state of
 equilibrium, above mentioned.  This is the cause which
 being combined with some external causes, produces those
 secondary or subsequent attacks of disease called relapses;
 hence in the convalescent stage of disease, the strength of
 the system should be promoted by the medicines best adapt-
 ed to this end; and by diet, most nourishing and easiest of
 digestion.
   Having made these general observations upon the  treat-
 ment of local  fevers, we shall  close our remarks on this
 subject by observing,
   1.   That it is not presumed that any one is to be quali-
 fied for the  highly responsible duties of treating  diseases,
 from the  knowledge derived from so limited a source as
 the present essay.  It is not our expectation to qualify men
 by it, for the medical practice.   Our  oject in  submitting
 these general observations to the public, is  to  facilitate the
 acquisition of truth upon  a subject of great  importance to
 everyone who duly appreciates the blessings of health, to
 furnish  materials of thought,  to such as  love to think for
 themselves upon subjects which more especially  interest
 them; and also to such  as have minds, as  well calculated
for manufacturing good thoughts, as those whom they have
 heretofore suffered to think for them; why should we prefer
 the thoughts made by others, to our own, when we possess
 as good a thinking machine within  ourselves; and equally
 as good materials of thought, upon  the same subject, are
 within our reach.
   2. The medical gentleman will not condemn our remarks,
 because he does  not find in them  a minute detail of the
different means of cure, times of exhibiting, and  quantities
 for each particular case; for he knows that such changes
are to take place  in each of the above mentioned particulars
as cannot be anticipated, but must  depend  upon the exist- 
61
ing circumstances of the  case;  different means  are to be
employed in the same kind of disease, in different individu-
als, and in different stages of the disease in the same indi-
vidual.
6 
CHAPTER  X
AN EXAMINATION INTO THE EFFECTS OF MERCU-
  RY, BLEEDING AND ANTIMONY, IN THE TREAT-
  MENT OF GENERAL AND LOCAL FEVER.

  That each of the moans above specified, has been, and is
now frequently resorted to, for the cure of febrile and in-
flamatory diseases, by physicians who profess to  have been
regularly initiated into  the profession or  faculty,  will not
be denied by any one who possesses that knowledge, which
the most common experience and superficial observation so
abundantly furnish.
   That these means are employed by men, highly distin-
guished for their learning, their natural  abilities, their  ex-
tensive observation and experience; and for their virtue
and benevolence, must also be acknowledged.   Nor is it
without reluctance that wo enter into an examination and
exposition of the extensive evils and  vast amount  of human
suffering, which have grown out of the erroneous   opinions
 of such great and good men; yet whatever absurdities and
 errors may be discovered  in the opinions, no  expressions
 are designedly made to affect the persons or characters of
 these men.
    We respect and admire true science, disinterested benev-
 olence, republican liberality and the love of virtue, where-
 ever they are to be found.  We respect  the man who pos-
 sesses them, whether he be a king or a beggar,  a physician,
 a preacher, a lawyer or a statesman. The proper exercise
 of these qualities is what constitutes the gentleman; what
 ever may be his occupation  or profession,  and whenever
  we discover these qualities in a physician, however widely
  he may differ  from us, as regards his  particular opinions 
63
upon  medical subjects;  we  find him to be a gentleman,
ready to receive any information connected with the various
branches of his profession; his mind is open to free inquiry
into the opinions of those who may differ from his own; he
does not condemn and treat with contempt, both the persons
and opinions of all those whose  minds view things in a dif-
ferent light from his.   In the society of,  and by conversa-
tion with such a man, we derive not only interesting instruc-
tion, but peculiar satisfaction and delight, even though he
be  not of our particular opinion.
  That every physician ought to possess the character just
described, was the opinion of some of the most eminent med-
ical and surgical authors.   The amiable and benevolent
Dr. Thatcher, while speaking of the character, qualifica-
tions, and duties of a physician, observes: "The man who
maintains this important station, should possess the strictest
integrity of character; disinterested  benevolence and phi-
lanthropy should be interwoven in the constitution of his
nature.  He should possess  that  modesty and humanity,
 which melts at every distress; extending the hand of relief
 and comfort to the afflicted, especially to 'the widow, to the
 fatherless,  and to him  that  hath none  to help him.'  He
 should devote no less attention to the  bed of helpless, pinch-
 ing penury, than to the sickly couch of wealth  and luxury;
 and mingle a sympathizing tear  with those, whether rich  or
 poor, who are called to shed the tears of inconsolable sorrow.
 Whilst manifesting an ardent zeal  and solicitude for the
 welfare of his patients, and devoting all the energy of his
 soul to their service and comfort; he is not to be actuated
 by the sordid motive of acquiring feme or emolument; but
 by the irresistible dictates of that tenderness and sympathy
 which have their origin in  the best  feelings of the heart.
 To these meritorious qualities, should be added, an acute,
  penetrating genius, a retentive memory, intuitive  discern-
  ment, and an intrepid and decided disposition of mind.
    The character here portrayed, it must be confessed, is of
  no ordinary cast, nor is it frequently exemplified; but  such
  was the great Hippocrates; such was the pious and saga-
  cious Sydenham; such the illustrious and learned Bcerhave
  and Cullen;  and no less deserving the applause of man- 
64
 kind, were those luminaries of American medicine: Rush,
 Miller, Warren and Barton; tho pride and ornaments of our
 own age and country.
   Every physician should be distinguished  for his  profes-
 sional knowledge and attainments; recollecting that  litera-
 ry diligence, when accompanied with original genius,  is
 the parent of all that is great and valuable in science, and
 that even men of tolerable capacities, may with proper ap-
 plication and industry, produce  valuable acquisitions, and
 render  themselves conspicuously  useful.  To excel in the
 profession of medicine, and to  practico with success and
 reputation, requires indefatigable industry, and a vast vari-
 ety of liberal accomplishments, as well as an understand-
 ing improved by knowledge and experience.
   "It would seem impossible to contemplate the mechanism
 exhibited in the formation of the human frame, without as-
sociating the most exalted sentiments of piety.  Our exis-
tence is indeed a continued  miracle; capable of being  sus-
tained only by the hand  of that Omnipotent Being, whom
we adore, as  "the  former of our bodies, and the father of
our (Spirits/'  From_the striking proofs of divine wisdom and
benevolence, displayed in the animal structure, may be de-
rived, arguments not only the most numerous, but the most
clear and decisive, and the best calculated  to confirm the
sentiments  of rational piety, and to  induce habits of  active
religion and piety."  In more than  one sense, the judicious
poet is correct, when he asserts, that:
           "The proper study of mankind, is man."
   Those, however, ofcultivated understandings, and minds
enlarged by the exalted principles of religion, will not read-
ily yield themselves bigots to any particular sect or religious
system; but exercise christian charity, piety, brotherly love
and universal goodness,  without wishing to offend others,
who may differ from them.
   "The study of medicine," says the amiable Dr. Gregory,
"of all others, should be the least suspected of leading to
impiety. An immediate acquaintance with the works of
nature,  raises the mind to the most sublime conceptions of
the Supreme Being, and  at the  same time, dilates the
heart with the most pleasing views  of Providence.  Thero 
65
are besides, some peculiar circumstances in the profession
of a physician, which should naturally dispose him to look
beyond the present scene of things; and engage his heart
on the side of religion.   He has many opportunities of see-
ing people, once the gay and the happy,  sunk in deep dis-
tress; sometimes devoted to a painful and lingering death;
sometimes struggling with the tortures of a distracted mind.
Such afflictive  scenes,  one would  imagine, might  soften
any heart, not dead to every feeling of humanity, and make
it reverence that religion, which alone can support the soul
in the most complicated distress; that religion which teaches
to enjoy life with cheerfulness, and to resign it with dignity.
   "Among the virtues peculiarly required in the character
of a physician, are those of temperance,  sobriety,  and pro-
bity.  Temperance is the only panacea known in medicine,
and the professors of health should enforce the  instructions
of temperance, by  the eloquence of example.   Of all the
disgustful objects ever  admitted  into a sick chamber,  a
drunken physician is incomparably  the most odious; and he
who sustains this character, ought never to receive the least
countenance in the line of  his profession.
   "The noble and disinterested sentiments of the venerable
Sydenham, as expressed in the following language are wor-
thy of being adopted by every physician.   "Upon deliber-
ate reflection, I find it better to assist mankind,  than to  be
commended by them, and more highly conducive to tran-
ouility of mind; popular applause being lighter than a feath-
er,  and  less substantial  than a dream.  I have  always
thought ita greater happiness to discover a certain method
of curing  even the slightest diseases, than to accumulate the
largest fortune.  For can a person give a stronger proof of
his benevolence and wisdom, than by endeavoring always
to promote the public  good, rather than his private interest,
 as he makes so small a part of the whole!   I am determin-
 ed to give myself little concern for the failings of others,
 being convinced that all that is incumbent on me is, to act
 like an honest man, and discharge  the office of a good phy-
 sician to  the best of my abilities."
    "The  education and course of life of medical men," says
 Mr. Abernethy, "tend to make thera sober  minded, moral 
66
 and benevolent, and their professional avocations equally
 require that they should possess such eharactets.   On no
 other terms can they be admitted with confidence into the
 bosom of those families which may require their modical aid.
 Whoever, therefore, inculcates opinions tending to subvert
 morality, benevolence and the social interests of mankind;
 deserves the severest reprobation from cvory member of our
 profession, because his conduct  must bring it into distrust
 with the public.*1
   Thus much, for the opinions of the grout, in medical life;
 concerning the  proper character of the physician, and the
 natural tendency of the study und practice of the medical
 profession upon the mind and heart.
   That the exalted  and highly  dignified character  above
 described, has been  exemplified in many physicians of past
 ages; we fully believe, norarewc less compelled from evi-
 dence to believe that such characters are to be found among
 those of the profession in our own age.   We therefore re-
 peat that whoever  possesses such a character; we do, wc
 must respect, without enquiring whether he be a physician,
 a  preacher, a lawyer, a statesman, or a  private citizen.
 Whatever physician may bo found to have this character,
 however widely  he  may differ from us in his opinions on
 medicine, we respect him as a citizen, and as a physician,
 and far be it from us, to say  any thing, in our present re-
marks, with an intention to injure the reputation, the  inter-
 est or feelings of such a man.
                          6* 
CHAPTER  XI.
             ON  BLOOD  LETTING.

  Can the practice of,bleeding, for the cure of general and
local  fevers be sustained upon the testimony of correct
pathology, sound physiology, careful observation, and true
experience?  In  order  that a person  may be qualified to
give a correct decision in regard to the merits of this ques-
tion; it is indispensable that he conceive just notions of fever
itself; that he  have a true knowledge of the nature of dis-
ease, of the general doctrine of life, and of the nature and
uses of the blood, that he mark well what he sees and feels
of disease, and that he be not one of those, who are deter-
mined to be ignorant, in spite of experience.
  We have made some observations upon  the nature and
use of the blood in  the begining of this essay, with which,.
we  believe every enlightened man will fully agree.  Our
theory or doctrine of disease, of fever, and inflammation, we
have also given, with some of the evidences and authority
for  the same.   These doctrines are in  accordance vith  the
best of our judgment  and knowledge; therefore, in forming
our answer to the question at the beginning of this chapter,
we shall apply the question to these doctrines as a t?st, and
give our answer according to the result.
  Any mode of practice  in the treatment of fever, which
harmonizes with true pathology, with physiology aid expe-
rience, must be regarded as good, according to oui present
state of knowledge; if then, the practice of  bleeding is  not
found to be so parallel with the steps of nature in the cure
of disease, as  some other  known, and  practicablf means,
then we must pronounce it bad.
  We have said that there are many remote causes which
may operate upon the human system, under certaiacircum- 
68
 stances, in such manner as to derange that regular perform-
 ance of all the functions of  the  body, which derangement
 brings on a preternatural slate of body, or in other words, a
 diseased state.  A diseased state  of body cannot long con-
 tinue without giving rise to certain  exertions  of nature,
 which are commonly termed fever, and looked upon as real
 disease; but which are called by Dr. Johnson,a salutary
 action, or an  effort of  the constitution,  &c,; by Mr. Hun-
 ter, a necessary  action—a good  symptom,  vVc; by Dr.
 Gregory, the operations of nature tending to the  restoration
 of health,  the steps of nature in curing disease, eve.
  We stated that  all the actions of the system,  (morbid  or
 diseased actions accepted.) are supported by the life-giving
 stimulous of the blood.   We have now arrived at  the con-
 clusion that disease is the immediate  cause of fever—that
 fever is a  necessary and salutary action, and that this ac-
 tion is supported by the blood.   V/e must inquire into the
 immediate and subsequent effects of bleeding to sec whether
 they are such as may be desired in the removal of disease.
  The immediate effect of the abstraction of blood, is debil-
 ity or weakness; this is a fact which all experience proves;
 nor can it be  successfully controverted.  The  secondary
 effect of bleeding, is a protracted recovery  from  disease;
also an increased susceptibility of the  system to be effected
by such causes as are calculated to produce  disease.
  The first of the above positions is based not only  upon ex-
 perieme, but upon the  physiological fact, that  all the
strengh of the system is derived immediately and  directly
 from tie blood; and hence to pretend that a small quantity
of blool may be abstracted without producing a proportion-
 ate decree of weakness; would be as good philosophy as  to
 say thtt one grain of mustard  seed  makes no part of the
 bushel or to say that the body contains one, two or three
 poundsof blood more than is compatible, or proper for its
safety (r health, is to say that nature performs work of su-
pererogition, to  interrupt her own laws.  Such opinions
would to but little honour to men of sense.  Bleeding redu-
cesthe ?orce and frequency of the pulse;  that is, it "dimin-
ishes the action of the heart  and arteries, and, thus reduces
fever.   Well, saye  one,  if bleeding  reduces the  fever,  it 
69
 must be good.  But stop, what is fever?  O! I had forgot-
 ten, that 1 read in a former part of this book, that fever Ts a
 necessary and salutary effort of the constitution to relieve
 some oppressed organ, to restore  some impeded function,
 to remove the disease.  Well  then,  bleeding is not good
 simply because it reduces fever.  But does not bleeding re-
 move the blood which  is most impure  and which is conse-
 quently a cause of disease?
   We are fully aware that many are honestly of this opin-
 ion, but wherever we find a  physician  holding out such an
 idea to the people, we  are obliged to lay one of these things
 to his charge, viz: that he is unpardonably ignorant, of the
 true  knowledge of his profession, or else, he is wilfully
 dishonest, or in other words, is willing to sacrifice the health
 of his patient to his own interest.  Foreign or extraneous
 matter is only mixed mechanically with the blood, not chem-
 cally combined with it.  Where the secretory functions are
 suppressed, as that of the kidnies and skin, that matter  or
 fluid which should have passed off, by these secretions,  is
 retained; mixed with the general mass of the  blood, and
 produces unusual irritation.  The proper way to purify the
 blood in such case seems to be the way which nature takes;
 that is, to restore the action of the skin, thus producing per-
 spiration; and the action of the kidnies, thereby separating
 more of the unhealthy particles from the blood.
   Now we will suppose that there are twenty-eight pounds
 of blood in the body, and with  this is mixed four pounds  of
 impure fluid from retention.  Now we take one pound  of
 blood,  and we remove  but one twenty-eighth part  of the
 morbid matter, at the same time taking away the one twen-
ty-eighth  party of that strength, of which the patient may
stand in the greatest need.  But says one, the  doctor says,
"it is the  bad blood which he draws," and I think he is  cor-
rect, for  on watching the operation  of bleeding, I have fre-
quently noticed that when the blood first begins to flow, it  is
quite thick, and looks dark and clotted.  All this may be
true, and frequently is, as respects  the appearance of the
blood; but let us look into the cause.  It is customary, pre-
vious to opening a vein, to apply a ligature around the limb
between the point to  be punctured, and the heart,  for the 
70
purpose of retarding the blood in tho vein-, and thus render-
ing the vein to be opened, more conspicuous and prominent.
The blood contained in the veins on the side of the ligature
more distant from the heart, by being obstructed, looses its
colouring matter, by uniting with a larger  quantity of the
carbon of the animal substance; hence it becomes  darker,
and  by its  quiescence, partially coagulates,  forming the
small clots before mentioned.
  Therefore, when the blood begins to flow, upon the open-
ing of the vein, it looks dark, «S_c; but  after it has  flowed
sufficiently  long, to remove that portion which had been
retarded by the  ligature;  it appears of a brighter red, no
clots arc discovered, and all conclude that the bad blood is
all drawn off, and consequently it is time to stop—yes, we
agree  with them, it is time to stop—to stop such absurdities,
such imposition, and such sacrifice of life!  If tho blood ab-  .]
stracted by venesection differs at all from the general mass
of blood, we would be led  from certain circumstances, to
believe that it is the  better portion of the blood.
   It is well known to physicians  that in  many  diseases,   i
there  are very frequent local determinations and conges-
tions of blood in different organs, as the brain, the lungs, the
liver,  &c.; of course, the congested or stagnated blood, ceas-   i
es to give that stimulous and strength to the system which
is  usually imparted by this fluid.  Then tho only depend-
ence which the constitution has for strength to support life
and to make the  necessary efforts to remove disease, must
 be  solely derived from the circulating and vivifying blood;
 it is the blood which is in active circulation, (except the ob-
 struction caused by the ligature,) that is drawn by venesec-
 tion ; hence according to  the  reasoning  above, it must  be a
 portion of the blood  of the better quality, that is drawn off
 by the lancet.
   Though  bleeding, when it is performed during increas-
 ed action of the heart and arteries, invariably reduces this
 Action fur the time;  yetitis known to have a different effect
 if performed at the time  when the action of the heart is be-
 low par, from the oppression ofgcnoral disease, concussion
 of the brain, suffocation  from gases, &.c.  In these cases,
 bleeding increases  the action of the  heart and  arteries by 
n
accelerating the febrile action, or forwarding the process of
a reaction?  Well then, says the believer in bleeding, you
have established the propriety of blood-letting in this state
of the system, upon your own principles; for you say herer
that bleeding increases the action of the heart and arteries,
when performed under the above described  circumstances,
you say also, that it accelerates the accession of febrile ac-
tion, or forwards the process of reaction: you have said that
this febrile action or reaction is a necessary and  salutary
action or effort of the constitution, tending to the restoration
of health!  Now agreeably to all this, it seems to me that
bleeding must be good; for if the fever is a salutary  action,
tending to remove disease, it cannot comeon too soon, when
there is disease existing in the system, the sooner it com-
mences, the sooner the restoration of health will be accom-
plished.  Now  we look upon  this 'kind of reasoning, as
arising from a very superficial  examination of the subject;
and under no other examination of it, could  such a series of
reasoning appear even in the slightest degree plausible.
    In order to forma correct  decision as to the merits of any
 question, it is not enough that we examine and  bring for-
 ward all the evidences which can be found to favour one
 side of the question, which  we might,  from  a superficial
 view, think best supported; but we should also examine and
 weigh  well the arguments against this side.
    We have already observed, that all  diseases consist in
 either functional  or organic lesion; and that their immedi-
 ate consequence upon the system, is oppression  of its or-
 gans, and depression of its general strength.   We have
 also remarked that a natural fever or reaction, on account of
 the existence of disease, does not  take  place,  until the dis-
 ease is so extended, as to endanger the immediate safety of
 the individual affected; that is, fever does not  take place, so
  long as there is sufficient strength and vital stamina in the
  constitution; to bear up  under the oppressive influence of
  disease.  Hence the interval, between the primary appli-
  cation of an efficient morbid cause to the body, and the com-
  mencement of the reaction or  fever,  designed to remove
 .the effects produced in the body, by the operation of the ex-
  ternal morbid cause,  will be longer or shorter in proportion 
72
  to the extent or intensity of the cause itself; and the strength
  of the system at the time.  Nature suffered to take her own
  course, always starts at the best time and under the most
  favorable circumstances.
    To illustrate our idea, we will  suppose an individual to
  receive a fell from some considerable eminence;  in which
  he strikes upon the feet in  such a manner as to produce  no
  external wound, but as soon as he comes to the  ground  he
  falls apparently dead.
   This is a case of concussion of the brain; that is,  the
  brain is so much  jarred by the fall, as to cease  in a meas-
  ure, to  perform  its usual function.  The  equilibrium of
  the circulation is disturbed;-a congestion of blood  takes
 place in the brain, and perhaps in some other of the internal
 organs.  Now, though this  is very oppressive to  the system
 yet  from the vigor of the constitution, the system is enabled
 to bear it, and still perform the vital  fdnctions sufficiently
 to support life; till  nature shall have prepared her means, so
 as to make her efforts of restoration, under the most favora-
 ble  circumstances.
   But if bleeding be resorted  to, a degree of debility is there-
 by produced, which incapacitates the system for the endu-  «;
 ranee of the derangement, till all would, (except  for bleed-
 ing) have been in  readiness for the work of reaction.
   Thus  we find,  that by bleeding, we give rise to the ne-
 cessity of a premature accession of fever; we also diminish
 the strength of the constitutional efforts or fever, and at the
 same time add to the strength of the disease.  I fit is not the
 vital energy of the system which stays the ravages of dis-
 ease , we know of no property in animal matter from which
 disease can meet with any resistance.
  Mr. Hunter says: "that  bleeding  increases irritability,
 and causes an  increased disposition to act, without the pow-
 er to act with."  The way  in which bleeding increases ir-
 ritability, is this; that it produces direct debility.   When it
 is said that a part or the w hole body is irritable, it is meant,
that such part, or the body is much affected by slightcauses;
 there is so much weakness, as to disqualify the  part  for
resisting slight attacks. In this state, the body corresponds
with the mind of those persons, who get angry from slight 
73
and trivial causes;  such are said  to  have irritable  tem-
pers or minds, and every body knows that this irritability
of temper arises from weakness of mind.
   Bleeding causes an  increased disposition to act, since it
increases the  weight of the disease  by diminishing the
strength of the one who bears it.  The same load that would
be regarded as light, by the strong man, would be declared
by the  weak man to  be  insupportably heavy; and if the
burden  were to be carried to a little distance by the weak
man, he could not stand and hold it, till the obstructions could
be moved out of his path, but he sees that his only alterna-
tive  is to make onwards; and from his being weak, the bur-
then heavy and his path rough, he probably falls  before he
gets  half way; he is no more able to raise the load, no, not
even to raise himself.   Not so with the strong  man,  he
stands with his load on  his shoulder till some one  (the phy-
sician,) goes  and moves the obstructions out of his way; he
then advances with firm and sure steps, arrives at the des-
tined spot, throws down his burthen, and is free and ready
to attend to his business.  In speaking of the weak man,
it should have been observed,  that should he  get through,
and throw off his burthen, still he is so much exhausted as
to require much tonic medicine and a convalescent stage of
several  weeks.
   "Bleeding  increases the disposition  to act,  without the
power to act  with."  Suppose a hungry person, just to sit
down to a table furnished with food agreeable to his taste j
but there is  only  enough for his present necessity;  now
suppose one to come and begin to  carry off  the food from
his table; would not his  disposition to act,  be increased,
without the means to act upon ?  He would see  that  his
only chance would  be,  to make sure  of all he could, while
it is going.
  So when the human system is labouring under disease,
and some wise son of Esculapius  comes and begins to ab-
stract the.blood; the disposition to act is increased, because
the system seems sensible that a certain effort must be made,
and that her power of  making it is going.   Nature  there-
fore  makes the attempt; but too often finds  her resources
deficient, from loss of blood.   But say our brethren of the
                           7 
71
bleeding faith, wc know that wo can reduce lover and in-
flammation bv bleeding, sooner than by any oilier means.
We admit that this assertion is correct; but it is one of tho
Wrongest arguments, which can be used against the very
mode°of practice, for the  vindication of which  it isurged.
For every one who has a correct view  of fever and inilam-
mation. (which  we call local lever,) must see, that they
should not be reduced, till the disease, for the removal of
which 4hcy are excited,  shall be subdued.   So bleeding
docs not effect the desired object, it only docs it apparently.
Thou-di the removal of disease is  invariably attended with
a subsidence  of fever, yet the reverse of this, in no case,
can happen.
  If an individual  discovers that  his health is somewhat
deranged, the natural desircto live, together with the recol-
lection of the enjoyment of health, prompts him to mako an
attempt to restore health,  lie sends for a physician  of the
regular order; (because he desires regular treatment;) his
physician comes, and after feeling his pulse,  viewing his
tongue, and making some inquiry of the state of the bowels,
pronounces his  patient to be sick of a fever; if the fever be
high, the physician recommends his patient to be bled; upon
being bled, the pulse sinks, the  strength fails,  the fever is
diminished or weakened, and the disease strengthened.
  From such harsh and presumptuous treatment nature re-
treats, but as soon as the doctor is gone, nature marches
forward to prepare foi#action.   She finds her  resistance is
greater and her resources less, but still she feels and  knows
the necessity of immediate action; she accordingly musters
all the force in her power, by going to the different organs
of the body, and with all the force and beauty ot'native elo-
quence, represents the oppressed and suffering condition of
the general system.   She succeeds in enlisting as  many
volunteers as each organ, consistent with its own immedi-
ate safety,can spare; she concentrates these volunteers, (a
portion of the strength of each organ,)  into a common array,
marches them into  head quarters,  and  then  places them
under the command of the heart; the operative commander
in-chief of the arterial and veinous regiments.   The heart,
without  delay, leads the army into the field of action- the 
75
disease, the opposing army, is strong, and well disciplined,
under the command of morbid contractility ■ the action com-
mences, it is warm and  nearly equal; after a while, owina
to the superior skill of the heart in military tactics, nature's
army begins to gain ground; nature, at a distance, looks on
with  the rejoicing of hope; at this time, all  bids fair for
victory, on the side of nature's army; but at this instant, the
eye of nature beholds at a distance the approaching doctor;
in a moment the scene is changed—a cloud of gloom hamTs
over  the prospects, which, but  the minute previous,  shone
with promising brightness.   Nature is too well acquainted
with the  common course of the doctors in treating disease,
not to sicken at once by the anticipation of the consequence.
The doctor arrives; he finds that nature's forces,(the fever,)
are still active and tolerably  strong; he bleeds, thus tak-
ing away from the right  wing of nature's army a strong
and much needed company; the enemy takes advantage of
the weakened part, and rushes onward; the only chance on
the part of nature is a retreat; she gives orders to the heart,
the chief commander of her  forces, to save the army by a
speedy retreat; this is done, the enemy advances and takes
possession of nature's ground.  All this, the doctor says, is
favourable; but nature feels the oppression of the enemy,1
and after calling the roll, arranging her army, and refresh-
ing it by means of the  absorbent  system, marches  them
once more against the enemy; knowing the strength  of the
enemy's army, and feeling  the weakness of her own, it is
but with  the smallest encouragement that she can urge her
commander, (the heart,) onward to the contest.  In a little
time, the  opposite armies meet;  the action commences;
every moment lessens the chance of nature's success;  the
enemy advances with firm and undaunted steps; nature's
army becomes alarmed on account of its weakness; all, all
is gloom and darkness; a few of nature's friends, standing
at a little  distance to behold the issue, seeing the success of
the enemy, begin to shed the tear of disappointed hope and
total despair. The enemy  rushes on, there is no chance
for a retreat; nature gives conlmand to surrender, even to
an enemy from whom she expects no quarters; the enemy"
slays the  prisoners and demolishes the citadel—all is gone 
76
 Death has closed the scene.  Tuis  is the termination of
 thousands of nature's contests  with disease, which but for
 the practice of the physician, would have  terminated suc-
 cessfully.  Wc appeal  to the experience of tho candid and
 impartial reader, for a confirmation of this assertion.  Kav
 friendly  reader, how many of your friends, relatives and ac-
 quaintances, think you, have sunk into a premature grave,
 in consequence of being bled when sick?  Be candid and
 rational; you cannot be otherwise, when you know, that
 your own life and happiness are to bo involved in tho issue
 of your conclusion.
   We are fully convinced that a number of our acquaintan-
 ces  and  friends, yea, even of our nearest and dearest rela-
 tives, have fallen early victims to the doctrine of bleeding.
 We would cast no reflections upon their physicians; it was
 done by  them with the  intention of good.  Some little knowl-
 edge  I have of the effects  of bleeding, by personal experi-
 ence.  A number of years>go, while residing in my native
 State,(New York,) at my father's house; I was taken with
 the premonitory symptoms of fever. After being indisposed
for several  days, the physician, (who at the time  was tend-
 ing upon my brother, who lay sick, not of fever, but for the
want of it,) was requested  to  prescribe for me;' the  first
thing which he gave me, was a dose of calomel pills; their
operation produced a considerable weakness, so much  in-
deed, that I was obliged 'to give  up, and go to bed,' to use
 the common phrase.  I was now  really sick, and  nature
 knew it and felt it; she  accordingly, in her kindness, made
an effort to relieve me, by increasing the action of the heart
and arteries, in order to  restore  the action to the general
system; but unfortunately for me, while nature was making
this effort, my  excellent doctor  came, he felt my puho, U
was  quick and strong, my skin was hot and dry, my tongue
furred and parched, and  in fact I had a high fever; he safd I
must be bled, and what  was still worse for me, he had not
forgotten to bring his lancet; he bled me, I became faint and
very weak, my heart and in fact whole system become more
oppressed, my fever, unhappily, was much reduced -and for
four  weeks, I lay in an almost helpless state, under a course
of mercury, or in more  fashionable language, of cooling 
77
powders.  But as good luck would have it, my physician
was one of those sensible men, who know that when there
is but just strength enough in the body to support life, if any
strength is taken away the patient must die.
  When  the doctor saw this to be my situation, he ceased
giving me any more harsh medicine; and by  taking some
mild and nourishing drinks, and some  warm teas, which
were administered to me  by the hand of some kind and dear
friend, my strength was increased, and I gradually, after a
long convalescence,recovered.
  In complimenting the doctor for his good sense in with-
holding his strong medicine, I should have said, that after I
had become very weak, my aunt told  the doctor  that he
must give me  nothing harsh,  for my  weakness would not
permit.  In giving this account, I should not do justice  to
my own feelings, or to the kind  and generous doctor, if I
neglected to state, that he acted the  part of a benevolent
man towards  me, and undoubtedly did the best he could
under  existing circumstances.  I mean that he did accor-
ding to his best knowledge and judgment; and for his kind
attention and solicitude for my welfare,  I shall ever cherish
for  him a grateful remembrance.
  My brother, who was sick at the same time, lay about
eight weeks; was reduced to the very threshhold of death;
but from being about  'given up' by the physician, on ac-
count of his recovery being despaired  of, he had a little
respite from medicine, during which time, nature being un-
molested, overcame the disease.  A dear sister was sick  at
the same time; she was bled, and she lay ahout three months
under  a mercurial treatment and died; alas! she  fell a vic-
tim—an early victim  to calomel and bleeding!
  These, gentle reader, are truths, which will remain when
you and I shall have  embarked for a more hospitable and
friendly shore, a more calm and peaceful realm, and when
the life-killing and heart-chilling practice of bleeding and
mineralizing shall be buried in deep oblivion.  But bleed-
ing is fashionable, and some are determined to be fashion-
able at all hazards.  It is a vulgar saying that one might
as well be out of the world as out of the fashion, and were
there  anv sense or truth in the expression,  then to be in
                             7* 
7S
 fashion, in this  one respect, would be as bad as to be out of
 it.  But what is themodus operandi, or manner  in which
 bleeding acts,  in  the removal of the disease?   Who i«
 able to  tell us?  We must  say that we have never  seen
 even a plausible explanation given concerning its curative
 powers, in our leading; and wc believe  we have carefully
 studied and read those authors on practical medicine and
 surgery, who most  boldly and strenuously advocate  tho
 practice of bleeding for the  removal  of febrile  and inflam-
 matory diseases.
   The fact is obvious, that bleeding  is a mode of practice,
 which, when used for  the cure of disease, admits not of a
 rational explanation, nor will physicians attempt to explain
 its effects to men of enlightened and experienced minds.
   They  may say, that bleeding is an  ancient practice,  and
 that it has been  sanctioned by men of much learning and
 experience, and  that this is sufficient authority.  But the
 inarch of science and truth have condemned many of those
 practices which  were thought proper  in ancient times.  As
 well might we say that it is right to worship idols  because
 it  was customary in ancient ages; and we  might add even
 too common in our own day and country; for whether is it
 better to  worship the sun, moon  and >i,irs, or to wor.-hip ■*
 wealth, fashion, fame and worldly applause?
   Well, says my friendly and well disposed  reader, from
 what you have said on the subject of blood-letting, I am dis-
 posed to regard it as  a bad practice in general, yet I think
 you must admit (hat bleeding is good in some few cases;
such for  instance as  plcuri-y and cases of violent bruises
 from falls and blows.  No, kind reader, we cannot admit
 that the abstraction of blood is good practice, in even these
cases.  To agree with our fellow-men  in sentiment, feeling
and mode of thinking, when such  sentiment, feeling and
thinking are agreeable and consistent with reason, and pro-
ductive of general good and happiness, is a source of much
gratification toan improved and virtuously directed mind.
But whenever we discover that  our fellow-men are labor-
ing under unreasonable and erroneous impressions or sen-
timents, to agree with them in such sentiments, would be
hypocrisy,not wisdom; would be vicious, not virtuous; and 
79
would excite the sensation of an admonishing and condemn-
ing conscience, not the peaceful delights of conscious good-
ness.   Pleurisy is an inflammatory disease, that is, a dis-
eased state of that delicate and finely organized membrane,
(the Pleura,) which lines the internal parietesof the thorax
or chest, and forms a complete envelope for the lungs.  This
diseased condition of the Pleura necessarily demands and
gives rise to inflammation, which, through the medium of
universal sympathy, affects the whole arterial system, and
therefore comes under the head of general fever.
   It is well known  by all who have been the subjects of
this disease, that it is one of excrutiating  pain and almost
insupportable suffering.  The acute pain arises from dis-
tension of the pleuritic arteries  and veins, increased and
morbid sensibility, and the unavoidable dilatation and con-
fraction of the lungs in performing the  function of respira-
tion.   But this pain is only a secondary and, necessarily,
consequent symptom;  that is the  inflammation.  Nature's
efforts to remove the disease could  not be performed, but at
the expense of this,  severe pain.  We  must recollect that
the part affected is highly sensible and constantly agitated
by the  motion of the lungs; the causes, (we mean the imme-
diate causes,)  which produce the pain, are absolutely  re-
quisite for the adjustment of the derangement; hence  the
pain must be regarded as a partial and necessary evil, which
is more than counterbalanced by the good which grows out
of the direct causes that excite the pain.
   From what has just been said, we come to the conclusion,
that means may be used in the treatment of disease, which
relieve pain, but strengthen disease.   So in pleurisy, bleed-
ing generally gives speedy relief, since it produces a vacu-
um in the vessels of the bleeding vicinity; thus making room
for some of that blood, which should and would have gone
to the affected  part; but how long would  this relief from
pain continue?  The answer  is  obvious, viz:  just long
enough for the  vacuum to be filled, and the blood to be again
(and°necessarily  too,) injected into the arteries and veins
ofthe pleura.   Then,  when nature commences her efforts
 to relieve the oppressed organ, the pain, as an unavoidable
consequence,  returns.  If the doctor is present, he bleeds 
so
 again, and gives relief for the moment in the way before ex-
 plained.   Should nature once more be able to make an ef-
 fort, as sure as the doctor finds it out, he  bleeds.  Now  if
 anyone wishes to know the result of such  practice, let  him
 call to his mind the cases  of pleurisy which  he knows to
 have been treated in this manner, and then tell me,  if such
 patients have not been doomed to a speedy dissolution, a long
 convalescence, or to a slow, sluggish and  ineffectual fever,
 ('.crmed by  the  books, typhoid pneumonia.) or in simple
 language disease of the lungs, accompanied with the  inef-
 fectual and puny efforts, which nature makes after being
 deprived of her strength.
   The result of what we have said upon bleeding in cases
 of pleurisy is, that pain in all diseases is a consequent and
 unavoidable symptom;  that the degree of pain will be pro-
 portioned to  the degree of sensibility in the affected part,
 and the extent of the disease; that pain  may be relieved^
 without removing disease, and that in all  these cases there
 is danger  that  the  relief  is  purchased at too dear a rate;
 that bleeding though it may, and frequently does give tem-
 porary relief, never fails to add strength to the disease by
 weakening the vital powers of the system;  that there is no
 more propriety for bleeding in cases of pleurisy, than in any
 other inflammatory  affection  of the internal organs.  In
 cases of severe falls and bruises, it is customary for  physi-
 cians to bleed immediately- and the custom is sanctioned
 by the  common consent of thousands;  but we  appeal to
 those physicians of modern education, for a refutation of
 this practice; they know it is condemned by the greatest and
 best authors on modern surgery.  When a blow  or fall is
 first received, it  produces general  oppression, which can
on y be obviated by a reaction; bleeding protracts the inter-
 val between the reception of the injury and the commence-
 ment of the reaction or  fever, and necessarily  renders the
reactive effort less effectual  when it does come on.
   Authors have recommended that bleeding be  delayed till
 a reaction takes place, and then let the bleeding be in pro-
 portion to the  strength of the reaction.  We would strongly
 recommend, that in all such cases, bleeding be  delayed till
reaction takes place, and then (unless we presume to know 
81
more in such matters than the Governor of nature's laws,)
not bleed at all.   The equilibrium of the circulation is de-
ranged or destroyed by the blow or fall,  and the reaction
or fever is all that can restore it.  Those physicians, whose
practice it is to bleed in cases of concussions from falls and
blows, are either self-sufficient in knowledge, or else their
minds have not kept pace with  the acknowledged improve-
of their science.
   Dr. Thatcher, (a warm advocate for the practice of bleed-
ing,) speaking of it under the head of the general treatment
of fevers, says, a cautious and  deliberate consideration of
numerous and variant circumstances, is requisite in  deter-
mining on the propriety of abstracting blood from the gen-
eral  system in fevers, since the diminution of that fluid,
which is the immediate pabulum of life, cannot be a matter
of indifference to the constitution; if it be the most powerful
means of influencing the vital actions, so it is the most dan-
gerous, when improperly employed; if the most effectual  in
diminishing excitement, it is consequently the most apt to
exhaust the vital energy.  We have no infallible index to di-
rect us; it is impossible, from the state of the circulation in the
fever, to point to any certain criterion for the employment
of the lancet; the state of the pulse is often ambiguous and
deceptive.  These  circumstances  require the  nicest dis-
crimination, as the result is often very different in cases
seemingly analagous.   A precipitate  decision is  fraught
with danger, and a mistake may be certain death.
   Typhus,  which  is  the fever most prevalent in our cli-
mate, under all its modifications and forms, is attended with
great general debility; and as exhaustion of vital energy
soon ensues, it is obvious that to diminish  the quantity of
the vital fluid, must be to increase that dangerous state  of
the system which accelerates the fatal termination.   Vari-
ous, therefore, are  the circumstances to be taken into view,
and great is the diversity of opinions to be examined,  in
order to a rightdecision of this difficult point in practice.
   It is admitted here by Dr. Thatcher, that there is no cer-
tain criterion,  whereby we can determine the propriety  of
bleeding,  and in  this  sentiment we  must cordially agree
with him; for  it appears to us  impossible  to point out the 
S2
 propriety of a practice which has no propriety in it.   lie
 says also that it, (bleeding)  is a dangerous practice; that
 many circumstances are to be taken into the account in de-
 ciding the point;  and  from  what  he  further tells  us, we
 would think that even the best qualified and  most experi-
 enced  might sometimes make a mistake, come to an incor-
 rect conclusion and thus hasten the fetal termination.
   But if this language of Dr. Thatcher's be true, respecting
 the obscurity in which his  supposed propriety of bleeding
 is involved, can wc  reasonably suppose that the superfi-
 cial knowledge, and of course non-experience of the young
 medical fops, or rather self-styled regulars, who arc poured
 forth upon the  world, with their unbounded confidence  in
 calomel and the lancet, are  sufficient to direct them  to a
 proper decision of this point  of practice?  No, they arc not
 qualified to decide, according to Dr. Thatcher's own senti-
 ments.   Our reader will, we  think, conclude with us, that
 physicians, especially the young, who have not yet learned
 the bad effects  of bleeding by  experience, do  frequently
 make "precipitate decisions  which are fraught with danger,
 and mistakes  which may  be certain death."   But what
 must be the consequence of that  indiscriminate  use of the
 lancet and calomel, which is practiced in the southern states
 by planters and overseers, who are as little acquainted with
 the science of medicine, as a native African is with that of
 astronomy or  navigation.  (Jan  the  consequence be any
 other than thatof hutnan sacrifice?  This must  be the ine-
 vitable result.
   Then we ask of our candid  reader, will you  adopt the
 practice of bleeding, and for  any little indisposition, which
 you may feel, run the risk of having part of your very life
 taken from you?   If  physicians will persist in a practice
 which is so destructive to  life and so repugnant to reason
 and common  sense, will  you not rather act and  think for
 yourself?
   We shall here give a few remarks on the subject of blood-
 letting, made by the learned and experienced Dr. J. F.
 Daniel Lobsteiu, of the medical faculty at Paris, late physi-
 cian of the military hospital  and army of France, member
of the medical societies of Philadelphia, of the city of New
k 
York, of Massachusetts, of Maryland, of Lexington, (Ky.)
of New Orleans, of Pittsburgh, Pa.,of many others of Eu-
rope, and of several learned and benevolent societies of the
United States, author of several works on medical and lite-
rary subjects, physjcian  and practitioner of midwifery  in
the city of New York.
 "For the life of the flesh is the blood." Lucretius, xvii. 21,
"A long time has elapsed, since I determined to publish my
remarks on the pernicious  effects of bleeding, which not
only during that time, but especially at present,  is consid-
ered as almost a universal remedy, and frequently resorted
to as a restorative  in the slightest  indisposition; notwith-
standing the direful consequences attendant on such prac-
tice, it continnes to be the main pillar of the medical  profes-
sion.   Were bleeding and mercury  totally  prohibited, a
great many physicians would find  themselves in the inex-
tricable mazes of a sad dilemma; their time easily disposed
of.   It is astonishing to find that so many persons, and still
more astonishing, that so many physicians have  fallen into
this extravagance.   Blood, as the most precious  matter for
life, is lavishly squandered where there is no necessity; yes,
often without knowledge for what purport.
  "My remarks shall therefore convince my fellow-citizens,
that so far from blood-letting being  beneficial, it is produc-
tive of the most serious and fetal effects.  Should I contrib-
ute by these remarks, to save more lives in future and arrest
this cruel practice, I would feel that gratification,  which ari-
ses from the  consciousness of having performed a good act.
How much is it to be regretted that  such an awful  scourge
of humanity should exist.
   "During my residence of fourteen years past, in this hap-
 py country of liberty and independence, I am bound to say
that in all my practice of twenty-seven years as a physician,
never have I seen  in  any part of Europe, such extrava-
gance of blood-letting, as I have seen in this country. How
many thousands of our fellow-citizens aresenttoan untime-
 ly grave! how many families deprived of their amiable chil-
 dren! how many husbands deprived of their lovely wives!
 how many wives of their husbands, who have fallen victims
 to bleeding, and the same may be said of mercury.   W e no 
more count the loss of blood, (by bleeding) by ounqes, but
by pounds.   Each head-ache, each indisposition, is among
physicians  quite a sufficient  pretence to say, "you mutt
be bled."   In the blood  is the human life; in the blood is
placed the strength of the whole organic life; without blood
there is no heat, no motion of the system; yes, take away
from the brain  the blood, and the self cogitative powers
will be instantly extinguished.
   "Is it not evident that the most robust persons, are such,
heccause rich in blood?  Certainly it is not such  persons
who are attacked with nervous weakness.  Strength and
blood stand always in direct relation.   He who takes blood
from the patient, takes away not an organ of life, but a part
of life itself.
   "In burning fevers, it is by numerous experiences proved,
that the most simple fevers, by bleeding, become nervous
and putrid  fevers, of which I can attest many such instan-
ces.   In pure gastric fevers, bleeding is always pernicious;
it does not  vacate the diseased matter which is situated in
the intestinal canal, and  can only  be removed  by gastric
remedies, while bleeding in  such  cases vacates a part of the
strength which is necessary to be acted upon,  in order to ex-
pel the disease.
   "I desire it not to be forgotten, that in regular gout, the
inflammation is  nothing else than a crisis, a local metastasis,
by which a dangerous stuff from the internal parts is thrown
to  the external.  Nothing  takes more of tho necessary
strength away, than bleeding; and  the conclusion is, either
the attack of the gout disappears directly, and the disorder
is thrown internally, or to some dangerous part, as the head,
the lungs,  &c.   Hence  arise inflammation of the lungs,
apoplexy, or inflammation of the stomach.
 "In nervous affections, bleeding is no remedy; the nervous
affection itself has from its  nature  with the  blood nothing
common; on the contrary it arises from a defect of the blood
and of weakness.  I have seen during my residence of nine
years in Philadelphia, many ladies with nervous affections,
and of such, four highly respectable ladies, whose physician
I had the honor to be.  Their former physician, in all slight
indispositions, ordered them  to be bled; whereby they be- 
85
came more and more nervous, and  those  had no nervous
attacks, when I stopped the bleeding.  I treated in a simi-
lar manner, a very respectable lady in Philadelphia, who
was  attacked with a very severe pleurisy, and 1 saved her
without  bleeding, which to many  in  that city was  very
astonishing.
   "It is alleged that the climate of this country requires in
all indispositions,  to be bled; and 2d-  the  people of this
country are accustomed to be bled.  Let  us examine these
reasons.   How it comes to  pass that during my residence
of fourteen years in this country, I can prove by a great num-
ber of persons who have been  treated by tuc  during (hat
time, and in the same dissases in which such persons  were
treated by physicians of this country, who employed calomel
in great' quantities, blisters and  blood-letting,  cups  and
leeches to supererogation; and of all those persons who have
not fallen victims to such  treatment, their  convalescence
was  very long before they could  obtain a little strength.
Ladies who were  very nervous tormented  wi  h hysteric
spasms.   The former recovered by my treatment, in a very
short time, and the  latter  as I dispensed wish the  use of
bleeding, lost their spasms and became directly  better; all
which lean satisfactorily prove.
 "Where I have not employed bleeding, such persons recov-
ered by my treatment in a very short time.  If now the
climate of "this country should require in  all  indispositions
directly to commence with  bleeding, and  I have neglected
it  all these persons were inhabitants  of  this country  and
el'imate;  all.these should  have died, but they recovered
sooner.                                        .   ,. ,
 "2   That people in this country are accustomed to be  bled,
this is a true, a very true verity; but what is ihe true reason
of it? Whether is it the patient or the physi, nn? I believe,
to speak  with justice, itis the latter. What does the patient
know of what is convenient  for him?   He compaunsot
headache, ciamps in the stomach,  cholic, dyspepsia, &c,
he sends for his physician in whom he very !:,e  y has con-
fidence; he thinks'that all that isordere 1 h.n. will e eonve
nient fo'r him;  and the doctor after fee ing his pul*^i  ttfe
strong declares to him his severe sentence,  "you must be 
88
bled," and thus is a habit of bleeding established.  I know
very many cases wherein a physician has accustomed his
patient to be bled four times a day!  But time  proved the
result of such treatment by the death of a great  number of
such patients.  I am  certain that all  such persons who
have been bled a great many limes in their lives, their con-
stitution must become weaker every year, but their repent-
ance will in future be too late.
  "The duty of a true physician, who is  not  an  egotist,
is to answer to the confidence of his patient, to recover him
as soon as he can, and not by weakening remedies to pro-
long the treatment, which is probably the  principal cause
why a great  many  physicians employ such treatment, es-
pecially if the patient is able to pay, thereby to inscribe to
him a great number of visits, and the patient by this inten-
tion, afterwards falls a victim to tho  avariciou>ness of the
physician.   How many patients have perhaps been treated
by such an intention?  If the physician can persuado his
patient to be bled freely, if he do not soon die  under such
treatment, nevertheless his constitution is enfeebled and
becomes weaker every year; and thus the patient is obliged
frequently to call for his doctor, who has  the pleasure at
the end of the year to have a great many  visits inscribed
 to  his patient.
   "Such a treatment I shall never undertake, notwithstand-
 ing different physicians  would persuade me to  do it.  The
 quickest recovery of my patients, shall always be my great-
 est satisfaction."
    The above are the words  and sentiments of the distin-
 guished gentleman whose name we have given at the com-
 mencement  of the remarks.  We give them as his words,
 and we leave our readers, to  make  their  own commenti
 upon them;  observing  only,  that we  think  they deserve
 serious consideration; as coming from  one of such high
 standing in  the profession both in Europe and America; one
 educated in  the  old schools of blood-letting and mercury;
 one who against early prejudices and popularity  has come
 out boldly and independently in the cause of truth and hu-
 manity.   When a man  is thoroughly convinced that he is
  acting in a bad cause, it is the surest proof of his  goodness 
87
and magnanimity, to come out and enlist in a good cause.
The love of popularity and the pride of boasting ignorance,
has bound many as with fetters of iron, to a bad cause, and
induced thousands to misrepresent a good cause and do all
in their power to injure those who are innocently and devo-
tedly engaged in it.
  In noticing the different ways in which inflammation or
local fever may terminate, we mentioned mortification as
being the most unfavorable termination.   Under one variety
of circumstances, inflammation will end in resolution; under
another in adhesion; when influenced by others, it may end
in suppuration or the formation of matter, and when opera-
ted upon by other circumstances still less favourable, it may
terminate in mortification, or the death of the part.  Each
of the above named terminations, may be traced to an ade-
quate cause.  If a person of  sound constitution receive  a
wound, giving rise to inflammation, this inflammation, if not
prevented by art, will very probably  end in  resolution,  or
in other words, a restoration of the  form and functions of the
part, without producing disorganization, or organic lesion.
If the  constitution is less  vigorous, or if there should acci-
dentally be suffered to remain in  the wounded part some
foreign or extraneous  mdtter, suppuration will be  likely to
ensue.   But  if  the individual should be labouring under
much debility at the time of the reception of  the wound  or
soon after, whether this debility be depending upon former
disease or excessive depletion, we may reasonably conclude
that in such a case mortification will be  the  result.  How
many cases of mortification have been produced by the de-
bilitating effects of blood-letting?  Any man possessing but
a moderate portion of common sense may see how bleeding
is calculated to produce mortification.   No part can keep up
its action any longer than it retains its  power to act with.
It is well known that mortification is most apt to  occur to
the aged, and such as are much debilitated by the effect of
unwholesome food and  bad air.
  It is also known, that except in cases of local disease,
mortification more commonly happens in parts most distant
from the centre of circulation, in the extremeties where the
powers of life are weakest; all going to prove that debility 
s8
 or diminution of vital action is the immediate cause of mor-
 tification.
   Improvement in  surgery consists primarily and  more
 essentially in lessening  tho  necessity  of  operations, and
 secondarily, in ascertaining the easiest and safest  mode of
 operating, w lun the first object fails to be accomplished.
   We. as in :Jical reformeis proles*, to  have discovered a
 plan of treatment  for local fevers,  which shall in general
 prevent the  occurrence  of mortiiieation, and thus  obviate
 the necessity of surgical  operations.  We know full well
 that  he  wh > skilfully amputates a limb, gains much ap-
 plause; but we think  that the reward of him, who so treats
 the disease as to remove it, and  thus save the limb,  is much
 greater an.I far more desirable, since it consists in the pleas-
 ure arising  from the consciousness of having done u useful
 and good art; though by this it should not be inferred there
 is no good in the  former act; but  we are apt to judge of the
 rectitude of actions, as we do, that of people; viz: by com-
 parison or analogy.
   We might say much more upon  the  subject now under
 consideration, without the fear of subjecting it to the incon-
 venience of even  a partial exhaustion;  but for the accom-
 plishment of our present object,  and in accordance with the
 brevity of this essay, enough has been said;  we feel confi-
 dent that our candid and  impartial  reader  will acquiesce
 with us in the following conclusion.
   That blee ling seems to be a bad mode of practice, let us
 view it on what side soever or in whatsoever disease. That
 it  is much better calculated to  make people sick,  if prac-
 tised upon them when they are  well, than  to make them
 well if practised on them when sick.  That it ought to be
entirely abandoned  by every physician.  And that if peo-
ple areso  partial to  it,as to be  determined  to r'sk it, they
should by  all means get bled when they are well and better
able to bear  the  loss  of blood.  That finally it becomes
every lover'of health and life, to study well into these things;
to ascertain  whe;her they be true or not. 
CHAPTER  XII.
OF MERCURY, AND ITS EFFECTS UPON THE HUMAN
                   CONSTITUTION.

  The preparation of mercury most in  use as a medicine,
is commonly denominated by writers on materia medica,
the mild muriate of mercury—calomel; or the sub-muriate
of mercury of the London and Edinburgh pharmacopozias.
This preparation of mercury,  (calomel,)  is said to  possess
many various and valuable medicinal properties; known in
medical language, by the terms, cathartic, laxative, altera-
tive, diaphoretic, expectorant, deobstruent, anthelmintic,
sialagogue. &c.  Though it is frequently given to act in
each of the ways above mentioned, yet it is most frequently
exhibited, with a view to obtain the benefits supposed to arise
  om its cathartic or purgative effects.
  But  before we proceed further to examine the subject
now before us, it may "not be improper to submit a few pre-
liminary remarks for the consideration of our reader.
  Since our remedial agents are generally confined to the
vegetable kingdom,  it may be thought by some, that we
possess some hereditary or innate  prejudices against miner-
als, and that on the other hand we  are prepossessed in favor
of vegetables.   To this idea we must answer, that whatever
may be our prejudices against the one,  or Cur preposses-
sions in favour  of the other, they  are all honestly and can-
didly acquired; they are founded upon that kind of science,
whose basis is fact,  derived from actual  experience and ob-
servation.  We have no prejudices against the name of min-
eral, and if articles  of the mineral  kingdom could be so used
as to contribute to the relief of suffering humanity,  without
at the same time subjecting the system to accidents or dan-
cers, the occurrence of which to it would be more intolera-
*   '                      8* 
00
 blc than  death itself, we would heartily unite with our
 professional brethren in the use of minerals; but when we
 have sufficient evidence to convince us that certain miner
 als, which are now extensively  used as medicines, exert u
 highly pernicious influence upon the constitution, and can-
 not be used in any case, even in small quantities, without
 danger, we are then obliged, in obedience to the demands of
 our own conscience, of justice, of love to mankind, and of
 moral duty, to denounce the uso  of them, and to use every
 honorable and laudable means in our power, to show to the
 world the evils consequent upon their use.
  By many English  und American physicians, calomel is
 administered for the cure of almost every disease, td which
 the frail system of man is incident.  Tho learned French,
 German and Italian physicians,  together with most all con-
 tinental  physicians, express much  astonishment at the
 abundant use of mercury by the English. The former only
 use it in  a few peculiar cases, while the latter exhibit it in-
 discriminately in almost every case! But, if possible, Amer-
 ican physicians are  still more  profuse in the use of this ar-
ticle, than the English. In cases of fevers, after having intro-
duced the treatment by bleeding, a quantity of calomel, com-
bined, perhaps with jalnp, is administered; it is given with
a view of obtaining its cathartic effect, and thus reducing the
action of ihe heart and arteries by  mercurial depletion.
But it is necessary here, that we make some inquiries into
 the natural  and chemical  history of mercury, since what
 little has been said, alone  relates more  particularly to its
 medical  history, that is, its character as given  in materia
 medica.  The  principal ore of  this metal, is the sulphuret
or natice cinnabar, from which  the mercury is separated by
distillation with quicklime or iron filings.   Mercury is a
 brilliant white metal,  having much of the color of silver;
 whence  the  terms  hydrargyrum, argentum vivum, and
 quick-silver.  It is liquid at all  common temperatures, sol-
 id and  malleable at forty degrees, and it boils and becomes
 vapour at about six hundred and  seventy degrees.   Its spe-
 cific gravity, compared  to  water,  is  as  13.5  to 1.—
 Mercury is sometimes adulterated with the alloy of lead and
 bismuth—a fraud easily detected by the want of its due flu- 
91
idity, and by its not being perfectly volatile, but leaving a
residuum when boiled in a platinum or iron spoon.   Native
mercury occurs in small globules, in most of the mines pro-
ducing the ores of this metal.  Mercury and chlorine, com-
bine in two proportions, and a protochloride and perchlo-
ride of mercury  are the results.  These compounds are
usually called calomel and  corrosive sublimate.  In the
London  Pharmacopoeia they have received the improper
names of submuriate and oxymuriate of mercury.
 Pkotochloride op JYlERcuKY.-This compound commonly
termed calomel, is first mentioned  by Crollins, early in the
seventeenth century.  The first directions  for i:s prepa-
ration are given  by  Benquin, in the Tyrocenium Chem-
icum, pub'ished   in 1608.  He  calls it draco  mitigatus.
Several  other fanciful names have been applied to it,
such as  aquilla mitigata,  manna mctallorum, panchyma-
gorum mincrale, sublimatum dulce, mercurius dulcis, Sfc.
   The most usual mode of preparing Calomel consists in
triturating two parts of Corrosive Sublimate with one of
Mercury, until the globules disappear, and the whole  as-
sumes  the  appearance of a homogeneous  gray powder,
which is placed  in a sand  heat and gradually raised to
redness. The calomel sublimes,  mixed with a little cor-
rosive sublimate,  the greater part of which, however, being
more volatile than the calomel, raises higher in the mat-
rass; that which adheres to the calomel may be separated
by reducing the  whole to a fine powder, and washing  in
large quantities of hot distilled  water.  Pure calomel, in
the form of a yellowish white insipid powder, remains.  It
was formerly the custom to submit calomel to very  numer-
ous sublimations, under the idea of rendering it mild;  but
these often  tended to the production of corrosive sublimate,
and the calomel of the first  sublimation, especially if a  lit-
tle excess of mercury be found in it,  is often more pure
than that afforded by subsequent operations.
   Mercury was regarded by the Greek and Arabian phy-
sicians as a violent, and  dangerous poison, and for a long
time was excluded from the list of medical agents; it was
however finally used as nn external application  for the
cure of certain affections of the skin; from this it gradually 
92
came into use as an internal remedy, against the plague. It
was mostly used in this way by noted empyrics.   The em-
ployment of it for the cure of diseaess, was prohibited for rt
long time by the government of France.   But for the cure
of some peculiardiscases.it was regarded and proclaimed
by many to be a specific. From this  it became more gener-
ally used, especially  by the Fnglish, until it has been car-
ried to that extent  in  which it is given in almost every dis-
ease, which comes  under the treatment of those physicians
who use it.   Calomel is defined to be a stimulating, irrita-
ting and  debilitating purgative.  In common  with other
cathartics, it possesses a specific quality, whereby it stimu-
lates the bowels to an  increased  action;  thus evacuating
their morbid contents, and giving rise to an abundant serous
discharge from  their  internal  surface.   Calomel appeals
also to exert a marked and peculiar effect upon the secretory
function of the liver; exciting this organ to unnatural and
excessive labour in the secretion of bile.  When calomel
is suffered to remain  in the  system  for  much time, under
favorable circumstances, as respects the action of the ab-
sorbents, it is carried  into the circulation, in which case it
has a strong tendency, (as many  know too well by  experi-
ence,) toaffect the salivary ghinds, the palate, the gums, the
tongue,and teeth.   It has been said by some physicians, and
indeed is as strenuously contended by many of the  fncultv
of this day, that in  order to broak an established fever, it is
necessary to produce salivation.
  But let  us examine this  proposition, and see whether it
stands upon reason, or whether it be  raised upon the unsta-
ble basis of bare assertion.   To break a fever is to remove
thecause which gives rise to it. Now wc would ask of those
who deal si liberally in calomel, how the cause offever can
be removed by salivation?   Dies the cause flow off with
the abundant discharge of  saliva, which happens in these
cases?   Does  all the morbid matter  of the system become
concentrated in the glands, and other parts about the  mouth?
Or does salivation  itselfcure a fever, or is it merely the sign
that a fever is broken because the cause is obviated?
   We are ready to answer that the process of salivation has
po tendency to remove the cause of  fevei; but that it is a 
93
symptom of a favorable crisis, brought about by the efforts
of nature, exclusive of any aid from calomel.  This latter
position, we shall now endeavor to prove by medical reason-
ing.   It is  well known to physicians, that, in order to pro-
duce a salivation in cases of fever, it not unfrequently  re-
quires the continued and repeated use of mercury for sev-
several  days, and  sometimes  for even several  weeks.
Whereas if a portion  of calomel be administered for  the
counteraction of some slight indisposition, it not unfrequent-
ly, (circumstances favoring,) affects  the constitution and
produces salivation in a greater  or  lesser deg-ee.  By  ex-
plaining the causes of these phenomena in  medicine, and
the manner in which they are brought about,  we shall prove
that  salivation is  only a symptom of a favorable  crisis of
the disease producing fever.
   1st. While  speaking of the action of the arterial and  ab-
sorbent systems, we observed that these  are antagonizing
powers; that is, when the action  of the  one is increased,
that of the other is diminished.   In fevers the action of  the
heart and  arteries is increased, and the action of the  ab-
sorbent system is uniformly diminished.  Calomel being
administered in small doses insufficient to produce cathari-
sis, and with the  intention of effecting a salivation, remains
in a state of inertia  in  the  intestinal  canal,  since  the
absorben's, which open upon the internal surface, are in a
state of inactivity, in consequence of the accelerated action
of the heart and arteries.
   The exhibition of the Calomel, being continued, must of
course cause and increased accumulation of it in  the  ali-
mentary canal.
   2.  So long as the fever continues, but very little, if any,
of the particles of mercury are taken into the circulation;
but when nature shall, unassisted, have removed the cause
of the fever, the high or febrile action of the heart and  ar-
teries subsides, and the  absorbent system takes on its cus-
tomary action.  Nature finding, to her disappointment and
regret, an accumulation of foreign, irritating and poisonous
matter in the bowels, orders the absorbents, (whose office it
is to clear the system  of unnecessary  and cumbersome
matter,) to take up the globules of  mercury, to carry and 
94
deliver  them to the different secretory  and excretory or-
gans, for the purpose of their removal from the system. The
mercurv, while taking the round of the circulation, comes in
contact  with the salivary glands, whose peculiar sensibility
renders  them extremely susceptible of its action.   A swel-
ling and inflammation of the glandsand adjacent parts takes
place; an increased secretion and flow of saliva soon follows;
ant in this slate the patient is said to  be laboring  under
mercurial  salivation.   But it h to be recollected that, previ-
ous to the  commencement of this state of salivation, the ac-
tion of the heart and arteries becomes slower and more reg-
ular, the skin becomes soft and moist, and  other symptoms
are present, indicating a restoration of action  throughout
the system.   The irritation ofthe mercury upon the glands
of the mouth gi\es rise to more or less of  local fever, which
sometimes,  by sympathy,  extends to  the whole system,
producing what is properly termed the mercurial disease.
  It is evident, that the calomel cannot with entire impunity
remain  for any  length of time  in the  alimentary  canal;
hence we may reasonably infer,  that  during the fever,
while it is accumulated there,  it is a source of oppression of
the vital powers, and  consequently brings on  debility; so
that the patient derives no advantage from the calomel, ex-
cept it operate as a cathartic; but  is obliged  to endure its
primary oppressive influence, and all the pain aud incon-
venience  of its secondary effect of salivation.
   Those of our readers,  who have had  their own systems
subjected  to a course of mercurial salivation, need  not be
told that it is a distressing operation in the first instance;
nor that it makes a deleterious and lasting impression upon
the system.
   This we hear from respectable and  intelligent people,
almost every day.  Hence, we say that it is time to aban-
don a practice, which under the most favorable circumstan-
ces, does  not produce as much  good as  another practice,
which is entirely void of danger.   We do not say that calo-
mel does no good in any case, but we  say that it is very
liable to produce bad consequences, and should be substitu-
ted by something equally efficacious in its remedial agency
and destitute of deleterious qualities. 
95
  We shall here insert some of the observations of James
Hamilton, M. D. Fellow of the Royal College of Physi-
cians and Professor of Obstetrics in the University of Edin-
burgh.  "Among the many poisons which have been used
for the cure or alleviation of diseases, there are  few which
possess more active and of course more dangerous power
than mercury.  Even the most simple and mild forms of
that  medicine exert a most extensive  influence  over the
human frame, and  many of its chemical preparations are
so deleterious, that in the smallest doses they speedily de-
stioy life.  When the  effects of mercury upon the human
system are accurately  investigated and duly considered, it
cannot fail to appear, that  infinite injury must accrue from
its use in many cases, and that whenever from Ihe nature
of the indisposition, violent remedies are not absolutely re-
quired, a safe substitute for so hazardous a medicine ought
to be found.   Preparations of mercury, exhibited either in-
ternally or externally  for any length of time,  increase,  in
general, the action of the  heart and  arteries, and produce
salivation followed by emaciation and debility, with an ex-
tremely irritable state of the system.
   "These effects of mercury  are  expressly mentioned or
virtually admitted by  every author, ancient and modern,
who has uirectedits use, and it must appear very extraor-
dinary that their full influence should have been hitherto
misunderstood or at least not sufficiently regarded.  Accel-
erated circulation of the blood in consequence of the use of
mercury, is attended with the most  obvious of the circum-
stances which arise from inflammation.
   "Reasoning upon the subject it might be concluded, that
 if there bean inordinate  action of the heart and arteries,  at-
tended with an altered state of the blood  and with debility,
 while the increased secretions accompanying the inordinate
 action  have  no tendency to allay  it, the health must be
 rapidly undermined, and  if  there  be ulcerations in any
 part of the body, they must as certainly degenerate into ma-
 lignant sores, as blistered surfaces or scarifications mortify
 in cases where the living powers are much exhausted.  Ex-
 perience has proved the reality of these conclusions,  but
 prejudice and inaccurate  observation led many practition 
96
 era of deserved reputation toattribute those effects of mercu-
 ry to other causes.  From tho cases reci'o.l by  Dr. Black-
 all, there is reason to boheve, that the  inflamma'ory diath-
 esis induced by mercury, may continue for a very consider-
 able time after the mercury  had  been  laid aside, and with-
 out any manifest si:ns.
   When inJi\ i.lua!s in this state arc subjected tonccidcntal
 exposure to cold, or indulge in irregularity in living, a vio-
 lent and anomalous  indisposition  takes place, which is apt
 to terminate fetallv,  or to occasion a broken state of health.
 In  some cases of salivation, besides the ordinary ulceration
 ofthu guns, an I loosening und final separation of the teeth,
 the tmgue, moveable  palate, tS_c, swell anJ ulcerate to &
 frightful degree.
  "Mr.Benjamin Bell ol serves, that besides the usual symp-
 toms of fever, ''mercury is apt to excite restlessness,anxiety,
 genera! de! i!i'.\, and a very distressful irritable state of the
 whole system.   The cjnsequenccsof  this rlfect  upon the
 nerves, are differ i»L upon  different  individuals.   In some,
 temporurv deliii im takes place; in others, palsy or epilepsy
 supervene; and  in many,the memory  and j idgment arc
 more or  less permanently  impaired.  Instances, too, have
 occurred, where sudden death has supencned, apparently
 in consequence of a  very trifling excr.ion or agitation."
   "Mr. Pears.')n has well described  such  cases  under the
head of erelhismus.  lie says, this slate is characterized by
great depres.-ion of strength or sense of aii'.iety  about the
precordia, irrcg.ilar  action of the heart,  frequent  sighing,
partial or universal trembliag; a small quick and sometime!
intermitting pu!: •, occasi.nal vomiting, a  pale contracted
countenance, a sense of coldness, &,?."
  Aiinng the anomalous complaints dii- ing from this causae,
(viz: mercury,) may  he enumerated, impaired or capricious
appetite for fjjd, with all the ordinary symptoms of indiges-
tion; particulary retching in the m aimig and flatulency,
disturbed s!c ■.>, wi a  frightful  dreams, impaired or depraved
vision., frequent aches  and pains in different  parts of the
body; occasionally such suddei failure  of strength, as if just
dying, and at other timps, evident palpitations at the heart,
accompanied with difficulty  of breathing.  Dr. F ilconar 
97
iays, that among the ill  effects produced by  Calomel, it
tends to produce tremors and palsy and not unfrequently
incurable mania.  Mental derangement with eventual fa-
tality has sometimes followed a course of mercury; and the
probable reason why it does not do so more frequently, is
that the irritable state of mind which usually precedes actu-
al derangement commonly alarms the attendants and leads
to active precautionary measures. Another consequence of
the use of mercury is a  very violent affection of the skin,
originally hinted at by Mr Benjamin Bell, and more  lately
particularly described by Dr. Alley of Dublin, Dr. Spens,
of Edinburgh,  and Mr Pearson of London.   Experience
seems to prove that mercury may remain in the system in a
state of inertia for a considerable time, and  afterwards by
some inexplicable circumstance may become active  and
produce its specific effect.   The  ordinary mode of exhibit-
ing mercury for the cure of chronic hepatitis or common
liver complaint in this country, not unfrequently hurries on
the disease, or by impairing  the constitution, lays the foun-
dation for paralytic affections, and it may be truly affirmed,
that it thus often shortens life.  That  there are many indi-
viduals v ho have often  with impunity taken calomel as a
purgative,  is not to be denied; but it is equally true,  that
extreme irritability of the stomach and bowels, ulcerations
of the mouth, with caries of the teeth, dropsy, epilepsy, and
various other modifications of disease, have  followed the
use of that preparation.   Ir. several cases,  the author has
decidedly ascertained that ulcerationsof the villous coat of
the intestines in infants and young children, have been in-
duced by the frequent repetition of doses of calomel.
  Had these injurious effects of calomel upon delicate con-
stitutions been  hid from the rest  of the profession,  and
known only  to  the author, some  apologymight be offered
for the pertinacity with  which that  medicine is still pre-
scribed; but so  feris this from being  true, that it maybe
confidently  asserted,  that no medical  man of competent
knowledge and observation,  could administer calomel as a
purgative in a hundred instances, without being convinced
of its injurious tendency. Of this, innumerable proofs could
be cited; but it is sufficient  to appeal to the testimony of 
08
professor Carlisle and of Dr. Blackall. "That grn-emen,"
says Mr Carlisle, "should violently persist in directing large
doses of calomel, (and I consider any dose above four grains
to be large,) and order these  doses to be daily  repented in
chronic and debilitated cases, is passing strange; men start-
ing into the exercise of the medical profession, from a clois-
tered study of books,  and  from abstract  speculations; men
wholly unaware of tho fallibility of medical evidence, and
unversed in the doubtful effects of medicine, may be them-
selves deluded, and delude others for a time, but when ex-
perience has proved their errors, it would be magnanimous
and yet no more than just, to renounce both the opinion and
the practice."
   It appears to us, that the above remarks of  Dr. Hamil-
ton, and others of the profession, whose  names  are  given,
contain  much truth, which will be  responded by  the experi-
ence of many of our  readers.  We deem it unnecessary
to make any comment upon these  observations, since they
are so plain and evident  that  every  one can comprehend
them and draw his own inferences.   It is  not  unusual for
many physicians, (when any doubts are expressed by those
interested concerning the safety and propriety of  taking
calomel,) to say, that though mercury is  sometimes attend-
ed with  bad consequences, still it is the only remedy which
will save life in certain cases; and rather than die, it would
be better to run the hazard of taking it.
   Now  it must be acknowledged that this is  no moro than
bare assertion, and though it  has  been  an argument suffi-
ciently strong to induce thousands to take mercury at the
expense of their  own health and life, still  we are disposed
to think that such arguments will not convince the thinking
and intelligent mind.  We are not fond of suspecting the sin-
cerity of men's opinions; but when we hear men say that in
certain cases  nothing will  prove effectual except calomel,
and then in these very cases, see them resort to  some other
means, such as croton oil or some  other vegetable produc-
tion, we are  compelled to suspect their siuccrity.   As an
instance of the inefficiency of calomel for the relief of some
diseases, we will relate the circumstances and treatment of
a case of bilious cholic which occurred  about a year a^o, 
99
in the northern part of Ohio.  A gentleman was attacked
with the ordinary symptoms of bilious cholic.  A physician
was sent for, who commenced the treatment by administer-
ing a large  dose of calomel—it had no  effect—the dose
was repeated and repeated, till in the course of about three
days, the doctor acknowledged that he had administered to
this patient two ounces of calomel and fourteen drops of cro-
ton oil; all this  had  been given to no purpose; the patient
grew worse, the friends became alarmed; and upon expres-
sing their fears to the doctor, were told by him that ihe case
was desperate,  and the only chance would be to give more
calomel.  As it seems the friends had common sense enough,
to convince them, that two ounces of calomel were as much
as could, under the most favorable circumstances, be pro-
ductive of any good, and that inasmuch  as no advantage in
this case had been derived from calomel, they were unwil-
ling that  any more should be given.  They were all at a
loss to know  what to do, if they should  send for another
doctor of the regular faculty, they had no reason to doubt but
that he would pursue the same regular course of giving
calomel, as the  one had done, whom they had already em-
ployed, he  himself being a regular doctor; as  any   one
must know from his having given two ounces  of calomel.
At several miles distance, there lived a steam doctor, who
was quite successful in curing diseases, but he did not fol-
low the fashion: and to  employ such a man for  a  doctor
would bring a lasting disgrace upon the whole family, be-
sides incurring the particular ill will of the faculty.  It was
no time for protracted deliberations.   Something must  be
done soon.  The patient was  convinced that unless some-
thing could be done for his relief, different from what had
been done, he must  soon  yield  to a dissolution.   Under
this conviction  he came to the unreasonable conclusion,
that of two evils it is best to choose the least: that rather than
die, he would send for a steam doctor!  The humble steam
doctor came, without any calomel or lancet; poorly equip-
ped indeed to combat disease;  but his means, though seem-
ingly weak, were irresistibly strong; because they ran par-
alfel with the steps of nature in the cure  of disease.   In  the
course of a few hours, the patient was essentially relieved, 
100
and in about two days  was able to be up and about.   The
above statement is given upon good authority, and can be
proved, to satisfy the doubtful.
  It would be well for thus:: physicians, who talk about tho
inefficiency of vegetable medicines, to  tell us why thoy ro-
sort to the usa of croton oil, where calomel fails. Perhaps it
will be as difficult for sjmo of them to answer this question,
as to tell us the propriety and goodness  there is in thocourse
which samaof thcni take in regard to the reforms J practice
of medicine. Many of them condemn this practice, and call
those wlu fellow  it a set of  quacks,  ignorant of medical
science,  an J  devoid of the  commm feelings of humanity.
In speaking to others of the practice, they represent it as a
 ystom of practical  nonsense, and base imposition.
  Njw it can be proved that these very men, soma of them,
have availed themselves of the advantages  of the  reformed
practice, so far as maro  accident has placed it within their
knowledge; and this they  have done too, incases where
their own practice failed; thus tacitly confessing in private,
tho superiority of the reformed practice, and taking  every
opportunity in public, to injure its honest goad reputation.
  We have nothing to say against these man, because they
follow our  practice; on the  other hand, we are glad that
thoy avail themselves of this maans to  relievo thesutferings
of our fellow-man;  for  it is evident that men whase profes-
sion it is to relieve the sick,  should have a knowledge of
the3afest and surest means  to do it.   We only say that it  is
ingratitude in tham  to use the maans which they obtain from
us, anl than to slander and  abuse us and our practice, be-
cause we use such means.  We acknowledge what tho reg-
ular fe;ulty say in regard to  calomel  being a powerful ar-
ticle; an J to strengthen their evidence of this fact, we  will
relate a striking example of its herculean powor,  which ex-
hibited itsslf in tho constitution of a srnill child.
   Tin circumstances areas fellows: A child in  tha  town
of-------was taken sick  in the evening; it had a high fe-
ver, &/2. The parent?, though usually in tha habit of em-
ploying  the r^g ilar ca!om9l doctors, concludad  that they
would now,  for the first time, try  what virtue there is to
be found in vegetable medicine.   They accordingly called 
101
 in a Botanic doctor, who after inquiring into the case,  left
some medicine, and gave directions for its exhibition.  He
left, and the medicine was given as ordered, and had the
desired effect.  The next morning, the doctor called to see the
child, he found it running about the room, engaged in eating
apiece of bread, which it held in  its  hand.  Notwithstand-
ing the favorable situation of the child, the parents expressed
some fears concerning it; thinking that it had got well too
soon, for one so sick as it appeared to be, and that its appa-
rent health was only illusory, and  would last but a short time.
The doctor  assured them that the child was well, and that
it was unnecessary to give it more medicine.  The Botanic
doctor then left; and in a short time the parents called in a
regular doctor, to learn  whether the  child  was well, or
whether  its health was only  apparent.  The doctor after
makingsome inquiries and ascertaining that a Botanic doc-
tor  had attended, assured the parents that the  child was
very far from being well, that the fever would soon return
unless something was done to prevent it.  This was what
they expected; the  doctor  was  engaged to treat the case.
He commenced his treatment regularly, by giving a dose
of calomel, and ended it as regularly by giving a dose of the
same; but from the commencement of this regular treatment
the child grew worse regularly. It lay  seven weeks, most of
the time, in  a helpless  and  distressing situation.  It was
subjected to a regular  course of cooling powders, which
produced a severe  salivation, giving some grounds to sus-
pect that the cooling powders  contained some calomel. The
mouth, gums, lips and cheeks were literally destroyed by
mercury; and the prospect was  no other than that  of the
grave. At this time, and while the child was in the  above
described situation, the father of the child, went for the same
Botanic  doctor who  had treated  and cured the child in the
first instance. The doctor, with much reluctance, consented
to go; and after using rational means for a short time,  the
child got better, and finally recovered, with a disfiguration
of the face, which would ever after  render life a burthen.
Here  is  evidence of the power of calomel.
  This is the substance of the account which  we received
from the mouth of the Botanic physician who treated the case
                          9* 
102
and who sustains a highly respectable  character both  for
general intelligence  and christian  virtue  Mnny more
cases of a similar kind, might be related, but wo shall only
ask the indulgence of our reader, while  wo submit a  few
remarks more upon this subject.
  It 13 a common practice  to administer mercury or calo-
mel, to children  laboring under an affection characterized
by, at first, the usual symptoms of common cold or catarrh,
followed by a scarlet eruption upon the skin, a swelling
of the glands of the throat, oppression of tho brain, &c. cal-
led scarlet fever in the books.   Now every physician should
know, that in this disease there is a peculiar and strong ten-
dency to diseased action in the glands  of the mouth, and to
functional disturbance in tho brain.  It would also seem that
an uncommon quantity of the morbific poison, giv ing rise to
this affection of the system, is determined to the above named
parts, but  not till a partial subsidence has taken place in the
fever of the general system.   Here it is evident that the ir-
ritation produced by mercury upon the salivary glands must
add much to the affection of these parts, induced us a natural
consoquence ot the disease.  It must a'so increase very much
the danger of inflammation of the brain, or lather  tho  dis-
ease which causes this inflammation.   For if the irritation
produced  by the mere  extraction of a tooth be  sufficient to
induce an inflamed brain, huw much more might we expect
this result, from the extensive irritation excited bv salivation ?
 Again, the action of calomel upon  the internal surface of
 the bowels is that of a powerful chemical and mechanical
 agent, irritating  these parts st> much, as to determine so
 large a portion of nature's efforts to the rcg ilation of this
 difficulty, that an insufficiency is  left to act upon the exter-
 nal exhalents, for the removal of the morbid matter from the
 system.  Here  we would  remark that  the  eruption  upon
 the skin, in cases of measles, small-pox, saarlet fever, (as it
 is called,) and all other cxanthematous diseases, is caused
 by the determination and lodgment of the poisonous matter,
 which is  the immediate operative cause of the disease.  Tho
 inflammation of the skin is the process which nature takes
 to expel the poison, when it has reached the skin, and should
 this salutary process be checked by improper medical treat- 
103
meat, or by unforeseen accident, then a reversion of th«
poisonous matter takes place; that is, it recedes from the ex
ternal surface, to the internal organs; and in this way some-
times proves fatal.  This is what the good old women call
the striking in of the measles, &c; to prevent which, they
give warm teas internally, and apply external warmth; so
that in this  circumstance as well as in a thousand others,
they manifest their good sense and experimental knowledge
so conspicuously, that even the learned  regular  doctor
might learn an important practical lesson from this source.
How many children who have fallen victims to calomel, in-
stead of scarlet fever,  might have been saved by the more
rational treatment of some  good old lady.  Bat says our
reader, you would not have it, that the old women are more
successful in treating scarlet fever, than the regular doctors?
Yes kind reader, this is just the way we would have it; be-
cause this is a notorious fact, to which thousands will bear
testimony; and the reason is plain, because their remedies
act more in accordance with the course which nature takes
to cure disease.
   In cases of common  continued fevers, calomel is exhibited
in small and repeated doses for a considerable time, in order
to obtain its specific effect upon the  constitution, which is
indicated by the common symptoms of salivation.   In  this
way calomel is frequently administered  under  disguise, in
order to deceive the patient and friends; or in other words, as
the doctors say, to take advantage of the patient's and friends
prejudices.   In this way it is given in the name oicooling
powders, and thousands have been subjected to  this mode
of cooling treatment, and been continued under it, till  they
have been cooled into the cold embraces of death!  Beware
then, of cooling powders, since they act in direct opposition
to nature.   We know full well,  that the increased heat of
the system in fever,is  uncomfortable to the patient; butitis
but a natural consequence  of the increased action of the
 heart and arteries; and as we have before said,  this action
is indispensibly necessary, so long as the disease continues.
 For the sake of the real good, let us bear the apparent  evil,
 with patience.  It would be folly to complain of the sun, be-
 cause bis intense rays dazzle and pain our eyes when wq 
101
 look at him.  In the treatment of the common summer com-
 plaint of young children,calomel exerts an extremely dele-
 terious influence; and to conceive how this is the case, it is
 only requisite, that wo consider the nature and properties of
 the article, and the delicate organization of the parts with
 which it comes in contact.
   Every one at all conversant with  the  science  of  life
 knows that all the organs of the infant, are of extremely del-
 icate texture; their structures are less able to withstand the
 influence of feieign or  extraneous irritants, than the same
 structures  in adults; that their food  must be of die mild, and
 unirritating kind, to correspond with the weak powers, and
 highly sensible state of their stomach; that like the young
 and tender plant, it requires that their treatment, both in a
 physical and medical sense, be gentle,  mild and attentive.
 Now,  notwithstanding the apparent fineness  of the com-
 pound particles of mercury, sill when viewed with a micro-
 scope, they present sharpcutling edges and angular points.
 In this magnified state, they present their real shape, though
 not their true size; for  however  powerful the magnifying
 quality of the glasses  may be, it is impossible  for them to
 give form and appearance to mere nothing.   Then it must
 bo admitted that by the aid ofglasscs  we can learn the form
 of these small panicles of mercury; and since it is a physio-
 logical truth that the solvent powers  of the gastric juice,
 cannot change the form or quality of such substances, it is
 very  evident that the tender organization of the internal
 lining  membrane of  the  infantile alimentary canal, must
 undergo more or less of disorganization  or decomposition.
 Instances are on medical  record,  which fully substantiate
 this doctrine.  Thousands of young children have been sent
 to the dark and dreary mansionsof the dead, by beingsub-
jected to the violent and decomposing  influence of mercury,
 who might  have been saved by mild and rational treatment.
 How long  shall  this custom of human sacrifice to the  mer-
 curial god be continued in this civilizsd  and enlightened
 country ?
   Let this subject, in comnvn with others of less importance
 have a  place in the serious reflections of every parent—of
 every philanthropist.  Let no one who lays claims toscien- 
105
fcific knowledge, be destitute of a knowledge of the sciencs
of animal life, which is commonly termed Physiology.  It is
essential to the Preacher, the Lawyer, the Statesman, the
accomplished scholar, tha private gentlemen, and finally to
every one who regards his  life and health.   To  the physi-
cian this knowledge is indispensable, and if he has it not, ha
is more liable to  commit practical errors, which the world
may justly regard as inexcusable, and which will be record-
ed in tho public mind as errors of unpardonable ignorance.
  Dr,  Chapman of Phi'adelphiahas given it as his opinion
that  mercury is a common cause of chronic hepatitis or liver
complaint; and from its specific and powerful action upon
the liver, we  have no reason  to doubt the propriety of his
opinion.  The large quantities  of calomel which are admin-
istered in common cases of continued fevers, are directly
calculated toexhaust  the powers ofthaliver,and thus to pro-
duce in this organ functional derangement and chronic in-
flammation.  Many of the  most marked  and aggravated
symptoms which are indicative of what has been called bil-
ious fever, are brought on  by  the action  of tho mercury!
The biliary secretion of the  liver is  morbidly increased  by
the action of this mineral; a large quantity of bile is accu-
mulated in the hepatic acina or the biliary  reservoirs of the
liver.  Tfi8 debility caused by  this over action renders the
excretory vessels of the liver unable to carry off this super-
abundance of secreted  bile; the biliary absorben's which
open upon the interval  parietes of the biliary cells, act  in
relief of the distended cells,  taking up the bile, and carrying
it into  the circulation,  whence it is  deposited under the
skin and in the exterior coats of the eye.  This is what gives
riso  to the peculiar symptoms of bilious fever, and calomel
isoneoftha tmin exciting  causes, as above explained.
  Thi3 view of the influence of calomel will account in part
for tho great prevalence of liver disaases in tho Southern
and  Western States, where  mercury is given in such abun-
dance.   Bat it is said that  all that is said against the use  of
calomel  is the result of vulgar ignorance and prejudice.
This is  said  by many physicians especially the young
and self-knowing.  Now we would ask, are all who object
to tho use of this article, to be regarded as vulgar and iguo 
108
 rant?   Must a large number of highly respectable and in-
 telligent individuals  who denounce the use of calomel and
 tho lancet, be classed among the  ignorant and vulgar; by a
 ■et of young conceited and self-sufficient bigots in medicine?
 No, the prejudices of these individuals are the products of
 that knowledge  which  they  have derived from  sound  rea-
 son, and from careful  observation and long experience;
 these prejudices have  arisen from seeing the beauty and
 health of the young demolished by mercury and frequently
 their lives destroyed by blood-letting!
   Tho cause of medical reform, is the cause of the people,
 the cause of physical happiness, and the cause of humanity.
 We, who are engaged in it, view  it in this  light; and from
 this view of the subject  wc are constrained to persevere; to
 go forward, regardless  of the oppostion of those who con-
 demn every thing which is not popular; who would sooner
 support  popular evil, than unpopular good; who assumu
 the name of republicans, and deny every  thing like  trua
 republicanism in their conduct.  The efforts of such to in-
jure the cause, will prove as ineffectual, as falsehood against
 truth.   Such malicious attempts  to injirea good cause,
 never fail to fall, from the specific gravity of their own evil,
 before they reach the cause, towards which they are direct-
 ed; and  by the repulsive powers of good against evil, they
 are returned,  to reward the original giver.
   We shall now bring this part of our subject to a close, by
 merely remarking, that all we have said of the  use and ef-
 fects of the mercurial preparations, has been said in candor,
 and from that conviction of mind which has been produced
 by careful study and cool deliberation, and from experience
and observation.  Those  who receive the same impression
 from the evidence which is given, us  we have received;
 will think with us that mercury is productive of much  evil,
 in many cases where it  is exhibited as a medicine—that it-
 operation upon the human constitution is extremely delete-
 rious under many circumstances—that it is  not a specific
 for the cure of any disease, nnd  where other  medicines
 equally efficacious and  void of danger  can be used, calomel
 should be dispensed  with.  Now if our reader is not con-
 vinced of the  propriety of the above conclusions, we shall 
107
have no reason to censure him, but  we would merely 6ay
to him,  that further investigation may discover  new  lioht
and bring arguments into view which have heretofore been
behind the curtains of early education and prejudice. Truth
like gold, grows brighter by use, and its value will be the
more duly  estimated  as its utility is the more plainly dis-
covered.  Those who sincerely seek for truth, are such at
are in the love of it. 
CHAPTER   XIII.
OP THE USE AND EFFECTS OF ANTIMONY IN TUB
              PRACTICE OF MEDICINE.

   Artimomu^.—The etymology of this word is rather ob-
scure,  but that which is most  generally received, is anti
against,and monas a monk; because Valentine  by  (he ad-
ministration of it,  poisoned his brother  monks.  The most
abundant ore of this metal is  that in  whirh it is combined
with sulphur, the grayore,orsulphuret ol antimony.
   Tho color of antimony  isthat of a grayish white, having
a slight blueish shade; it  has a lamellated texture, and ex-
hibits plates crossing each other in every direction; its spe-
cific gravity is 6,  702; it is sufficiently hard to scratch all
the soft metals; it  unites  with sulphur and phosphorus; it
unites by fusion with gold, and renders it pale and brittle; it
forms several distinct compounds with oxygen.
   The preparation ofantimony  most  used in  medicine  ii
called antimonium tartarizatum or tartar emetic.  This  ii
prepared in  the following manner, according to the French
pharmacopoeia. 1st, a subsulphate ofantimony is formed by
digesting two parts ofsulphuret of antimony in a moderate
heat, with three parts  of oil of vitriol.   This insoluble sub-
sulphate being well washed, is then digested in a  quantity of
boiling water with its  own  weight of cream of tartar,  and
evaporated at the density of 1,161; after which it is filtered
hot; on cooling, crystals of the triple tartrate are obtained.
Pure  tartar emetic  is in colourless  tetrahedrons  or oc-
tahedrons.   Its taste is nauseous and caustic, boiling water
dissolves half its weight, and cold water, a fifteenth part.—
Sulphuric, nitric,  and  muriatic acids,  when poured into  a
solution of this salt, precipitate its cream of tartarjand soda,
potassa, ammonia,  or their  carbonates, throw down its 
109
oxyde of antimony.  When tartar emetic is exposed to a red
heat, it first blackens, like all organic compounds, and after-
wards leaves a residuum of metallic antimony and suhcar-
bonate of potassa.   From this circumstance, and the deep
brownish red precipitate, by hydrosulphurets, this  antimo-
nial combination may readily be recognized.
  Of all the antimonials, tartar emetic is most extensively
used, and it is also the principal emetic  derived from the
mineral kingdom.   It usually excites vomiting  in the dose
of a grain or a grain and a half, but the common mode of ad-
ministering it, is in divided doses, three or four grains being
dissolved in four ounces of water, and an ounce of this solu-
tion  being given every quarter of an hour until it operates.
In this mode of administration, it generally excites full vom-
iting, evacuating not only the contents of the stomach, but
inverting even the  motion of the duodenum, and either by
this or the compression exerted by the action of the muscles
on the abdominal  vicera, causing bile to be discharged; it
also frequently excites purging.
  It is an approved opinion among physicians generally,
that emetics stand along with the  major remedies for the
cure of many diseases, especially where these diseases are
depending upon derangement in the prima via or stomach.
  We have shown  in our former remarks in this work, the
way in which  emetics produce their beneficial  effects,  and
in this place it would be superfluous to repeat  it, since  it
is presumed that the reader bears it in his memory.  But
it will be necessary to say something more in this place, in
relation to some of the erroneous  notions,  entertained  by
many people, and  sanctioned by many physicians, either
from interest  or ignorance, concerning the incidental and
secondary effects connected with emesis.
  It is thought by some that disease or derangement of the
stomach is to be aseribed to the presence of bile in that organ
—that bile may gradually and imperceptibly accumulate in
the stomach to such extent or quantity as to render it indis-
pensibly necessary to resort to the aid of emetics  for  its
evacuation.  That personsuninstructed  in the anatomy and
physiology of the human system,  should indulge such no-
tions is not at all surprizing; but that physicians  claiming 
110
and professing a knowledge of the science, should attempt
to confirm these notions, is to  us a matter of supremo aston-
ishment.   Do not the physicians, who hold these ignorant
and puerile ideas, know that the bile is discharged through
the biliary duct, from the liver and gall bladder into the du-
odenum, and that there is a constant action'of the stomach
and duodenum from above downwards, w hich is termed pcri-
estaltic, which forces the contents of the above mentioned
organs downwards, and successfully  prevents the  bile or
any thing else which may form a part of the contents of the
duodenum from  ascending thro' the  pyloric orifice into the
stomach?   Do they not also know that this action cannot
be otherwise than from above, dow nwards,except it bo inver-
ted by the agency of emetics or some other causes which
produce the same effect, and that in ordinary cases of emcsis
the action of the stomach only is  inverted, in which cases
no bile is discharged; and that in severo cases of vomiting,
which are condemned by all prudent and well informed
physicians, not only the stomachic contents are discharged,
but those also of the duodenum and small intestines; and that
in such cases and such only,  is bile discharged by vomit—
that no cause  with which we are acquainted, (except that
of vomiting wherein the action of the stomach is  inverted,)
ever does operate upon the  system in such  maimer as to
produce the presence of bile in the stomach; and that when-
ever  the matter vomited exhibits a bilious appearance, it is
to be regarded as a symptom demanding a check put to the
vomiting—since in  this case, the action of the emetic has
become too general—has superseded  the limits  set by the
wisdom and judgment of correct observation and  experi-
ence? The physician who is not acquainted with the above
mentioned facts, may have an apology—a pitiful  apology to
make, for advocating the use of antimonial cme'ics, on the
ground that by their powerful action, they clear the stomach
of bile!  We call it but a pitiful apology, since to acknowl-
edge it, or to use it, is to confess a degree of ignorance, repug-
nant to common sense, and highly disgraceful to any mem-
ber of the profession; a degree of ignorance sufficient to
debar any  member of the faculty, the prerogative of claim-
 ing even an alphabetical knowledge of the medical science. 
Ill
To recommend the use oFthis mineral on the ground before
mentioned, having a knowledge of the facts  already stated
m relation to this subject, is to practice a species of base de-
ception and hypocricy, to promote self interest, or what is
still worse, to indulge in an  erroneous practice, merely  to
subserve the purposes of an ancient and beloved prejudice.
  We have been  asked by a practitioner and honourable
member of the faculty, (whose head had already been whit-
ened by the frosts of many a cold winter,) "whether medical
reformers were in possession of any vegetable emetic, which
would 'throw bile,' equal to tartar emetic!"  We must con-
fess, that  we think it much to be lamented that the medi-
cal fraternity  is partly formed of such ignorant members;
that so  many profess and  make  such high pretensions to
medical erudition, who are not  acquainted with the first
and most  simple elements of the  science.   Yet these men
pass the medical boards and obtain certificates of their exten-
sive acquisitions—in true science?   No, but in learned and
polished ignorance!
  The same erroneous idea is entertained by many in re-
gard to the superabundant accumulation of bile in  the intes-
tines and the absolute necessity of taking calomel "to carry
it off."  It is thought that calomel possesses some peculiar
power of removing bile, and that this bile is situated in  the
intestines, and is therefore the cause of disease.   Do phys-
icians sanction this belief?   Yes, they urge the use of calo-
mel upon this ground;  the idea, absurd and  unscientific as
it is, had its origin  amongst physicians.  We cannot ascribe
this error to the people any  more than we could a  thousand
other errors and  absurd  prejudices which 'are  prevalent
amongst them;  which originated in the ignorance of pretend-
ed science, and of which some of  the members of the medi-
cal faculty in the present day complain, as if they had  not
arisen from their  ow,n order.   It is very obvious that in
those diseases, which are generally considered bilious, there
is, so far from  being any bile in the stomach, a deficiency of
it in the intestines where it should be.  Owing to obstruction
or loss of action in the excretory ducts of the  liver, the bile
is not passed from the liver to the intestines, but is absorbed,
carried into the circulation and deposited under the skin,&c. 
112
   Then in this species of disease the  object of medicine u
 not to carry off, or evacuate bile from the stomach, which
 contains none, and from the bowels in which this fluid is de-
 ficient; but rather to arouse the action of the whole exhalent
 or excretory system; to remove any obstruction which may
 exist in the biliary ducts, and thus, instead of evacuating bile
 from the stomach  and bowels, to promote tho  flow of this
 fluid into the intestines,  where the office of it is needed and
 for the sake of health imperiously demanded.
   From what has  now been said, we think that every one
 can see that large discharges of bile,  whether it be from
 emetics or cathartics, are no recommendations of the propri-
 ety or utility of the articles given to produce this effect; but
 on the other hand these bilious discharges  are indicative of
 the excessive and dangerous action of such articles.
   Some other arguments which  have more solidity and
 logical strength, must be sought for in order to convince the
 intelligent, that calomel and antimony are necessary todis-
 chargc the bile.
  The grounds upon which Medical  Reformers renounce
 tho use  ofantimony or that preparation of it called tartar
 emetic,  arc the following, viz: That this  medicine,  when
 taken into the stomach, is exceedingly apt  to produce spas-
 modic pains or cramps, and that violent inflammation of this
 organ, is sometimes the result; these  grounds, we consider
 as furnishing tangible objections against the use of the article
 under  consideration.  We appeal to the  experience and
 observation of our candid and intelligent reader, to confirm
 the validity of the above objections.  The vegetable  king-
 dom furnishes emetics against which the specified objections
 above, cannot with propriety be urged.  These produce all
 the salutary effects arising from the use of emetics, and that
 without those incidental bad  effects  which arise from the
 use of mineral emetics.
   While prescribing emetics in the treatment of diseases,
 we are not unfrequently  told that our patient cannot under-
 go the operation of an emetic, and that he  would  about as
 soon run the  risk ofdying as to attempt it,  inasmuch as he
 had experienced such excruciating pain from their opera-
tion on some previous occasion. And the only way in which 
113
 we can prevail upon such patients to submit to this remedy
 is by assuring them that no such  inconveniences as they
 complain of from the use of mineral emetics, will be excited
 by those which we prescribe—that thev  are easy and per-
 fectly safe m their operation.  We are happy to say that in
 giving this assurance we are fully  sustained by the stron»
 evidence of long tried experience.
   We administer emetics to evacuate the contents  of the
 stomach; to restore its action and secretion; to arouse the
 portal circulation, and in a minor consideration, to determine
 the circulation to the surface; to lessen spasm of the alimen-
 tary canal, and thus restore a regular action throughout its
 course.   We give no emetics "to throw bile;" this  is too
 absurd and ridiculous an idea to be entertained by professed
 physicians; we never read in any respectable medical work
 that emetics should be given "to  throw bile."
   Several kinds of vegetable emetics  from the mildness  of
 their operation, may be given in those cases of disease, the
 debility of which would totally proscribe the exhibition of
 mineral emetics, especially  that  which is  in most general
 use, tartar emetic.   Other metalic preparations are some-
 times used in the practice of medicine, with an intention of
 obtaining their emetic effect upon the system; but their ope-
 ration in general, is not more efficacious, yet by far  more
 harsh and  dangerous than  that of vegetable emetics.   We
 deem it unnecessary to dwell longer upon this subject, as we
 think the reasons given are sufficient toconvince those who
 have availed themselves of the  advantages of experience
 and attentive observation.
  These remarks have not been made to gratify a disposition
 to differ in  opinion from those of the common and fashion-
 able practice, nor have they been made to comply with a
 vulgar prejudice of the people; but honest conviction of their
 truth and propriety has called them forth,   That man who
can be convicted that a course is  wrong and still  follow it,
 and recommend it to others, can  act, as no honorable  and
 honest man should.   The  desire  of every practitioner of
medicine should be to encourage improvement in the science,
 nor should  he  himself neglect to  contribute the product  of
 hi  talents to this end.  The medical man, who after having
                          10* 
114
finished his collegiate studies and entered upon his practical
career, closes his Looks and shuts up his mind to all further
inquiry, settles down in a set of preconceived opinions, foun-
ded upon a limited  study of books,  who condemns without
investitmtionany new theory or mode of practice, who dares
not meet those who  hold this new  theory  in an open, fair
and public discussion, bul seeks every private or public op-
portunity to slander nnd misrepresent both the new theory
and him who practises  it, and that, many times at the ex-
pense of condemning and ridiculing things which he knows
and in his own heart confesses to  be true; such a man
should be banished  not only from the medical world but from
all respectable society.
               TO  THE   READER

  Friendly  Reader,  if you have perused the preceding
pages with care and attention, you are  now prepared  to
render a decision, according to your judgment and  under-
standing of the facts and arguments therein advanced, of
their real and comparative merits.   We are aware  that
our cause,  though good and true, is  as  yet on  the back
ground, when compared with the common practice in point
of popularity; but we know that our intelligent, liberal and
candid  reader  will  admit, that thousands of  important
truths, which were once unpopular, and even regarded  as
errors  and illusions, optical or mental, are now admitted,
on  all  hands, to  be clear and sound truths; and  we are
even led to astonishment, that such ignorance ever could
have existed, to intercept the radiant beams of such simple
and self evident truths.  So conspicuous do these truths now
appear, that we should think it would have required  a state
of darkness a thousand  times thicker than ever w as known
in Egypt to render  them obscure.  If the reformed theory
and practice  of medicine is not true, or nearer to truth than
the common  mode, why do so many embrace it  in this
enlightened age?   If it is said the  ignorant only embrace
it, we  answer that this is, by us, classed among the long 
115
list of misrepresentations furnished by our opposers.  We)
contend all improvement is  the  result of  progressive
knowledge;—that our system of practice is a material and
essential improvement upon the common system—and that
those minds which are neither slaves to  ignorance, preju-
dice, nor popularity,  but  which are open to investigation
and free inquiry,  and which in this way are enabled to
keep pace  with the march of improvement in general sci-
ence, are  the ones to adopt  and advocate our system of
practice.   We are by no means afraid that our system will
be disparaged by comparing the talents, the acquirements
in general  knowledge, the respect, ability and honor of the
minds of our friends, with those  of our opposers—we will
not say enemies, for  we do not believe that all who oppose
our practice are  so weak minded and unchristian as to be-
come our enemies, simply because evidence compels us to
differ from them in our opinions of the practice of medi-
cine.  We believe that we can account for a large propor-
tion of  the opposition which we receive  from the  people,
and for even some of that which proceeds  from physicians,
upon other and more commendable grounds than those of
self-interest, premeditated hostility, envy, pride, and fear
of rivalship.  It is to be attributed partly to the fbrc^or
iafluence  of early  education; partly to a conscientious
belief that we are  right and  others are wrong; and partly
to circumstances too numerous  to  be mentioned  if they
were known. The remaining part of the opposition which
meets us, we are sorry to say, a.;ses among the people;
but more especially among the physicians, from the causes
given above.
   If our system of practice is assailed, either by the peo-
ple or by  physicians, it is not with arguments—no, not by
any thing  which has the shape or shadow of argument—
but merely by assertion!  slander, or low and contemptible
ridicule.   We are not surprised that such things are aimed
at us and our cause, by those  who would  injure us, even
though the time  and  labour which (hey spend in this way
should be so poorly rewarded.   In  many cases,  they seem
to be excited to slander us, by the poisonous effects of those
very arrows which proceed  primarily  from their own 
no
quiver; but being aimed at truth, which to them is  irn
pregnable, they are reflected again tolhnsc who sent them.
This is one of tho many  instances which go to prove  that
vice creates its own punishment before its operation ends.
   Reader, you are in possession of a mind—a mind made
to think, and one which if properly cultivated and improv-
ed, can think as good  thoughts  as  any other.  Weijdi the
matter fairly, tint you may clearly determine  whether its
specific  gravity be greater or less than that of the one to
which it stands opposed.   Comparo  the subject with the
facts drawn from experience—compare it with reason  and
your own  judgment, and  form your opinion accordingly,
whether for or against us.
address to rnvsiciANs of the pxsiiroNAnLE and common
          order,—especially to the vouno.

  The station occupied by the physician in society  is one
of honor and  repectability; and if his deportrr.ent and ac-
quisitions in science be equal to the requisition of his pro-
fession, his reward is by no means unmerited.   The duties
of th&mcdical profession are in all respects highly respon-
sible; none shoulu attempt to discharge them who  possess
not the requisite  qualifications, whether these be the un-
asked gifts of nature, or the rewards of study and persever-
ing industry.
  The study  of medicine, in  all its departments, tends to
make men humane, benevolent,  humble,  sober-minded,
moral, liberal,  and  admirers and lovers  of  nature and
of nature's God.  How  can we become acquainted  with
our physical  frailties—our  mental sympathies—our mu-
tual and  moral  dependencies—our common  origin and
fiaal destination,  without being feelingly  impressed with
the fact,  that we are all brethren;—that we have  one
common parent;  and this idea  cannot but make us kind
and  humane  to each other.   Can we become acquainted
with  the  human mind,  its capacities and excellencies,
and  still  not  be  benevolent?  Can  we  contemplate the 
117
beauty and wisdom displayed in the formation and adapta-
tion of the different organs of the human body, and not ad-
mire and  love its author, and not be convinced of our own
weakness  and be  humble?  If we know the human mind,
we shall  know that it cannot reap permanent happiness
from light and frivolous amusements;—but that to be so-
ber minded and virtuous, is to promote our best possible
interest—I mean our common and individual happiness.
The study of any true science enlightens, and by so doing
renders the mind  liberal and moral.   Where did ever the
real philosopher exist, who could justly be called immoral
or illiberal?  From what has now been said, it will be in-
ferred, that physicians  who are qualified for the practice
of their profession, are liberal among themselves and with
their fellow men. In medicine as well as theology, there are
different opinions and different denominations.  But should
the preacher limit his benevolence and charity to his own
denomination?  Should  the physician of one denomination
treat  contemptibly  all those  of  any other?   Should not
the whole sum of talents and experience of all physicians
be thrown into one common stock for the benefit of all ?  If
one physician, or a number, make any important improve-
ment in the medical science, should  they  be condemned
andslanderedon account thereof?—has the science already
arisen to that point of perfection which neither admits nor
needs  any further improvement?  Has not each  man  a
riodit in this free country to enjoy his  own opinions?  And
have not we as reformers in medicine as good a right to fol-
low that mode of practice  which we think best, as  those
who oppose us have to follow their own mode?
   We condemn no man, nor do we condemn any physician
for his opinion; if he is honest, he takes that course which
ha thinks  best  for the welfare of his patient.  He has been
led to adopt the opinions  which he professes, by a train of
circumstances over which he might have had but little or
no control.  Had similar circumstances operated upon re-
formers, they would have adopted the same opinions.
   As regards myself, I  commenced the study of medicine
with the expectation of finishing it in the commoa way, and
of practising the common blood-letting and mercurial sys- 
118
tern; but by an auspicious combination of events, my course
was changed; which change has obtained mc the knowledge
of a safer and more efficacious  mode of practice.  I pursue
it, because 1 am fully convinced of its superior nieri's over
the common mode; and to pursue any other mode of prac-
tice  under  such conviction,  would  bring me under the
severest condemnation of my own conscience.  Reformers
do not complain or censure other physicians for their differ-
ence of opinion, nor for their censuring the reformed prac-
tice upon the ground of such opinions; but it is the misrep-
resentations,  the  premeditated  falsehoods  and slanders
which physicians raise against them,of which they complain.
It is because physicians refuse to meet us in open, fair and
public discussion that we complain.   They chargo us with
ignorance of medical science, yet they dare not meet us in
debate, notwithstanding their boasted  superiority of learn-
ing.  We offer to meet  them  in open discussion upon our
own ground or upon theirs—they  refuse. They must know
that error has much  to  fear from investigation, and is ex-
tremely weak  when brought into contact with truth.   If, as
theysay,we have  no grounds of our own and are unac-
quainted with theirs, they need not fear but that they will
gain the victory.
  Ye learned sons of Esculapius, if ye think that the reform-
ed system of medicine is founded upon false science, come
forward boldly and meet its founder; he has challenged your
fraternity to meet him in public debate, to discuss the mer-
its and demerits of the respective systems.   Have any of
your faculty met  him?  No, they dare not; they know full
well that their system would fell from the weight of his ar-
guments, as the superstructure of an edifice falls for want of
a foundation.
   Tothe younger class of physicians,—to you whose minds
have not become so deeply  rooted  in prejudice—not so
much contracted by illiberality—to  you who have just en-
tered  the  practical career, I would say, reflect upon the
high responsibility  of your calling; be liberal  in  investi-
gating different theories and  modes of practice, that you
 may be better enabled to determine which is best.   Look
 around you, and see if there are any ruined constitutions, 
119
the state of which is to be attributed to calomel—(hat Samp-
son of the materia medica in which  you place so much
confidence.   When you take the lancet to open the vein,
turn your mind to the physiological importance of the fluid
which is to follow the point of it.  Ask yourselves if na-
ture demands such treatment at your hand—ask if by this
course you are running parallel with the steps of nature
in the cure of disease.  Let the questions be answered with
discretion and sincerity.  Again, ask yourselves if the opin-
ions  and  experience of the many who  follow a different
practice,  are  not  worth looking at or regarding.  Ask
why nature, who in general  distributes her gifts  with an
impartial  hand,  came to favor you with all  useful knowl-
edge in matters of medicine,  to the exclusion of all others
—if it be  just for you to condemn a  practice, the theory
and effects of  which are totally unknown to you—if it be
reasonable for you to say that  all patients who die under
the Botanical practice  are killed by  if, and that all who
recover under it would have  got well without  it—that all
who practice it are ignorant and unskillful ?  Ask whether
it may not be possible that  some Botanical practitioner, in
his awkward mode of practice, might not have accidentally
blundered into some useful point of knowledge, with which
even yourselves have not become acquainted, or have over
stepped in the high and lofty path in which you have trav-
elled?  Truth, like gold, occupies the lower spaces of the
intellectual spheres, on account of its great specific gravity.
No man goes into  the air in search of gold;  it is found in
lower and more humble situations.  So the man who would
find solid  truth, must not ascend into airy regions of ab-
stract speculation, but must bend down to the region of
materiality and experimental  facts.   Ignorance creates
pride, and pride raises the eye of the mind above its prop-
er sphere; it sees many beautiful things apparently, but
they are unsubstantial as midnight ghosts,—they are all
grand optical illusions.
   If,  after  having perused  the several subjects of this
essay, you shall have discovered any  material  error there-
in, you are now solicited to point them out, .that they may
be seen by all who are interested or concerned.   If you 
120
believe me to be in error will you not help me bv your ar-
guments to get clear of them; will you not meet nic in pub-
lic debate or in private epistolary discussion.   If you can-
not convince me of my errors, if I am in error, perhaps I can
convince you of yours- cither of which would tcpnductive
of alike beneficial results.  A«  y.amgmenin  the science,
it becomes us to discover a disposition for  individual and
general improvement.  What can the world  think of us, if
we neglect to improve our oppoi (unities for improvement in
the science, and spend the time due to this, in slandering nnd
trying to  injure  the reputation of the innocent nnd well
meaning, who may chance to dilfer from us in opinion.
   Is it not our duty ns physicians to unite in promoting the
general improvement of our science; to investigate, compare,
weigh and decide upon nil arguments which may be brought
up in favor or against any mode of theory or  practice; to use
every  possible  means  which arc calculated to render us
more deserving nnd worthy of the confidence  which is re-
posed  in us?  If we regard any  mode of practice as being
bad, it is  our duty to endeavor by open and fair arguments
to prove it to le so, and thus stop  its progress.   Truth can-
not be permanentK injured  by slander;  in fact it is  some-
times brought to light by it; the shafts of envy  and slander
may sweep away the nntsof prejudice which intervene be-
tween the minds  of the people  and the truth.
   If the  rapidity  with which any cause  spreads and gains
strength, can be  considered  as any  evidence in its  favor,
certainly the cause of medical reform can claim much from
thissourcc.   Jt is spreading  in every State  in the Union; it
is being  adopled and advocated by  the best nnd most en-
lightened of mankind; it is making rapid  inroads upon  tho
provincesof the common practice, and bids fair to supersede
it.   These things are encouraging to all reformers in med-
icine; to  all who treat diseases  according to  the indications
of nature.  One thing more I will mention as an incentive
to young physicicians to investigate all modes of practice;
that they may adopt the best.
   In these United Stales, thousands of our fellow-beings
have had theiHives rendered more intolerable than  death
itself, in  consequence of taking morcury for  the cure  of dii 
121
ease.   I have witnessed several instances of the destructive
effects of this mineral; you are only now commencing in
the field of practice, but may you not anticipate some ruined
constitutions as the result  of your practice, ifyou deal in
mercury ?   And should you be so unfortunate as to produce
the effect mentioned—I mean an ulcerated or destroyed face,
a useless limb and a wretched  life; I say, should you be thus
unfortunate in  your practice, you may"have for your con-
solation the following  thoughts.  Had  I  been  amongst
those  practitioners, whom  I call ignorant impostors, a'nd
had I  used means like theirs,  this ruined  constitution and
unhappy li'e would  not have been  laid to my charge;the
disease might have been cured in less time, and the patient
have been blessed with a sound  and  healthful  constitution,
and the enjoyments of all the happiness attainable in this
world; and my mind would have been saved from the tor-
ture which it now feels, from a consciousness of having done
wrong.  Let this be a subject for reflection.
11 
ESSAY   ON   CIIOIiERA.
OF THE NATURE  AND TREATMENT OF SPASMODIC
                          CHOLERA.


  It is very gener dly admitted, by scientific modiral men, that a true
knowledge of tho pathology or naturj of any di-ease, is  indispeii'dbla
to him who would  treat such disease  successfully.   The  particular
character of sonic diseases is invoked in much obs,:.irity, owini} to tho
Indeterminate and indefinite symptoms which accompany them.   All
symptom* of di^ea^e are either direct or indirect, internal or external
signs of derangement in the'opeminns of nature's law*, which are  ap-
plied to the government of the  human system. I inert symptoms are such
as proceed immediately from the organ affected, to which the) an> re-
ferred by the sense of perception, called fe.Tmg; indirect symptoms an:
those whi  h are felt in some organ '* part other than that which  is the
principal seal of ihe disease;  t.'icst: symptoms  are  sometimes called
symptomatic or sympatheiic.  External symptoms are such as are man-
ifest to the observation  of the physician and others.  '1'heie aro tho
principal symptoms obtainable in diseases of infants.   Internal symp-
toms are such as are only to be ascertained in  general by ih? patient's
feelings; by these the seat of diseases of the internal organs is princi-
pally ascertained.   In every  disease of any important organ, all of
the above named symptoms are present.   In cholera,  during the  ad-
vancement of the disease through its different stages, there are diarrhoea,
chills, paleness of the surf ice, vomiting—with a scum; of oppression,
and fullness in the stomach, great thirst, compressed and feeble pulse,
contractions or cramps in different parts of the muscular system, mostly
In the extremities, profuse, cold and clammy sweats, cold extremities,
eyes sunk in their sockets, exhibiting a wild  and anxious  appearance,
die features in general greatly depressed, faintnes--, short  and hurried
respiration, blueness of the skin, with a peculiar  blue appearance seal-
ed immediately under the finger nails, the skin of the hands corrugated,
appearing as if they had been soaked in warm  water; these are the
general symptoms of cholera.
   Different opinions are entertained by medical men, respecting Che
 primary seat of the diseased action in cases of cholera.  Soire think
 the liver is first affected,  causing an obstruction to the discharge of lite
 bile into the intestines, and  thus giving rise to diarrhoea.   Others con-
 sider the primary affection to exist in the stomach and bowels.   Now
 it must be admitted that those symptoms which appear in the beginning 
123
 r>"f thi- disease, show plainly that each of the  above mentioned organs
  ire involved in the commencement of cholera,and that whether we re-
 gard the original affection as being exclusively confined to the liver, or
 to the stomach an I bowels, or to all of these, we are taking but a limit-
 ed an I i tconect viev of the disease.   We grant that the disease first
 exhibits itself in  a deranged state of the stomach  and bowels , but this
 very fact is sufficient to prove that the derangement first commences in
 the capillary  system,  and that inasmuch  as this system of vessels is
 found upon every surfaceof the body, whether internal or external, the
 whole system must be primarily and simultaneously  affected at the ac-
 cession of cholera.  The immediate consequences of a loss of action in
 thecapillary system, are a loss of equilibrium between the sanguineous
 circulation of the interior and  the exterior parts of the body, a pals and
 sunken  countenance, a diminished action  of the excretory system, in
 some cases and under favorable  circumstances, an exudation of serous
 fluid from theslrin and internal surface of the intestines, coldness of the
 surface, and oppressed respiration.  This state of the  system cannot
 exist long without producing serious  derangement in the functions of
 the stomach and bowels, which disturbance  soon involves  the brain
 through th.3 medium of nervous sympathy.  As soon as the action of
 the brain becomes much diminished,  the heart's action is necessarily
 diminish? I, since it is depending for action  upon the influx of nervous
 fluid sent tr it  by the brain ; this lass of action  of the  bruin  and heart
 disenables the  venous system to expel the blood  contained in it.  The
 muscular system becomes  subject to, and  affected  with  involuntary
 contraction, (commonly called cramps,) owing to a  deficiency and ir-
 regularity of influx of nervous fluid to neutralize the organic contrac-
 tility of the muscular fibre. The contractions or cramps  in this disease
 appear to he the result of the operation of two  opposite and antagoniz-
 ing principles;  the vital or  living principle struggling  to  overcome  the
 inorganic or chemical principle,  termed  contractility  when  applied to
 animite  objects,  and the attraction  of cohesion  when used in refer-
 ence to ('earl substances.
   This chemical  principle in the living animal is kept in subjection by
 the combined agencies of animal heat and Ihe nervous fluid.  Whenever
 these two agencies become deficient from any cause sufficiently strong
 to effect their diminution, the  contractile power operates ungoverned,
 causing the  particles which constitute the muscular  fibre to contract
 upon themselves by paroxysms, divided by intervals of indefinite dura-
 tion.   This crowding or compression of the mus; u ar fibres upon each
 other is manifest from the hardened elevations  appearing upon the ex-
 tremities during the spasms, which every one must have observed and
/elt, who has attended patientslaborittg undercholera.  The pain caused
 by these involuntary contractions, is of the most excruciating and insup-
 portable kind.  The severity and  continuance of the < ramps are control-
 led by, ant'  proportioned to the severity of the diseased .action and the
 strength of the constitution; this will appear  obvious when we consider
 the fact, that in those cases in which the subjects are old, or much debil-
itated by some  previous disease, the cramps are but few and but slight
in comparison to  such cases where the subjects are you n gaud unaffect- 
124
ad by previous disease.   In the latter cases, the morbid contraction* or
cramp, are s'ronglv and-iolentl)  counteracted by the life preserving
efforts of the constitution, or if you please of nature. The namr il conse-
quence of this reactive effort, is pain, ann that too in  proportion 10 tits
strength of the effort made, and the cause of resistance .   In ihe former
cases, or those in which the subjects are  old  or much drbilitnted, ths
restorative effoit on the part of the constitution is weak, the pain slight,
the intervals of reaction long, and the chance of recovery very doubtful
and unpromising.   L'pnn the above theorv,  may  easily be explained
the reason  why those that are  taken with the symptoms of the second
stage of cholera, after having labored under a diarrhira for one or two
weeks, are made such ready and  easy victims to the disease.  Theit
cramps are less severe and less frequent; they many times sink rapidly
under the  pressure of the disease, in spite of the mo>t poworlul and ac-
tive means used to arrest il.
  Debility or weakness is 'he  principal, and I might almost have said
the only proximate cause of cholera.   It matters but  little what be ths
cause which produces this debility, the consequence is nearly the some,
whetherit be brought on by intemperance in  the use of ardent spirit",
uncleanliness, poor living, the use of bad water, cro.vded and ill venti-
lated dwellings,  too much fatigue, the loss of blood for the cure of dis-
ease, the use of strong purgatives from the  mineral kingdom, or the de-
pressing influence of fear.   Yet it must be acknowledged  tnat some of
the above  mentioned causes tend more speedily to the production ol
debility than others, such for instance as intemperance in  the use of ar-
dent spirits-, the loss of blood, and  fear.
   In .'ome cases of cholera, and in most which have come under my
own observation, the very power  upon which nature depends for tho
purpose of counteracting disease, is to a grenier or less decree carried
out of the system  by copious alvine evacuations and cold clammy sweats.
Such evacuations contain  ihe  nutritive portion of the blood, which is
nothing less than the  main spring of animal  life.  The  continnanco
of these discharges will in a short time destroy the life of the  'Longest
constitutions.  The immediate cane of these evacuatii us is a  loss of
action in the capillary system, or in other word«,a  dealh of ihe surface.
of the body.   To check the general effusion of the fluids from ihe body,
a natural warmth and acticn must be established in ihe c ipillaiy  sys-
tem, the surface of the body must assume its usual warmth and colour,
the fallen  countenance must n-e, the optic orbs must regain iheir bril-
liancy,the superficial veins must be filled, an equilibrium <,f thr circu-
lation must be established.   These are the ends to be effected in order
to constitute  a successful mode of treatment for cholera   It remains
now for us to enter into an iin estigation of the  effect-, reasonableness,
and efficacy of the means most generally used  for the cure of this dis-
ease.  This investigation nhould be conducted  according to the eviden-
ces derived front  the knowledge of experience nnd ohscnation under
theguidance of reason; examining all evidence through the telescope of
truth, casting aside the loo much employed  u.inxrs of prejudice and
partiality, which always reflect false images, conveyiug enormous im-
pressions concerning the objects which produce them. 
125
   The means most generally used for the  cure of cholera claim  our
 first attention in the present investigation.   The means most general-
 ly used in the treatment of cholera, may be reduced into the  following
 classes: 1st, stimulants, 2d, cathartics, 3rd, emetcs, 4th, rubefacients or
 externa] wanning applications, 5th, warm bath and frictions, 6th, bleed-
 ing and cold applications.   The articles of the above enumerated clas-
 ses used in treaiing this disease, have been variously selected according
 to the judgment and opinion of different physicians.  Amongst the ca-
 thartics, some and even most have used calomel in combination with
 opium; others have used the more powerful of the vegetable purgatives;
 while others  have confined themselves to  vegetable cathartics of the
 mildest kind; so of stimulants, some have recommended entirely that
 class usually called narcoics, being only stimulating in  their primary
 effects-laudanum may be reckoned first among these; others have used
 only permanent and diffusible stimulants.
   But without entering into a detailed account of the multiplicity of
 simples  or individual medicines with their reputed success, it will be
 sufficient for our present inquiry, to consider the   reasonableness and
 success of the two general modes of practice in cholera, viz: the deple-
 ting or calomel  and bleeding, and  the stimulating.   In the first stage of
 cholera when the loss of action in the capillary system is but slight and
 principally manifested by a deranged state of the bowels, a dose of cal-
 omel of sufficient quantity to produce  a brisk cathartic effect, may in
 some  instances produce  an  equilibrium in the  general circulation.
 This it may do,by the agitation which it gives to the abdominal viscera
 and the consequent acceleration of the circulation produced thereby. I
 presume that no one would claim the name of general stimulant for cal-
 omel ; it stimulates only locally, and even so, only  by a mechanical ir-
 ritation ; in this way it not unfrequently destroys the texture of the part
 with which it comes in contact; its operation, as a  chemical agent
 upon  the living animal, is in agreement with the life destroying princi-
 ple of inorganic contractility ,and as a consequence  of this its effect, the
 living principle of vitality acting against it,  gives rise to cramps of the
 stomach and howels, not uncommon in cases where this article is ex-
 hibited.   It is well known that calomel as a  medicine is slow in produ-
 cing its effect, and  when we  consider the liability of the first  stage of
 cholera to run into the second  without being governed by any certain
 period, or without giving timely warning by any indubitable symptoms,
 I say, a consideration of these facts in connection,  will form a power-
 ful aigument against its use, even were it generally proved to be bene-
 ficial in cases where its operation is obtained.
  Doctor  J. \V.  Francis,  of New  York,  while speaking of the
 useof calomel in the treatment of cholera, observes;  that  "mercury
 from the peculiar irralibility and debility which it often induces, adds
 to the predisposition to the disease, and when formed,cholera,in a ma-
jority of cases, is too rapid in its course to be checked by the  uncertain
 and tardy salivating influence of calomel or  other  mercurials.  That
 our list of mortality by cholera has been  enlarged by this  method  of
 treatment, is the opinion of some of our best prescribes."  From the
 very nature of cholera, the mercurial action is not so readily induced,
                                  11* 
120
 and the disorder advances from this rnnse, and the probable neglect  la
 the meanwhile of the me of other means.
    Evrry medical prartitkinrr knows, or should kno v thai these viowa
 Of Mr.  I'r ..ncis, a* to the nature -n I effects r>r mercury Mm correct sand
 tvery peron acquainted with cholera, knows that it "is to. rapid in  its
 course," to be .becked by ihe tardy operation* of calomel;  nay that
 the most acii.eand powerful medicines too often  fail t» niresttis final
 progress and termination.   Painful  experience, has  but too clearly
 proved ihe trmh ol the assertion of Dr. Pinnris, \i. • "That the calomel
 treatment of cholera, isbui the » resiling o(n pigmy with a giant."
   That anv one ac(]uainted with the effecis of caloa;el, nnd with ths
 nature of cholera, si ould  rely upon so slow an agent lor ihe cure oft
 disease so rn| id in its progress is a suhjeciof much astui.ii.hmen'.  |{ut
 after expe.ieice has fully shown  the inefficiency and ii.contMencv  of
 the practice, that men of acknowledged acquirements  JM  m(.,(j.„, ,_,.
 Cnce, should still persist in the course  and recommend it 10 oihers, is a
 malt. r,oi nil others, involved in ihe ino-t piofound irtinnionnl ty and
 inconsistency.  ('alomel, exhibited  in ihe second  stage ofcholrra,  or
 after tho com nencement of the spasms, cannot claim the merit of being
 even in the slightest  decree  auxiliary in  arresiing the pr.^ress of this
 disease.  For in almost every <a-e of cholera  in ne setond  stage, the
 ■cnon of the stoma.h and bowel,  is so much impaired, that weie it not
 for a change effected in these organs by  ihe efforts vf nature, the calo-
 ii.-l could produce no cff.-i t.  I ndertho most favorable cin unistanrc,
 it requires several housforany sensibe effect to be pro'need by thin
 medicine; it must therefore appear ol>  ran m every reflecting and cor-
 rectly mf.rmrd mm I, that in the treatment of such a disc..,., as cholera
 no  tune should be lost, but that s .ch  medicine should  bo u«ed as will
 produce an immedinte crT.-ci to restore the lost ecuon of the st-mach
 and of the rapilliary sy-t-in  in general.    In cases of rholera,  which
 have a.rived to the second stage and in whi  h  no other means are em-
 ployed than calomel, one of two things is inevitable, via-  that the pa-
 tient must bo relieved and cii'ed by the sanatne eff.itsof nature, inde-
 pendently nlany efleciof the medicine, or he mu»t c i  .   l„r alicr ths
disease  has p-,wS-d intothe fpilini-(,ic 8tagei jt a|mo.t tl|iifori„,y ,fMni.
nates, either favourably or otherwise, in  a shorier period  of time than
 would be ieq..ned for the operation of calomel even under tolerablr fa-
 vorable tircumstancrs.   Medicine to counteract the cholera  must be
quick powerful  and permanent in it, effect; quick, l-.t the disease
til "*v?iPr,*reMe'_b«y-'«»'»"»limits of medical jnris.lic.ion: power-
ful,lest it be earned  before the  progress of ihe disease, a, a .inw in
the euireut of the ocean; permanent, lest tho disease after a smut and
deceptive rem. s.on, return with greater violence than at first.   Il stim-
u ants be found most efficient and  consonant with nature in the remo,-
_i-/~i,~i  .   /   j .    y,,      ---""'-"* "nn nature in tne remov-

J^_l.  '.w'     C„t,0,,f'W,,,bee'Wb,i,,,ed  i,,,he treitmentof all
STo.tl; iS! '"  .^ tW° ,,',e8.Qf ,be human -X't-n-one of health
2\el,  I H       "•»■••«■ '" .uelf . unit; ,,,.  lessor diminution
f ■!___! * ^11    consequently destructive u, the li„ng principle which
(■ preserved by action forced by proper tfmulL   Th,d.Uy fo_4 which 
127
we take is made suhsprvient to this object, viz: to support the power of
■ction upon which life depends.  The only difference which distin-
guishes affections of the human system, termed disease, is in the d-gree
to which action is diminished, and the part which may be most affected
by the lo«i actian.   I pou t tese circumstances depend the almost i. fi-
nite number of varying lymptoms which appear  in the progress of dis-
ease,   t'holera itself, wo.rd b? divested of  its  singularity, if it were
not that its  character  i« marked by these conditions, in an uncommon
degree; that is, great diminution  of action  suddenly  induced.   The
indication of cure i- conspicuously marked out in the pathology of the
disease.   It is simply to effect a restoration.and equalization of action
throughout the system.   Whatever wi I do this effectually, quickly,
and permanently, w.ll deserve  the  title of cholera specific.
  In  times and in places,  dining the prevalence of cho era, a diarrhoea
is-justly regarded as the unwelcome  and in many ea=es true precursor of
cholera.  Every reasonable person would feci himself in danger, should
he permit such cot.plaint locontinoe at such a time I'o-.- any considerable
perto  I; he cannot trust to medicine of tardy operation ; his only safety
consists in the immediate ns.'of such medicines as will make an immedi-
ate impression upon his system as to restore pii equilibrium in the circu-
lation.  Hen -e the use of calomel in chol -ia  is inadmissible even in the
1st stage. Its operation in the 2d stage must be uucei t riu and of doubtful
efficacy, since  in most cases, except where powerful stimulants are used
the 2nd stage runs into the .'frd, or stage of  col'apse, before  calomel
could operate even under the most favorable  circumstances.  Of its ad-
ministration in ihe stage of collapse, it is hardly  necessary  to speak,
since  1.0 man of common sense  and  possessing  any knowledge  of the
disease, and of the  nature of calomel, would he  so presumptuous or
rathersoweak minded as to a (minister it.  In  this stage,  which is
upon the very verge of death's domains it is certain that  none other
than  powerful stimulants can be of any avail, nor is there much reason
to expect any  benefit even from them.
   Calomel being the champion of the modem materia medica, no won-
der that physicians, confiding in its  efficacy and advo.-ating the  safety
and propriety  of its administration,shoul I regard it as the sheet anchor
of their success and the polar star of their hope, in the treatment of one
of the most mali.naiit aiirt unmanageable diseases  that ever traversed
our country.  I nder the  iufluenceof this hope, which has not one rea-
sonable argument for its  basis, physicians have resorted to the abund-
ant use of calomel for Lie cure ol cholera. They have'given ita fairtrial
both  as regards the quantity and the  great variety of circumstances, such
as temperaments, constitutions, ages, sexes, climate, season of year,
and different stages of the di-ease attending the patient for w hose relief
it was administered.   From fifty to two huudied and  fifty grains have
 been administer, d  atone time to  the same indi.iduat; but what has
been  theconsequM.ee of such a practice? Has it not generally been the
death ofihose who  were the subjects of it I   In cholera, as in all other
diseases, nature takes steps to effect wh; t is  termed a natural cure; but
 the operation  of calomel does not run parallel with the steps of nature,
»a the cure of diseases; so far from  its  removing disease,  it may and 
128
 frequently does become the real and original source of many and pate
 ful diseases.
    If in the treatment  of cholera the  indication or intention be art
 duction of the powers of life, a warfare against the efforts of nature in
 behalf of t'm patient's health, an experiment in the taeory of depletion,
 ■n attempt to cool  the system according to the much la lived of frigid
 treatment of ice, cold water  to abbreviate  the period common to the
 spasmodic stage and hasten the stage of collapse, then bleed! bleed, ad
 deliquium aiumi! and the above  described  indication in each  of
 its branches will be fulfilled.  The powers at life will be diminished,
 a successful warfare against the efforts of nature will have been insti-
 tute I ; an expt rimeni, a coin incing one, will have been made in the de-
 pletory theory, an effectual  attempt will have been made 10 lessen the
 superabundant  nnimal heat, one even  better calculated no  to do,
 than the use of cold water an 1 ice.   The stage  of spasmodic contrac-
 tions will have been abbreviated and the stage of collapse prematurely
 ushered in.   Ye advocates of the lancet  and professed conservators of
 your fellow men ; entailer this subject can lidly ; consider it in the con-
 nection and light of true physiology and rational philosophy, and then
 tell me if my conclusions be not correct; tell me if the light of my short
 experience has shone  falsely upon my  mind ; tell me if  I am rash  in
 coming to the conclusion that more lives have been  lost by an unnatu-
 ral treatment in cases of cholera, than by cholera  itself.  Those who
 uphold  the practice  of bleeding in cholera, will use the lollowing argu-
 ment for its support, viz : that bleeding relieves ihe  spasms or cramps.
 Now this fact, as well as a 1 other things which can  be shown as facts, I
 am ready to admit; yet notwithstanding this admission,  this argument
 is the most convincing mid powerful  one which  can be brought against
 the very doctrine  for the support of which it is usually adduced.  Bleed-
 ing relieves spasin9.   What causes spasms?  Is it not a dtfi.'iency  of
 the blood and animal heal in any part of the body, which deficiency
 gives the ascendency to the principle  of inorganic contractility, over the
 principles of expansion and dtlatation,or in other words the anti-chemi-
 cal principle of animal vitality?
   The principle of vitality is contained in the blood nnd kept alive by
 exercise;  that is, by going the rounds of the circulation, and giving off
 such parts as are no longer useful and receiving such as  are condusire
 10 health and life.  Now if the  vital  powers would   yield passively to
 the absolute control of the  chemical  principle before described, no
cramps or pains would occur; it is the  resistance offered to this principle
 —the efforts of nature against disease, which  causes the pain; take
 away nature's resource —the blood, and the pain will soon ocase. This
is  the way in which  bleeding relieves cramps.  This is proved to be the
case by the subsequent results.
   There is another way in which cramps are removed in  cases of chol-
era, analagous in its effect,and upon the same principle as bleeding;  I
 mean by the profuse, loose, watery  stools and the copious effusion of
cold sweat fiom the  skin. In these evacuations, the vital powers run off
rapidly, and if  not soon checked by some means, they will as certain-
ly and effectually relieve the cramps as bleeding.  It must  bete be re- 
129
tnembered that the cold sweats  and profure  slvine evacuations,  ttt
totally unlike those *nlutnry and all important evacuations which pro-
ceed fr >m the same sources in limes of health, but which instead of les-
sening the vital powers, tend to cleanse and purify the blood, and  thus
imparl new tone and vigor to the whole system; for in cases of cholera,
as soon as such kind of evacuations can be obtained, the patient is safe,
the cramps aro relieved, by a removal of the cause which produced
them.
  But the la«t and generally as  forcible as any argument that can be
brought to sustain the practice of bleeding i«, that some who have  had
the cholera and been bled have recovered. This is no more than to say,
that  in some  cases of cholera,  the str.-ngth anil  natural powers of the
patient are sufficient to overcome the cause, in spite of the impediment
produced by bleeding: the case is protracted, but not rendered hopeless
by bleeding.  The relief obtained by bleeding in cases of cholera,is
like that obtained by the same  means in other cases; it  is momentary
relief, fi.r which the patient  sooner  or  later  mast pay dearly.   All
physicians of common sense and information dread the  consequences
of profuse diairlicea and cold sweats in cholera, or in fact in any other
disease; why not dread the loss of blood  whi.'h  in proportion  to the
quantity taken and the patient's strength, produces the same result? I
have found that in till cases coming under my own  observation, which
were attended with cold  sweats and profuse diarrhoea,  unless these
latter could be checked very soon, the patient  would sink into the stage
of collapse and die; and in every one of such cases the spasms  have
been light and few in number, compared with those who have not had
the evacuations a bo e mentioned or have been soon relieved of them.
In cases where the vital p >wers have been much diminished by diar-
rhoea, the system becomes insusceptible to the action of stimulants; and
wheie these fail, there is no remaining hope.   Reasoning from the idea
of continuous symp ithy existing between the  skin and the internal liv-
ing membrane of the bowels, and from analogy and personal experi-
ence, I sappose  that  ths inner c >ats of the  stomach  and bowels are
cold  and almost as insensible,  in cholera, as is the external surface.
We know that in in my case the  skin is so  insensible,  that po.verful
frictions made with warm brandy and cayenne,hy the hand,are not felt
by the patient. Then, if the stomach and ho a els or their suiface be in
this condition, and we have every reason to beli ive them to be so, to a
certain extent, where would be t e propriety in bleedirg or in adminis-
tering calomel ? Nothing but the most (.o.verful stimulants can give re-
lief in these c tsesjand in some cases not f rirly passed into the stage of
collapse, even s:i nulants  the mo.t powerful produce little effect; they
fail to ex.c'ue more than a parti il reaction.  Those who in cases of
cholera use the lancet and  stimulants, may be compared to a house,
divided against itself. They carry  the meansof death  in one hand and
those of life in the other; with one hand they  tear  down, and w ith the
other they build up; they  practice upon the compound theory of deple-
tion and rcp'et.ou ; they are divided against themselves, denying by the
act of one band the propriety of what is done  by the other.  It may be
«aid that I am rather too sanguine in my exposition of the calomel and 
130
Heeding practice; this charg* will be«et aside in mr own mind by ths
still small voice of coii-cienr ■, which .idicr  npprn.es or con leinus all
our action;, a c.rdiug as they are f >un ! riiht or wrung.
   I am a va.e fiat when writing upon :. subject of so inu.-h importance
nsthe present, i: is my \m>perm is duty to speak what I am convinced
is truth; mil 1 do ihis, tegar.'l.-ss ofgiv ing off ncc, or of losing po; u-
larity.  It is well known ih it the practice of bleeding  issupp r«e<i by
one very plausible argumi-nt, via: that it relieves pain; anil by .moth-
er less reasonahlc, y. t more potent, viz : popular prejudice.   Hut I am
happy to  see,  'hat the  cl.'uds of  ignorance  and rnor nre  breaking
■ way hefuie the ap;im ich of kno.v ledge and  irulh.  A f.'w years past,
Medical lloiany was ban ly  known, in the whm in wl.ich it i-now
known—I  mean as a mode o,' piactice, opposed to bleeding an I mrr-
cirializiu^, and removing the cause of die disease upati rational prin-
ciples.  Hut  where is it now!—who are its  friends.'—what is its suc-
cess?—and for what reas in d . ihe old fa-ulty fe ir it.atid uri c 10 mis-
represent it?   '1 hese me qui stions  which  intty he ansvveied  cnrteetly
by every honest an I iiitelligenl peis ut.   I'cihaps no disease has been
;o  instrumental in rem ii gpt"j ulicesfrom  tin  public mind, nnd open-
ing the eves of thousands to  the truth of the  II >' inicor reformed prac-
tice of medicine, ns the one now under consid.'intum.   The dread of
cholera and itself,;, is has been more ;han <■ i, 11 a 1 to  the piejudice enter-
lained by thousands against  any impro ed svstem  ofmediane.   'the
treatineutof all anti-miner d doctors in ca-es of cholera,  have been stim-
ulating.  Medical Reformers, or ihe follo-vers  of I 'r.  Worster U.-nch
of New York, (one of  which, I have  the honor to  be,) the Thotnp-
60ni ins—the followers of the  excellent and  lung  lo  be lamented  If.
Howard ; together w ith many of the most respectable of the ■•I.I faculty
of phvsici ins both of Kurope  and America, have p. rs ied the stimula-
ting piactice in Lie treatment of this .'iscise.  The aiti< In used, t tough
of the veg  t ible kingdom, have been various; some have u*e.l the slim-
ulating narcotics, as o,iium  and camphor; others'  alco.nl,  brandy,
myrrh, c.iyenur1, turpentine, essential oi s, ether, &.C. 4c. Tne stitnii a-
liug practice  has, in a.I places where it has been pursued, proved tno.it
efficacious.   This has  been  a<;kn iwledgcd by  many  ri'Spe.  able phys-
icians who did nut resort to it t.cmseUes;  reason supports it; common
sense is in its lav.>r, and  nothing  but blind  und winul prejudice now
opposes il.   Look at p'aces around  us; I >ok at the resu is of liie two
modes of practice in Wijton, in Cincinnati, in  'i'roy, in Lebanon, in
Chibcoih •, in Columbus and M .ys  i.le.
   The object in the treatment of t.'ho.era is to equalize the circulation,
—to  nealra ize the  piiiuip'e of in rganic  conlmctility, by diff sinjj
throughout the system the principle of vitality contained in Ihe bluo.l.
I have witnessed the good oil. is of stimulants in bringing this slats
about.  1 have witnessed the r.siug  f ihe fallen and coi.trailed coun-
tenance,— the drying up of the told sweats,—the rest >m>g of war.ol-
io the extremities an I surface,—the raising  of ihe mpeifi ial veins,—
ihe Subsidence  of the spasm-,—and the well knowu glo.v  of health,
in many cases treated  entirely upon the stimulating plan.   The re-
gion which takes place is a fever, and iu all cases tends to the reete- 
131
ration of perfect health.   No danger of a patient's having cholera, w
long as  he has a fever.  Cholera is a state of the  system directly op-
posed to fever; and when called to a patient who is supposed  to  have
cholera, if I find him laboring under the common  symptoms of fever,
I am ready  to  insure him  against cholera, so long as  fever exists.
There ars affections of the system, which are  incompatible with chol-
era and which cannot run into it.   In no  one  case,  have I wit-
nessed the failure  of the stimulating  treatment  fur cholera,  where
Ihe sympioms  and circumstances of the  case  were  at all  favor-
able at the commencement of such  treatment.  The  aged and the
debilitated, and  particulaily the intemperate  are generally   ready
and easy victims to this disease.  To  such ca-cs the heart and other
internal organs  have so far lust their  excitability as  to be  inade-
quate to vhe pr iduction of a complete reaction, even from the influence
of ihe most efficient stimulants.  Here we are only  able to produce a
a partial reaction.   The pxiant in th.-se. cases cobs not die under  the
usual symptoms of the stage ol'co lap-e, hut under  the exhausted strug-
gles of a reactive effnt.   In these ciais the sympto.us appear to  en-
courage a  hope till within-* very short time previous to death.  But by
a cln.fi exa nidation in such cases, it wid be loin I that the pulsation at
tho wr.st is very weak and iutermitti g, that the face is visited byalter-
 nate^as'ies of heal and  cold, that the  breathing is short and oppressed
 anJ the patient is uneasy and resiles*.   In  such  cn-es the camps or
 spasms arelight and few in number, and Lie iea-on isob.ious; because
 the vital powers are weak and cast y  yield tJ the life destroying princi-
 ple of inorganic co.iri.ii i:y.   It is not foe me togwe the preference
 to any one sti nulattt or stimulating pr. pa.atiun; since different articles
 and preparations of this class have been used  with apparently equal
 success.  In the s-'outh, about New Orleans,  and in different pans of
 Louisiana, laudanum has been used with great success.  It sliould be
 remembered  th .t this too, in its primary effect, is a diffusible and pow-
 erful sti nulant, can j ing before it the  sanguineous circulation  and  the
 nervous flui I 01 principle  of nervous  excitability.  In Germany  and
 some other puts of Europe,  the  camphor t.eatment has been most
 prevalent and successful.   The  Thmnpsonians have been  generally
 successful in thetratment  ofthis di.ea-e, an I their stimulants have
 been cayenne, mvr.h,in the lorni of a  compound tincture, lobelia as an
 etneiic, the 3rd preparation of this aiti le, valerian, bayberry, &c. ice.
    Being  myself one of the order of physicians termed .vledtcal Reform-
 era—one of the folio vers of the talented and learned  Dr. Beach—it
 would  be improper for me  to speak of the sure .'ss of our order in the
 treatment of choleia, as it will be said that I  am interested, and there-
 fore not a suitable person to judge.   I  rirall  however mention some of
 the principal stimulants used by us,  and leave those acquainted wnh
 our practice to judge of its  success.   Our stimulants  are camphor in
 the form of compound tincture, capsi .utn, laudanum and valerian; we
 use  frictions and apply warming applications externally; prohibit the
 use of cold drinks or any kind, having no confidence in cold vrater nor
 in ice for the cure of a disease, which if unchecked, needs not the assis-
 wnceofice to render its victim  cold!   Common sense if not opposed 
132
by rulgar prejudice, would dictate that in a'l cases of cholera from the
coldness present, warm and stimulating medicines should be adminis-
tered.  Accordingly end fortunately for the patient, when a person die-
tan t from medical aid happens to be attacked w.th this disease, the
bystander* and friends, if they do not lose all pros, nee  of mind, retort
immediately  to  the admit.isttation of camphor, brandy, laudanum,
warm tetsorsnme other means calculated to give relief,and ihe conse-
quence of such proceedureis in geuetal the .elief of  the patient—thus
in many  instances rescuing the patient from Ihe unnatural and life de-
stroying practice of bleeding and calomel.
  '1 he habit of using preventives, recommended by some, cannot fail
to be pernicious  in us consequences   To keep the s> stem constantly
under the influence of stimulant*  must  lend in derange the  returnl
functions < f the system. It would tend to produce debility, and thus
render the system more liable in be attacked, nnd  by habituating it to
the use of stimulants, less susceptible of  their  acti. n in ca^e of sn at-
tack.  The best prevemivt is u strict observan. e ol temperance in all
things, and a  confidence in some medicine or some mode of | r.icticeiu
case of un attack.  To confide in the  efficacy of medicine and the
skill and knowledge of some physician whose attendance could be ob-
tained if needed, is ihe surest safr-cpiard ngn.nst lear, the most j ower-
fu,  and  perhai s most common ex. iting  cause ol cholera.   \\ hen a
patirnt laboring  under diarrhoea gi.es way  to the influence of  feai,  he
is most sure to be thrown into the second sta,e ..f. holera.   Uui  n the
first stage relief is almost ce.tain tfapplic ition be not too long defenfd ;
and  he who in this state ind. I^es  m fear, discovers  his want of confi-
dence in medicine, and i- truly to be | itied.   Let  -every one spend  a
few houisof de iberale reflecno.i upon thi« subject; It him > owe t<> the
conclusion that he will use some particular medicine dictated by bis
judgment, in  case of an  xttack ; let  hi.u  seevne a co fidence in such
medical  aid as rehson and his own judgment shall joint out;  then let
bin) pursue a lempemte course in all tnings, shun..ing all tnedi. mes as
preventives while in health, and he may with propriety consider him*
eelf comparatively secure from an  attack of this disease. 
 
 
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