Lectures of Rush
copied by 
F. Bache
[illegible]




 


 


 


 


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Franklin Bache
Bache
Vol. 2nd
Vol. 2nd 

 


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1 
The Institutes of medicine are only useful in their application, 
as a help to the practice of Physic; the Institutes
are a part of an arch, which cannot be supported, unless the 
whole arch be perfect.
It has been said, that the practice of Physic is not 
so certain a science as Chemistry, Anatomy or Midwifery. Formerly
we did not know the use of some parts of the human 
body, now perfectly understood; but this does not prove 
anatomy to be an uncertain, but an imperfect science;
neither should you confound the imperfection of the Practice
of Physic with its uncertainty. It has also be said that 
the practice of Physic is stationary; but this is not true, for 
according to the population, the deaths 21 years ago, were
half again more numerous than at present.
That branch of medicine, which treats of [cross out] remedies,
is called by the school men.
Therapeutics
I refer you to Dr Barton for an exact account of the 
doses of medicines; I shall only notice the principal
divisions of the Materia Medica; Make till you
what tools to work with; I shall have but few medicines
from my belief in the unity of disease.
I shall give you some rules for the discovery of diseases,

2. We must attend to the season of the year
3. We must never loose sight of the 
laws of epidemics thus Diseases &c. (in other side A)

(2)
which will be partly a repetition.
1. The same disease in cold or warm countries may
require opposite remedies -
2. And even in the same latitude, the same disease
will require different remedies, according to the proximity
of seas or rivers. The bilious fever is milder according
as we recede from the sea.
We are like the British, as to our aliments, dress,
and our buildings; and if our imitation stopped here, no 
harm would be done; but we follow their practice of 
Physic: you should all vow to be independent of British
books and universities; even in our practical illusions,
we go to great Britain for Similies; thus we 
hear persons speaking of music like the nightingale, or 
skipping like a lump lighter, although they [cross out] have
never [cross out] heard the one or seen the other.
We must recollect that we are not in the moist
climate of great Britain, but in a warmer and a 
colder climate. We are under the necessity of altering
our remedies for the same disease, in conformity to the 
variation of the climate, thus diseases which will yield
to bleeding one year, will not bear the lancet the next.
By this mode of practice, you will be blamed for instability,
but never yield to prejudice, the world will at 
last do your justice; that these changes may take place
in disease, Webster and Dr Haen vouch for, and Dr 

4. Recollect that all diseases take on
the appearance of the prevailing epidemic -
thus &c. (in other side) A

3(3)
Sydenham bore testimony to them in a variety of diseases, 4 this Sydenham
remarks [cross out] that air intermittent fever, which
put on a comatose appearance, [cross out] was cured by [cross out]
[cross out] remedies [cross out] necessary for intermittents
6. natural habits should be studied, as they sometimes
influence the forms of diseases; thus the natives
of cold climates fall victims to the yellow fever, when 
going to the West Indies, while the old inhabitants are not 
affected by it; in Barbadoes the legs generally swell in 
an intermittent fever; thus also imigrant Irishmen require
much more bleeding in an intermittent fever, before 
the bark will take effect than a native American;
this was a remark of the late Dr Reynolds. In attending
the sick of armies or navies, compond of a mixture
of different nations, it is very useful to know this 
rule.
national habits influence not only the force of 
diseases, but also the [cross out] operation of remedies; thus the Laplanders
drink a large portion of ardent spirits, without 
detriment, and an Egyptian will require a 
large Cathartic [cross out] to purge him; it is the same case
with the European in Calcutta, according to Dr Hunter;
this remark applies also to the Tonic medicines, for 
it requires twice as much bark than is commonly
used to cure an intermittent of the West Indies
7. you should also enquire into the government,

8: The rank in life has great influence
9. The occupation should be attended
to -
11. Some persons have certain peculiarities
of constitution; these should be attended
to; they are called idiosyncrasies - 
A As Consumption Palsy hemorrhagy,
piles &c.
B In fact the disease will often appear to 
yield to any other than the usual mode
of cure -

(4)
government, religion, and employment or profession of your patient,
10 but above all discover the predisposition; they are 
the following;
The arterial, hepatic, nervous, muscular, cephalic
phrenetic, alimentary lymphatic, and cutaneous -
The bad effects of not attending to the predisposition
is illustrated by the fable of the wax and 
brick; and of the Ass and Mule with their bags
of cotton and salt -
"What is one man's meat is another man's poison", 
or in the other words Remedies which will cure some 
will kill others. You should be acquainted [cross out] with the 
chronic diseases of your patients, 12 as also, their common habits;
thus Rum would do a man accustomed to drink that 
liquor, more good, in Typhus fever, than wine.
13 You should also inquire into the hereditary diseases
of your patients, and look back even beyond the 
preceding generation; gout and Madness often miss one 
generation, and appear in the next; we should attend
to fetial diseases, A and become acquainted with the 
habitual remedies of your patients, thus if a man have 
been often relieved in a certain disease by bleeding, he 
will require more of it the next attack, to produce a 
cure; B the age of our patient should be attended to, thus 
vomits are safer remedies for children than adults from 

A And they return cephalic diseases
with more certainty -
B. together they have the disease of 
pregnancy -



(5)
from their being no danger of rupture, or breaking a blood
vessel; and blisters behind the ears, are less dangerous for 
children than [cross out] old people; A calomel and bleeding
can be borne by children, during dentition, Consumption 
is often cured under Puberty, as also children
will recover, after having the black vomit, of the yellow
fever, and of Epilepsy, but an adult, [cross out] rarely
The sexes have an influence on diseases; in diseases
of women, inquire into the state of the catamenia, whether
excessive, deficient or stopped, B in the diseases of men, assertain 
the following particulars; to whether he makes use 
of tobacco or Secret drams, more especially of his use of tobacco
in chronic diseases; interrogate him also, concerning what 
he eats; discover whether the disease arise from Love, Envy,
or mortified Pride; this information, if it cannot be obtained
from his friends, seek it of his enemies. I had a patient
from Barbados with Gout; he told me he was very temperate;
I asked him what he called temperate? why, said he, one
bottle of wine, when at home, and three when abroad;
how often abroad? twice a week was his answer; he 
went back to Barbados and died a martyr to his temperance!!
We should never loose night of the remote cause, in 
our enquiries for it we should look 4 or 5 months back; for 

"Causa sublata tollitur effectis" not 
always true - 

(6)
the more violent the remote cause, the more violent the 
disease; the remote cause has lurked 3 or 4 months in 
the system, before the exciting cause has [cross out]
roused it into disease.
Of Diseases said to be incurable
Are there any incurable disease? Lord Rames, says,
no; in the womb of time, in all probability, there are 
cures for all diseases; thus Syphilis, before the use of Mercury,
was as fatal as Cancer is now; intermittents were formerly
uniformly fatal; to say any disease is incurable, is 
as Lord Bacon says, establishing [cross out] Ignorance by law: you should
not decline taking a patient, because you think his disease 
incurable, although Hippocrates and Celsus advise
otherwise
Of Diseases, which it is unsafe to cure.
Some diseases should not be cured, 1st such as the 
sores behind the ears of children, without substituting
a Diarrhea; 2: Bleeding piles in old people, or in persons
having diseases in the head. 3. Gout should be kept in 
the limbs, when it keeps off melancholy nausea and 
bowel complaints; intermittent fever should not be cured
if it succeed mania and vertigo, headach, Palsy or fear of the recurrence
of the original diseases; upon this principle, a 
Physician of our hospital, Dr Thos Bond, was in the habit 

The cure of sore legs has produced death
in old people a diarrhea should be
cautiously restrained when it succeeds
cobi, headach, or anamia. The Tupis
purlis should not be cured; it is a 
laboratory pumping of the mucus which 
naturally collects in their tracheas -

(7)
of sending some of the maniacs every year to the swamps of 
Gloscester County, to bring on the intermittent fever; old
ones should not be cured in old people; rheumatism should
not be cured in Pulmonary consumption or mania, nor
Gonnorhea benigna in an intermittent fever; habitual dispose -
to sweat should not be restrained, the itch should not 
be cured in a hypochondriacal predisposition, nor gout
or a rheumatic pain in the head when it keeps off Mania.
Pains are very often useful; they sometimes keep as
alive; Dr Sydenham says, the pain of the gout has keep
many persons alive; and I should, suppose in the ear in which 
a predisposition to Cattarrh was cured by leaving off thick
wooling stockins, that the pain prove from the cold feet kept 
off the catarrh -
Of Specific Remedies
are these any specific remedies? Dr Sydenham and 
Dr Boyle say yes; but the unity of disease cuts the sinews 
of this opinion: it is to be lamented that the idea 
of specifics did not die with the belief in Morbific
matter; to be sure Mercury seems to be a specific in the 
venereal disease; but here it acts mechanically by mixing
with the virus, and only upon one part: but although 

 


(8)
I do not believe in specific medicines, yet I believe in specific
stimulants, but the kind of [illegible] stimulus, is the same as 
that in any other part of the body -
Of the Operation of Nature, in Diseases -
How far can nature cure diseases? this power got 
the name of the his Medicatrix naturæ; it was called
by Stahl, the "anima medica" from its supposed intelligence:
Cicaro justly says, "never was there an opinion
however absurd, which was not embrassed by some Men,"
the belief in the no great power of nature, I have held
long; the seeds of it were seen as early as 1772, as will be 
seen in an oration I delivered before the philosophical
society; nature I consider is nothing but Physical necessity:
what does nature do? 1st in hæmorrhagy she does 
very little; 2 what does she in a yellow fever or a typhus or a tetanus,
she would not cure one in an hundred. 3. but we will 
complain of nature upon another score, she is sometimes
mischievous, or in making too much blood after an amputation. 
4. sometimes she is inert as in atomic gout;
sometimes she alarms the system with much pain, when 
there is but little danger as in the Stone in the bladder;
in other diseases we have not sufficient pain to warn us of  

A Scirrhus and aneurism 
B. Inverts the motion of the stomach and 
bowels -
C and finally destroys life in a violent
and general convulsion -

(9)
our danger, as in consumption A [cross out]; in these ideas, I am 
supported by many great men who have declared their opinions
lately; Dr Willis says, speaking of the Plague, that so 
far from leaving the diseases to nature, we must fight with 
her, with the medicines of art: Dr Pringle says, that nature
was unable to cure, or if she did, it was but imperfectly, certain
diseases of the poor people: Dr Moseley says we must take 
the disease out of the hands of nature.
Thus, if I would not reject nature altogether, I 
should trust her in very few diseases: besides, admitting that 
she may sometimes cure diseases, can there be any objections
to our helping nature, and rendering the cure more shady
Where is the analogy in the good tending of bleeding in 
Pleurisy, and opium in Dysentary, to the direction of nature,
and who does not use these medicines in those diseases; let us 
inquire what nature does in a bilious fever; she overhelms the 
whole frame with blood, B she tears the blood vessels, [cross out]
dissolves [cross out] the blood, [cross out] deluges the body with unprofitable
sweats. C but still I admit that she has some power 
in slight diseases, but, as weak medicines, if trusted to alone
to cure violent diseases, will do no good or harm; nature
is much like the moral faculty, she has to be 
regulated otherwise she will go wrong; thus, when you 

 


(10)
are called to a patient with a violent disease, I would
advise you to treat nature as a noisy cat or dog, turn
her out of doors, and shut the door upon her.
This great idea of the power of nature in the cure
of diseases, was taken from her operations in the healthy
state, which will by no means hold good in disease which is a 
state in which one part will be prostrated, another
overacting, one part cold, another hot, the blood beats
upon the brain, convulsions ensue and death closes the 
scene; such gentlemen are the effects of disordered
and debilitated nature
He strengthens his ideas by the analogy of moral 
good and evil -
The advantages to be derived from observing the 
tendency of nature
We should take advantage of the tendency of nature 
to this or that part, in throwing off the disease;
sometimes in a fever she will attempt to relieve herself
by the bowels; take the hint and cure with purges; if 
hemorrhagy take place, bleed; Dr Sydenham used purges
with success in a fever in London, from observing that 
nature had a tendency to throw off the disease is that 

A for aliments and drinks, air and exercise 

(11)
way. In infancy and childhood, nature throws off disease
by sores behind the ears; there let us deplete - In youth,
to the lungs; let us apply blisters to the breast; in old age
the tendency is to the bowels; let us therefore cure old people
by purges; nature may be compared to a finger part,
which points out the road, but does not move a step
herself; but however safe we may be in a weak disease,
in choosing the part point in out by nature as our 
only emunctory; [cross out] let us beware of an equal confidence
in more violent diseases, as this would be like opening
but one door of a church, in case of fire, for the people
to escape at, when it would have been easy to have
saved all the people by throwing open all the door.
Nature is either too quick or too slow, too anticipating or 
too procrastinating, too partial or too general; she is too quick in [cross out] Yellow fever, too
slow in Typhus; to anticipating in sweating on the first day 
of a disease, too procrastinating, in the sweat at death -
In this discussion, it will be expedient to inquire
how far the longings of our patients A are to be gratified; I
admit that in some instances this indulgence has been the 
means of a cure; thus a draught of cold water has produced
a sweat which has saved life, when it is probable; that 

A As oils, acids, diluting and demulcent
drinks -


(12)
if the system had been a little more or less excited
it would have produced death; also a piece of beef stake,
or ham, has given the system, in some rare instances, in Typhus fever, a 
tilt in favour of life; cold air has acted in the same 
way, by some happy chance.
The predisposition should be watched narrowly
also the disease itself, and lastly the symptoms -
Of the Choice of Medicines.
1. Medicines are generally contrary to our tastes and 
appetites; these quantities have been given them, to prevent
us from using them as aliments; they may be considered
as so many slow poisons of different strengths, from arsenic
and opium down to Nitre and Chamomile tea -
2. Medicines may be agreeable, and have a tendency 
to dissolve acrimony A 
3. Those which are agreeable, but act by raising and 
stimulating the system, as common aliments and drinks
4. Those which are both agreeable and disagreeable;
as cold and cool air; hot, cold, and cool water, and 
ice, and exercise and labour -
Let us have but few Medicines.

 


(13)
1. Let us have some with energetic qualities, as 
Mercury, purges, vomits &c -
2. Then a few 
3. Then a few bitters, for bitters all act differently
He compares the practice of giving few medicines in 
combination, to the combination of the remain bitters,
so as to form any word, whereas, the contrary practice
he compares to the Chinese alphabet, which has a [cross out]
different character for every word
Of the Mixture of Medicines
Should we give Medicines alone or in combination?
I say, in both ways; the bark, opium, ammonia Rhubarb
act very well by themselves, yet it is necessary often
to combine them; this Dr cured a cancer by 
Corrosive Sublimate and Hemlock, [cross out] which had resisted
the power of Hemlock alone -
Jalap is improved by combination with cream of 
Tartar; and Senna, when combined with Manna or brown 

 


(14)
sugar; Dr Fourdyce tells us squills are improved by combination
with gum ammoniac, and sulphatic of Zinc
when mixed with Ipecacuanha; alum is rendered
a bitter astringent by combination with red Roses; and 
black pepper and Capsicum never heat the stomach
when combined - 
Of Consultations.
They should be required,
1. In all doubtful cases -
2. In all dangerous, but not doubtful cases -
3. In tedious cases -
4. In desperate cases -
5. In cases in which the patient is a friend, his 
solicitude will derange his judgement. - never have a 
consultation with a Physician who [cross out] practices
[cross out] upon different principles from yourself; it is like yoking
an ox and an Ass. together; persons who will consult
under such circumstances, are like merchants, labouring
for money, and not for the life of the patient -
of the preparation of Medicines -
1. The same medicine will agree or disagree, according




(15)
to the different forms in which it is prepared; thus bark
is a different medicine in Zinc, decoction [cross out] extract
[cross out] or substance; some persons can take opium, but not Laudanum -
2. Other medicines cannot be taken, because they 
formerly disagreed; this arises from association; hence
a Lady could not take Calomel when she knew it -
3. We should not prescribe medicines, shocking to 
delicacy or which are expensive; under the former head
we may mention. Cow's dung, called album græcum; cow's 
Urine, called flower water; as expensive prescriptions
we may enumerate, wine and opium baths happily
for as the best medicines are the cheapest -
In preparing medicines for the sick, we should
pay attention to the label, the manner of writing it;
to spelling correctly, and making the proper abbreviations
of the words -
pullar medicina, aliquado, oftima medicina";
hence, sometimes a patient has recovered [cross out] after
having been given over by the Physicians -
You may persuade your patient to take his medicines 
by explaining their intended effect. - 

A There is now and then a recovery after the 
occurrence of every mortal symptom -
B Male nurses are the best, since they
do not despair as soon as female -
C This takes place when the force of the 
[cross out] remote cause is such as to depress
the system below the point of reaction 

(16)
It is well for Physicians to sit up with their patients
in dangerous cases; by this practice they will learn
some things; they will discover the seat of pain in 
sleep; the state of the mouth and eyes may be seen
with more advantage in sleep never give a patient
over in an acute disease; A we must dispute every inch 
of ground with the disease: in chronic diseases, we should
be very prudent in giving our opinion; we should take 
patients in our own hands, and in some instances rescue
them from their relations and female nurses; by 
[cross out] attending to this rule, many are matched from the 
grave B
The Grades of Excitements
1. Preternatural excitement, but regular.
2. Debility, from action or abstraction.
3. Depression -
4. Disease
5. Oppression C
6. Prostration; which forbids depletion, stimulants
alone, will raise the system -
7. Disorder -
8. Subsequent debility, as the durable consequence

A. and stimulants proportional to the excitability;
of the debility be more chronic, then stronger
stimulants may be used -
B. The reins and implores as to attack disease
in its forming state -

(13)
of cured disease or disorder
1. Elevated excitement is known by sprightliness
and wakefulness; the remedy is a purge, or the 
loss of a few oz of Blood, or low diet -
2. Debility from abstraction or action is cured by
rest; A obvious debility generally preceeds general diseases B 
3. Depression is indicated by sighing, fainting,
this is cured by gentle laxatives -
4. For the cure of disease we have either stimulants or Sedatives,
the two grand divisions of the 
Materia Medica. -
In all diseases, there is unequable excitement.
Here he enumerates to different combinations of excitement
and excitability -
The following circumstances should be inquired
into, in determining the state of the excitement and excitability -
1. The recovery of the disease,; if recent, we may
always presume on a good stock of excitability -
2. From experience; similar diseases have generally
equal degrees of excitement and excitability; 

A In the muscles and the observe of both
in the bowels -
B This has the effect of producing pain
in the diseased part -

(18)
in Tetanus, there is great excitement, but little excitability 
A
3. The grade and seat of the excitement should
be determined by remedies; Dr Sydenham has unfolded,
a doubtful chronic disease, by exercise and a few glasses
of wine. B
4. There is not much excitability left in tedious
diseases; in the camp and Jail fever, wine, bark and 
Spirit are the only safe remedies; for we may be certain
that the excitability is worn down, and consequently
may safety begin with stimulants -
By stimulants I mean those remedies, which increase
life wherever it is wanting, and equalizes
the excitement. Those remedies which increase the 
quantity of life and tone are called Tonics -
By sedatives I mean those remedies, which blunt 
sensation, and diminish motion; they act in 3 ways
1 By the abstraction of stimuli, as cold and darkness,
bring the abstraction of the stimuli of heat and light,
2. Such as first appear to be stimulants, but are sedatives
in effect; these are [cross out] cathartics


Cold air? has been found useful in convulsions
and Hysteria, and all diseases consisting
in morbid excitement in the muscles and 
nerves - 
A as well as from labour, I shall hereafter
speak of the efficacy of this remedy and the 
time at which it is to be used -

cathartics, emetics, sialagogues, or errhines; these all produce
indirect debility - 3rd Those which act insensibly, as Digitalis,
Sugar of Lead &c - There are called direct
sedatives -
Direct Sedatives.
1. The first direct Sedatives bleeding; we shall speak 
of it hereafter in fevers -
2. Cold is a direct sedative; Dr Sydenham introduced
cold air in the cure of fever, under this head is included
cold air, water, and ice -
3. Fear acts as a direct sedative, it equalizes excitement,
hence it [cross out] will cure hiccough by debilitating the 
diaphram -
4. Rest this includes absence from business and 
study. A -
5. Abstinence as a relative term; it is either a 
seduction of our usual food in quantity, as it is 
necessary to do with old people, who cannot have the 
quality altered, or it is an abstraction of quality, when 
it is necessary to have a certain quantum of distention.
More nourishment is afforded to the body by fluids than 

A and prevent eating much -
B as carrots parsnips and beets -
C Reasons for believing Hippocrates' maxim 
1. By feeding a diseased body, by increasing the
quantum of blood, or risk disorganization and 
death -
2. In a diseased body there is less occasion
for the stimulus of food, as the stimulus
of disease is a substitute -
C. in the stomach which robs the other parts
of the body of their necessary excitement to 
resist the disease; in order to shew the good
effects of dieting in keeping off disease I mention
the following case - Dr Gregory &c.

(20)
an equal quantity of solid food; elements may be arranged
in the following order, according to their 
grades of nourishment 1st Fresh full grown meat;
2nd the fat of such meat 3. Poultry. 4th Salt Meat
and salted Fish; this last I consider as low diet, for the 
stimulus of the salt is but transient!!!!; after salt
meat and fish, I place 5 eggs, then 6 scale fish, then
7 shell fish, after that 8 Milk, next the 9 Saccharine
vegetables, B then the oily vegetables; and lastly
gum Arabic; but there are morbid states of the 
system in which it will be necessary to abstract
aliment altogether -
Hippocrates said, "the more you nourish
a diseased body, the more you injure it" - C
3. Because By digestion, [cross out] the diseased body has 
an [cross out] accumulation of excitement; C Dr Gregory and his officers
were cured [cross out] of a predisposition to disease
when in prison, by having to live on rice and 
water; upon being released, they found all their 
brother officers, [cross out] dead, who had lived at Madras  

A. Pude says that those animals which 
die of famine have the internal surface
of their intestines very clean and white;
what would be the effect of fasting in 
clearing the bowels filled with bile -
A. It acts more certainly if attended with 
taciturnity-

(21)
All these things prove the necessity of a diminution
of aliment in quantity and quality in disease. Indians 
abstain from food 3 or 4 days before battle, in order
to render their wounds less fatal; not only abstinence,
but fasting are useful, in all cases in which 
patients are above far; it has cured Asthma A Wild
Beasts are tamed by fasting; [cross out] might we 
not tame Mad Men in the same way? Adults can 
bear fasting better than young persons; Sedentary better
than labouring persons; in winter it is easier borne
than in Summer, according to Celsus; but, says Celsus,
if our patients will eat, give them an emetic immediately
afterwards; Butchers tell us that meat 
is less liable to [cross out] putrefy of those animals
which are fasted before being killed -
6. Darkness is a sedative -
7. Silence is a Sedative?
8. Reduced air is a sedative; it acts by reducing 
the stimulus of oxygen upon the lungs -

let us now speak of those medicines
which lessen action in directly, by 
first producing a stimulating effect
A Nitrous oxide upon the mind -
B Diuretics were to act in this way -

(22)
Of Indirect Sedatives
1. Some Medicines have a specific action; thus Rhubarb
affects the bowels, but has no action upon the blood;
bark is exactly the reverse; carbonic acid gas is a posion
in the lungs but a cordial in the Stomach; Jalap acts
upon the bowels, garlic and Assafœtida on the nerves, A and 
oil of amber on the muscles, while opium and wine 
act upon all these systems -
2. Certain medicines act on all the systems [cross out] through the 
Medium of the [cross out] nose, skin, rectum, mouth or 
stomach, but as the stomach has the greatest range
of sympathy, it will be acted upon with the greatest
advantage - We may make medicines act on different
systems by combination; then Aloes and Assafœtida
will act upon the bowels and nerves, and nitre
acts upon the Stomach, blood vessels and renal 
glands.
3. Some remedies act by getting into the blood B
4. Certain Substances go through the body without 
doing good nor harm as madder !!! -
5. Some remedies act chiefly on the sensibility

mustard plasters act upon the sensibilities,
and if they produce any effect upon
the pulse, it is indirectly, by means
of pain -
1. They discharge matters from the stomach;
they invest the peristaltic motion; they
act on the Kidnies open the pores, relax
spasm - 


(23)
others on the irritability; thus Camphor acts, chiefly upon
the sensibility; Digitalis certainly chiefly on the 
excitability, and opium and Bark on both; Tobacco, when 
applied to the skin does not affect it but produces
nausea, Mustard, irritability of the skin
but no effect on the stomach -
Among the indirect sedatives I place 
Emetics 
I Emetics - These Emetics said by some to be unnatural
remedies; but this cannot be, does 
not nuture but the dogs to vomit themselves?
Emetics may be either prompt lenient or forcible
vomiting may also be brought on by a rotatory motion
and Association -
1 Under the head if prompt emetics may be 
enumerated, irritation of the fauces with a feather;
white vitriol, large draughts of water previously
made nauseous, rotation and association -
2. Under the head of Lenient emetics may be 
enumerated Tobacco, Chamomile Squalls, Ipecacuanha,
and like warm water. -
3. Under the head of forcible emetics may be 

I was in the habit during the war of carrying 
a number of emetics in my pocket and 
giving them to every solider that complained
of headach and sickness of stomach, which symptoms
indicated the coming on of the camp fever -

(24)
enumerated Tartar emetic, glass of antimony, antimonial
wine, Turpeth mineral, blue and green
vitriol, and water, to act by its quantity.
Emetics are required in the following
cases
1. The forcible and prompt emetics are 
required when poison either by accident or design
has gotten into the stomach -
2. They are required when the stomach is loaded
with bile or mucus, or indigestible substances, here lenient.
3. They are required in the first stage of Dyspepsia,
if attended with languor of the stomach; here 
the lenient [cross out] and forcible must be used -
4. They are indicated in Diarrhœa and in some 
cases of dysentery, from [cross out] counteracting the peristatic
motion of the bowels -
5. The small pox is often prevented in its forming
state by lenient or forcible emetics, also they are
useful in the last stage of Typhoid fever Dr Huxon
tells is they are safer than purges, I believe it,
for I [cross out] never saw death produced by emetics, although

A after bleeding has been used -
B. They are suddenly useful sometimes in 
asthma, by relaxing the spasm of 
the trachea upon which it depends.
11. They are useful on opening the pores -

(25)
many patients have sunk under purging -
6. They are also useful in Catarrhs, pulmonary consumption,
Cynanche Trachealis, and asthma; A here they 
soften the pulse and mitigate the cough B
7. They are good in the diseases of the trachea
generally from the sympathy of that part with 
the stomach -
8 They are given in Hæmorrhagy -
9. They are useful in removing the torpor
of the liver or spleen and in dropsies of the abdomen; the lenient or forcible
must be used -
10. Dr Hunter tells us, he has resolved a venereal 
bubo by the action of emetics -
12. The lenient emetics will do good in slight
pains in the head when arising from a foul stomach -
13 Emetics are safer remedies with children than
grown persons; from their stomach's bony lined with 
mucus.
Rules for the exhibition of emetics -
1. You should give dry vomit in pressing occasions, and 
in large doses -

A or fullness and pain in the head.
A In order to prevent spasm to the 
stomach -

(26)
2. when the case is not very pressing, you should divide
the dose to prevent danger -
3. In all cases of plethora, indicated by the pulse A and 
in fever, their use should be premised by bloodletting;
it renders then more prompt, useful, and safe -
4. We should not give great quantities of water during 
the operation of Emetics; this custom is called, working off Emetics,
but it weakens the action of the emetic upon the stomach unnecessarily; it arose from 
Dr Boerhaave's system of diseases, namely, that they arose from 
acridity -
5. you should always give a vomit in the morning; because
nature points out that time as the most proper, especially
if a dose of opium has been taken the night before -
6. you should never allow your patients to puke in a 
recumbent posture, A if the vomiting be too severe, give 
a few drops of Laudanum, or some chicken water, which 
last you may use very plentifully untill you have accomplished
your end; if we find them safe, they must be 
repeated every day or two, otherwise they will do no good;
hence the sickness produced at Sea is so beneficial -
Formerly vomits were given to remove foreign matters

Cathartics are to be used 
2 when the stomach is filled with bile
and when our patient will not take an emetic.
3. They are alike indicated when these
matters are in the bowels -

(27)
matters only from the stomach, and hence only one emetic was [cross out] given in a disease,
but now that we know that emetics are useful in many diseases, let 
us give them much oftener -
[cross out] 1 Vomits [cross out] must not be given in congestions of the brain or 
lungs.
[cross out] They [cross out] must not be given in inflammation of the stomach, when
there is reason to apprehend the production of Spasm,
nor in the advanced stage of Pregnancy, nor to those subject
to Ruptures -
9. They [cross out] should not be given in [cross out] any case of low fever, but [cross out] in 
slow chronic fever, they may be given gr? -
II Cathartics - 
A Cathartics are such medicines which have a tendency
to empty the bowels; they act either by translating action-
to, or originating [cross out] it in, the bowels; they may be divided
into lenient active and drastic. -
The lenient Cathartics are castor oil and sweet oil
The active, such as aloes Rhubarb - Senna
The drastic, such as Calomel Scamony, gamboge,
Quicksliver, black Helebore, Bucks thorn, Jalap, and lastly
fasting -
4. In the Torpor of the bowels which occurs in Hypochondriasis & colica pictonum the drastic are necessary.

A When weakness does not forbid them.
b- They are good in diarrhea when the 
pulse is not too low -
B. As well as by discharging matters from 
the bowels -
C. this proves the increased action of the 
absorbents -
D This fact was observed by Dr Sydenham
and confirmed by Sir John Pringle -

(28)
5. In all febrile diseases in which pulse is above
par; and in Dysentery, A the lenient and active purges
are indicated -
8. The drastic purges are to be used, when the head is affected, or 
the pulse active; they are good in St Vitus' dance -
9. They are also indicative in all the diseases of the
[cross out] liver and Spleen, and omentum -
10 Male action hemorrhagies, whether from the lungs
bowels or Uterus the lenient purges must be used as 
well as in all cases of tonic or inflammatory dropsy; in this last 
case they act by increasing the action of the absorbents B x
11 In the stoppage of the hæmorrhoidal vessels,
or piles, and in diseases of the skin, the lenient purges
must be used -
* Persons have been found to weigh more after 
taking a purge, from the absorption of moisture from 
the air, C
Rules for the exhibition of Cathartics -
1. The drastic purges act better by being mixed
with the lenient, D as Calomel and cream of Tartar,
Jalap and cream of Tartar, calomel and Rhubarb 

A Hence they are improper in Typhus fever,
where Dr Hamilton used them; I make our
exception to this rule, as when we give them
for their reclusive action -

(29)
Jalap and Rhubarb and Senna and Manna.
2. after having been purged for some time, a much
less dose will act -
3. Liquid purges are to be preferred; they wash the 
bowels -
4. In long continued purging the Cathartic should 
be changed -
5. no solid food should be taken during the operation
of a purge -
6. no watery aliment should be taken to work off 
a purge; you should not be contented until you 
had induced an artificial diarrhœa, for it is thus 
nature carries off any offensive matter from the 
Stomach -
7. Their action is increased by having fasted the day
before -
8. They should be repeated every two or three days,
but in a bilious fever they should be given every day 
They are forbidden -
1. When the patient is below par A even great slim
is not to be removed, when attended with great 
debility; it is best removed by tonics -

 


(30)
2. They are forbidden in most of the diseases of the lungs.
3. They are forbidden in hemorrhagy from the bowels -
4. They are forbidden upon the accession of Colica Pictonum,
for a reason to be mentioned hereafter -
Horses have more irritable bowels than men.
On the use of Clysters -
1. They are to be preferred when the stomach rejects purges;
2 They are to be used in obstructing matters in the 
rectum -
3 They are proper when a revulsion is wanted from 
the head, throat - lungs or stomach -
4. The are necessary when the kidnies, uterus, or 
bladder are pressed [cross out] by the contents of the bowels -
5. When we wish to pulsate costiveness of the 
lower bowels; the French are very fond of their use 
Clysters act by their quantity and quality
1. Quality, take from 1/2 pint to 3 gills of water, add
a little Molasses or oil, with a little aloes -
2. Quantity; or a portion of simple water; it will often
produce a stool -
air and the smoke of tobacco have been used
when a structure or intussusceptio [cross out] is suspected.

 


(31)
But however severe your clyster may be, it only affects
the lower bowels, just like that brush which is used to 
remove the soot from the liver part of [cross out] a chimney;
it is calomel and Jalap alone which can sweep the 
chimney from top to bottom -
III Diaphoretics -
That these medicines act by depleting is evident, from 
our diminished weight after their use, this effect is 
often seen in Partitions who side in races; Dr Sydenham
says that patients will feel stronger after sweating; this 
arises from pressure being taken off; it is often the 
same after purges for a similar reason -
I. They act upon the skin immediately, as air 
oil, water, vapour, blankets, salt, sand, and clay. Dr Sydenham
excited a sweat by blankets in the plague; they act 
by containing the heat of the body. 2 In Hats they sweat
with hot air in cells; [cross out] they are called Indateria -
Salt, sand, and Clay have been used, covering the 
patient with them except the head; Salt is best; when 
we wish to sweat the head, we must cover it with blankets,
and throw over it the vapour of vinegar -

A. It is used in slight indispositions.
B. by cold air and cold water, they acting by &c.
C. I explain this by the sympathy of continuity
between the stomach and [cross out] skin -

(32)
Pediluvium. A It should be used for a half hour,
and the patient put immediately into bed. [cross out] fomentations to 
be useful, Pringle tells us, should be used for [cross out] one 
hour -
II Sometimes sweating is produced, B by reducing 
the capillaries to the sweating is point, [cross out] -
III They may be obtained by cold suddenly after
heat, as is the practice with the Indians -
IV They may be obtained by exercise and rest
[cross out]
1 [cross out] Some Diaphoretics act by exciting nausea in the stomach, C and whether
the skin be above or below the sweating point
they produce their effect, but neutral [cross out] Salt produce
the effect without exciting nausea, as nitre -
2. Some act upon the blood vessels as well as stomach, as 
wine, opium, [cross out] vinegar serpentaria, Chamomile,
Eupatorium, Centaury -
3. Some act by distinction as [cross out] water -
5. Purges may be enumerated under the head of 
Diaphoretics; and more especially the popular one of 

A. Hence the popularity of sweats in the fevers
of Britain; which are of this kind - 
B Flannel should be worse -

(33)
10 and 10 in yellow fever: a man in Edenburg was in the 
habit of curing himself of the venereal by copious
sweating; in this case the sweating was so profuse, that 
the shirts of the person could not be washed without 
tearing, such was their brittleness 
Diaphoretics are to be used 
1. In acrimony -
2. In mild fevers A -
3. In fevers having a tendency to relieve themselves
in this way; also in the centrifugal diseases of gout 
and Rheumatism -
Formerly sweating medicines were given in all 
diseases; from an idea that they arose from specific
morbific matter; and at present they are persisted
in, from a belief in Dr Collin's theory of Spasm of the Capillaries -
When we wish to sweat ourselves we should 
go to bed, for we sweat more in 9 hours in bed, than 15 
out of it; B the linen should be changed 4 or 5 times
a day we must not attempt to sweat when the heat 
of the body is above 100 degrees, for if it does take place,
it is either partial or injurious; in this state of a patient,

A which have been impregnated with 
sweat should be frequently changed -
Here I make two remarks - 1 Nature &c (in other side)
B That Brutes never rest to them although
they use both emetics and purges -
A Dr Sydenham used to open the urinary
passages in small part in this way -

(34)
patient, I ordered the use of the sponge; the sweat followed 
uniformly the track of the sponge.
7. It is supposed necessary to give diluting drinks
to sustain the patient; they do no good, unless they 
blunt acrimony, or act by distention -
8. The linen, including sheets and blankets. A [cross out]
otherwise the sweat will putrify 
in them -
9. Great care should be taken to prevent [cross out]
excessive sweating, it is a mortal symtom -
in typhus fever -
1 nature seldom brings in sweats, except in violent
states of the System, that is, in the forming state of fevers,
and at death from all diseases B
IV Diuretics
Diuretics are medicines which increase the 
flow of urine - They are 
1. External; as cold air, and cold water; A we are 
all acquainted with the effect of [cross out] cold water,
by going into bath early in the spring; the same 
effect will be produced by placing the hand 
in cold water in sleep; this is a boarding school
trick; warm water will produce the same effect.

A Different preparations of iron and 
the vegetable acids -

(35)
2. Going up and down stairs has a diuretic effect
3. Certain noises such a the pouring of a tea pot; Dr Whytt
tells us of a certain man, who always had a inclination
to make water when he heard the sound of the bag
pipe -
4. Fear, I have published a striking instance of 
of the effects of fear as well as abstinence in dropsy, in my Inquires -
5. Such substances as act directly on the kidnies, as
Carrots, water Melons &c Parsley -
6 Such as act indirectly upon the kidnies, as Squills
Digitalis, Turpentine, onions opium, fixed alkalies and 
neutral salts &c &c A 
Diuretics should be given in some cases, to act 
only as evacuants; [cross out]
The premonitory sign of the plague of Bussora 
[cross out] was a great discharge
of urine; the same thing, in some instances I 
noticed in the yellow fevers -
1. Diuretics of a mild kind should be given
in the forming state of dropsy -
3. They are indicated in obstructions of the 
Ureters, either from engorgement of the kidnies,
or Spasm of the urethra or the neck of the bladder -

They are also indicated
In pneumonies, catarrhs asthma and 
pulmonary consumption; thus should 
be lenient or stimulating, according 
to the greater or less morbid action
of the lungs -
A Iron is good to raise the uterus to the emenagogue
point; when the system is above this 
point, I always depend upon depletion and 
afterwards exercise -  

(36)
4. They are forbidden in debility either from action or 
abstraction; hence in atomic dropsy they are forbidden;
for here tapping very often kills; in this same
way would diuretics be fatal -
V Expectorants -
Matter is of 3 kinds, Pus, Mucus, and Phlegm, the 
great use of the lancet has in a great measure obviated
the necessity of expectorants -
3. Some expectorants act directly upon the lungs
such as volatile alkali, Tartar, oil of amber; the 
vapour of these substances ascend from the stomach 
and is taken up by the bronchial vessels; to this class
may be referred, to boars tea, barley water, liquorice, the 
smoke of Tar, and a combination of Tar and wax,
thrown upon hot coals -
VI Emenagogues -
no medicines act specifically upon the Uterus, Madder
is said to have such an action; but experience 
does not sanction this belief, for it has not been remarked
in the human female, but in Mares only.
As emenagogues, Aloes, Gum Guaiac; Seneka &c &c 
as also Matrimony, exercise &c &c A may be 
used - 

A It acts further on the parts near the
glands -
B. Even in adult life, nature relieves herself
by the emunctory of the mouth. 


(37)
VII Sialagogues -
They have been divided into those which act upon
particular glands and parts, as tobacco radix Spirethic;
and those which act upon the whole system
of glands as Mercury and Saccharum Saturm and arsenic.
Calomel acts in two ways, by revulsion and 
depletion, A a Salivation is an unpopular remedy; it 
is said to be an unnatural remedy, but this is not 
true, for we see, when children have sore mouths, that 
nature puts in this mode of action; this sometimes
happens in Cynanche Trachealis., B further, Dr Sydenham
makes mention of a malignant fever, cured by a spontaneous
Salivation, and a spontaneous salivation generally
attends those cases of small pox which terminate fatally:
a spontaneous salivation has cured Gout and Dysentery,
the former case was under my care, the latter,
under the late Dr Clarkson; in madness, we see a constant
action of the salivary glands; hence Maniacs
have been called Spectatores; besides, a sore mouth
in fever is universally considered as a favourable sign;
[cross out] and why shall we not take this hint, and assist nature? 

A This I used in '95; it produced
universal clamour.
B. This I have on the authority of Dr.
Chisholm - Cheyene gr?

(38)
we have to regret, that we cannot always produce
a Salivation. It is rendered more certain;
1 By bleeding, if the pulse be tense-
2. By low diet; this acts as bleeding [cross out] they both prevent [cross out] a 
tendency to gangrene -
3. By Vomits; which act by awaking sensibility
and the action of the absorbents of the stomach
4. By opium, this either prevents the mercury passing
the bowels, or acts by raising the system to the salivating point,
when [cross out] below it -
5 By Cold; this acts by bringing the system within
the sphere of action of the Mercury A
6 Dr Porter of St. Croix, informed Dr Cheyme that 
An increased Salivation by Jalap; I have myself
accellerated the action of mercury by combining it, with nitre -
7. By injecting mercurial ointment into the 
bowels; B
8. By varying the preparation, as to Corrosive Sublimate,
or red precipitate, or Turpeth mineral -
9. By withdrawing the medicine for a few days or weeks -
The above modes of accelerating a salivation must 
be used only when the system is above the salivating
point; but when the system is below that point, the 

A And the armpits also; by mercurial
locks -
B. But lately an ingenious friend of mine
explains it by the oxygen which the preparations
of mercury contain - 

(39)
system must be prepared by giving bark and other tonics;
in these cases, it must always used as a revulsive,
and not as a depleting remedy; mercury may
be given to Maniacs by spreading it upon bread, and 
covering it with Butter -
All these internal modes are accellerated by 
rubbing the skin with Mercurial ointment, A and 
the gums with Calomel; it is not by cutaneous absorption that 
the two last means have their effect, but by the absorption
of the vapour by the lungs, never the reason 
the arm-pits are preferable from their proximity
to those organs B 
Dr Spalding of Massachusetts has communicated 
a case in which a salivation took place 6 months after
the exhibition of Mercury; we had an instance in our 
hospital. It is to be regretted we cannot produce
a Salivation certainly; it failed 3 times out of 4 in 
the yellow fever -
To obviate the effects of Mercury -
1 Purges are to be used, of which Sulphur is to be 
preferred -
2. Bleeding, if there be either great pain, a 


 


(40)
tense pulse or a tendency to Mortification.
3. Opium. 4. Blisters. 5 Washing the mouth with 
a solution of Borax [cross out] in a solution of Green Tea -
6. Washing the mouth and fauces internally and 
externally with cold water; this practice was formerly
thought madness -
Mercury is useful -
1. In Malignant fevers -
2. In Morbid determinations of the blood to either 
the brain, trachea, lungs, liver, or joints -
3. In Dysentery and Diarrhœa when obstinate.
4. In Dyspepsia, when it resists other remedies -
5. In obstinate Ulcers -
6. In the venereal disease; there, to do good
the salivation must be complete!!!! -
7. In Hydrophobia; but the disease is generally
too violent for the Mercury to affect a cure; in some 
[cross out] diseases it does harm if it salivates, and good, when it touches
the mouth only; this is sometimes the case in visceral 
obstructions, and certain cutaneous affections -
8. and lastly, Mercury is useful in visceral obstructions,
and in certain cutaneous diseases.

A Happily for us it is not easy to make
the mercury take affect here -

(41)
Mercury is forbidden.
1. During great action in the arteries
2. In the low state of the system, when depletion is 
improper; A
3. In children under the age of 6 years; for under
this age the gums are so tender, as to be liable to 
take on gangrene -
4. In old persons, above 60 years of age; but there
are two exceptions, namely, when all the teeth are 
sound and firm, and when they are all wanting;
but in desperate cases, do not be afraid, for it is better,
to run the risque of an uncertain gangrene in the 
jaws and the loss teeth, than lose our patient -
It must be regretted that this remedy is loathsome,
and often very painful; when we reflect, we 
loose our teeth and have a sore tongue, we are reminded
of the punishment of those parts which 
ate the forbidden fruit, and are constantly sinning -
VIII Errhines -
Errhines are such substances as excite a discharge
from the nose; they produce their effect generally by 
sneezing.

 


(42)
Many diseases go off with a sneezing; under the head 
of Errhines, we have Tobacco, Turpeth Mineral,
muzewort, white Hellebore; they are not to be 
used when the blood vessels are turgid; they are 
good remedies in Tooth ach, and ear ach -
IX Blisters -
At a time when Spanish flies were expensive, I 
made a more perfect and prompt Blister of equal
parts of Cantharides and Mustard -
1. Blisters are indicated in congestions of the lungs,
brain, & joints -
2. In diseases of moderate action -
3. In Sudden congestions; here boiling water should
be used -
They are forbidden.
1 In all fevers, above or below a certain point, called
the blistering point; the proper state of the system
is attended with the typhoid pulse -
2 They are forbidden in highly irritable people,
and persons disposed to be affected by strangury -
Rules for the use of Blisters -
1. They should not applied on the diseased part,

 


(43)
but near it.
2. When the disease is deep-seated, it is no matter
to what part they are applied, unless [cross out] it be emptied
by contiguous or continuous sympathy -
3. They do most good when the disease is loosened
4 In Malignant fevers, when there is a tendency
to destroy a virus, make use of blisters even before 
the system is at the blistering point, for the purpose
of actuating morbid action from the virus; this 
may be considered as a kind of cutaneous Salivation.
5. In fevers in which there is a tendency to gangrene
in the extremities, Blisters should applied
to the thighs -
6. Blisters should be taken off, after having 
risen, or after giving unnecessary pains -
7. Blisters to the head never rise, but a 
serous matter oozes out. -
8. The application of 5 or 6 blisters at the same 
time is sometimes necessary -
9. They never discharge much, after the 1st 
or 2nd dressing - 

 


(44)
10 If a blister be applied at the blistering point,
Serum will be discharge alone; if above that 
point, a sore, or pus is produced, if below, an angry
dry sore is produced which often turns to gangrene;
so that if a blister first discharges Serum and afterwards
pus, it is a good sign, since it indicates
the system rising; but, on the other hand, should a 
Sanies follow, it is a bad sign -
The importance of the application of blisters at a certain
point, is exemplified by their effect in Dropsy;
for when applied [cross out] at this point, they do extraordinary
good, in evacuating the water; and extraordinary
harm, if applied at any other time - 
X Issues -
These are either Setons or perpetual blisters -
Let it not be supposed that such inconsiderable
discharges cannot cure disease; for a Sea Captain
was cured of [cross out] Consumption by a gleet, as I formerly
told you. 
They are indicative.
1. When a gradual discharge of redundant fluid 

A after the system becomes accustomed to them
by habit; beware of suppressing them, without
substituting some other drain -



(45)
is necessary, as in Consumption. -
2. They are indicated in local congestion in the
head and other parts -
3. Also In Cutaneous eruptions in exposed parts,
such as the hands and arms -
Issues keep off Malignant fevers; those who 
have seen many plagues can tell when a person
has that disease by a pain in his issue; there 
is also an acridity in the breath, of which the 
patient is unconscious -
Perpetual Blisters -
Are the best issues; they are less offensive to the 
prejudices of people; they do most good, when most 
distant from the part intended to be relieved according 
to the observations of Dr Willis A
Thus we have finished the consideration of Sedatives;
They should be applied gradually, whether the system be oppressed
or prostrated; but cold water is an exception
I cannot dismiss this subject without reminding
you of the importance of these remedies in all diseases of action;
all Physicians agree that in diseases of action we must 

I shall here speak of another class of sedatives remedies,
which act first as gentle stimulants and exposed the 
excitability by degrees, - there are gentle exercise and
action medicines; gentle exercise includes motion
in a carriage and walking slowly - rheumatism
and catarrh have been cured in this way among
the certain remedies!!!! is opium in small doses in 
making use of these means of lessening the excitability,
beware of ever letting the system descend
to depression, oppressive [cross out] prostration

(46)
deplete, but they do it in different ways; 1 some leave nature
to wear herself down; 2 Others stimulate to expend excitability;
but then methods can only be proper in an excited healthy 
body, and not in an irregularly excited morbid body;
if we leave nature to herself she will do mischief, and
how much more proper would those [cross out] sedatives be, which take 
down the system without expending the excitability -
Stimulating Remedies -
There is a natural attraction in the system for aliment,
and [cross out] aversion from Medicines; it is this 
aversion!!! which constitutes!!! the Modus Operandi!!! of Stimulants -
Debility is the predisposing cause of disease, [cross out] which is always 
partial; Stimulants raise the system, but not in a Morbid
degree -
Stimulants have been divided into Stimulants,
properly so called, and Tonics; Stimulants those medicines
which raise the morbid body and Tonics, those 
which remove the Subsequent debility; but there is nothing 
gained by making this distinction: for the detail I 
refer you to Dr Barton's Lectures, Murray, and Cullen -
Some medicines act upon the nerves; some upon 

 


(47)
the muscles; some upon the arteries and veins; others upon all
the systems, a bark and wine; it is difficult to say when to 
begin with stimulants; the stages of the disease and the degree
of previous depletion should be attended to, if they produce
quickness of pulse, and fullness of the head and breast,
they should be discontinued; but if they produce none 
of these effects, but rather enlarge and render the pulse
slower, they are perfectly safe; thus it is easy to know 
when we have stimulated prematurely -
1. Soporifics are those medicines which are intended
to produce long and profound sleep; sleep to do 
good should be profound, and long, to give time for 
the accumulation of excitability; in this way a gentleman
of Maryland cured himself of a Typhus fever by taking
a spoonful of Laudanum, which produced a sleep of 
3 days and nights -
2. taking medicines in fevers of high morbid action
are very bad, because they increase the fever; The 
Farriers of England overcome the most obstinate -

A For he wished to cure disease by expending
the excitability by degrees; but this can only
be successful in weak diseases -

(48)
in horses by depriving them of sleep by mechanical
means -
Waking medicines are repeated small doses of Laudanum,
an erect posture, conversation, strong tea and coffee &c.
Rules for the exhibition of direct Stimulants -
1 Deplete before the exhibition of Stimulants, and do it 
equally, otherwise Stimulants would be in proper, this advice
is directly contrary to Dr Brown's; A hence the following 
Dr Brown often fail in curing nervous diseases, because
they deplete the nervous system only, and immediately attempt
to Stimulate; nor can we stimulate one system and deplete 
another, thereby bringing them to an intermediate
level, since we have no medicines which act exclusively 
on one particular system: hence you perceive, it is 
necessary to plumb (as the Carpenters express it) the 
blood vessels, which are the monarchs in the action. -
Sleep cannot take place in less the systems be plumbed;
thus if the nerves and the muscles be at the sleeping 
point, but the blood vessels above that grade, either
from fever or too much exercise, our sleep will be 

A when we have reason to believe that the 
excitability is exausted, 

(49)
imperfect; if the muscles be above par, Dr Franklin advised
walking one's chamber, to equalize that System; an 
adodyne often fails of producing sleep, from the dose being too 
large, thereby raising the system above the sleeping point -
2. In accumulated excitability, ie, in the beginning of 
fevers; Stimulants should be given in small and frequent
doses; by this means you will be able to approximate the 
quantity necessary to induce the sleeping point -
3. In the protracted state of a disease and in chronic
diseases A the reverse is proper; we may give stimulants
at once in the close of all most all fevers, and in the 
jail and Comp fever, at any stage of the disease; Dr Robins
of the East Indies is of the same opinion in the 
practice upon Soldiers; if you were to give small doses
the excitability would be gradually wasted without rousing
the system, which would be doing harm -
"Mella Medicina, aliquand. optimo Medicina;" thus 
it [cross out] sometimes happens that patients recover from Chronic
diseases after having been given over by their Physicians;
this arises from the gentle operation of the Stimuli of life 

 


(50)
being exactly proportional to the small quantity of remaining
excitability, and thus creating healthy excitement -
4. Give single Stimulants at first, for then you have a greater
numbers in reserve.
5. In the use of Stimulants, habit blunts the effect, in this 
case alternate the stimulants and recur to former ones; in this 
way, a much less dose will have its effect. [cross out]
6. After an internal of 3 months, a man had the same effect
produced upon him by [cross out] one grain of opium, which 3 months before
would have required 20 Grs: this often happens with bark; it sometimes
produces no effect; omit it for some time, and then 
you may recur to it, often with success; we are sometimes unable
to salivate; let us omit the mercury for some time, and 
then, by recurring to it, we may succeed -
7. It will often be necessary to apply the same stimuli in 
a different form; then Dr Whytt tells us that the dry opium
may do good, when the recent [cross out] would produce no effect;
also, heat, applied by sand, made no impression upon it -
8. Sometimes we must reduce the doses by degrees, and 
not suddenly; when a medicine becomes disagreeable, it is an 
indication that it is doing good, and therefore we may lessen


 


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it by degrees.
9. Change the part to which the stimulant is applied, for if 
a man always chew his tobacco on one side, it will produce nausea
if chewed upon the other; hence when a the stomach becomes
blunted to the power of [cross out] any medicine, twice the dose given by
injection will produce the original effect; bark will produce its 
effect by injection. Tetanus has been cured by heat applied to the 
back -
10. A Stimulant which will hurt, when applied to one 
part, will do good to another; this arises from the different
degrees of excitability of different parts; thus a cock was revived
from a Stupefaction from electricity applied to the 
head by the same application to the breast; hence, might 
not opium in the rectum!!! counteract opium in the Stomach!!!
11. Certain Stimuli bear a relation to the thing for which 
they are intended to excite; this the tail of a leach is excited
by electricity but not by the strongest alkohol, also
if a nerve be paralized by acids it is restored by an alkali,
but not vice versa -
From what we have said it is perceived we require all 
the Stimulants, in order that we may find one which 
will vibrate with the state of the system; to give an exact 

A. 14th and lastly; always keep your eye upon the 
predisposition; without attending to this rule,
you will often prescribe at random and 
some times will do more harm than good -
B. wine, and certain authors of the mind -

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analogy; the widow of the late judge Hopkins could not 
hear the report of a cannon, but that of a Musket, perfectly;
in these apparent anomalous cases the less stimulus
produced its effect by its being in exact unison with
the tone of the fibres acted upon -
13. Remember the exacerbations of diseases; and take
advantage of their weakest state, for the exhibition of your 
stimuli; for then they will act with more effect, the 
morning, for the most part, is the best time to give your 
stimulants, for then we are weakest, and consequently more excitable;
it is from want of attention to this rule that we so often
fail in curing chronic diseases A
The Manner of action of Stimulants -
Stimulants act -
1. By reducing suddenly Morbid action in every part 
of the body and which have been suppose to act as sedatives
as opium!!! wine, violent exercise 
2. They act by reducing morbid action by expending excitability;
these are Digitalis, opium!!! in jar of lead, bark B
3 They act by removing morbid action by abstracting
Stimulus from diseased parts -
4 They act by removing morbid action [cross out] by 
exciting a stronger and less diseased action in the affected

A Coma from opium has sometimes cured
and often suspended consumption; mania
has done the same -

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affected part, other part less essential to life -
Rules to be observed when we use that method of reducing
Morbid action namely, by translation -
1. Dr Darwin has found it necessary to produce delirium
to relieve Convulsions, that is, he prefers convulsion in the -
dias to convulsions in the limbs; I agree with him; in 
the same way Drunkenness has cured Dysentery and Tetanus
A 
2. The lungs are certainly slightly vital!!! organ; And [cross out] when we translate
a disease to them, we may expect a recovery; I have always encouraged
my patient when they have coughed in Yellow fever
[cross out] It is sometimes necessary to translate to a more [cross out]
vital part, in order to rest the diseased part, for fear
it should be worn out, thus we produce Dysentery in Vertigo
by a purge -
[cross out] 3. When the counteracting [cross out] action becomes weak
by habit, it will be necessary to vary the part to which it is applied;
4th here we may take advantage of the sympathies; by 
continuous sympathy we are enabled to throw the disease outward,
and we translate a disease to the skin from the lungs
by inverse sympathy -
5. Morbid excitement should be translated to different

A The skin and the bowels, should be the place,
above all others; to which we should
invite disease -
B when we wish to attract gout from
vital parts -
C. Here we should follow the suggestions of 
nature and give gentle purges, and make 
use of warm applications -

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different systems; purges remove many diseases in this way; and 
in Tetanus the cure is generally attempted by translating the 
disease, from the muscles to the nerves and blood vessels A
6. Morbid action should be translated as distant as 
possible from its original seat: thus applications should
be made to the feet in diseases of the head -
7. We should discover the weakest parts, or, the ball of 
the big toe, and the ankle, from walking, as proper for the 
application of Cataplasms; B but if there should be no weak 
part, make one by exercise and long friction; if going upstairs
cures drunkenness, it can do it in no other way, than by weakening
the extremities -
8. Observe the tendency of nature: in Infancy, diseases of 
the head relieve themselves by sores behind the ears, therefore 
in diseases of the head in children, take advantage 
of this indication of nature, and make your applications there -
In Youth, the determination is to the lungs, therefore 
use blisters to the arms sides and breat; in old age, the 
tendency is to the bowels, and lower extremities - C 
of Tonics -
Those medicines which are fitted to remove debility are called 

 


(55)
Tonics; debility is the predisposing cause of all diseases, sometimes it 
is so great as to produce death without disease; Tonics act as 
Stimulants, that is, either by sympathy or antipathy -
Rules for the exhibition of Tonics -
1. They must be given sparingly, when to overcome debility simply,
but when they are intended to remove morbid action, they 
must be given in greater quantities; hence when we give bark
for a fever, we order ℥ii a day, but when for debility simply,
ʒss 3 times a day -
2. In debility, we must persist in their exhibition for 
months, and sometimes [cross out] even years; these remedies were 
called by the Romans, Annalia -
Tonics have been divided into aliments drinks and 
Medicines -
1. Aliments should be proportional to the state of the 
system, and according to its strength may be either arrowroot
Saloop, Tapioca, Sage, Potatoes, broth, Baked apples, or Rice -
2. aliments should be of the most pleasant kind, for 
the pleasure acts also -
3 They should be 4 or 5 times a day, and if our patient
cannot sleep, twice at night; for the stomach, like 
a School boy, is certainly at his chief if not employed -
4. Solid food is more proper in chronic diseases, but 

 


(56)
liquid in acute; farmers will tell you that those animals which 
are fed in liquid food will have more fat, but less flesh; it is 
because solid food yields its nourishment more slowly that it 
is more proper in Chronic diseases -
5. In chronic diseases, indigestible substances are often necessary
to excite the system to a more vigorous action -
6. The less nourishing the food in chronic diseases the better;
hence we should prescribe solid vegetables rather than Meat,
and Salt meat rather than fresh, in consumption, when the 
patient is very weak, and we fear hemoptesis, Salt meat is to 
be preferred, as it will invigorate the system, without filling 
the blood vessels, Hippocrates tells us, "the more you [cross out] nourish
[cross out] a weak body, the more you hurt it -
7. The diet which you prescribe, should be regulated by 
the national habits of your patient; thus, for removing debility
in an Englishman, order cheese, beef stakes and porter -
In a Scotchman, oat Meal, [cross out] & Barley broth -
In an Irishman, potatoes and sawins Butter milk -
In a German, Sour Crout -
In a Dutchman, a herring -
In a Spaniard, garlic and Onions -
In a Frenchman, Soup Maigre -

 


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In a native of North or South Carolina and Georgia, Rice
in the form of pilar -
In a native of Virginia, Maryland and Delaware, Hog and 
Hominy -
In a native of Jersey, Pennsylvania or New York, Poultry,
Eggs and oysters -
In a native of New England, Pork, Molasses [cross out] Peas and onions -
8. You must not always forbid eating, because your patient
has no appetite -
9. Give a homogenious diet; remember that the british
officers, confined by Tippo Saib, were protected from the 
diseases of India, by living upon two founds of rice every day;
Milk has cured Rheumatism and gout, and Carrots, asthma
in the father of judge Cooper. -
Great advantage arises from eating at a uniform hour
in debility; this is an objection to travelling; some persons get
sick, if they have to wait for their [cross out] dinner, but a quarter
of an hour -
Malt liquors and wines are Tonics, they contain aliment;
by mixture with Sugar, they are rendered more Tonic; they 
are Tonic in the following order; [cross out] Malt liquors, as Porter and 

 


(58)
ale, then the high wines, as Madeira Cherry &c then the 
low wines, as Champagne, Burgundy, cyder; I exclude ardent 
spirits, for although they [cross out] may preserve life for a few years,
they invariably make drunkards, and it would be far 
better to let your patients die of debility, than by such
detestable [cross out] brunonian medicines, to preserve
life for a few years: the intoxicating power if liquors is increased
by sipping -
Baths as Tonics -
Baths are called warm when between 100 and 110 degrees of 
heat; cold bath contracts the body; hence rings fall off the fingers;
involuntary flow of urine, and prolapsus ani take place -
1. Cold water should not be applied, while the body
is sweating, or debilitated -
2. When applied, it should be for a short time -
3. The head should always be wetted; it is to be preferred 
at 12 O'Clock -
4. The patient while in the bath, should be constantly
in motion, and when out, frictions should be used -
5. Baths should be used twice a day in most diseases
to do good - 

 


(59)
The shower bath is good is diseases of the [cross out] brain
The hot bath is necessary only in protracted debility when
the system is in a Stricture state, that is, with rigid fibres;
the hot bath dissolves the blood, and the warm
bath enlarges the body and increases the pulse; it discharges 
much less perspiration than the hot bath; it does
most good at 12 O'Clock, it may be continued from 10 minutes 
to two hours and an half; if used a long time, we 
cause debility by the pores; it is an excellent remedy
in that form of Madness called Manalgia; the Indians
cure fever in this way; Dr Franklin used an air bath 
to invite sleep; his method was to sit in a chair with 
only a shirt on;
Baths are sometimes used of hot water and Salt,
or Nitric acid, as also of dry salt or dry sand, dry 
clay, oil and vapour -
Mineral Waters -
They have been recommended by all ages and countries; we 
should always go to their source, if we wish to use then
with advantage, for they lose much by transportation;
they have been improved by art-
They act in 3 days - 

A. They produce their salutary effect by imparting
a stimulus to the whole of the stomach; they 
are rendered more efficacious when taken
warm - it was formerly supposed that they 
acted by their quantity; but this is a mistake
and it is now found that 2/3rds of a pint
taken at two draughs before breakfast and 
1/3rd before dinner is sufficient - 
2 It promotes perspiration 

(60)
1. By their ingredients -
2. By their temperature -
3. By their quantity - The ingredients which in 
part tone, are principally, the carbonic acid gas, Iron
and the Sulphurous acid gas A
They often do harm the first two or three days after
being used, but afterwards, good; but if no benefit
should arise after being used for a week or 10 days, their
use should be discontinued -
Mineral waters are very useful in affections of the 
stomach, bowels, and nerves; I take no notice of the 
purging Mineral waters. 
Exercise as a Tonic -
Both Exercise and Rest are Tonics, according to the 
state of the system.
Exercise has the following effects;
1. It increases the circulation of the blood -
3. It increases the action of the absorbents -
4. It promotes Sanguification -
5. It increases Strength; - 

7 and lastly, it removes visceral obstructions -
A The dry hand has discussed tumours
when rubbed upon them for several
hours - 

(61)
6. It prevents and often cures obesity, who ever saw a fat Sailor or Soldier,
Exercise may be divided into 3 kinds; active, or walking;
passive, as in a Carriage, and mixed, as on horseback; 
frictions are good, it is called in the east Indies, Shampooing;
[cross out] frictions the dry hand is best; A it has removed puking:
sometimes flour is put upon the hand; the flesh brush, or 
a rough cloth is good; frictions on the sound arm has cured
Palsy upon the opposite side - Rocking in a cradle has prepared the system to be cured
by more active [cross out] remedies in Consumption; & sea voyage is 
also good, it agitates the muscles, and excites the stomach
and mind; if you want dry air, send your patient to the 
middle of the ocean, for there, little!!! evaporatin!!! takes place;
swinging is a Tonic, it renders the pulse slower and fuller, I
know this from experience, I have cured Consumption by 
it; a box made to perform a rotatory motion is good in Chronic
Madness - I have called [cross out] it a Generator. Riding in a carriage
is a popular remedy; it differs very much according to 
the construction of the carriage - it is possible Balloons may supercede
the [cross out] use of carriages in affording that passive exercise for 
which at present the Carriage can only be used; it would

 


(62) 
enable the invalid to travel though air, purer than that 
which is near the earth -
Suspension by the arm, and the lifting of heavy weights
are often used in debility; partial exercise will increase
the heat of a particular part; thus the hand would
communicate considerably more heat to a portion of water
if exercised in it, than if it be left without motion;
partial exercise sometimes produces general good effects,
as in Taylors, weavers, and Shoemakers; riding on horseback
is a mixed exercise; talking loud is a mixed exercise;
silent women are generally unhealthy. A respectable 
Physician accounts for the frequency of consumption
among the women of the society of friends from their never singing; Watchmen
Sea Captains, organists [cross out] and Trumpeters are generally 
long livid, and never affected with Consumption -
The affection of high life, which forbids laughing 
has destroyed one of our greatest pleasures, it strengthens 
the lungs; it adds to life as Sterne says; the habit 
of wispering in high life has increased the number 
of Consumptions; even Children should be taught
to halloo very loud when out of school. 

A dancing -

(63)
General excitement is walking, running, shuttlecock
and nine pins A &c - together with all labours whether
agricultural or mechanical; Celsus says, walking is 
more exercise when up or down hill; the Indians,
when tired by walking, take up a small log, to restore 
their strength; it acts by [cross out] rousing their excitability;
thus also dancing Masters dance in boots, to walk 
them to dance better with pumps; exercise in the 
open air is always preferable -
I have heard of two cases of Dropsy being cured by falls;
the one, by falling from the yard arm of a ship; the other,
[cross out] from the tape a worm; what would be the effect of 
prescribing jumping from a certain bight, in some 
chronic diseases; the Indians Dr Alex Drummond
wished to obtain all the advantages of exercise by using 
the cold bath; but he did not succeed; in short there
is no substitute for exercise -
3. Exercise should never be taken before breakfast,
nor after night, for in the morning there is too much 
and in the evening too little excitability -
4. Attend to the occupation of your patient - 

 


(64)
5. The kind of exercise is in a great measure regulated
by the seat of the disease; thus riding on horseback should
be recommended when the stomach lungs or bowels are affected, Motion
in the arms should be prescribed in pulmonary consumption;
digging in a garden if the kidnies are affected; walking
when there is weakness in the lower extremities; as well
might we tell a patient to take medicine, without suggesting
a particular remedy, as to prescribe exercise,
without telling what kind -
6. Exercise to do good should be constant; Dr Sydenham 
mentions this; here we have the reason why the 
Soldiers of Greece and Rome were so healthy -
7. Fatigue often prevents the good effects of exercise -
8. Sometimes we may remove chronic diseases, by changing
the occupation of our patients; I have cured a Hatter
by placing him in a iron mongeri stori; I have cured 
many boys, by removing them from sedentary to active 
employments; a change of dwelling is often a means of 
curing of diseases, as also by removing from the city to the 
country, or even by a change of dress; changes always relieve,

A Into its previous state of debility -

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we relieve ourselves from sitting by standing, and standing
again by walking; thus also we relieve one foot by standing
on the other, like the chickens [cross out], change of dress is often pleasant
on another account than the mere novelty; for it often
pleases by associations, the origin of which the mind does not notice,
thus to put on a coat which we wore at some agreeable
place, gives pleasure, although we do not think of the 
circumstance at the time; this is a very curious fact;
we should be as particular in choosing a situation for 
health, as for pleasure - Travelling I distinguish from 
short excursions from home; by travelling I mean, taking
along journey; by this means we prevent the system from 
colapsing, A Dr Sydenham was well aware of the importance,
but he adds, to do good it should be constant -
Rules for Travelling -
The following circumstances should be attended to 
in travelling -
1. Food and drinks should be carried with our patients,
in order to avoid the inconveniency of long stages -
2 The patient should be down between every stage 
for we are more refreshed by one hour's lying, than 

 


(66)
sitting -
3. The patient should attend to the room, examine
whether there be a window open, or a piece of glass broken,
or whether the chamber be damp -
The Invalid should avoid company; watering places
are often the passports to the grave to many in debility; in
pain the landlord makes noise an item in his bill; some
persons are too debilitated to exercise their intellectual
faculties, thus Dr Johnson sent word to Burke, that he 
[cross out] was too weak to see him, that [cross out] his conversation was too much
for him, [cross out] it was a stream of mind -
Sea air is a wonderful thing; it cannot be 
imitated by art; hence Venus is said to have sprung
from the Sea; Sea air is useful in many diseases but 
in _ or consumption; a sea voyage acts, from 
having no one to acquire after our health; many are made
worn by such inquiries, a man's asthma was uniformly
increased by the inquiries of his friends; a husband
cured his wife of a chronic disease, by giving her a dollar
a day, if she would not complain - 

2. If the disease arise on high, we must 
direct our patient to low and level
countries -

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Living in the Country increases the size, as also longevity;
in this way the Romans kept Health at bay, for a 
long time by removing to naples, and the Portuguese, by 
going to South America -
Rules for changing the Climate -
1. If it be a disease of heat and moisture, send your 
patient to a dry cold climate -
3. The stay in a different climate must sometimes be 
for life, and never for less than two years -
4. We may make a substitute by art for heat, cold or moisture;
if you wish heat, let your patient live in a Stove 
Room; if cold; let the appartments have double windows,
with buckets of ice between then, as is done in 
Russia; if you wish for moisture but a basin upon 
the stove; and do not let the patient move out of the 
room; this I have called a hybernating remedy; the 
patient should not take tonics at this time -
The pleasures of the Senses are a great Tonic
even tobacco becomes useful, if long used; the use 
of the pleasures of the senses, I have published with 

 


(67)
my introductory lectures -
I took notice of the effect of conjugal felicity; sometimes
wine and intoxicating remedies may were diseases;
smelling a flower garden has in Some instances done more
good than [cross out] taking pounds of bark or steel; the 
smell of spices is excellent in some diseases; the smell of Tar
has cured Consumption, and even Music alone has cured
debility -
The pleasures of the mind are often useful, as the 
intellectual, moral, social and domestic pleasures. -
It is often well to infuse hope; it is the vehicle 
in which all over our medicines should be given; I saw a 
patient much invigorated by this Physician saying,
that it would puzzle him to die of his disease, if he 
wished it, but great cures have been affected by a 
contrary manner; such as by a solemn countenance and 
even insults; remember the hypochondriacal lady and 
Cullen -
Electricity and Galvanism as Tonics -
On this subject I can say nothing from my own experience 

 


(68)
experience; they are tedious and expensive remedies -
Gases have done some good; oxygen and the nitrous
oxide have removed pains in the breast, but their 
effects are but transient, and they are difficult to 
be procured -
In great debility, rest is a tonic, especially if it be 
accompanied by silence, and exercise, a sedative;
you should, in chronic diseases, require your patients
to go to bed early; Dr Sydenham advises this; at 9 O'Clock
the system requires sleep; the patient should use a 
feather bed in winter, a Matrass in Summer; the 
patient should never sleep upon the back; sleep
should be taken in an easy chair when there is too great 
a tendency of blood to the brain, or a disposition to headach 
after sleeping horizontally -
Medicines as Tonics -
I have left the consideration of Tonic medicines purposely
to the last; they are derived from the vegetable
animal, and mineral kingdoms the vegetables are 

 


(69)
Gentian Colombo, Bark, Calamus, Garlic, Tar &c among
the animals, we have Musk and Castor; among the 
minerals we [cross out] have the preparations of 
loin and head; so that Iron, & lead, instruments of 
death in the hands of the Soldier, in the hands 
of the Physician on the preservation of life;
Iron is the only substance which creates strength,
without subsequent debility; perhaps because it 
affords the principle of excitability; Mercury is a 
great medicine in chronic diseases, like change of 
climate and diet it is a revolutionary remedy; it 
should affect the mouth: an ancient philosopher said, "why did that 
man die, while sage was growing in his garden";
and I say why are there deaths from debility while
Tar, Garlic and Iron are to be procured, and swallowed;
Dr Young, speaking of his chronic debility, says he was kept alive
by Tar water in winter and Steel in Summer. -
The exciting causes of debility should be avoided, such
as costiveness venery, Tobacco, Cold, especially cold feet, tight ligatures &c
Some Physicians cure debility with one remedy, some with 

A. Dr Physick teaches us that the external
remedies most proper here are blisters;
the internal dark wine and opium.
B. The quantity of a tonic clyster should 
be small; not to exceed 4oz.

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other, but all, all, all are often necessary and barely sufficient
for the cure of some cases -
Gentle Stimulants should be used when the excitability 
is accumulated, as in asphixia, such as cold water
and a burnt feather; in frozen limbs cold water should
be used -
2. Sometimes the excitability is exausted, and the excitement
prostrated, as in the beginning of a Malignant fever,
or the close of a Typhus, here very violent stimulants
should be used, such as caustic, hot iron &c -
3. In Gangrene, in which there is neither excitability
nor excitement in a part, all that can be done is to remove it 
by stimulating the adjacent parts A
1. Some medicines produce their effects by licking;
thus a mug of Strong beer if sipped gradually, will
produce intoxication -
2. The Tonic medicines may be administered by 
Clysters; in this way aliment, bark and opium may 
be administered, B for the bowels retain there irritability 
longer than any other part of the body; they even 

 


(71)
retain it after death.
3. Some produce their effects though the medicine
of the nose, as volatile Salt, Camphor spirit cephalic 
snuff &c -
4. Some, by the lungs, as the vapour of Tar, the smoke
of resin, Ether, and garlic -
5 Others, by the skin; a book was published at 
Montpelier by Dr Prestiene, who cured diseases by medicinal
frictions; he made use of camphor, opium, &c 
the form of liniments; if they did very good, it was 
the mere friction -
Frictions are of most service upon the stomach -
navel, belly, the inside of the thighs, the soles of the 
feet, the back bone, the arm pits, and near the 
anus: Tobacco or Stramonium applied to the stomach
produces vomitting, sweet oil to the belly, has cured
Dropsy - Frictions act in 3 ways - 3. by sympathy; tobacco
and Stramonium act in this way -
External Stimulants act less well in adults than 
children; hence the reason why garlic, Turpentine 

 


(72)
Ether and Laudanum act is certainly in children, garlic
[cross out] in spirits, and applied to the back bone is 
good in the whooping cough of children -
1 of Medicines which remove Disease by abstracting,
redundant and foreign matters from the body, [cross out]
which offend by their quantity or quality -
We come now to speak of those redundant matters,
as bile, fœces, worms, pus, air, water, stones which are 
removed by purges, anthelmintics, lithontriptics,
depletiars, Deobstruents, and lastly Surgical operations
2 Some medicines act by mixing with, and thus destroying
matters which offend by their quality -
3 Thus Calculi in the kidnies have been cured
by lime water; the sulphuric acid is said to have the 
same effect; mercury destroys the bubo by mixing with 
the venereal [cross out] virus -
3. Some medicines cure disease by removing
obstruction; [cross out] this latter is generally the effect of disorder, the 
remedies are bark, iron, mercurial frictions, and fasting
so as to render the lymphatics hungry; fear has sometimes 

1. according to its causes -
A. The remedies under this head are 
bleeding sweating and purging

(73)
cured [cross out]; in this way the royal touch has 
cured Scrofula -
4 Some medicines cure diseases by changing the 
quality of the fluids; they are called deobstruents;
they remove fator from the bowels; they are the different
kinds of teas - worms are destroyed by certain poisons -
5. Some medicines cure diseases by changing the texture
of the Solids; gain certainly alter the aggregation
of the fluids and solids; but they are not so useful as 
was expected; Dr Beddoes gave them up before his 
death -
of Remedies for the relief of Pains -
Pain is the effect of disease; it causes are either mechanical
or chemical; pain is sometimes a remedy -
These remedies act.
2. According to the seat, whether it be internal or external,
or in a more or less important system -
3. According as it is chronic or not -
4. According as it is constant or not -
Depletion is necessary in pain; A cholic is a - 

A and thereby obviated the pain -

(74)
pain, and is therefore cured by copious bleeding; fasting is a 
cure for pain; hence a man fasted who was about to be tortured; A
4. Cold air relieves pain; a painful limb has been relieved
by being thrust out of bed, 5 cold water is good in 
hæmorrhoids, arthritic gout, and Rheumatism -
6. Hot or warm water relieves spasm in the stomach and 
when injected into the bowels it relieves cholic and nephritic complaints
7. Demulcent and oily substances relieve pain; poultices 
of sweet oil will remove pains in the belly; oil
lessens the pulse, as was proved by Dr Jackson of Georgia;
hence the Roman had no Rheumatism, for they bathed
in oil, and used oily perfumes
8. Gentle frictions of the hand will remove pain -
Much water will relieve pain, but a little produces 
the most intense pain -
9. violent frictions remove pain; it was in this way 
Capt Cook was cured by Cholic by the natives of the 
Friendly ilses; Capt Lewis speaks of the native of the 
western coast of america [cross out] treading on the 
belly -

 


(75)
belly. Mustard Cayenne pepper, Ginger, a hot iron, have 
all relieved pain Dr Davidson cured his gout by barely
touching [cross out] the affected part with a red hot iron, a dutch Physician got 
great credit for curing the toothach, by cutting the nerve!!!! -
During a surgical operation, you should allow your 
patient to cry out; a french Marquis expired from being
too proud to cry out when cut for the stone - Soldiers often
alleviate the pain of whipping by biting a bullet, they also 
bite the ground in the agonies of death as Homer tells us; horses
cure their cholics by biting the Hanger, hallooing relieves
hare, a man got two black!!! fellows!!! to cry!!! out which he as 
suffering some severe pain; water relieves pain, as in the case 
of Lord Nelson, as also rest in a recumbent posture; unemployment
has the same effect in Rosiosco; he cured the 
pain of his wound by the employment of [cross out] Fever,
when in prison in Petersburg -
Passions alleviate pain; the sight of a long absent
friend has cured the toothach; the Indian are very often 
unable to feel pain from the anger produced by the 

A except we concentrate our minds on the 
misterious process -
2. we know that the natural pains of mankind such
as parturition in women are alleviated by coming
on at intervals; what would be the effect of making
surgical operations at intervals!!! ?
B. sorting as to produce Coma, as a slight degree
of apoplexy -

(76)
results of their enemies; animal magnetism has no effect
in relieving pain; A
On Surgical operations -
1. nature pain comes on gradually, but this is not 
the case [cross out] in surgical operations; this suggests the 
propriety of bringing on the pain of Surgical operations
gradually, for we all know that the blister produced
by hot water is unsupportable, but that by cantharides
[cross out] comparitively trifling -
[cross out] 3 Women have brought forth Children without 
pain, when intoxicated, why not then give a strong dose 
of opium B just before a Surgical operation -
3. Singing has cured Gout; the noise of cannon has 
prevented the sensation of a wound; what would be the
effect of beating a drum during a Surgical operation!!!! -
Of the Means of promoting Longevity -
Strength is not health, a watch spring can last as 
long as an anchor, if the force applied to each be proportional
to its strength. 

 


(77)
Dr Sydenham tells us that to cure acute diseases, does not 
always prove that the principles, upon which the cure depended,
were correct, thus yellow fever has been cured by bark
and wine, but this is an unnatural method of cure, thus 
lso, there are 3 ways to get into a closed room, by the 
window, and by breaking open the door and by unlocking it; but there is but one
natural way, [cross out] that is, the last mentioned; there are two 
ways of going to Charleston, by hugging the shore, and 
by means of the compass; but the last method is best, because 
it is the method of principle; a man threw
shingles into the sea to know the way back from the 
west Indies; [cross out] but gentlemen, the waves of the sea are not rendered
more certainly instable by the winds, than
the operation of medicines, by a thousand different
circumstances -
Bonaparte, with all his victories, has not invented
a new mode of killing; Dr Johnson said that good
writing consisted in proper words in proper places; thus 
gentlemen, good practice is proper medicines in proper
doses, places, quantities and times - 

 


(70)
Perish all the imitating horn book Physicians
who move in the old beaten track of medicine -

A. They bring both units -

(79)
Practice of Physic -
We now come to the last part of our course, in which 
we have to apply the Physiology, Pathology and 
Therapeutics which we have just finished, to the 
Practice of Physic -
The question arises; how shall we treat of diseases some
say, by classes, as animals and plants; this is called
Nosology; Dr Sydenham have first suggested this plan; then 
it was followed by Sogar Rogel Sauvage & Linnæus and Cullen; fashionable
studies have often given rule, unjustly to other 
sciences;
The following are my reason for rejecting nosology -
1- Because it is in compatible with anatomy
and Physiology, A for some viscera are [cross out] insensible;
and between other parts these exists such an 
intercommunion of sensation, that the one is never affected
without the other; this is the case between the 
stomach and bowels -
2. nosology is incompatible with the causes of 

A.
3. It is incompatible with the effects 
of climate, predisposition and a 
lessen of years - this the same &c.

(80)
diseases, because the same cause will bring on different
diseases; and the same disease may arise from 
different causes, as from cold and intemperance -
[cross out] A The same disease is different in different persons,
from climate; time has the same effect as in the 
case with Leprosy; the asiatic plague and our 
yellow fever are the same disease, but how different 
from climate!
4. nosology is incompatible with the changes
in Epidemics, where shall we place Dr Sydenham's
variolous disease -
5. nosology is incompatible with the seats of 
diseases, for we see the same disease, [cross out] attacking every 
parts of the body in percussion; [cross out] thus rain is rain whether
it fall upon the hills or valleys, and a club is a 
club whether we receive from it a blow upon the head or any 
other part of the body; why do we not call gout by 
different names according to the part of the body, which 

 


(81)
it attacks, we never say Gouts; we might [cross out] as well have 
different kinds of death, as different kind of disease:
how absurd it would be should I call myself by a 
different name, when in this or that corner of the room?
equally absurd gentlemen is it, that disease should be 
called by a different name when in this or that corner 
of the human body -
6. nosology is opposed by the illusive nature of symtoms,
and the want of them altogether; thus in the 
East Indies the liver is absorbed, without giving the 
least pain; consumption is often in attended by pain;
besides We are deceived by Dr Hunter's delusion sympathy;
who can tell which is the original affection, when a 
nausea and headach exist together -
7. nosology takes no notice of the stages of disease;
to this circumstance I know of no exception -
8. It is contrary to truth; (here he points out two 
errors in Cullen) thus Cullen calls apoplexy, Palsy
[cross out] and Mania, nervous diseases, where as they 

A More especially those affecting the viscera
The cases in which nosology has done 
harm -

(82)
are arterial; Dropsy and Scurvy he calls cahectic diseases; 
whereas all Dropsies, and all Scurvies but one, are cured
by bloodletting!!! -
9 nosology excludes the diseases of children A
10 And the diseases of brutes -
11 nosology has made no provision for new diseases or new forms
of old diseases - a Frenchman was about to be executed;
his priest told him, he could not find in his 
book a single prayer which suited him; another Clergiman
got up and made an extempore prayer,
suited to the occasion; behold a parallel [cross out] to 
a nosologist and Unitarian; thus Gentlemen, you 
should be extempore Physicians -
[cross out] 1st, nosology has done great harm by preventing
us attacking diseases in its germ, and by teaching
us to wait untill a disease unfolds itself into 
its appropriate genera and Species; under this impression,
a Physician in berjuice would not prescribe
for two days in a fever; believe me Gentlemen,

A and a gangrene, a wither from heat or 
cold is the same disease, and requires the 
same remedies -
B. Whereas, when from the forum it is treated
by bleeding, but when from the latter, by 
vermiferge medicines !! - 

(83)
Gentlemen, you might with the same propriety delay the 
to extinguish a fire, untill the manner in which 
it caught was ascertained, as not to prescribe for 
a disease, untill the cause is known -
2. nosology has done harm by teaching that there 
are as many different diseases as predisposing causes;
thus an inflammation in the lungs, whether from gout 
or cold is exactly the same A; and dropsy in the 
brain, whether from contusion or worms, should be treated
in the same way, B -
3. nosology has done harm by requiring different
remedies for every stage, supposing them to differ
specifically -
4 nosology has done harm by supposing disease to 
be different, because in different parts; thus Mania
and Hepatitis depend upon the same morbid
action in the pulse, and yet how different they 
are treated [cross out]; Mania and Rheumatism,
are also the same; in short Mania is Rheumatism

A. about the cause, the seat used
the names of diseases -

(84)
Rheumatism in the brain, and Rheumatism, madness
in the joints!!! -
5. nosology has done harm by multiplying remedies,
thus we have brain worts, liver worts, spleen
worts, bowel worts, and womb worts - On the other 
hand the unity of disease gives as a select number
of remedies -
6 nosology has done harm, from its having created
disputes among Physicians; A
7. nosology has done harm, because it subjects us 
to the charge of the uncertainty of medicine, whereas
the unitarians think it of no importance to discover
the seats of diseases -
8. nosology has done harm by [cross out]
under valuing the works of Sydenham, which are of 
as much importance to the Physician as the bibles
to priests -
9. nosology has done harm by requiring no thing 
but memory for acquiring a knowledge of medicine; nosology

 


(85)
nosology may be compared to a cabinet in which there is a 
great number of small closets, to each of which the nosologist 
has a different key; but the Unitarian has but 
one key, with which he opens [cross out] them all; Recollect
the involuntary exclamation of the quaker
to his horse; "Thou hast a good memory, horse, but 
a [cross out] very bad judgement"; the same may be said 
of the nosologists; they have good memories, but 
[cross out] no occasion for judgement -
Every stage of a disease requires great attention,
and often appropriate remedies; thus we see, that 
nosology instead of being useful is hurtful, in as-much 
as it prescribes the same remedies in every
stage of the same disease. In the mixture of Epidemics,
from the influence of season, we are often under
the necessity of using, not only different but even
[cross out] opposite remedies in successive years; further,
the quantity and strength of a remedy should be 

 


(86)
varied by the importance of the part affected by disease;
thus an inflammation of the brain requires more 
prompt remedies than an inflammation of the joints;
as also, an inflammation of the trachea requires more
attention, than the same disease in less important
parts.
But, Gentlemen, I have been accused by my
brethren of rendering the practice of medicine, too 
mechanical, and at the same time, too simple;
as to the first charge, I deny it; so far from being mechanical,
my opinions are more dependent upon
reason, and requires more in turn thought, than 
perhaps any other system in the knowledge of man;
besides it is attended with more solicitude, for we 
must not only visit our patients frequently, but even
in some urgent cases, watch every change in the system,
for they will vary the [cross out] exhibition of Medicines.
But it has been urged that many great and successful 
Physicians have been nosologists: this I admit; 

 


(87)
but here it must be remembered that their Principles
only were nosological; it was thus with Sydenham
Boerhaave, Cullen and Huxon; these men were 
Unitarians in practice. -
But why have the nosologists not gone through with 
the matter, they have divided great diseases without 
applying the principle to smaller ones; thus the symtoms
of a diseased cerebrum, and diseased cerebellum are not only
different but quite distinct so also are the symtoms of the diseases
either of the trachea, glottis epiglottis, pleura, and the 
concave and convex part of the liver; but who has ever
dared, however infatuated a nosologist he might be; nay who 
has ever dared to offer such an insult to human reason
as to give a Cerebretis, a Cerebelletis, a Trachetis
an interno-hepatitis, an externo-hepatitis a Glottitis, an 
Epiglottitis, and Pleuritis!!!! - where was the mighty
reason of Dr Sydenham when he suggested such vague
illusive and preposterous ideas; but yet his invaluable
treatise upon epidemics turns the scale in his favour -
Here Gentlemen I have ended my reasonings against 

 


(88)
against the old nosological system, and let me be -
reach you to cast back this 3 headed monster, this 
man destroyer to that dark abode, from which no being
but an inveterate for to Mankind could have 
let loose upon [cross out] the world; there let him
gnaw his own chains amongst the piles of musty books,
which he has reared to mislead and perplex Mankind,
and let no Mortal have Mercy on him -
But yet we must conform to custom; we must 
in some measure bend to the tyranny of prevaling opinions;
there are some truths which require strong heads
to embrace; such is the belief in the unity of disease -
A Lady in London having been bled by an eminent 
Surgeon, sent for him to examine a blackish appearance
around the orifice: the Surgeon gave her no 
name for it, but told her to its was very common; [cross out] she
then sent for another Surgeon, when was in like manner
unsatisfactory; but the third gave her case, for
he gave her name for it; it is an ecchymosis Madam,
the lady took his prescription with confidence, [cross out] with 

 


(89)
the highest notions of [cross out] his minute knowledge of his 
profession; then gentlemen we must ecchymose, or 
in other words we must give names to diseases if it is 
our intention to succeed in our practice -
Dr Brown's classification of diseases -
Dr Brown divides disease into [cross out] sthenic and asthenic;
but I reject this division) -
1. Because even the lowest diseases are attended
with some inflammatory action -
2. Because he does not give each division its proper
proportion; he says the asthenic take place oftenest -
3. Because the same disease is often first weak
and then inflammatory, and vice versa -
Dr Darwin's division of Diseases -
Dr Darwin has divided diseases, into those of 
sensation motion, association and volition -
But this division is founded on the phenomina
exhibited under the influence of the healthy sympathies
of the body; and it is therefore grossly incorrect,
as these sympathies are destroyed in [cross out]

A as Hectic fever, the blood vessels -

(90)
disease and return with health; thus the return
of the sympathy between the nose and diaphragm
in sneezing is an indication of convalescence - Dr Darwin's 
theory of disease may, not ineptly, be compared with the famous
and brilliant russian bridge of ice, its dazzles from
the genius exhibited in the structure, but is dissipated
by this influence of the first vernal Sun -
I formerly divided disease according to the system
they attacked, as for example, into arterial Hepatic
nervous, muscular, cephalic, phrenitic, alimentary
lympatic and Cutaneous diseases -
I was led to this divison-
1. Because some diseases affect some one of these systems 
nearly exclusively; A such as Dysentery, affecting exclusively
the intestines and syphilis, the lymphatics;
Tetanus the muscles and Hysteria the nerves. But 
when I considered that disease sometimes affected
two, three and even all the systems at once, and 
also that morbid excitement often left one and 
seized another system in the same fit of sickness,

 


(91)
I was forced to abandon this decision and set sail
once more on the tide of uncertainty, rather than 
to be satisfied with having put in at a wrong 
part, and thus have I been beaten about in the 
pursuit of truth, with reason as my [cross out] compass,
untill my lawdable recherches have been crowned with
success. I have at last found the only spot of ground,
upon which I can rest with safety, and build a 
consistent theory of the practice of Physic; it is gentlemen
in the belief in the unity of disease -
It is a dificult thing to arrange a science;
it has been compared by the schoolmen to an Eel and 
a circle, to the former, as being difficult to seize, to 
the latter, as having no beginning nor end. -
Of the Phenomena of Fever.
The Blood vessels, being the Watchmen of the system,
and their motion bring essential to life, are the most usual
seat of disease, [cross out] and when it happens, it is called Fevers -
Before I proceed upon the phenomena of Fever, I 

 


(92)
shall beg leave to deliver a few general propositions -
I Fevers of all kinds are proceeded by general debility;
this debility is natural or accidental; the 
former is the effect of the sanguineous predisposition
and exists at all times in many constitutions: the latter 
is induced
1 By such preternatural and unusual stimuli,
as after first elevating the excitement of the system
above its healthy grade, and thereby wasting a parts of 
its strength, or what Dr Brown calls excitability and Darwin
sensorial power, afterwards reduces its down to 
that state which I shall call debility from action or 
2. It is produced by such an abstraction of natural
stimuli as to reduce the system below [cross out] its healthy
grade of excitements, thereby inducing what Dr Brown
calls direct debility, but what I shall call debility
from abstraction; where this debility is induced by 
abstraction, the system becomes more excitable, and 
more liable to an attack of fever, than when it is induced

 


(93)
induced by action; but to this there is an exception,
and that is when the remote causes of fever act 
with so much force and rapidity, as suddenly to depress
the system, without an intermediate elevation of it,
and before sufficient time is given to expend any 
parts of its strength or excitability, or to produce the 
debility of action. This debility from action is moreover
on a footing with the debility from abstraction when it 
is of a chronic nature. They both alike expend so 
much of the quality or substance of the excitability as 
to have the system in a state in which irritants are 
seldom able to excite the commotions of fever, and when 
they do it is of a feeble nature, and never we observe persons
who have been long exposed to debilitating causes often escape
fevers while those who are recently debilitated
are affected by them, under the same circumstances of 
exposure to those causes -
That fevers are proceeded by general debility.
I infer from their causes all of which act by seducing
the excitements of the system - by the abstraction of 

 


(94)
stimuli, or by the excessive or unusual application.
The causes which operate in the former way are 
1. Cold - This is universally acknowledged to be & predisposing 
cause of fever; and that it debilitates I infer 1st 
from the languor which is observed by the inhabitants of 
cold countries, and from the weakness which is felt in 
labour or exercise in cold weather: 2nd from the effects
of experiments, which prove that cold air and cold water
lessen the force and frequency of the pulse -
2 The debilitating passions fear grief and despair
3. All excessive evacuations, whether by the bowels,
blood vessels, pores or urinary passages -
4. Famine or the abstraction of the usual quantity
of food
The causes which predispose to [cross out] fever by 
the excessive or unusual application of Stimuli are 
1. Heat. Hence the greater frequency of fever in 
warm climates and in warm weather -
2. violent emotions and stimulating passions of the 


 


(95)
mind -
3. Unusual labour or exercise -
4. Intemperance in eating and drinking -
5. Certain causes which fact by overstretching
a part or the whole of the body, such as lifting a 
heavy weight; also external mechanical violence, or 
extraneous bodies acting by the gravity, burning and 
the like. The influence of debility in predisposing to 
fever is further evident, from their attacking so often
in the nights, a time when the system is more weak
than at any other in the four and twenty hours -
II Debility being thus formed in the system by 
the causes above enumerated, a Sudden accumulation
of excitability takes place, whereby a predisposition
to fever is created. It is not always necessary that 
a fever should follow this state of predisposition. Many
people pass [cross out] days and weeks under it without being attacked
by a fever by carefully or accidentally avoiding the 
application of additional Stimuli or irritants to their bodies. 

 


(90)
But the space between this state of predisposition when recent
and fever is small; for independently of additional Stimuli,
the common impressions which support life sometimes
become irritants, and readily add another link in the 
chain of causes which induce fever; and that is 
III Depression of the whole system, the indirect debility
of Dr Brown. It manifests itself in weakness of the limbs,
inability to stand or walk without pain, a sense of fatigue,
a dry, cool or cold skin, chilliness, a shrinking of the hands
and face, and a weak or quick pulse. It is not necessary that 
a paroxysm of fever should follow this depressed state of the system;
many people, by rest or by means of gentle remedies prevent
the formation of fever; but when these are neglected,
and the action of stimuli whether morbid or natural are continued.
IV Reaction is induced, and in this reaction, according to 
its greater or less force and extent consists the different degrees
of fever. But let is not be thought from this that I 
admit Dr Collin's supposed "vires naturæ medicatrices";
to have the least aging in this reaction of the blood -

 


(97)
vessels. I believe it to be altogether the effect of their 
elastic and muscular texture, and that it is simply
mechanical as the motions from impressions from other kinds
of matter - 
The reaction or morbid excitement of arteries discovers itself
in preternatural force [cross out] or frequency in the pulsations.
To this remark there are some exceptions -
1. The arteries are sometimes affected by great morbid
excitement, while the natural functions of the heart
are unimpaired, as occurs in some stages of consumption
and hectic fever -
2. The heart and pulmonary are sometimes affected
by great morbid excitement, while the pulsations of the 
arteries at the wrists are perfectly natural -
3. The morbid excitement of the arteries
is sometimes greater on one side of the body
than on the other, proved by the strokes of the 
arteries not being synchronous, and the different 
appearance of the blood drawn
from both arms at the same time 

 


(98)
4. The arteries of the head lungs and abdominal
viscera are sometimes excited in a 
high degree which the arteries in the extremimies
exhibit Marks of a feeble action; this 
occurs most frequently in malignant fevers -
While morbid excitement thus pervades
the sanguiferous system, a debility in the 
stomach, bowels, and muscles is induced by 
their excitement being abstracted and 
translated to the blood vessels - this principle
is illustrated by what takes place in Tetanus,
where it appears that every particle of excitement 
is concentrated in that one system
alone -
I shall now endeavour to illustrate the 
propositions which have been delivered, by 
taking notice of the manner in which fevers 
are produced by some of the most obvious 
and common causes -

 


(99)
Has there been a sudden abstraction of heat
in the autumn by the shifting of the wind, or 
a cold night succeeding a warm day, and are 
these not the sources every year of fevers? -
Again has the body been suddenly debilitated
by labour or exercise? here the excitement
is diminished but the excitability increased, in
such a manner that a full meal or an intemperate
glass of wine, if taken immediately may excite
fever; hence the frequency of fever in persons upon
their return from hunting, surveying, long rides,
or from a camp life.
But how shall we account for the production
of fever from the Measles or Small Pox,
which attack without predisposing debility; but 
I answer that the contagions of those diseases, seldom
act so as to produce fever, untill the system be 
first depressed; this is obvious from their always
being proceeded by languor, and all the other

 


(100)
symtoms formerly mentioned - thus it is frequently
with the plague and yellow fever - even wounds
and other local irritants seldom induce fever, before 
they first produced the symtoms of depression formerly
mentioned 
Let us now proceed to consider how facts accord
with the phenomena of fever.
I shall divide the phenomena into two kinds
I Such as are transients and more or less common
to all fevers; then I shall call symtoms of fever -
II Such as, being more permanent and fixed,
have given rise to certain specific names. These I 
shall call states of fever, and 
I Inflammation; it is produced by an effusion of 
red particles of blood into the serous vessels - This 
is what Dr Boerhaave called error loci; inflammation
is an unit, and [cross out] varied only by its seats and 
grades; we have analogies in combustion, thus the combustion
of punk is like the inflammation of a carbuncle
while that of pine wood resembles erysipelas -
2. Secretions, or an effusion from ruptured vessels, 

X Under this head I include Hydatids,
which have been even found in the 
heart - 

(101)
of the serum of the blood, constituting Dropsies X
3. Secretion of lymph and fibrin, forming a 
membrane, which adheres to certain surfaces of 
the body
4. Secretion of pus, sloughs, and of a black matter,
which, when in the stomach is called black
vomit
5 An effusion by rupture, or a congestion of all tho
component parts of the blood
6. Gangrene from the death of the blood vessels
7. Rupture of blood vessels producing hæmorrhage
8 Redness Phlegmon, Pustules Petichiæ
on the skin, and tubercles in the lungs, on the 
liver and bowels
9. Air. How far this product of diseased action in 
the blood vessels may extend to every part of the body,
I am not prepared to say
10. Scirrhus, Cartilage and bone
11. Calcareous and other earthy matters
12. Death -

The two extremes of Morbid excitement
seem to meet in a point, for low typhus
fever sometimes produces death without
any mark of disease also -

(102)
All these effects of fever are different, according to its
grade, Dr Blane says fevers are rarely inflamatory 
in the west indies, that is, they pass rapidly from simple morbid excitement
to congestion, hæmorrhage gangrene and death.
This remark is confirmed by Dr Dalzelle, who says,
the Pneumony in the negroes of the french west indies,
rarely appears in any other form but that 
of notha, from the arteries in the lungs being too 
much stimulated to produce common inflamation;
but such is the force of Morbid excitement in hot 
climates, that it sometimes suddenly leaks over all 
its intermediate effects and discovers itself only in 
death; this appears to have taken place in the 
cases at vera Crux, mentioned by Baron Humboldt
To the first class of the states of fever belongs
1 The Malignant - It constitutes the highest
and [cross out] worse grade of morbid diathesis; it is 
known by attacking frequently without a chilly
fit by coma, a depressed slow and intermitting

 


(103)
pulse, and sometimes by the absence of pain, and 
with a natural temperature or coldness of the skin;
It occurs in the plague yellow fever gout, Small
Pox Measles, in the hydrophobia, and after taking
opium, and other stimulating substances
2. Gangrenous State of fever - this includes
the intestinal state of fever 
3. Synochus fortis - this state of fever is know
by a full quick and round pulse, without tention;
it occurs in the autumnal fever, colic and 
gout 
4, Synocha; it is known by a quick frequent 
and tense pulse; it constitutes the 
common inflammatory fever.
5. Synochula; known by a small - but tense
and quick pulse; it occurs in chronic Rheumatism 
and pulmonary Consumption
6. Synochoid; here the pulse inclines
to the state of syncocha -
7 Synochus mitis, or the mild bilious, or intermitting 

 


(104)
intermitting state of fever
8. The Typhus state of fever; known by a weak
and frequent pulse; it occurs generally in the 
form of jail or hospital fever.
9. The Typhoid, Hectic or Puerperal state 
of fever
10 The Hectic state of fever differs from all 
other states of fever, by the want of regularity in 
its paroxysms. It occurs in pulmonary consumption,
some cases of Lues, of Scrofula and of 
Gout. The force of the pulse is occasionally
Synochoid, Typhoid and Typhus -
11. The next state of fever is the remitting
and intermitting, which is common to all other
states of fever
12. Febricula; it is that state of fever in 
which the morbid actions is so feeble as [cross out] scarcely
to be perceptible; it is known in america
by the name of "Inward Fever" 

X He considers fever in its forming state
as a sacred thing, not to be attacked
by remedies - 

(105)
The states of fever already mentioned, must
only be considered as simply, primary; but 
these again by combining their grades, produce
an endless variety of subordinate forms -
Of the Remedies for preventing the formation
of Fever -
We now proceed to the remedies for removing
the predisposing causes of [cross out] fever - and 
here we beg that the nosologist will stand 
back; he takes no cognizance of a disease in its 
forming state; X he only prescribes for the disease,
when at its acmé ; but we must try 
to visit our patients out of bed -
Premonitory Signs of Fever -
These are 
1. Elevated excitement
2. Debility from action or abstraction
3. Depression 

 


(106)
1. Elevated excitement generally takes place in 
the diseases of Children; it shews itself in the 
hair standing on end; it is known by a frequent 
full but not morbid pulse, by wakefulness
or else only partial sleep, natural dreams, by red
or yellow eyes, by a burning sensation in the 
mouth after taking pepper or wine by a smell
like hepar Sulphuris upon rubbing the hands
together by colours like the rainbow, constantly
passing before the eyes, by the breaking out 
or drying up, of old sores, by a hot breath, by a 
cessation of customary pain, by our taking less 
of our usual food, or less of stimulants, as of Coffee
or Tobacco; I know a gentleman who could tell when
he was in this predisposed state by his Tobacco
not imparting its wonted agreeable stimulus;
it is also indicated by an unusual discharge of 
urine, as well as by great activity of body and 
vivacity of mind: more or less of these symtoms 

 


(107)
preceed diseases of great morbid excitement chiefly, as 
the yellow fever and plague -
The remedies for removing this kind of predisposition 
[cross out] to fever are Rut, Purges, Abstinence,
and sometimes the loss of a few oz of blood; hence 
it is common to bleed Soldiers by regiments,
when they arrive in the west indies; it was 
removed in this way in Virginia in 1741 according
to Dr Mitchel; much blood must not be 
taken: discharges from issues and blisters have 
removed this predisposing elevated excitements.
2. The second premonitory sign of fever
is debility - it is indicated, by fatigue from 
the least motion or it exercise, great desire
for rest; Children shew it by requesting to be 
taken into their mother's laps - 
The remedies for removing this predisposition
to fever, are rest, a little warm Tea, pediluvium little

X [cross out]
In short, the only way to conquer!!! a fever in its
forming state, is to submit to its -

(100)
little study, gentle purgatives, cheerful society X and 
sometimes the loss of a few oz of blood -
3. The third premonitory sign of fever
is depression; it is indicated by weakness of 
the limbs, inability to stand or walk without
pain or a sense of fatigue, by a dry, cool, or cold
skin, by lassitude yawning and some pain;
by chilliness and a shrinking of the hands and 
face, and by a weak and quick pulse -
The remedies for removing this predisposition,
are a cessation from exercises study and 
labour; I have seen the yellow fever prevented by this 
means; thus by going to bed with out cloths on, 
and by taking the precaution not to move, we
may prevent the tending, of this predisposition
[cross out] to end [cross out] in fever; but should you 
attempt to remove your cloaths or stir, the fever
would be immediately induced; * other
remedies are fasting or abstinence, gentle stimulants,

X wine whey, 10 drops of Laudanum with 
a few drops of Hawthorn - I have said 
gentle stimuli, since they are alone
suited to depression, which is always attended
with accumulated excitability -
* But the business must be of such a kind 
as only to stimulate the mind gently - 

(109) 
stimulants, such as the pediluvium, the warm 
bath, or a warm bed *, also diluting drinks, such 
as chamomile and Sage teas X when you make 
use of these preventives, it may be necessary
to give a salt herring to produce thirst -
Then predisposing causes of fever are obviated 
by business and employment; Dr Cullen
says prevented *
Dr Lind prevented this predisposing depression,
by putting persons so predisposed on 
board of ship, and sending then some distance
from the shore; here the gentle stimulus 
of the sea air removed their predisposition;
removal to the country has had the same 
effect; as also gentle evacuations used near the accession
of the fever, as lenient purges and gentle
vomits; Dr William Brown speaks in high terms
of a remedy something of this kind, in which [cross out]
were combined the cathartic, emetic, and 
Sudorific powers; it was used by a naval 

X There should be excited by diluting
drinks which do not stimulate much -
X The jail Fever in this way -

(110)
Surgeon, who called it his Thunderbolt, other
remedies are bleeding, and sweats X Sir John
Pringle has prevented it in this way, inducing 
[cross out] a perspiration by wine whey and 
the spirit of harts horn; also cold air and 
water, of this I can speak with confidence,
as I know it from the experiment upon myself,
and lastly Blisters to the head, on the 
authority of Dr Lind; he says he has prevented X
Thus I have mentioned the symtoms
and manner of obviating the three promonitory
signs of fever, but it must be remembered
that they may be blended; we cannot 
expect order in the action of debilitated nature;
besides, sometimes, a little morbid action 
is present; different systems will have 
different degrees of excitements; thus the head 
may be excited the muscles may be weak,
and the blood vessels prostrated.
But before I leave the consideration of 

X Dr Hillary was of this opinion;
A It must be recollected that every paroxysm
of an intermittent fever, is a complete
fever of itself.
B Here are the [cross out] exceptions to this 
rule

(111)
the remedies to prevent the forming state of 
fever, let me press upon you a sense of its immense
importance, so much so, as in a great
measure to destroy the mortality of the plague
Of the Means for extinguishing Fever
It has been a question, whether we can be said
to cure a fever, or only to conduct the system
safe through its course; Dr Cleghorne rejected
the idea of curing a fever of warm climates X
a thing which he conceived impossible; thus the 
intermitting fever is not cured by bark, it only
prevents its return by removing predisposing
debility; A the opinion is further favoured
by the analogies of Small Pox Measles and 
whooping cough; but there are some exceptions, 
as 
1 B - Fevers have been cured by great hamorrhages
from the nose as well as from the after
bleeding; Dr Moseley says the same happens, 

X This practice I was induced to adopt
from observing that the yellow fevers, for 
one year, fell upon the stomach and bowels
curing itself by puking and purging; this 
was irritating the tendency of nature -

(112)
in the west indies, where patients with fever
have been known to wake up perfectly free
from disease in a [cross out] bath of their own blood - yellow fever
has been cured after 4 or 5 days by bringing on an artificial 
Colera [cross out] Morbus X
2. Fevers have been cured by sweats, but 
Pringle denies this; at least it is not so safe as 
curing by profuse bleeding, or inducing an artificial
Colera Morbus -
3. They have been cured by copious blood lettings -
4. They have been cured by a strong dose 
of opium, as happened in two instances in this city -
during the yellow fever, the one in which the opium
was given by mistake, and the other in which 
the Physician had mistaken the disease; in both
cases the patient slept profoundly for 36 hours,
and awoke perfectly cured -
5 - Large doses of bark have cured fevers, but 
this remedy acts by oppressing and prostrating 

A And perhaps contributed to the fatal
issue of the disease -

(113)
the system, and is pernicious, as it invariably causes
dreadfull congestions of viscera -
6 Fevers have been cured by large draughs
of wine -
7. The pediluvium has cured them, but of 
this I have no experience, but on the contrary
have seen it increase fever and delirium A
8 Affusion of cold water, in this way Dr Currie
has cured yellow fever but not after the 5th day -
9 Banguios, an indian remedy, consisting in 
first sweating the body profusely with vapour,
and then dashing into very cold water; the Russians
use a similar remedy for their health -
10 Overstretching after the manner of the Indians,
as by hanging by the arm from a tree -
11 - By Frictions; thus Capt. Cook [cross out] was 
cured of a Rheumatism - in one of the Friendly
Islands, in one hour.
12 Violent exercise or labour; thus a Scotch
Physician cured his patients by tying them to 
his plow 

X or it was produced & in an Indian constitutions
or one equally robust - 

(114)
13th and lastly Fevers have been cured by 
sudden emotions, as anger, joy, grief, terror, instances
have [cross out] been known of persons being cured of 
malignant fevers by the terror created by a storm
[cross out] or battle -
It is very certain that innumerable persons
have recovered from fever, but not until these
fevers had run their course, we may think we 
have strangled a fever in one day, but here we
are not certain [cross out] that it [cross out] was not a fever of one paroxysm;
but even though the fever be not ephemeral; or 
one which would have terminated in two or three
days, yet it must (if strangled) be either very
feeble or of a centrifugal action X for we see
the Indians never survive their remedy for fever,
after being inervated by their intercourse with 
civilized nations; it is always best, as I said before,
to lift up the latch than to burst open the door
of a disease, except in very urgent cases - 

A and again when the storm subsides, he gradually
expands his sails to be moderately stimulated 
by the gentle stimulus of mild breezes -
The first division of Sedatives into 
A Evacuants
1. By the sudden suppression of the natural
evacuations; them by producing plethora - 

(115)
But there is an erroneous opinion prevalent
in England, that fevers will cure themselves, or be
removed by the assistance of Jame's powders and pediluvium -
but our fevers are a direct evidence of 
the fallacy of this opinion; we must in our fevers
unload the system, or if I may be allowed the 
expression; we must throw part of the cargo overboard,
as a skillful mariner would do in a storm A
Of the Remedies for fevers -
Then remedies are of two kinds, sedative and 
stimulating -
Sedatives are indicated in the malignant,
synochus fortis, synocha, synochula and synochoid
state of fever; the most important sedative 
is the evacuant, I bloodletting -
[cross out] 
It is indicated
2. In habits subject to fever -
3 By the first symtoms of fevers, [cross out]
[cross out] such as sleepiness with a weak pulse, or delirium

X This conjecture is string thread by 
the spleen being found much less, upon
direction than formerly, since bloodletting
has been used more freely in all diseases:
this is a remark of Dr Wistar - 
It prevents hemorrhagies, induces sleep;
prevents acute diseases terminating in incurable
chronic diseases; it is less terrible than other 
remedies; it prepares for the use of bark and 
wine - 

(116)
delirium with a throbbing one -
5 By a tendency to rupture in the blood
vessels, when the spleen is full and very small;
the lancet here perform the vicarious office 
of the spleen X 
8. It is indicated in most instances from 
its immense advantages; it is a stimulant when 
it removes prostration. 2. it often strengthens
when it removes depression. 3. it lessens pain
4. it checks costiveness nausea and vomitting - 5 -
it renders the system susceptible of a salivation,
it removes blackness of the tongue, as well as 
chilliness; it disposes to sweats, before which, if 
diluent drinks had been given it would only have 
added to the plethora; it checks diarrhœa; it cures
a fever before it takes on the gangrenous grade,
hence the cause of the different opinions given by 
Dr Sydenham and Dr Morton, both practitioners 
in London of the same fever, as Dr Morton 

X Therple those of old people arises from their taking little
exercise, therefore sweating little, from their costiveness,
from their eating very much - 

(117)
from his aversion to bloodletting, allowed the fever
to put on the gangrenous form; lastly bloodletting
prepares the system for taking bark -
Bloodletting has been thought highly improper
when resorted to in warm weather, or for 
the diseases of those born in hot climates; to 
remove this error I need only say that Galen
bled in the plague in a hot climate, and Sydenham,
Cleghorne and Moseley, have all 
done the same.
Bloodletting has been objected to in great apparent
weakness; but here bloodletting
will make us stronger -
Infancy and childhood has been thought an 
objection to bloodletting; so far from it, they 
require more bleeding than adults in the 
same disease, from their natural plethora; X
then blood is very sizey
Old age has been thought an [cross out] objection;
but on the contrary they require more 

X If other [cross out] symptoms call for it, such as the 
pulse -
X Neither are abscesses nor sore breasts objections;
The length of the fever has been supposed an objection; 
but this is not the case; neither are tremours
to forbid it; the patient getting worse after
the bleeding, is no objection but an indication
that you have not bled enough!!!! - 

(118)
bleeding in the same disease.
The time of menstruation was supposed
to forbid it, but it really calls for more bleeding;
it is also supposed improper in pregnancy,
but this opinion is entirely erroneous, for so far 
from being forbidden, you must, in order to produce 
the same effects, as [cross out] when the system
[cross out] is not in that state, take double the quantity
of blood - Fainting after bleeding was supposed 
to forbid a repetition; but the fact is, this 
will go off after two or three bleedings; neither
do cold feet forbid it, as was formerly
supposed; nor sweat X nor dissolved blood,
but on the other hand, proves its utmost
necessity; neither [cross out] is, a great proportion
of serum, great length of a fever; nor petechiæ,
any objection to bloodletting X you may bleed 
after the 5th day in a Pleurisy -
II Emetics -
The second evacuant Sedative are Emetics;

A We cannot regulate their effect; they will
either vomit too much or too little
Senna may be given ℥ss - in half a pint 
of boiling water, brown Sugar may be added,
and a little orange peel -

(119)
but these are not efficacious in fevers unless repeated
3 or 4 times; A they are not to be used in 
Pregnancy, but are extremely safe for Children;
the preparations of antimony are to be preferred,
except in Dysentery; they are best in the 
the begining of fevers especially if they [cross out]
arise from hoino miasmata - 
II Purges
The next evacuant are purges; they are indicated
in fevers of high morbid action; they prevent
the stimulus of fæces and their pressure on the 
descending aorta; they remove acrid bile;
they discharge chyle, and lastly they render
[cross out] the bowels weak, thereby inviting the disease to 
pass out [cross out] through them - 
Purges are either lenient, [cross out] active or 
drastic; some purges act as diluents, as such, the 
Sul.te of Soda and cream of Tartar are excellent;
Sulphur acts chiefly on the lower bowels,
but Calomel and Jalap, like chimney sweeps, 

 


(120)
clean them from top to bottom;
In fevers with paroxysms, purges should
be given in the internal, or near the end 
of the paroxysm, because then the system
is generally weak, and the excitability of 
the bowels accumulated, and therefore
will be acted upon by a much less purge,
Dr Sydenham forbids purges at the crisis of 
a fever, but this advice arose from his belief
in morbific matter: our patients often 
ask when we [cross out] prescribe bloodletting, why 
not substitute a purge; the reason is this, a 
purge cannot be given at all times, but bloodletting
is safe whether performed in a paroxysm
or an intermissions -
In Bilious fevers, it will be very necessary 
to inquire into the state of our patient's 
stools, with respect to their colour and 
smell; our patients often tell us they have 

 


(121)
been well purged; that they have had so many 
stools, but if you inquire into their colour and 
smell, the answer is generally "quite natural";
let me assure you gentlemen that in such a 
case you have done no good; you have only emptied
the lower [cross out] bowels - hence you must continue
your purges until you probluce purges of a greenish
or blackish tinge, and, then only are you certain
you have cleared the upper bowels -
IV Clysters -
These are the next evacuant sedative that may be 
used in fevers; they are good to evacuate 
the hardened fœces in the rectum, which 
sometimes exists there, although the patient
may have liquid stools; they remove sickness
and vomiting, and relieve the aorta, kidnies
liver bladder, and upon the whole
are less offensive to patients than purges -
Dr Sydenham records a fever in which 
Clysters were useful, but purges afforded no 

A But it will as by cure the forming state 
of the plague -

(122)
relief; the reason of this was, that a purge act, generally
4 or 5 times, whereas as clyster produces but 
one evacuation, and further, there is no occasion in 
giving a clyster for the patient to rise from bed 
They may act by stimulating, and cure fever by 
translating excitement to the rectum, we know 
that piles sometimes have that effect, if Clysters
disagree, suppositories may be resorted to -
V Suppositories 
The most usual are Salt, soap, wax, and 
Salt and water; this last is particularly useful
for Children, in their fevers -
VI Sweating Medicines -
These are either external or internal - the 
external are 1 - Blankets, used after the manner
of Dr Sydenham, 2 - a warming fan, moved slowly
up and down the patient, 3. Dr Darwin advises
putting the head under the cloaths, thereby preventing
the warm air to escape, 4 - Hot oil, supposed 
at one time to be an antidote to the plague. A 

of all these different methods, the 1st 
the 2nd, the 6th and the 8th are only
to be used -

(123)
5 - Warm bath, 6 - The application of flannel dipped 
in hot water, 7 - The vapour bath, 8 - Bricks,
and bottles filled with warm water, and wrapped 
in flannel; applied to the feet; but these
external sweating applications should be used only 
in fevers of great morbid action -
The internal sweating medicines are 1 Nausious,
such as small doses of of Tartar Emetic, antimonial 
wine, and Ipecacuanha; this class of 
medicines was [cross out] introduced by Dr Cullen; they act by 
the inverse sympathy between the skin and 
Stomach - 2 Diluent drinks; this remedy is good 
in the forming, but not the formed state of fever;
in the latter state, they should only be taken to 
allay thirst; 3 - There are a certain set of medicines
called sweating medicines, as Dover's 
powders, Virginia snake soot, valerian &c -
1 I object [cross out] to sweating medicines as a means
of curing fever, because [cross out] sweaths cannot be excited

 


(124)
at pleasure, and never when this body is above
100 deg. of heat [illegible] Because we cannot always 
[cross out] proportion the degree of sweating to that which 
would be useful to the patient - 3. Because we 
cannot always stop them, when we know them
to be excessive, now this objection does not apply to 
bloodletting - 4. Because they are disagreeable -
But notwithstanding they are undoubtedly
sometimes highly proper - as when, 1. we are see nature
endeavouring to relieve herself in that 
way. 2. when experience has proved them to be 
useful to our patient, thus I saw a case of gout
in the stomach and [cross out] bowels relieved only by sweating.
VII Siallagogues -
Then remedies are useful in fevers of high morbid 
action; in fevers which run their course
in 4 or 5 days, they are entirely forbidden, or the 
Mercury has not time to reach the [cross out] month;
Dr Jackson says, he never salivated with a dry or torpid
skin; when the mercury is applied by friction 

They must also be used even before the pulse
has descended to the blistering point when there 
is great determination to the brain.

(125)
it is hurtful as the friction increases the fever;
when it is necessary, it is best to apply 
the mercury to the arm pits -
VIII Blisters -
Blisters are only proper when the pulse has 
descended to the typhoid grade of action,
which I have called the blistering point;
before that point they stimulate too much,
and below it, will produce no effects; yet 
when the action of a fever is very high, and you 
fear black vomiting, you must use them, even 
though they should produce mortification of 
the wrists; when the effect of a blister is to lessen
the frequency of the pulse, and also when 
they produce Strangury, it is always a good
sign -
B. Remedies abstracting the 
Stimulus of Heat -
This is the second grand decision of 

 


(126)
Sedatives, used in the care of fever, these are 
cold in the forms of air, water and ice -
Air should never be applied at a less temperature 
than 22 deg. and at the same time 
equally Dr Sydenham made her patients sit up
in bed to guard against unequal depression;
Dr Wallace mentions a man who was drunk when
he lay down, and yet sober when sitting; so it is 
with headach, we very often do not feel it untill
we lie down, and we often wake with 
headach from the same cause, which is the 
tendency of blood to the brain in these cases;
this tendency exists in a great degree in fevers,
but cannot be relieved [cross out] by posture,
[cross out] and then as a substitute it is necessary to 
apply cold water to the head; water has several
advantages over cold air, besides its being more 
readily procured; Mahomet, who died of a Color 

 


(127)
Mordius, called out to his wife to throw water
on him; Bruce the celebrated traveller in 
Africa mentioned that a nation cured inflammatory
fevers, by constantly keeping the 
patient's matrass wet. There are three ways 
of using cold water; by affusion, infusion, and 
ablution -
I affusion - This acts, first, by stimulating
from the manner of application, which 
is generally by buckets of water being dashed
over the patient - and - 2 - By its indirect effect
in producing a healthy action. It is extremely 
prejudicial to the system in yellow
fever, if it be not previously prepared for it 
by copious depletion; when used without these
precautions, its effects fall upon the bowels,
and in many cases bring on death -
I object to this method of using cold 

X with more safety and certainty 

(128)
water 1. Because it supposes the cause of fever to 
be a spasm in the capillary vessels which terminate
in the skin - 2. Because it requires such 
nice discernment to discover the proper time for,
and the quantity of the remedy, for there is a point
to indicate water as well as sleep; to do this, would
require the constant attendance of a Physician -
3 - Because it is disagreeable, and attended
with danger in the winter - 4 - Because the visceral
congestions and inflammations which take 
place generally in the autumnal fevers forbid
it - 5 - Because all the advantages are to 
be obtained by depletion * even the greatest
advocates for water as a remedy in fever allow that 
it does not shorten, but only lessens the force of
the paroxysms of fever; why make a patient in 
a fever get out of bed to be drenched to 
lessen the paroxysms, rather than effect the 

 


(129)
same end by the safe and easy operation of bloodletting,
or cold air; but hereafter I shall mention
its use in a contrary state of the system -
II Infusion 
The 2nd mode of using cold water is by infusion;
it is, inserting the whole body into water at the 
same time, and thereby obtaining Sedative effects;
we have an account if a man in London, curing
himself of the plague by dashing into, and 
swimming over the Thames; in Dr McLane mentions
a similar instance of a cure from a malignant
fever by jumping into the sea from a ship -
The same objections may be made to this method
of using cold water, as was made to affusion;
there are few patients that would submit
to it; it may be beneficial if used as 
Dr _ directs; that is, by placing your patient
up to his neck in water and compelling
him to make every exertion with his limbs, 

 


(130)
and thus wear down his excitability, but why this
parade; why not take down the system at once by 
bleeding -
III. Ablution
This is nothing but rubbing the body with 
wet cloths, every two hours or oftener; it lessens
the frequency of the pulse diminishes the 
heat of the skin often produces sweat, [cross out]
relieves pain, and often induces sleep; it is safe
in as much as it does not require the patient rise 
out of bed, nor does it require many attendants,
ablutions of the feet and hands often produce the 
same effect and a bladder partially filled with 
water and applied to the head is often very useful
in fevers, when there is an obvious determination
of blood to that part; you must sometimes
use ice especially in your applications to the 
head, it being a very insensible part; I know 
that ablutions are good from my own experience
in 1793 in the yellow fever, when I cured 

In favour of this method of abstracting heat
from the body. I may sensation that it is not 
incompatible with the delicacy of Females, nor have 
our male patients to discharge the female nurses.

(131)
the forming stage of that disease by ablutions, 1st
of the hands, then of the feet, and so on gradually;
I conceive the skin, the blood vessels and the nerves
to be an emit and when anything is applied to 
one of these systems it is felt by the other 
two; here I may mention, that the hands and 
face are exceptions, for their sympathy with 
the rest of the body is dissevered by habits. X
Dr Currie thinks that all cold when applied partially
is hurtful, but I disagree with him; he says 
it is forbidden in partial or general sweats but I have 
not found it so; on account of the universal sympathy
between the skin and lungs, cold is always hurtful
in complaints of that organ -
Cold when applied by ablution is good in bilious
fevers; it lessens heat, and instead of its effects
falling in the viscera as [cross out] those of affusion are 
apt to do it creates a pleasant centrifugal tendency.
Dr Cummings says, spirits when applied to the skin
is productive of considerable advantages it produces 

X This was observed by Dr Fuller -

(132) 
considerable cold by its rapid evaporation, but this remedy,
generally speaking, is too expensive. [cross out]
Abstinence -
This is another sedative precaution used in fevers;
in them, all kinds of stimulating food should be forbidden,
such as butter milk, meat broths, malt liquors
and ardent spirits; and weak tea and Coffee, Sago,
oatmeal or corn gruel, rice, tapioca; arrowroot gruel,
Jalap made pleasant by lime juice and Sugar, potatoe
tea, or asparagus broth, roasted apples, broth of the 
water of wheat bread, or potatoe broth, may be taken;
in inflammatory fevers light and Company should be 
excluded, for the pulse even in health is lessened
as strokes in a minute by the abstraction of light X
The Abstraction of Invigorating Passions -
This is a very important consideration in fever; our 
patients should not suffer under the effects of any 
stimulating passion; we should even call in the aid 
of the Sedative fear, to counteract them - 

 


(133)
The stimulus of motion should be abstracted by 
rest; though Dr Jackson advises gestation, but he 
alludes to the synochus mitis and Typhus fevers;
The stimulus of thirst must be removed, and acrimony, 
generated by heat and abstinence should be 
washed out: the proper basis of all diluents is 
water; these diluents may be the following, an 
apple dried, green, or roasted to a pint of water
with some sugar to make it palatable; tamarinds,
Currant Jelly, balm tea, Lemonade, toast tea, toast
water, blackberry jelly, grape jelly, or dried cherries;
I have mentioned a number of diluents, since
they should be varied, to prevent the patient getting
tired of them; they should always be made as 
pleasant as possible; I shall hereafter mention
many more diluents adapted to other states of fever.
It has been a question at what temperature
then drinks should be taken; some say, in a cold state;
[cross out] but [cross out] they should not be either cold 
or hot, Dr Currie says, that when water is proper for 

X Of its sedative effects - 

(134) 
the skin, it cannot do harm in the stomach, but I differ 
from him, for we know that sudden death is often produced
by taking cold water into the stomach; but Dr Currie
accounts for it by saying that the stomach is debilitated
in all such cases; so far from this being the case,
those who generally suffer from cold water, are persons
who are highly excited by labour - I shall account for it
by shewing that different parts of the body are more 
or less susceptible of the impression of cold water in 
the following order, the stomach most susceptible X
and next different parts of the skin; of the skin, the 
hands!!! and feet!!!, arm pits and back are most sensible,
then comes the bowels, and lastly the head,
which is least sensible, hence the necessity of using 
ice to that part; Dr Currie further says, that 
cold water always acts as a stimulant, and yet he 
says it produces sudden death by acting on the debility
the stomach; now one would suppose that 
water in such a [cross out] case, so far from producing death,
would by its Stimulant quality, renovate a person -

X That is between 86 to 96 degrees 

(135)
Having rejected both hot and cold, I prefer tepid
diluents * at this temperature they allay most 
certainly, the thirst; disputes have arisen as to the 
quality of diluents.
The spanish Physicians, Dr Cleghorne tells 
us, invariably prohibit drink in the forming state
of fever; this is true, but it might be added, "in the 
last stage also"; if our patient be not satisfied by a 
pint of water, then it will be necessary to make use 
of such substances as will allay thirst, without increasing
the fluids of the body; this may be done 
by chewing an apple, [cross out] sucking an orange or washing
the mouth with flaxseed tea or a solution of Gum
Arabic; I think it probable, salt would have the 
same effect, we know it allays the thirst of many 
domestic animals, probably it acts by inviting Saliva
to the mouth, and producing an excitement
transcending the stimulus of thirst; in the intense 
heat of 130 deg. in 1804, those Soldiers, of Sir 
David Baird's army in Africa, who only washed

 


(136) 
their mouths were least affected by the heat -
C Translating Sedatives
The third grand division of Sedatives to be used 
in fever are such as divert local morbid excitement,
congestion, inflammation and Serous effusion from part, which 
are essential to life in the first degree, to such as are 
less essential to it. These are all such as were mentioned
under the head of evacuants, together with the 
following -
1 Neutral Salts - There are nitre, which
acts by inviting action from the blood vessels to the 
stomach; but it is seldom retained by it in gouty or 
bilious fevers. 2. The Sulphates of Soda, potassa and 
magnesia 3. The tartrate of potassa which is good 
in bilious fevers, and lastly the acetate of ammonia;
useful in nausea -
2. Certain preparations of Antimony; these
are very useful in fever; of all of these I prefer
the Tartrate of potassa - and - antimony; it is very safe;
and although it is not always of the same strength,

Dr Rush used to call it his 
antimonial powder with calomel 

(137) 
yet it is less objectionable than any other preparation
of antimony; it translates the disease to the skin,
1/8 of a grain of the tartrate of potassa antimony,
to 10 or 12 grains of the nitrate of potassa with the 
addition of 1/2 a grain of the promuriate of Mercury,
when the disease has a bilious tendency (and 
taken every two hours), constitutes the antimonial 
powder -
3. Seneka snake root has a centrifugal effects,
and is good in the synochus state of fever; but particularly
in Pneumonia, Rheumatism, and cynanche 
Trachealis -
4. Sugar of Lead is recommended in fevers to lessen
the frequency of the pulse, but it produced
Colic so often, I had to give it up -
5. Digitalis has been given to lessen the pregnancy
of the pulse in the hydropic and pulmonic states
of fever, but with its I have had little success; it 
is said only to be useful, when the pulse is full
and tense, but in this case prefer bloodletting

A By increasing the action of the blood vessels
and giving a centripetal tendency to the blood.
B It has [cross out] produced ecchymosis all over 
the skin -
C But it must not be continued too long 
otherwise it will become exquisitely painful
and distressing -
There being all the fevers above the par of 
action 

(138)
6 Other Remedies - Sweet oil has done good
in fevers of great Morbid action when applied with 
a feather, for if applied [cross out] by friction, it increases
the fever, A but it is hurtful in the delicate
state of the skin in gangrenous and petechial fevers. B
nitre and vinegar, when applied to the body in fever
is good, as also tight ligatures to prevent the return
of the blood to the viscera. Dr Stohl of Vienna
says wakefulness weakens high fevers, by preventing
delirium, for, says he, sleep is a tendency to delirium; C
but I shall say hereafter that sleep removes the 
delirium of fevers of weak morbid action -
The remedies already mentioned are those 
only which are proper in synochus fortis, synochus
Mitis, and all the intermediate grades - D
The Typhoid State of fever -
In this state of fever, there is generally a Synochus 
or a synocha action, and occasionally a 
Typhus; it takes place in the puerparal fever, and 
the Scarlitina Anginosa; it often takes on the pulse 

In this fever the pulse is quick has almost
lost its jerking; the skin is generally
dry and cool but sometimes partially moist
and hot; the urine is pale; the hearing dull;
the body is affected with tremours; the tongue
falters in speaking; the intellect is dull -

(139) 
of other forms of fever not mentioned; its symtoms
are wakefulness or not much sleep, natural dreams,
no chills; the pulse differs from a natural one, in 
having a jerk; the patients have also dull perceptions,
and the tongue is either very moist or very 
dry, this state of fever is called by Dr Butler the 
slow state of nervous fever -
The Typhus State of Fever
Towards the close of this fever, there takes
place an involuntary discharge of faces, and urine unaltering and a [cross out]
[cross out] delirium, called by Dr Cullen, delirium mite
to distinguish it from the ferox; Dr Butler calls
this the low state of nervous fever; then distinctions
are very proper -
Vulgar Errors -
I shall mention a few vulgar errors with respect 
to these fevers -
1- They are suppose to be nervous; but this 
is not so; their action is seated primarily in the 

 

(140)
blood vessels, while the nerves are only affected secondarily;
in fact they affect the brain and muscles more 
than they do the nerves; and if we agree to call
them by any other name than fevers of the blood 
vessels, let us adopt the term cephalic or muscular
2 - They have been supposed to be the effect of immoderate 
depletion; but nothing could be further
from the truth; for they are sometimes epidemic,
and in some countries, endemic -
3 It has been supposed that the Typhus fever
proceeded from miasmata; but do we not know 
that the yellow fever sometimes degenerates into 
this form of fever; I had a case of it in Mr Bell,
whose yellow fever, after some continuance, took
on this grade, and she died of the black vomit
at last; [cross out] Dr Pintard says this was the case with 
a yellow fever in the west Indies; and further, the 
bilious, which runs its course now, in 3 - 5 or 7
days, in 1775 ran on to 20 days -
4. It was supposed that the Typhoid and 

A [cross out] but here I have used vomits in the forming  
state; I was in the habit in the Revolution
of carrying vomits in my pocket and 
giving them to every soldier who was somewhat
unwell -

(141)
Typhus fevers were always chronic; but I have 
seen them prove fatal in 3, 5 and 7 days -
5th and lastly, it was supposed that Stimulants
should be used in every case; A but I object
to stimulants in every case for the following
reasons; we have already mentioned that there 
are two irregularities in the blood vessels, one 
owing to, their muscular coats, and the other, to the 
wrong direction if the blood - the latter irregularity
exists in the typhoid state of fever, and 
hence the reason why stimulants may be 
hurtful, by increasing this wrong direction of the 
blood; in some cases it will be necessary to draw 
a few oz of blood but in low habits, and such as 
have been debilitated by labour it will be improper;
should there be any tendency to the 
head, cupping may be useful; in this fever 
officers will [cross out] very of often bear the loss of a few 
oz of blood, but common Soldiers, never; here 
we have another argument against Nosology, 

 

(142) 
that the same exciting cause produces two such different 
effects; then let us exclaim in the language
of the Roman Senators; when speaking of 
Carthage; delenda, delenda est Nosologia
Remedies for the Typhoid [cross out] Fever
vomits are sometimes used, but, to be useful, they 
should be repeated frequently; Dr Hamilton
recommends purges in the low but not the slow
state of nervous fever, but, to be useful, they 
must be taken every day or every other day; nitre
or the antimonial powders are good when the 
fever is not a form of [cross out] the bilious - Blisters are good 
they, act by a centrifugal tendency and prevent congestion,
by translating excitement from the bowels to 
the part to which the blister is applied; ablution
and perhaps affusion, may be useful; the 
[cross out] former is best when we wish to reduce the Typhoid
to a typhus!!! fever; a salivation has sometimes succeeded,
when every other remedy has failed, but 
it is often very difficult to excite it. Dr Jackson's 

A By which means you will probably be able 
to remove it, without breaking down the 
sides of the Mill race - 

(143)
remedy of gestation might come in here, but it 
must be used, until the typhoid pulse is 
nearly subdued -
Suppose a Mill race, filled up with dirt
and stones; now if we open the gate suddenly, the 
water would tear away the sides of the race,
from its impetus upon the obstruction; therefore
we must let the water upon the obstruction by 
degrees; A to make the application; [cross out] exhibition
of gentle stimulants should be used first; and here if the pulse becomes slower
and fuller, it will indicate them to be doing 
good, but if, on the other hand, they should
have a contrary effect, you must lay them 
aside; so, you must watch the pulse narrowly -
Remedies for the Typhus Fever
here now come to the remedies for the low
state of fever, or what Dr Cullen calls the Typhus 
mitior; here the same remedies are necessary
as in the gangrenous state of fever,
since the two extremes meet -

The prostrate and gangrenous [cross out] fever I
included under the typhus state of fever -

(144) 
The term putrid is improper, since no putrifaction
can take place in the blood vessels
as Dr Seybert proved; in this disease the 
blood is dissolved, in one case from the 
excessive in the other, to the defective action
of the blood vessels [cross out] upon the blood - 

 

(145)
Of Stimulants used in Fever
Having finished the consideration of the Sedatives
used, in fever, we come next to the 
Stimulants - Then naturally divide themselves
into Internal and External -
1 The Internal Stimuli subdivide themselves
into Aliments and medicines; aliments, such
as meats and vegetables; Medicines, such as all
fermented and distilled - liquors, Volatile alkali, -
empyreumatic and aromatic oils, also certain
fetid animal and vegetable substances, opium
Ether, Bark and Bitters of all kinds, Mercury,
Pure air, Oxygen gas, invigorating passions and 
emotions, and lastly stimulating injections into 
the bowels -
2. External stimuli are warm water by ablution,
and cold water by affusion, Blisters,
Cataplasms to the feet and fomentations to the 
lower limbs, certain applications, calculated to 
inflame and irritate the skin, Caustics and 

 

(146)
scarifications, boiling water, Frictions, light, sound.
We shall now say a few words on each of the 
internal medicine stimuli just mentioned -
1 - Wine - This is a very agreeable stimulant,
it contains nourishment, as well as being diluent.
Wines are divided into such as are white, as the 
Madeira, Sherry; Teneriffe, and Sicily wines;
such as are red as Port and Claret &c &c. - less
of the white wines must be taken; they may be 
diluted, though they are not very likely to 
intoxicate when given in the low state of the system;
for there is no excitability for [cross out] them to act upon;
you may give them in the shape of wine 
whey; I lost a student in a typhus fever, for 
want of this remedy; the young man's parents
were afraid of his passing into eternity in a fit 
of intoxication !!! -
2. Malt Liquors - The bitters quality of these
makes them stay upon the stomach; from one 
to three bottle should be taken in a day, of all 

 

(147) 
kinds of malt liquors, porter is to be preferred;
it is even better than wine, wine it affords
more nutriment -
3. Ardent Spirits - These should be given 
to habitual drunkards, or those accustomed
to them; but even though your patient be 
not addicted to them, you may pour down 
a quantity indicated by his fever, without
any fear of begetting a habit of intoxication;
so low sometimes are our patients, that they 
may take a quart of brandy and wine every 
day with advantage; this was the case with 
a Lady with the spotted fever in Connecticut;
brandy allays thirst -
4 - Volatile Alkali - This remedy is good in 
doses of about 5 to 10 grains, in the form of a bolus,
or with a solution of gum arabic; the fixed
alkalies have been very strenuous by recommended 
by a gentleman of new york, for the purpose
of removing the septic acid, which he supposed 

Mask is generally used in those fevers which 
are attended with muscular action; but the 
smell of it is disagreeable and it is a very 
expensive remedy -

(148)
supposed to be the cause of the disease; this idea
is not new, Silvius supposed a similar acid, [cross out]
in a fever at Leyden; but I have no belief in 
the doctrine -
5- Empyreumatic oils, - Of them I know little;
oil of amber is good in curing hickups in 
doses of from 3 to 10 drops every two hours; but 
sometimes a hickup will yield to nothing
but bleeding -
6 - Aromatic oils - These are the oils of 
cloves, aniss cinnamon mint &c - Their principal use is to 
make medicines lie upon the stomach -
7 - Certain fœtid animal and vegetable substances
these are Musk Castor, oil of amber, and assafœtida;
all of which act upon the nerves; Musk
is not so good as either of the others, as it is disagreeable
to most patients -
8 Opium - This is an ipse agmen, a host 
of itself; it acts upon the lymphatics, nerves glands, 

I am aware that Dr Cullen considered 
it as a sedative - 

(149)
muscles, brain, mind, stomach, bowels, and skin;
hence it may be justly called an universal stimulant;
in thus acting upon all the systems, it 
differs from every other stimulant; thus Bark
acts upon the blood vessels, ardent Spirits upon
the brain, oil of amber on the muscles, bitters
upon the stomach, mercury upon the lymphatic 
glands, volatile alkali upon the nerves,
but opium acts upon the whole of the systems
of the body at the same time -
Opium may be compared to the Sun, diffusing
strength, through our whole system,
while other stimulants resemble a lighted
candle, whose influence extends no farther than 
throughout a chamber; its effects upon the arterial
system are not so great as those of 
ardent spirits, but the reason is obvious for 
while the force of the spirits is concentrated
in that one system, the opium is diffused 
throughout the whole body - 

A As it disposes blood too powerfully to the brain
these producing effusion and afterwards !!! - 

(150)
I was first made acquainted with the efficacy 
of opium in fevers [cross out] by an accident
which happened to a Physician in Maryland,
and have been since very much pleased
to find that the same remedy, at the same
time was made use of, in the same disease, by 
two eminent Physicians, once resisting in the 
East, the other in the west Indies -
Rules for the exhibition of Opium
1 - Small doses of opium should be given for 
fear of our overshooting the mark, and stimulating
beyond the sleeping point; there are 
two ways of inducing sleep; one, by raising the 
system to the sleeping point, and the other,
by stimulating to such a degree as to [cross out] depress
the system to that point, but this last
method is always unsafe A
2. The doses should be increased with the 
progress of debility; from two to 10 grains 

The common injection of this kind is a teaspoonful
of Laudanum in a gill of water  

(151)
during the day, and 8 at bed time; in Connecticut 1 1/2 grains has been 
given every hour in the Spotted fever; the failure of this medicine
often arises from being administered with too sparing a 
hand 
3. The dose should be increased during the night; the pulse 
should be watched; if it flag, you must wake your patient
to take a dose; otherwise the patient may die in his sleep -
4. Lay it aside when it begins to have no effect from habit,
and try other Stimulants; but after an interval resume it.
5. If it should induce headach, or disagree with the Stomach,
you must double the dose and give its by injection 
6. We should lessen the dose in proportion as our patient
recovers; when Opium looses its effect. Ether may be substituted
in doses of, from 30 to 60 drops every hour, but it is very volatile;
Bark has many advantages, such as durability and diffusibility
of Stimulus a julep of
Bark - ʒi Mint water ozj
Hux Tinc. ʒjss water - ℥VI
Laudanum Gutts LX has a better effect than to 
take the bark in substance, from the prejudices of most patient
for they will suppose their Physician has mistaken their disease
by giving Bark, which they think, only prefer in Intermittents;
the dose of bark may sometimes be increased to ʒVI,
but in some cases small doses do better. When the Bark looses
its effect, Bitters, willow bark, and a mixture of Coffee 

X For it acts as a stimulant; at the every
time I was using this noble medicine in 
this disease with great success it was used 
by two great Physicians, are in the east, the 
other in the west Indies -
A To have the effect of purifying the air -

(152)
and bark in a pint of boiling water, are good substitutes, it 
was in this last way, Assalini used it; the success of these
medicines is owing to the variableness of the ratio between
the excitement and excitability
11. Mercury - It is an excellent stimulant in fever,
it acts by inducing a Salivation; its efficacy was discovered
by accident, but it is of use even if it do not Salivate; X Salivation
is necessary in yellow fever, when bleeding is forbidden
by the pulse; when the smell of the Mercury is offensive
its use is forbidden.
Ammonia Ardent Spirits and Ether act upon the 
nose; bark Laudanum, large quantities of water and Sp. of 
Turpentine act upon the bowels -
12. Pure Air - In this state of fever cold air is prejudicial,
which cool air is beneficial - Dr Lind has prevented
the formation of fever by sending his predisposed patients
on ship board, some distance from the shore; here
the sea air removed the predisposition; but when pure
air cannot be obtained by change of situation, it should be 
done artificially, as by a large fire, in a large room, A by 
placing the patients on ground floor, or in Mud houses, for 
it is well known that mud will neither retain nor propagate 

A at least we have this on the authority
of Count Saxe -
A All died who laid in beds near walls, all
recovered whose beds were out into the middle 
of the room -

(153)
propagate contagion; A thus during the yellow fevers it was 
observed that men employed in digging cellars, and the 
Scavengers were less liable to take the disease; and it 
is well known that Dogs when bitten, bury the wounded
part. those people who lived in smoky huts were exempt
from [cross out] a disease which raged in -
The air of a room may be kept purely by a ventilator in 
the ceiling and floor, 3rd. By the deflagrating nitre or -
pouring Sulphuric acid upon nitre or common Salt, when 
either nitrous gas or muriatic acid is given off - 4th by 
removing the beds to the middle of the room, and never
allowing them to have curtains: Dr Baird sly prevented
the spreading of a dysentery by putting the bunks in 
the middle of the room. A 5th visitors friends or nurses
should never sits on the bed side, for the lungs in fever,
are often very sensible, and require every possible portion
of oxygen; I knew a man, whose lungs were so sensible,
as to enable him to tell, with his curtains drawn, whether
there were two persons in [cross out] his room. 6th. The excrement
should be evacuated into a pot half filled
with water and removed immediately; in this way the 
fœtid odour of the stools is suffocated - for this important

A Sir john Pringle has remarked that 
british Soldiers who were sick in the upper
stories of hospitals had a greater chance
of recovering - The same has been remarked 
in St Kitts - 
Conversation upon one subject has often prevented
delirium -

(154)
important advise, we are indebted to Dr Clarke of New Castle
7. the sheets and body linen should be changed every day
and the body of the patient, as well as the floor of his 
chamber should be washed - sometimes vinegar is used;
but this vegetable acid is very liable to putrify; ardent
Spirits should be preferred. A These matters are very useful,
as it prevents nurses and attendants from catching
the disease. The importance of Cleanliness may be drawn 
from the following fact communicated by Dr Bond: [cross out] 12
persons with Typhus were taken out of a ship which 
arrived here; they [cross out] were all attended in clean beds
and rooms, not crowded; these men all recovered; 14
other men in the same disease, were taken out of 
the same ship, at the same time; but in consequence
of the want of attention to cleanliness they all died. 9th 
13. Oxygen gas - This gas has been said to be very useful
in fevers, but I can say nothing from my own experience;
it is too expensive for common purposes, -
14. Invigorating passions and Emotions. Terrour has sometimes
cured a typhus fever, of this, we have many instances
in the attempt of the americans to avoid the British 

 

(155)
army; Love has had the same effect in a young Lady,
[cross out] whom a typhus fever was created
from an attachment to a young gentleman to marry
whom, her father refused permission; the family thought
she was dying, when her only request was to see the gentleman,
the effect was instantaneous, far from that moment
she recovered; the appearance of long absent
relations, public or private news has sometimes had 
the same effect; but these remedies should only be 
employed in the crisis of fevers; but there is one passion
that can never do harm; it is hope; we should
console our patients by telling them we have known recoveries
from a much lower state; at this time all gloomy
visitors should be interdicted, we should also prevent 
their knowledge of disagreeable or distressing 
news, and, even upon their inquiries, give them evasive 
answers 
Other Stimulants proper in fevers are aliments;
these are Sage, Panada, Arrow Root, Saloop - Bread and 
Milk, Musk, Tapioca, Rice, 3 Potatoes and one Onion made 
into a broth - 

 

(156)
According to their nutritious qualities, aliments may be arranged
in the following order, 1st oisters, fish, soft-boiled eggs, cheeze,
wild fowl, Poultry, [cross out] beefstakes, Ham, many prejudices
exist against aliments in fever, but they do good in three ways,
1 from the gratification of taste; [cross out] for a desire for food generally springs
up about the 14 or 15 day of this state of fever; 2. By the new 
stimulus which it affords the whole system through the medium
of the stomach, 3. Because it generates blood; for about 
the 14 or 15th day, the blood vessels become very empty -
Rules for giving aliment in Fever -
1. The quality should not be regulated by the appetite,
it sometimes craving more, and at other times [cross out]
less, than is beneficial to the system. -
2. The times of taking aliment should be frequent and
in some instances, it should be [cross out] taken in small quantities,
every hour during the day and night; but in all cases 
the food should be varied -
Of External Stimulants
Proper in Fever
1 Heat - This may be applied in the dry form, as 
by bottles filled with warm water, hot salt, oats, or sand,
their application is the more necessary when the heat of body 

A For the system is below the par of their 
action - 

(157)
is below par - 2. applications suited to inflame the skin;
These are the flesh brush, and frictions with the dry 
hand, as also pinching the skin and flesh; in this way
a Student of our hospital kept himself from dying a whole
night; also a strong solution of Salt [cross out], a decoction
of bitter and aromatic herbs, with vinegar and water 
[cross out] hot spirit, soap liniment [cross out] or Sp. of Turpentine
applied by friction - These applications should 
be made to the temples, arm-pits, stomach, and especially
about the navel and lower extremities; volatile applications
may be retained by flannels - cures have been 
made by liquid bark and brandy - 3rd. Blisters, Cataplasms 
&c. These are important; though Blisters are apt 
to produce mortification on the extremities, A yet they are excellent
remedies to remove delirium; cataplasms may be 
arranged in the following order, according to their strength
1st flour and vinegar, next salt and vinegar, mixed with 
flour, and afterwards Onions, then garlic bruised, and applied
to the feet stitched up in a bag, next mustard and wheat or [cross out] rye
flour, and lastly mustard by itself - Sir John Pringle
says applications to the feet do no good unless applied for 
[cross out]

 

(158)
an hour, 4th. Caustics and Scarifications. These are good
in Typhus fever; a gentleman was so much indebted for his 
life to a caustic issue on his neck that he intended to call his next
ship caustic. 5th Boiling water; This is excellent stimulant
should be applied near the heart or head to prevent 
mortification. 6th. gradual depletion of blood drop by 
drop is often found beneficial; I am disposed to [cross out] think highly
this remedy, as well as the application of Caustic from the 
effects of Spontaneous hæmorrhage [cross out], and sores upon, the gums
about the 5th day in yellow fever - 7th. Light is a very 
powerful stimulant - 8th found is sometimes very useful;
Soldiers are able to walk farther and longer by this 
Stimulus of martial music; it is the same with horses
in a team; but we have facts as well as analogies; Dr 
Dalzel says, a person in Cayenne was recovered by the 
firing of Cannon, and Dr Physick had a patient resuscitated 
by the screams of a frantic relation; the 
Malays of the East Indies keep their relations alive 
by constantly druming at these doors. 9th. Affusion. of 
this remedy I can say nothing from my own experience,
but only upon the authority of Dr Currie and Dr Jackson:

 

(159)
it insures reaction if it fall from any night, but ablution
as being a sedative, would rather destroy life; it is 
therefore only useful in Typhoid. In favour of Affusion
Dr Jackson says that Soldiers march with less fatigue 
when stimulated by rain than when marching in dry weather;
he also recommends, preparing the body for the water; by 
rubbing it with Sp. of Turpentine or Brandy; tepid water 
is to be preferred for affusion in the low state of fever;
but there is one objection to it, which is the difficulty of 
applying it, for how will we get our patient out of bed 
in that state; he must have a number of male attendants.
When applied the skin should be wiped quite 
dry with great care, otherwise it would have a Sedative
effect -
Cautious to be observed in the Treatment of Fever
1. Beware of forming sweats; Sir John Pringle says 
very properly, a moist skin is favourable; sweats
for the most part, usher in death; Morgani mentions
a disease in Italy which killed all by propose sweats,
while the Physicians were encouraging the Relations 

 

(160)
2. Beware of purges - One stool a day and that affected
by a Clyster is all that is necessary; but on the other hand
where the weakness is extreme, it will be well to have 
a stool only every 2 or 3 days; in fact it would be desirable,
since the stimulus of the fœces will help to surport
life - 
3. Attend to the urinary passages: the urine may be 
retained without the patient having notice of it from pain;
therefore it should be drawn off by a Catheter -
4. Never allow your patients to sit up on either to change
their sheets, to make water or emit their fœces; in every
case the bed path and male pessary should be used,
Mr Pack, a physician of Liverpool has invented one
for females - fainting and even death has been produced
by going to a close stool -
5. Beware of the warm bath to the whole body, as 
it cannot be done without removal from bed, which I 
have just forbidden. I have heard of a contrivance,
consisting in envelloping the patient in an oil cloth bag
and then filling it with water; this may do; our 

 

(161)
patients should be washed with soap and water every
two days - 
6. Beware of cold drinks; recollect the differences
between the sensibility of the skin and Stomach;
I know it has cured it but I hope Solitary facts
are not to destroy general principles - Great thirst
should be considered an alarming symtom; it arises from 
the last retreat of morbid excitement to the fauces and 
stomach 
7. Beware of allowing your patient to sleep more than 
two or three hours; when it happens we must wake 
our patient to take aliment and medicines; this 
should not be done when the sleep was brought on 
by a large dose of Laudanum; for here, by the stimulus
of the opium, the system is kept alive; our 
patients often sleep 8 hours from opium and awake
refreshed -
8. You will be surprised at my P the caution;
that you must beware of the remedies and cautions
I have suggested to you, and this for the following [cross out]
reasons - Because the Typhus Mitior takes on the appearance

 

(162)
appearance of Typhoid, while the Typhus assumes the 
Synocha and Sychocala action so as to require bleeding
at 17 or 18 days; at other times they are mixed
from beginning to end. -
To distinguish these mixed states of fever will
be attended with a degree of Solicitude, which 
the mechanical nosologist knows not; our practice
may be compared to that of a skilful mariner
who reaps or spreads his sails as the force or direction
of the wind indicates; remember the 3 imperative
rules of Hippocrates, Abstine, Sustine, Siste; and 
I am sure, If the blood vessels could speak, they 
might say, in the evening stimulate me, in the morning
deplete, and at noon Doctor do nothing. Fevers
are the evident outlet to life, and consequently decrease
particular attention to their phenomena -
9. My 9th caution is against the fatal effects
of that debility succeeding fevers which terminate 
suddenly -

 

(163)
Of the Treatment proper during the Convalescence 
from Fever -
In the restoration of the ratio between the excitement
and excitability, or in other words, in 
the recovering from the debility following fever,
depends the chief skill of a Physician; a larger
proportion of people die in this state of debility
than in the fever itself; it is now cordial aliment
should be given; in the intermissions which happen
at night [cross out] hundreds have been lost, who might 
have been solved by a little wine whey, Laudanum 
or a pupil to watch all night; this state, of which 
nosology takes no notice, is called convalescence; it is a 
compound of debility excitability, and a certain small
portion of disease; in this state, the system is subject 
to relapses or chronic diseases; we should prevent 
relapses by forbidding ardent spirits, wine or 
animal food; the caution applies to animal food, 

 

(164)
for our patients never have an inclination for ardent
Spirits or wine -
It will be necessary also to restrict our patients,
in the gratification of their venereal appetite,
in riding, walking, and in business, as also
to enforce our restrictions by letting our patients,
how much more dangerous relapses are; this was 
proved especially, [cross out] in our military hospitals. Beware
also of exposing your patients to a current of air.
I have said a small portion of disease accompanies
convalescence; I now say it is sometimes attended
with a chill, a fever, and sometimes night sweats;
in this case always bleed whether the pulse be 
full or not; dropsy and Consumption may arise from 
want of attention to this rule, and I add with confidence 
that in giving it I do not anticipate your 
reproaches from its unsuccessfulness, so sure am I of the 
correctness of [cross out] a practice supported both by 
reason and experience; if congestion of the liver 

 

(165)
or spleen [cross out] be the consequence of the fever,
then a few grains of Calomel, and frictions and blisters
to the part are the proper remedies: in convalescence 
the pulse should not ever be naturally
frequent at once; if our patient cannot sleep, give
him Laudanum; madness has been the consequence of 
this distressing relief of a Typhus fever; if there be no 
appetite, give the elixir of vitriol; if swellings 
of the legs attend, remove them by rubbing upwards;
the deafness of ten following fever is to be cure by 
the usual remedies; Costiveness should be removed 
by Rheubarb and other gentle purges;
the falling off of the hair which sometimes takes
place is cured by time; we must also leave to time 
the recovery of the memory, or a deranged moral
faculty or understanding; the venereal appetite is 
often excited at the crisis of a fever; hence we have 
the reason why the great Howard married his 
maid in a convalescent state from fever; the same thing 

 

(166)
I know of two Clergymen, whose piety would not pursuit 
them to gratify their lusts in an unlawful way; 12 !!!
men, who were recovered at Bush kill from fever married
before they left the hospital -
The stimulating quality of the food of our patients,
should be gradually increased with their recovery,
and in the following order, 1st Bread and milk,
then the pulp of a roasted apple or peach, then tea
Coffee and Chocolate, then oisters raw or half roasted,
next scale fish, chicken water or a boiled Chicken,
now wild fowl, and lastly beef stakes and ham; but 
in every case let the food be taken in small quantities
but very often during the day - Wine, in convalescence
is not so much liked as porter, but either 
may be taken in water; when the wine begins to 
afford a burning sensation to the mouth, it is a 
good sign, as it indicates a return of sensibility -
2. It will be well in convalescence to remove 
our patient to another room to prevent disagreeable 
associations -

 

(167)
3 Changing the clothes, shaving the beard, and 
even pamdering the hair may have a good effect;
recollect the hypochondriac who cured him -
self of low spirits by changing his clothes -
4 The 4th way of removing debility is by riding
in a carriage; but beware of the night and morning
air as well as fatigue - 
5. To accellerate other methods of cure, give Huxorn's 
mixture, but not for any length of time for 
fear of be getting an attachment to ardent Spirits -
Violent fevers often drive away chronic complaints -
1 As the Plague has been known to drive 
away gout.
2. Persons often come down from their rooms,
after [cross out] fevers, both stronger and fatter, and 
often with more symmetry and comeliness -
3 The plague has removed barrenness; Dr. Hodges
remarked this -
4. Fevers have elongated persons, especially those 

A That is the third the fifth or the seventh
B of the 13 remaining cases, 11 terminated on 
non critical days and in death; nothing is said 
of the other two cases -
C He says it arises from the morbific matter
being assimilated to the fluids of the body; but 
this cannot be the case, since the discharges, when
they do come on are not acrid or [cross out] morbid - 

(168)
approaching to manhood -
Of Critical Days.
Fevers have critical days, especially in the mild
and invariable climate of Greece, where Hippocrates
took notice of them under the names of dies
judicii - 
Every fever comes on as a tertine, but from stimulation,
it does not always appear as such; hence they 
generally terminate on the third, 5th, 7th, 9th,
or 11th day; at other times they are quartan, terminating
on the 14th. 17th or 20th day -
The yellow fever almost invariably terminates
on a tertian day, A though it rarely terminates [cross out] on
an even day; out of 60 patients, 47 ended upon critical
days and favourably; B Hippocrates says, two-thirds of all
fevers terminate or critical days -
Sometimes decreases terminate without any discharge;
Dr Sydenham explains this by the humour
of pathology; C this is called tapering off, but when 
they terminate suddenly diseases are said to snap off 

A By a knowledge of the critical days you 
have the following indications - 

(169)
1 A On critical days, the system will require more 
bloodletting -
2. You may give purges with more safety, by an 
attention to the critical days -
3. If the paroxysm has a tendency to return on an 
odd day, it requires to be attended more particularly,
than if you are threatened with one on an even
day -
4. When you are in doubt about the use of bark,
give it on a so non-critical day, for if it does no good, it will
do less harm, than if given on a critical day -
5. By attending to the days which are critical, we often
tell when our patient will get well, if the fever
takes place in August, it will probably terminate 
in 3 days, if in Sepr. [cross out] in from 3 to 5 days, if in Oct.
in from 5 to 7 days.
Of the Influence of the Moon upon Fevers
Dr Balfour contends that fevers are affected by 
the Moon; Dr Moseley says any difference in fevers
then, must be ascribed to the increased 

A Dr Balfour remarked that the fever
was worse on the full and change of the 
Moon -
1- It lessens the effects of pain, by being able
to tell our patient, that he will get well -
5. and lastly, a Physician often gets more credit
for making a correct prognosis than for 
curing the most difficult diseases -

(170)
moisture of the air at that time; but the same influence
is observed at a distance from the sea; Dr.
Maurbrook remarked it in the plague an hundred
years ago, Dr Peirtard remarked the same at Surinam,
Dr Moseley said sores were worse at the lunar
period in [cross out] the West Indies -
These things teach us to give stimulants 
on the lunar days, A and after recovery to give preventives
on the non-lunar days, as Tonics will act
better here, as they meet the system in debility.
Of the Prognosis of Fever -
To make these anticipations is useful -
2. Because it prevents the wasting of property -
3. By preventing sharks to relatives, should the 
death not be expected -
4. By giving opportunities to the patient to settle
his affairs, and prepare for a future state -
To make these anticipations is very difficult, 
since the same disease varies in different
seasons and countries ; the signs vary in the difficult 

A Thus a hoarseness was a favourable system
one year, and a bad one the next 
in yellow fever. 2. There is a differences
in the issue of the same signs in diseases
of the same class but not of the same 
grade; thus deafness &c 
B The appearance of black vomit has 
sent many to the grave from the fear 
which it instill in the patient.

(171)
difficult grades of the same disease; A thus deafness is favourable
in such bili. fever but unfavourable in yellow fever; in 
Typhus fever sensibility to a blister is good, in yellow 
fever, bad 3 The diseases of Children are different;
[cross out]
thus they recover from the black vomit; but 
this is owing 1st to their greater tenacity for lifes and 
2nd for the absence of fear for futurity, or for the tendency
of symtoms - B 4 further, symtoms, not mortal to 
middle life, would be certainly so to old age, lastly
many things vary the mortality of symtoms, such as 
being either robust or weak, the sexes, whether of 
long or short livid ancestors or whether drunken or 
sober - or whether a freeman or a slave -
Symtoms favourable or unfavourable
1. The violence and danger of a disease maybe 
in part predicated on the violence or danger 
of the exciting cause -
2 Diseases, which come on without premonitory symtoms
are dangerous - as for instance an apoplexy -

7- The fever suddenly to subside is a bad 
sign, unless it be produced by suddenly affections -

(172)
3. If the accession of the disease be very gradual will
render it more protracted and dangerous -
4. If the disease comes on without a chilly fit,
it proves the disease to be confined to the 
blood vessels; if after bleeding, a chill should come 
on, it is favourable, since it proves the disease 
to be let loose among the other systems -
5. The danger of fever is greater, in proportion
as the connection with other systems is destroyed;
hence it is that Hectic fever, in which all the systems 
except the sanguiferous, are either passive 
or healthy, is so fatal -
6 Paroxysm which come on [cross out] on an even day are [cross out] more 
dangerous than if thus come on, on an odd day.
8. To hear a person say, he feels too well is a bad sign !!! -
9. Chills at the close of a chronic fever are always 
favourable -
10. Procrastinating [cross out] fits are favourable,
anticipating infavourable. 
Lastly Violent fevers are dangerous in Pregnancy, 

A Thus also a bilious Pleurisy is more 
dangerous [cross out] than a simple Pleurisy -

(173)
as the system has to contend against two diseases A
Signs taken from the Body
I of those divided from the Blood vessels -
1. If the pulse be preternaturally slow, it is alarming 
in children -
2. The intermitting pulse is alarming; it is worse 
when it takes place every two strokes; if the intervals
be still shorter, it is less alarming; Dr Heberden 
mentions a man whose pulse was always intermittent 
in health, but natural in disease -
3. A pulse in fever above 120 strokes, is called a 
rapid pulse; I always fear, with this pulse, but yet 
I have had a recovery after a pulse beating 180 -
4. Fevers with a natural pulse must be 
respected -
5. You should respect a pulse which is frequent 
in convalescence; Dr Stohl says, the pulse 
does not indicate disease in the lungs -
6. Hæmorrhagy in the beginning of fever is 
good, at the end bad- If from the stomach 
liver eyes skin or old sores it is bad; but from the 

B Long protracted chilliness, and universal 
coldness unfavourable -
A upon the mouth and tip of the tongue 
C For it indicates a common synocha 
D It may to arise from a deficiency of oxygen 

(174)
[cross out] Uterus, hæmorrhoidal vessels or nose it is good -
II Signs taken from visible parts
1 Partial heat or cold is always a bad sign; as the 
feet being cold and the breast warm; to have the 
hands warm and wrists cold is always fatal B
2. Both the Color Mordeus and a natural heat 
are unfavourable 
3. It is unfavourable, should no heat attend
Convalescence -
4. Sores A are favourable, if they take place after the 
3rd 5th or 7th day; but sores in the pharinix larinx,
œsophagus or [cross out] root of tongue are always unfavourable -
an old sore to dry up is unfavourable.
III Signs taken from the Tongue
If the tongue be white, it is not unfavourable,
because we expect it, C if yellow, it indicates bile 
in the stomach, and is not unfavourable; when it 
is red and smooth, it is very unfavourable, as well
as when black; but distinguish it, from the black 
produced by liquorice, tobacco, claret, or black jellies D
when the tongue is green it is bad. I have seen but 
one instance, which was fatal - A dry tongue is unfavourable,

A I knew a lady in a bilious fever whose 
tongue was only dry when she [cross out] laid on 
her right side -
B a livid colour of the nails or fingers
is unfavorable 
C also a placid countenance, is unfavourable,
but a red countenance
becoming pulse is favourable -

(175)
unfavourable, but you must not be deceived by the dryness,
produced by breathing with the mouth open;
Dr Bordul says a matter like the white of an egg
upon the tongue is favourable; A if the tongue appear
natural it [cross out] is very unfavourable, since it proves
the disease to be concentrated in more vital parts;
Moisture, when it takes place suddenly after dryness
is unfavourable, if slowly favourable; when preternaturally 
hot, unfavourable, unusually cold, mostly fatal B 
IV. Signs taken from the Countenance -
1 Frowning or a likeness to ancestors is unfavourable;
as [cross out] it proves great emanation, causing the projection
of the bones, which parts are mostly like ancestors
C
2. The Hippocratic countenance is bad; it is as 
follows -
V Signs taken from the Muscles 
The fallen jaw on inability to protrude the tongue,
a slipping down in bed, and an inability to raise 
the arm are all unfavourable indications - Convulsions
in the beginning of fever, are unfavourable; should 

A A Priapism is sometimes a sign
of returning health, and sometimes of 
death - hickup is always unfavourable 
B decending pains are favourable, ascending 
unfavourable; moving pains more 
than fixed - 

(176)
you find your patient on his side after having laid 
several days upon his back, it is favourable - A
VI Signs taken from the nerves and Senses -
When they are incurable to heat or cold, it is bad,
return of sensibility to a blister is favourable, except
in yellow fever; pains in the back are favourable, since 
it proves the disease to have a centrifugal tendency; B
pain after bleeding is always favourable, a burning 
sensation in the stomach or bowels is bad, an itching
on the head or tongue is favourable; the return of old
habits or chronic diseases is favourable, as when 
a chronic costiveness or headach comes on; great acuteness 
of smell is unfavourable.
A contracted or enlarged pupil, an intolerance
of light, perpetual motion, and winking are unfavourable,
the half closed eye (except in Dysentery), one eye 
larger than the other, a glassy appearance, a defect of 
tears, pulse and double vision, involuntary tears, blindness,
squinting, a sudden appearance of animation in 
the eyes, matter lodged in the inner ear this a film

A The pupil of the eye becoming 
of a lighter colour are all unfavourable -

(177)
on the Cornea, A and according to Dir Mourbrick, seeing
a rainbow, are all unfavourable -
Acute hearing is unfavourable; some of the 
patients in the yellow fever, could hear across 
the Street; turning when the door opens, is favourable.
VII Signs taken from Respiration &c -
1 An alternately frequent and slow breathing with 
an expansion of the alæ nasi is unfavourable -
2. A Cold breath or the rattles, is unfavourable -
3. A quick, stuttering or drawling voice, if not natural
is unfavourable -
4. A wispering or loss of voice is unfavourable; lymphatic 
swellings are favourable in mild, but dangerous 
in violent fevers; great spitting is favourable;
great or little stench, unfavourable; an appetite for 
particular fluids, or aliments is bad - an appetite for particular
aliments is bad, but Dr Sydenham had one exception
in a chronic fever.
VIII Signs taken from [cross out] Secretions & Excretions
1- Sweats are unfavourable, but a Mador good -

A Coffee coloured or bloody urine, as well 
as high coloured urine are unfavourable 
A continual nausea [cross out] well as vomiting
at the close of a fever is unfavourable 

(178)
2. Partial or cold sweats are bad -
3. Saline or acid sweats are good, according to Dr Huxon;
but when they have a putrid [cross out] taste or smell, it 
is bad - hence Dogs, from perceiving the smell, often
howl about a hour, in which there is a person 
about to expire -
Suppression of urine, its excess or defect in quantity,
its paleness, and its being discharged involuntarily
are all unfavourable indications; the last 
sign is less alarming in women than in men, as 
the same effect is produced in them by coughing
and laughing; a sediment in the urine is favourable;
it is distinguished from gravel affections by swiming; 
gulping [cross out] in discharging great quantities of air from the stomach is bad; the [cross out] contents of the stomach to stream
out of the mouth; [cross out] also to vomit up fluids as cold as 
when taken is unfavourable; obstinate costiveness
is bad; involuntary stool, and evacuating air without 
noise is bad; natural stools and crepitus, after the 
contrary, is favourable; an habitual hour for going 
to stools is favourable - Discharging worms with fœces

A Slowness of answering questions is 
always unfavourable, as also the patient
having a presentiment that his disease will
prove fatal; it is a good sign when the patient
inquires concerning the health 
of this physician's family -

(179)
and slime, in the beginning is favourable, but 
in the last stage of a fever without feces or slime,
unfavourable -
Signs taken from the Mind -
Indifference to life is a bad sign; great laughter
or great crossness at a crisis is favourable, asking 
the hour of the night is favourable - a desire
to be removed is unfavourable; desire of life is 
favourable; it acts as a stimulus and [cross out] cooperates
with you - a want of affection for relations is bad; the 
return of mental habits, as of wit, of crossness, or an apology
for want of order in the sick room, are favourable -
Thus I have mentioned all the Prognosis of fever;
I have divided them into grades by 
the epithets of unfavourable, bad, dangerous, fatal -
but yet persons die with every favourable, and 
live with [cross out] every unfavourable symtoms, except indeed,
[cross out] the cold wrists, with warm hands, and the half closed
eyes in adult (except in Dysentery), from which 
symtoms I have never seen a recovery -

We must beware or giving direct answers
to the friends of patients [cross out] about
the termination of their diseases since all
the signs deceive use sometimes, hence you 
may say that you have seen persons recover
who appeared much worse and others dies 
who appeared much better - 

(180)
Before I enter upon the 6 forms of bilious fever,
I shall deliver some new views upon the 
Hectic fever -
Hectic fever 
This fever arises -
1- From Consumption, but oftener from 
sores in the joints -
2. From scirrhi and scrofula without sores,
as in the breast, stomach, and Uterus -
3. It arises from obstructions in the viscera -
particularly the liver -
4. From Gall-stones and stones in the Kidnies -
5. From Pins or sharp substances -
6. From Leucorrhœa and Menorrhagia -
7. From Slow passions -
8. From high excitability of previous
disease, acted upon by great stimuli -
9. Exhalations from Metals -
10- Dr Hamilton mentions an instance
from home Sickness -

 

(181)
11- From Pregnancy; I have known two instances,
which terminated fatally in Abortion
of dead children -
To understand this fever, it must be recollected
that local inflammation is produced
by local injury naturally; but should a part 
not inflame which is injured, then the whole 
system which is injured wishes to produce the cure - thus 
it is when inflammation does not follow the 
wound of a tendon, the whole of that system is 
sure to take up the dispute!!! and produce
Tetanus- now in the same manner I believe
[cross out] when local injury takes place in other parts
more intimately connected with the blood vessels,
and is not attended with local inflammation,
that then that [cross out] system takes 
upon the quarrel!!! and produces Hectic fever -
Hectic fever may be distinguished [cross out] in the 
following ways from Intermittent fever 
8. In Hectic fever, the urine is turbid 

A when it arises from a mineral atmosphere
or any other irritant, the patient
must be removed out of their reach -
B I have generally found the [cross out] blood 
1787 -

(182)
in the fit and clear in the interval, in intermittent
it is vice versa -
9. The hectic is attended with swelling -
10. The hectic fever comes on gradually -
11. In hectic, there is a deep colour in one or both
cheeks, which is distinguished from health by being
without intermediate shades at its edge -
12. There is [cross out] less headach in Hectic -
Lastly in Hectic, the appetite and bowels
are in good order; it generally occurs about the age
of 45; the pulse is sometimes synocha and 
synochus mostly Typhoid, but rarely Typhus -
Method of Cure -
All things which are in the reach of Surgery
should be removed as ulcers, pins, stones
in the bladder - A It is difficult to cure, since
it is insulated, like Tetanus, Cancer, Tic douleureux
It is the same with solitary vices -
1- The first remedy is bloodletting, if the 
pulse be [cross out] synocha or synochoid B 

A Perhaps it has been given with too 
little attention to the pulse; I am sure 
it would do good in the typhus state -
B But there are persons who cannot purchase
this remedy, and the season [cross out] may 
not be favourable; what are we to do here?
I say substitute labour or a Salivation -

(183)
2. nitre to take down the pulse when the pulse 
will not bear bleeding -
3. A Milk diet; would it not be better to 
give rice or whey, and weigh the patient's food?
4. Hops are good, or the powder of Malt -
5. Arsenic promises most, when it arises
from the obstruction without inflammation; Bark
has often done harm, as well as bitters; A Digitalis 
has been tried; this disease, like the shirt
of Hercules, cannot be cut or turn off, but it has 
shaken off by riding on horse back; B a Salivation
and labour are revolutionary and cheap remedies -
Some Questions -
I have supposed Hectic fever to be owing to 
the Blood vessels taking on a vicarious office,
if this theory be well founded, I would ask 
what would be the effect of irritants to the 
injured part, to bring back the action there;
and should you not be able to reach the injured 

 

(184)
part, why not translate the disease; a phlegmon
has cured a hectic fever - and cold has suspended an 
asthma -
2nd Question - I have said the disease is insulated
in the blood vessels, and have also taught
that it is for this reason more dangerous; now what 
would be the effect of tearing the disease from the 
blood vessels by large purges or vomits, or by irritating
the skin by cayenne pepper or Cantharides; the 
sweats in Hectic suggest this best remedy -
Six forms of Autumnal Bilious Fever
these are 
1 The yellow fever 4 The intermitting fever
2 The inflammatory bilious fever 5 The Ch. Bilious fever
3 The mild remitting fever 6 The Febricula.
Before I treat of them individually I shall
make a few 
General Remarks
1- You must not expect one form of the same
fever, you will do harm if you do - Dr - 

A This is a treacherous remission as Dr 
Moseley justly calls it; for the patient is in 
great danger -
B 2. It appears with a depressed pulse, and 
prostration -
3. It appears in great depression -
4. It appears as a synocha -
5. It occurs in colics -
6. It occurs in the form of dysentery Diarrhœa -

(185)
did great harm by describing but one yellow
fever, and by saying it only termitated on the 5th 
or 7th day. A Physician lost a patient in the 
yellow fever on the 14 day, but contended, it was 
not yellow fever, because it did not terminate
on the 5th; believe me gentlemen
Diseases are not to be modelled by nosological
chisels -
1 Yellow Fever -
In this fever about the 4th day, the patient sometimes
appears better, his skin is cool, his appetite returns
A but Dr Leinin has done great harm by saying,
that now the fever was going off; but the mild
symtoms arose from the system being depressed below 
the point of reaction; now this is proved by Stimulants
killing -
This fever appears
7- With Blotches buboes carbuncles -
8. In the form of a tertian intermittent, and 

A Milk of the Coconut -
X Made into a tea -

(186)
that of the most obstinate kind -
10. It appears as Febricula -
12- [cross out] In the form of universal yellowness -
14- Burning of the skin -
15- Disposition to faint -
16- Coldness on the skin -
17- In petechial spots 
Means of preventing vomiting in Yellow Fever 
It may be removed -
1- By bloodletting -
2. By washing the stomach by frequent draughs
of hot water -
3. By weak Chamomile or mint tea - virginia
make root; milk, A lime-water and milk sweet
oil, sweet oil [cross out] molasses and milk, opium when 
the pulse is reduced; a clyster of warm or cold water, Oats
roasted X 10 drops every two hours of the Sp. of Turpurtine,
not given too early; this has been used
by Dr Physick as an injection; abstinence [cross out] from
drinks and meats; blisters to the stomach, cold water 

A Putting the hands in cold water -
For Diarrhœa -
A Plentiful purges afterwards by bark
and blisters; and if these fail you must 
resort to it a salivation -
But the state of the pulse must regulate 
this remedy; in some cases it is unnecessary 

(187)
to the belly or hands; A yeast carbonic acid; For the bl. vomiting opium;
Cayenne pepper, acting by paralyzing the stomach;
cretaceous jalaps; cold water to the head, or alternate
heat and cold to that part - this is recommended 
by Dr. Peritard; hot or cold water to relieve 
the bowels by injections -
Suppression of urine is relieved by the 
Catheter, Coma by Cups and blisters to the neck -
II Inflammatory bilious Fever 
This grade of fever is between the yellow
fever and the mild bilious; it is cured by
bloodletting. A purges. bark, and a Salivation -
III Mild bilious Fever -
The best authors on this subject are Cleghorne
Hilary, Clarke, Moseley &c Jackson and Dr John Hunter
The remedies are 
1- Bloodletting - This evacuation mitigates the 
violence of the fever, and prevents the bad consequences
which [cross out] would otherwise follow -

 

(188)
2- Purges - I formerly tried to cure this fever
through the pores by the use of antimonials-
purges Salts, cream of Tartar, senna, Calomel, may 
be used; I relieved by purges in the break bone fever;
its name imports the viscera to have been safe.
3. Vomits are proper in the presence of 
nausea, or when there is great inclination to discharge
bile; cold water is more proper here, than
in yellow fever -
4. Blisters often act like a charm, about 
the 4th day, when bark will not stay on the 
stomach, take bitters - a Salivation is seldom necessary -
IV Intermittent fever -
This is a very common fever in our climate;
it is called the dumb ague, when without a fit,
They are quotidian, tertian, or quartan; it often continues
a long time, Bruce the celebrated african
Traveller had it 13 years; but it is never incurable 

 

(189)
when taken in time; it rises and falls with the 
action of miasmata; it has been induced by a Salivation,
and gout sometimes puts on this form -
The state of autumnal fever has different forms 
as - 1 The malignant form, 2- The highly inflammatory,
and 3- mild form; all of which requires
different remedies, even the mild form requires 
different remedies, as its beginning and end, or when 
it occurs at the beginning or the end of the Season -
The remedies divide themselves into such as 
prevent it, such as are necessary in the interval,
3rd Such as are necessary in the fit 
Intermittents are known -
1- By intermittents being epidemic at the time -
2. By the length of the fits -
3. From the presence of bile in the stomach -
4. From the time at which the fits occur,
as quotidian in the morning, tertian at noon,
and quartan in the evening -
5. From their generally prevailing in climates 

 

(190)
not very hot nor very cold -
6- From the urine being clear in the fit, but 
full of sediment in the intermission
The Method of Cure 
The remedies just before and during the paroxysm
of the inflammatory intermittent are bloodletting
and after 3 or 4 fits the use of the bark; just 
before the fit, to give 30 or 40 drops of Laudanum
often prevents it -
Many other remedies have been made use of,
such as wine and ardent Spirits, pepper, a teaspoonful
of Sulphur and ardent Spirits; Stramonium,
and Tobacco applied to the wrists, terror, a copious 
sweat before a fire; riding and dancing has been 
supposed to cure the bite of the Tarantula, where -
as it cures intermittents - Cayenne pepper pills;
but most of these remedies prevent the recurrence 
of the fit, but do not cure; it is bark, which 
is to remove the predisposing debility -
It may be asked why Dr Horne recommends 

 

(191)
[cross out] in the Intermittents of the west Indies,
bloodletting, and in the yellow fever of the 
same country, a contrary practice? the answer
is that in the one case there is inflammation, in the 
other, exhaustion. - It has been the practice in intermittents,
to wait two or three fits for the system
to wear itself out; but it is much better to take 
down the system by bloodletting, for thus we often 
convert an intermittent [cross out] into a continued fever, which 
is changing a sturborn [cross out] for a tractable disease;
Bark should never be given, unless the pulse be 
in a Typhus state; if excitement be above fear
dropsical the consequence of giving bark; here 
effusion is often, [cross out] bleeding and blistering - must be used
In the intermissions bitters are good, such 
as Calomel, Gentian, Bitters, Wormwood, centaury,
Chamomile, Tansy. 2 astringents, as Galls, black
oak bark - 3 a mixture of the tonic and astringent
quality, as willow bark, logwood, poplar bark 

 

(192)
4. Minerals - such as white vitriol and Sugar of 
lead -
5- Spicy substances; cloves nutmegs, black and red
pepper - also glue, turnips, to the thighs, a 
spider's well marked in bread, intoxication, salt 
and the white of an egg, stramonium or Tobacco 
to the wrists and arsenic -
6- Tourniquet upon the thigh renders the 
pulse softer and fuller, laying in bed and fasting
has a good effect -
But these remedies are generally superceded
by the Peruvian bark; vomits have been 
given to prepare the system - The best time to 
give bark is just before the fit; it may be given 
in powder, or infusion, either cold or hot, extract
or tincture; but this last preparation should 
not be used, for fear of begetting a relish for 
spiritual liquors -
Bark is prevented from acting by the following 

 

(193)
following circumstances 
1 From the existence of the inflammatory diathesis, -
this must be removed by bleeding -
2. From visceral obstruction, here also you 
must bleed -
3. It may be [cross out] from giving too small doses, here 
then increase them -
4 Or from too large ones, here diminish them -
5- From [cross out] long use; here then it must 
be laid aside, or mixed with make root or Iron -
6. From its either producing costiveness or 
looseness, both of which must be obviated -
7- Or lastly, From the bark not being good; here 
get better - But for the removal of almost all 
the causes of the want of effect of bark, the Lancet should
be resorted to, and in every case you will have sizy
blood-
I cannot leave the subject of bark without remarking 
the exalted station it has held in the Materia 
Medica, for so long a time; to its use millions 

 

(194)
owe their lives; it was discovered by an Indian introduced
by a Priest, [cross out] vyed down by the regular Physicians, and revived
by a quack -
This fever has disguised forms -
It appears in Sciatica; when natural!!! headach!!! arises
from decayed teeth - as also in the form of Puerparal
fever; and sometimes in Madness -
It also appears in the form of tenesmus and vomiting;
as also in a periodical fever in a part of the body only,
as in the right arm; Dr Moseley mentions this -
This fever terminates -
1. In Pulmonary Consumption, cough, or fever -
2. In Obstructions of the Omentum liver and spleen
3. In swelled legs and Jaundice -
6. In Hectic fever; a Salivation promises much 
here -
Dr Clarke mentions some circumstances, which would 
make it likely its ware contagious - Probably those 
obstinate intermittents which Dr Bond cured by 
Salivation were of the hectic kind - 

 

(195)
V The Chronic Bilious Fever
It appears on Synocha, synocula, typhoid and Typhus -
1 In this fever it is necessary to open the bowels 
more by purges than in other chronic fever, because 
it is necessary to remove the bile -
2. you must use the lancet even to the close of 
this fever, should the pulse be full, or the patient
in pain; in some instances even [cross out] the 30th day -
VI Febricula -
This is the last state of autumnal bilious fever; it 
occurs in intermittent!!! countries, its symptoms, a frequent
pulse, little headach, slight heat, high-coloured urine -
The Remedies are vomits, gentle purges, Blisters
Bark, and lastly bloodletting if the pulse be corded -
Remarks on the Plague -
2. This fever, like the autumnal bilious fever
can nix forms
3. It can be taken any number of times -
4. It attacks strangers more than natives -

 

(195)
5- The young and Robust are more subject to it, than 
the old and feeble -
6. It is worn during moisture -
8. It is not contagious; this is proved by Sir Welham
Wilson and Assalini; the supposition of its non - contagiousness
is an old opinion; to prove it, two dissertations 
were printed in 1721 and 1722 -
9. Cold and wet weather remove it -
1. It is hot climates attended by less reaction -
2. It affects the lymphatic glands more than the 
yellow fever; buboes and carbuncles are less common in 
yellow fever -
3. In the plague of a cold climate, is, in yellow
fever there is a centre!!! petal tendency; hence a bubo
with us indicates the disorganization of the bowels- It 
is singular that a bubo in the right grain indicates the 
disease to be at; its hight, whereas [cross out] its decline is 
shewn by its being in both!!! -

 

(196)
4. It has appeared in a sweating form, called the sweating
sickness -
In Hartford, Con. the Dysentery was more [cross out]
fatal than even the yellow fever was, the year before;
and yet [cross out] the inhabitants contend for the domestic origin of 
the former and not of the latter!! Nosology like a
Polypus, meets me in every part of my course - believe 
me, it is as absurd to suppose that morbid
excitement can be cut up according to the part 
affected, [cross out] just as the belief of the suitor that old!!! Moon!!! are 
cut up into Stars!!! -
Hence I believe that the Asiatic and African 
plague are the same disease as our yellow 
fever, differently modified by climate -
Of the Remedies -
1. Sweats have been used with advantage by Dr.
Sydenham in curing the London plague -
2. Vomits and Purges -
3. A Salivation, if it could be induced in 24 hours 
would be good in chronic yellow fever; Sir Robert 

 

(197)
Wilson says that opium and Mercury wine the most
successful medicines in curing the Egyptian plague
during the stay of the British army there -
4. A new method was used in curing this fever,
that of wrapping the body in numberless folds of linen,
for the purpose of producing profuse sweats;
we know that Swiming over the Thames cured the 
Plague in London, and a shower of rain has had 
the same effect, they both act probably by reducing 
morbid excitement -
Typhus fever
The Opium Fever
This fever takes place when this substance is taken in 
a large quantity either by mistake or to destroy life -
It is attended with inflammation, depression [cross out] or 
prostration -
It is cured 1 By rejecting the Laudanum by Emetics;
a feather may be useful thrust down the throat; an half 
gallon of water may be given; it acts by distending the stomach, 

 

(198)
and diluting the Laudanum; but if vomiting be excited
without relief -
2. Then bloodletting may be used if the pulse be 
active -
3. Affusion of Cold water to the head, Dr Griffits
cured this fever by cups to the temples, also flagelation;
remember the dog and the nux vomica, formerly acids
and sweet oil were used to blunt the opium; and other 
remedies to defend the system; after the depleting, [cross out]
the stimulating plan must be resorted to, such as clysters,
Cataplasms, sinapisms -
The Mercury Fever.
This noble medicine, although so valuable in many,
is yet the cause of some, diseases - It has induced
a Tertian and Quartan fever, the Synocha and Malignant
fever, Hemorrhagies, Diarrhœa, Dysentery, Angina
Pectoris and Rheumatism -

But it is said that the hydrophobia
affects the nerves more than the blood vessels,
therefore it is not a fever, but some 
malignant fevers affects the nerves more 
than the blood vessels - It cannot be 
communicated by biting in the human
species!!! or in horse cattle!!!; it cannot be communicated
by kissing or coition- 

(199)
The Hydrophobic State of Fever
For a minute detail of this fever I refer you to my Inquiries -
I believe it to be a fever of a highly malignant
kind; but Dr Currie says it is not inflammatory because 
their exists no febrile heat - but this is no reason,
because the fever may be so violent as to transcend
the inflammatory type; it is known as well by the dread
of air as of water; but neither of these syntoms is invariable It arises spontaneously in Dogs Cats Foxes
and Wolves only; it cannot be communicated by eating the 
flesh of sheep or hogs dying of hydrophobia; nor by the 
milk of Cows similarly affected; The cause in Dogs is heat
or want of water and aliment -
The disease affects the blood vessels and nerves
generally, but especially the larinx and glottis; hence
from the constriction of those parts the mad Dog is 
[cross out] unable to bark; hence we need not fear a dog 
that barks - 

It has been communicated by rabid
lap [cross out] dogs in 6 instances!!! through the medium
of the lips -
1- The first preventive is excision - there
is one instance in which it is said to have 
failed; it will succeed at any time after 
the accident if the symtoms!!! of the disease
have not taken place!!! - often the 
excision, the part should be kept open for
several weeks - 

(200)
The subject divides itself into 
1- Those remedies which are proper as preventives and 
2nd check as are necessary when the disease is formed -
1. The 1st preventive is the excision of the part - Dr 
Physick has thus prevented the disease 15 days after
the bite was received; there is no danger if no blood be
drawn - but yet it does not always produce the disease
when it is drawn; it is same with the variolous matter;
either from idiosyncrasy or being washed out by the blood 
drawn - Dr Hunter proved that the variolous disease
could not be taken, if the wounded part was excised on 
or before the 6th day -
2. The 2nd preventive is Caustics; there are the nitrate
of Silver, the Caustic alkali, Lime, hot vinegar, and 
Sulphuric acid -
3. Affusion from a tea pot on the part, to wash out the 
poison; but I don't recommend this -
4. Suction; This was practised successfully by Lenora,
upon, her Husband Edward of England; [cross out] 

Even at this time the wound should be 
opened afresh - it has different grades; synochus
fortis, synocha, and typhus gravior; there
is a constriction of the glottis and the patient
has at first a hoarse cough; a salivation
may be used; after the patient gets below far
then Stimulants -

(201)
and we have an instance of it which took place in Ireland;
Recollect the impressive case recorded by Dr.
Forthergill, in which two persons were bitten at [cross out]
the same time, one of whose died, but [cross out] the other
being a washer woman, and having the bitten part (her 
hand) constantly in the wash tub escaped the disease -
Some have tried to discover something, to throw the 
[cross out] poison out of the system; but this attempt is
fertile, and attended with the loss of your patient, the disease
generally takes place in a month or six weeks, but
in an instance in Dover (Del) it did not appear untill
10!!! years- I refer you to Dr Hillary -
Remedies proper after the Fever is formed.
It has been said to have been cured by sweats, purges
and a Salivation, also bloodletting as well as other 
remedies such as plunging the patient repeatedly in water,
it acts by creating a fear of drowning -
What would be the effect of pouring water on the 

A and as the nerves are very much affected
we might use Castor and Musk -
I mention Mercury as in stimulant because 
it is essentially so when it does not affect 
the salivary glands -

(202)
patient from a great night? what would be the effect of 
excititing a great action on the skin by the Sp. of Turpentine
or Cartharides? Spallanzani is said to have
cured a Dog of Hydrophobia, by letting him be but by 
a rattle make; what would be the effect of this counteracting
stimulus upon the human subject? What would 
be the effect of Ether Laudanum &c, but in 4 times greater
than common doses? what would be the effect of translating
the action from the larinx to the throat by external
application? and lastly what would be the effect of 
violent and repeated emetics to weaken the larinx
which is the head quarters of the disease; for Dr Physick
affirms, that death is generally produced, if not always,
by strangulation; nor is this disease alone in this 
respect; since Cantharides acts on the neck of the bladder,
Mercury on the Salivary glands, and the Eupas on 
the lower jaw producing lock-jaw - thus Dr. Physick

A But when we perform this operation
we only [cross out] obviate the effects of a symptom; we have to 
contend still with the disease -
Sulphur [cross out] has been recommended to 
to prevent the effect of arsenic, but I doubt 
whether an orpiment can be formed in the 
stomach when the poisons gets into the blood
Fever is the consequence, and here use remedies,
such as are necessary for other fevers; we 
need not seek & any thing to discharge the 
poison from the blood - I have heard that the 
natives of S. America cure the bite of a Snake by exciting
counteraction in the stomach by cayenne pepper -

(203)
has with great boldness and ingenuity suggested the 
propriety of making an artificial opening into the
larinx, communicating externally, which would effectually
obviate the production of Strangulation, so 
far as it would depend upon constriction of the Glottis - A
The Fever produced by Poisons -
When taken into the stomach their effects are obviated
in 3 ways -
1 By removing the substance from the stomach,
2. By neutralizing it by some other substance and 3.
By producing a new and greater action in some other
parts; thus, to destroy the Muriate of Mercury make 
in of the alkaline salts; it may be necessary to blunt
the effect of the extraneous body by Diluents such
as milk or oil. [cross out] Diluents act by diffusing
the poison. If the patient cannot swallow, then produce 
a tendency to the skin by counter-excitants.
For make bites, use excision, inflaming applications,

Of those states of fever which affect the whole
arterial system, but appear with greater
morbid excitement in some parts than other 
These are 
* I The sweating State of Fever -
A when poisons produces
the maniacal hysterical
dysenteric or eruptive
state of fever, in the remedies
necessary these states;
Some poisons affect the 
skin only, and the blood 
vessels only by sympathy, or 
the bite of the mosquito
the effluvia from the Rhus
Radicans - 

(304)
A
applications, suction and ablution - burying the part in the 
ground -
I The Sweating State of Fever -
It arises from too great or too little morbid excitement
in the blood vessels - when from too great 
excitement the sweating is generally in the day
when from too little, at night; they might be called
Tonic and Atonic sweats - It appears in the 
Plague Pleurisy Intermittent fever, Pneumony and 
Hectic fever; when caused by great morbid action
bloodletting according to Dr Sydenham, and sitting up
in bed. have been used with advantage. In cases 
of weak action, Sulphuric and and other Tonics
should be employed; but yet even in the typhoid
state of the system, a small bleeding may be sometimes
necessary; it is depleting by a smaller and safer outlet -
II The Fainting State of Fever -
This appears in all malignant fevers, arises from 
Prostration, and is removed by small bleedings, in 

A To prove that animal heat was not 
altogether connected with the form of 
the insulation -
B afterwards frictions, and warm fomentations
to the legs. 

(205)
the Rheiverian manner - I have known fainting
to attend a first and 2nd bleeding, [cross out] and yet 
not the third -
III The Burning State of Fever -
This is symtom of malignant fever and is either general
or partial; it gives a person touching the skin, a 
slight pain, and is hence called Color Mordeus; I have heard a patient
cry out with the heat!!! of the blood trickling
down his arm when bleeding him; I once saw this 
Color in great excess, when the pulse was absent, this 
I mentioned in my theory of animal heat - A The remedies
are two or three bleeding and cold water -
IV The Chilly State of Fever
This is distinguished from intermittent fever by the 
long continuance of the fit; it is cured by bloodletting!!!;
I remember to have bled a Lady untill I warmed 
her feet B
But let me conjure you not to view these forms of fevers 

A It has lately attracted the attention of 
Physicians of Europe; Dr Duncan has 
described it; it is attended with no [cross out]
febrile heat or frequency of pulse -
In the acute form there is only an increased
peristaltic motion of the bowels, but no stricture -

(206)
under nosological Spectacles, for they are so mixed 
as to put on the fainty hot and cold stages in 
succession; But they almost all yield to bl. letting!!! -
V The Petechial State of Fever -
A This is a malignant fever concentrated on the skin;
its remedies are bark, wine &c. it is the same to 
a malignant fever, as the _ is to the 
mild bilious -
VI The Intestinal States of Fever
These are Diarrhœa, Dysentery, Colera Morbus 
and Bilious Cholic - and first of Diarrhœa -
1 Diarrhœa - acute form 
This is excited -
1- By a cold evening following a warm day -
2. By exposure to night air -
3. By the suppression of a profuse sweat -
4. By the sudden evaporation of a sweat - 

A Thick as oranges Lemons [cross out] or pomegranate
A Also diluting drinks as chamomile tea;
if this fails, then inject Laudanum in 
the bowels -
It has been produced by drastic purges.

(207)
5. By a current of air, acting upon the whole or a 
part of the body -
Of those causes which produce Diarrhœa, by 
acting directly upon the bowels, we have -
1- Fresh meat after long abstinence, also tainted Meat -
2. Bad fruit or too much good fruit; skin-fruits A
are not so likely to produce it; these are oranges
pomegranates &c
3. Too much cold water - Dr Duir mentions this -
4- By taking too much bitters to prevent it;
Dr Duir notices this also
It may be cured by purges, or an emetic and Laudanum 
at night; A I shall hereafter treat of the chronic 
form of this disease -
2. Dysentery -
This is a higher grade of the last disease, and is 
produced by the same causes, together with human 
and marsh miasmata; bad wheat produced
it in Minorca according to Dr Cleghorne, when
seated in the lower bowels, it is attended with 

I have said that Diarrhœa was only
an increased peristaltic motion, now
Dysentery, added to this is attended [cross out]
[cross out] with Stricture, convulsions
and sometimes spasm - 

(208)
great pain, which sometimes kills; but when seated
in the upper bowels, it is not so painful, and is 
attended by anxiety about the precordia: sometimes,
both upper and lower bowels are affected -
We have a hospital camp and jail Dysentery
as certainly, as a hospital camp and jail fever;
that Dysentery is an introverted yellow fever!!!, I infer
from the liver being in both diseases paralysed;
sometimes there is no pain at all; thus patients
will walk about the room with it, till a short
time before their death; this is called a walking Dysentery;
when the disease affects the rectum it is 
called
Tenesmus -
This is produced by 1- acrid matter in the rectum
2. From the diseases state of the contiguous bladder
or Uterus - 3. From the presence of hardened fœces -
4. From the existence of an ulcer in the rectum -
a tenemus from an ulcer is mentioned by Morgagni 

The pulse is seldom excited in dysentery,
neither does pain [cross out] of the [cross out] head or 
delirium attend; I shall apply this 
hereafter; [cross out] it sometimes terminates
in a few days -
A That is, a disease with dysentenic pains
without any discharge from the bowels -

(209)
The stools in this disease put on the following 
appearances, and in the following order -
1st Blood and Mucus -
2- Blood and a quantity of fœces; blood from 
dilated, but not ruptured vessels -
3. Mucus alone; coming from the great intestine
4. Fœces with mucus, but without blood -
5. Little balls -
6. Fatty balls; they may be coagulated chyle -
7. Serum or a matter as limpid as water this 
comes from the liver -
8. A Membrane, supposed to be the inner Membrane
of the bowels - but this is an error -
9. Blood alone; such dysenteries are generally fatal
10. and lastly worms, especially the round worm -
Dr Sydenham has a suffocated or dry Dysentery; A
thus also we have a dry Opthalmia, a dry asthma
a dry Gonnorrhœa -
The patient sometimes feels as if he had no bowels,
but more frequently suffers acute pain, generally
seated in the Colon and rectum; sometimes the 

 

(210)
pains are in the mesentery; oppression shews the 
disease to be in the upper bowels, pain, the lower;
recollect some purges are fitted for the upper and 
some for the lower bowels -
In this form of intestinal fever the pulse 
is very various. - When acute, it destroys in 
in 3 or 4 days; when it last, two or three weeks 
it is called chronic Dysentery, or more proper
by Dysentericula; this Chronic Dysentery often attends
a Diarrhœa in it first and last stages -
The appearances after disection -
1- no marks of disease at all -
3. A membrane formed by the lymph of the blood -
4. Pustules like the small pox -
5. Tubercles -
6. Abrasion; so as to expose the muscular coat
of the intestine -
7- Gangrene; but distinguish it from ecchymosis - 

A 10. Sir G. Pringle found the Spleen enlarged -
I have never known a Dysentery epidemic in this city -

(211)
8. Contraction of the diameter, and thickening of the 
coats, of the intestines -
9- A diseased Liver; this is the case in India
according to Dr. Tho' Clarke; but in Germany the liver
was sound in every case according to [cross out] Sir. G. Pringle A
It appears in the malignant inflammatory
Typhoid and intermittent forms -
1 It occurs generally in high situations, where
the cold would have a tendency to suppress perspiration -
2. It occurs in the Countries in which there 
is a great difference between the heat of the 
day and night -
3- It is sometimes proceeded by Catarrh, as 
in the Philadelphia Frigate -
4. It occurs oftener in the country [cross out] than in 
the city, from the city - stomachs being fortified
by more cordial aliment A

A In Paris in this disease; the same was the case 
in Vienna - 

(212)
5. It alternates in successive years with the 
yellow fever; Dr Dalzelle speaks of a putrid Dysentery
in Portugal - it alternates with the bilious
fever, a patient may have the bilious fever, 
5 days after having a Dysentery; or even a complication
of the two disease; [cross out] here bark [cross out]
must be used.
6- It appears with different symtoms and 
is cured by different remedies; in one year, it 
is cured by purging, the next year by bleeding A
7- It affects the Blacks more than whites =
Dr Clarke saw it go off in a salivation; it is most 
fatal to children and old men -
8. Sometimes it is so violent, that all ages
sexes and conditions fall victims to it -
9- At Quito in S. america, a disease is described 
to have been epidemic; it was attended
with great pain, and mortification, in the rectum;
which nothing would relieve but a cut lemon 

A Diarrhea, transient pains in the lower
bowels, sickness at stomach - 
A These were probably malignant dysentenies
The first remedy in Dysentery is bloodletting 
A That this [cross out] may be the case, I need only to mention
that I have seen [cross out] Dysentery to [cross out] terminate
in black vomiting -

(213)
thrust up the rectum; this certainly was a suffocated
dysentery -
Premonitory Signs -
These are Costiveness and small mucous & broken stools A - &c - here
a purge will prevent its accession -
Remedies for Dysentery -
In the low state of Dysentery purges should not be 
given; nor vomits they have even produced death; cordials drinks
and injections were the only remedies which would
succeed in Chester; the drink may be made of burnt
brandy and loaf sugar; it was the same at Burden town -
in 1793 - A In this city the Dysentery has always been
inflammatory since 1750; hence I have bled from one to 22 times
in Dysentery; when we think it introverted yellow
fever, remedies of the same force must be used as 
for yellow fever - A Dr Cleghorne always bled in this 
disease when preceeded by a chill; Dr Frank of 
Straasburg said nothing would do but bleeding

A There must be [cross out] persisted in until you get fœtid
green or black stools or cyballa - liquid purges
are best - 

(214)
in their dysentery; and Dr Duic, nothing but 
leaches to the belly -
2 In this disease lenient purges are good, such 
as Castor, and sweet oil, fresh melted butter, milk,
vinegar and molasses, equal parts, 3 times a day; sulphur
may be given for the lower bowels, but senna
Rheubarb, Calomel, for the upper - In the west 
Indies Salt and Lime juice [cross out] are used; but both 
classes of purges should be helped by [cross out] laxative and demulcent
[cross out] clysters; A Dr Senac recommends weak broth taken 
in small and frequent draughs; he says he has 
cured [cross out] it by large draughs of warm water alone - 
3. Vomits seem to be forbidden, except in nausea;
they give a centrifugal motion to the fluids of 
the whole body 4 Moseley recommends sweating;
it should not be used; except there appear
a determination of nature to the skin, or where from the 
climate [cross out] being uniformly warm, we suspect there is 
a centrifugal tendency of the system -

Flax seed mullen, and mallows, tea,
arrow root, a solution of gum arabic, rice boiled
with water, little sugar and cinnamon 
Bees wax ℥ss put in Milk which has had 
two spoonsful of starch boiled in it -

(215)
Dr Sydenham recommends the following -
Boil mutton Suet ℥IV in a pint of milk, while
boiling add gradually some starch, with half 
an oz of Loaf Sugar; Pringle used the chalk Julap -
it is the following -
Chalk oz I to II - Gum arabic ʒii Salt Soda ʒi Mint water ℥i 
water oz VI - Laudanum Gts LX to C a sheet of paper
boiled until dissolved in a pint of milk has 
been used.
Blisters were first used by me, from a belief
that the dysentery was nothing but a retroverted
antimonal fever - The itch, or rather
the consequent scratching has cured this disease;
This is explained when we recollect that the 
skin and the bowels are antagonist muscles- Dr.
Darwin tells us that two men cured themselves of this 
disease by fighting why not cure some of our diseases
by shampooing - Opium increases or lessens the pain, 


Frictions upon the belly with hartshorn
and laudanum, or sweet oil and laudanum
to the navel; a bandage of flannel
round the belly -
A Dr Duic has found the distilled and 
fermented liquors useful, carried to such 
an extent as to produce slight giddyness;
when these cannot be obtained; smoking
tobacco is a good substitute - 
A In a Dropsy, in lock jaw, in Tympanitis


(216)
according to the propriety with which it is given -
Lying on the belly and smoking tobacco has been used
3. When it is attended with a Typhoid - or Typhus 
pulse, you must not bleed, but gentle purges
and vomits, opium and blisters must be used A - the 
bark seldom does good, although so proper in Typhus 
4. The Intermittent Dysentery should be treated
with bark, exactly as if a simple intermittent -
Recollect that the remedies should be varied
not only by every new occurrence of the disease, but 
sometimes in every individual case -
Dysentery terminates in the following ways;
in Rheumatism; in Opthalmia; in a Salivation; A in 
Dropsy; Tenesmus in chronic Diarrhœa; in chronic Dysentery;
and lastly in health and death -
Chronic Dysentery -
This is cured by bark, by a mixture of tar wax and 
soap; by opium; ligatures, riding on horse back -

Restlessness without pain, a streaking
voice, and a sore throat - This disease
is generally fatal when left to nature; and 
if we had nothing else to recommend Physicians 
than their dominion [cross out] over this 
disease, they would be entitled to the gratitude
of Mankind - 

(217)
when the bowels are inert; wax is good within in 
pills or a course powder, these pills are not dissolved,
which proves they act by their indigestible quality -
Signs favourable or unfavourable -
If the stools, are green fœtid, or cream-coloured
it is favourable, if otherwise bad; when streaked 
with blood it is bad; hamorrhægies generally
prove fatal, streaked stools are alarming - Delirium,
Hickup lying on the back, change of voice cadaverous 
[cross out] smell, and a sunken countenance are all bad -
Dr Rush believes Dysentery to be both contagious
and not according to circumstances; but I contend !!!! -
that it never is read by contagion in any age or country -
3. Colera Morbus -
This disease is attended with discharges both 
upwards and downwards, or either alone!!!; it is generally
excited by cool air in the evening; Dr Sydenham 
speaks of the dry colera, or the discharge 

A But in the mild colera laudanum may 
be used -
B This serves to distinguish it from nervous
Colic -

(218)
of great quantities of air both up and down -
I have said formerly that Diarrhœa was 
and increased peristaltic motion of the bowels; I
now say that Dysentery is the same with spasm;
and that Colera is distinguished from both, by 
discharges up and down -
The remedies should be accommodated
to the air; and the reigning epidemic; since
the year 1793, bleeding has been used with advantage;
opium, in the inflammatory Colera does harm A
4. Bilious Colic -
1 It is known, by its taking place, when Bilious
fevers are prevalent -
2. By its being proceeded by a chilly fit - B
3. By the discharge of bile upwards and downwards -
4. By the febrile pulse; it is produced
by all the exciting causes of intestinal fever -

It sometimes produces intussusceptis
A It often unlocked the disease, by 
salivation - 
They all relate to each other as point of danger -
thus 
The Dysentery accords with y. fever
Bil - Colic - with infla. bil. fever
Colera Morbus - with the Mild vomit 
The Diarrhea - with inter. fever -

(219)
It is often epidemic through a whole country,
and in Kent County Del.
The remedies are bleeding purging, vomits, warm
bath, and Calomel; A this last medicine, Dr Balfour
give [cross out] 10 grs at bed time, and two or 
three times the next day -
We have thus finished the 14 forms
of autumnal fever - I will enumerate them -
1. The yellow fever 
2 The inflam. bil. fever
3 The mild remitting fever 
4. The intermitting fever 
5. The chronic bil. fever 
6 The Febricula
7 Diarrhœa
8. Dysentery
9 Colera Morbus
10 Bilious Colic.
VII The Pulmonary States of fever -
These are Pneumonia vera, notha, and biliosa;
Influenza, Catarrh from the sensible
qualities of the air, and Pulmonary Consumption - 

A The absence of cough - hence then in the progress
of the disease, should cough arise it is favourable -
A [cross out] the inflammation often extends through
all the membrane, by the sympathy of continuity -
X a sense of general weakness, slight cough -

(220)
1- Pneumonia Vera -
This is again divided into Pleuritis and Pneumony,
but I would ask, cui bono; it is impossible 
to tell whether the lungs or pleura are inflamed;
neither is there any necessity to know [cross out] the 
remedies being the same in both [cross out] cases -
An Inflammation of the pleura [cross out] or lungs is 
known to exist by a tense or depressed pulse, pain in 
the side and shoulder or back, or a dull pain
in the breast, increased by inspiration - A [cross out]
a [cross out] - One!!! bleeding, a purge,
the soap liniment or a blister will always!!! cure it -
Its direct causes are transitions from heat to cold, contusions and gases; in - A 
direct causes, gout small pox. measles Rheumatism, yellow fever, suppression
of the menses or hemorrhoids, suppressed Diarrhœa, or Dysentery
and inflammation of the liver and spleen -
The premonitory signs are stitch in the side;
a sight chill * here 20 drops of Laudanum, or the 

Persons who have been thrown into water
after being died, [cross out] will have the stomach
full of water, and not much mucus in the 
Trachea, but if death takes place from drowning
the trachea will be found full of mucus -

(221)
loss of 8 or 10 oz of blood if the pulse be active, will 
remove the [cross out] predisposition -
The appearances after direction are -
1- A Sound, inflamed or red pleura or thickened
2- A membrane, either dense, firm, strong
soft, or reticular, [cross out] and covering all or a part of the pleura -
3. The pleura connected to the lungs by a Membrane,
which, when removed, discovers the pleura
sound - 
4. An Inflammation of the mediastinum, and 
intercostal muscles septum transversale pericardium
and even the periosteum of the ribs themselves -
The lungs sometimes exhibit no one sign of 
disease; and at other times, the lungs and pleura,
not only appear inflamed, but sometimes the 
pericardium, and heart itself - this [cross out] is proved
by the heart containing dissolved blood or tubercles -
Remedies from all its causes -
1. Bloodletting until the pain be removed
and the pulse reduced; this remedy is not regulated 
by stages; it is sometimes necessary in 

A I have in some instances bled not before 
the 2nd or 3rd day -
B The bleeding should take place in the affected
side; I recommend [cross out] this, because
blood has been sizey only on one side of the body -
A It has been said that a small bleeding will
even do harm; this I can believe because
as the pulse is depressed, the only effect of 
the small bleeding is to let the disease [cross out]
loose upon the system -

(222)
all the stages; A it has been objected to because
it was supposed to interrupt nature in her 
work of concoction, a foolish doctrine, held
when medicine was in the cradle - but this 
is not the only instance in which we have to 
lament an absurb restrictions, adhered to, while
the Careful doctrine which produced it,
has been long exploded - B It is not so dangerous
when from a wound!!! in the lungs - the first 
bleeding should be large to do good - A pregnant women 
require more bleeding; 2 lenient purges are 
often proper, such as Castor oil, senna, salts, and 
opening clysters; if there should be pain in the 
side, let a large blister be applied to the 
part, when we believe the mediastinum to be 
inflamed, apply it to the breast; otherwise to 
the back between the shoulders - Badley recommends 

 


(223)
recommends their application to the thighs
4. After depletion, diluent drinks may 
be taken with advantage, especially in those 
cases which have a centrifugal tendency; This 
effect may be had by adding Seneka make root
to the drinks, or by giving the antimonial powders;
if attended with cough dimulcents are requisite,
such as barley water, and the liquorice mixture;
if sufficient bleeding cannot be used to 
remove obstructions, which is the case at the 
close of a disease, then Expectorants, such as the 
volatile alkali, horse radish, oxymel of squills, and 
squills and Calomel, and vapour should be used -
if the Calomel touch the mouth, so much the better;
cupping between the shoulders is a good expectorant;
but expectorants are never necessary, which the 
lancet is used properly - Emetics are excellent at
the end of the disease; I have seen patients matched 

A Dr Sydenham has very sensibly remarked
that the matters which requires expectorants,
are best abstracted by [cross out] veins - 
2 It ends in Hydrothorax; those having 
this disease once, are more subject [cross out] to it
afterwards - I have attended one man 22 
times in this disease -

(224)
from the grave by an emetic - A
It ends in life with the resolution of 
the-[cross out] inflammation -
It ends in death, from the blood vessels
being surcharged with blood, from suffocation;
1 It ends in Vomica; the signs of this are 
partial sweats on the neck and chest - when it 
is near suppuration!!!, it will be well to give emetics
to break it; I have never tried it, but I have known
many instances of recovery; the breaking of a swing
has broken one at Pittsburg, which ended in a recovery;
Hippocrates recommends shaking by [cross out]
by the shoulders, to produce the same effect -
Symtoms favourable or unfavourable -
Delirium on the 5th day is always alarming -
a Diarrhœa, is unfavourable, a pain in the left 
side is a [cross out] worse symtom; than when on the right it is more dangerous in young
children than in adults, more dangerous in pregnant 
women; dangerous in old people, dissolved 

 


(225)
blood is dangerous; it is favourable when the 
pain retreats to the arm after bleeding -
2 Pneumonia Notha -
In this disease the blood vessels are so engorged 
with blood, as to disable them from putting on 
an inflammatory action; respiration is performed
with difficulty; no cough attend; it is a violent
and dangerous disease; it often comes on suddenly
and soon proves fatal - I have called it an apoplexy 
of the lungs; it ends in intra-and extravasation
of blood; it sometimes occurs 3 or 
4 times during life; Mr Jonas Philips died
of a 4th attack of it in a few hours -
It seldom comes on with premonitory
signs - when it does, they are drowsiness, heaviness
&c- In its forming state, a few oz of blood drawn
very often will prevent its formation -

 


(226)
In this disease the following circumstances should
be attended to -
1- It generally attacks those who are debilitated 
by autumnal diseases or labour, by hard drinking
or a scantiness of food; it attacks the slaves
in the west Indies; In the Southern states, it 
often comes on in the winter, after an attack
of the autumnal bilious fever, the proceeding 
fall - Those who escape the bilious fever in the 
west Indies, are attacked by Pneumonia
notha in the fall - Dr Dalzelle informs us that 
the Pneumonia vera is a very rare disease in 
the west Indies among the slaves; the gout is very
very often translated to the lungs in the spring
or in moist [cross out] and open winters, in which case it is generally
notha, though sometimes vera - yellow fever and 
Influenza have both been thrown upon the lungs,
when formed the remedies are, 

A The blisters should be applied to the 
sides shoulders arms and wrists at the 
same time - but as this is a Soap bubble 
disease, no sooner have we depleted than
we must pour in stimulants 
B It is attended with sickness at stomach 
and vomiting of bile -

(227)
1 Bleeding, even though the pulse does not indicate
it; for it will rise by its use; but sometimes
our patient's habit of body will forbid
bloodletting; but you often change the disease
to a vera by this remedy -
2. Blisters, vol. alkali Ether, Laudanum, and Mustard
to the feet - A
3. The vapour of hot water, as well as the 
smoke of resin have done good after bleeding; I think
I saved the life of a Lady by it -
3. Pneumonia Biliosa
In this disease we have two morbid actions
going on at the same time; B it is generally attended
by a dark tongue, and takes place late in the 
autumn, winter or spring; when a person escapes
the bilious fever in the autumn, he generally
is seized by this disease in the winter; it appears 


It is very fatal in countries subject
to the plagues; this is mentioned by Dr
Webster; yellow eyes [cross out] often attend -

(228)
under two forms, 1st with the synochus or synocha
pulse, and 2nd with the Typhus pulse -
The first form is cured by bloodletting, from
3 to 4 oz; in this manner Dr Cleghorn cured this 
disease; but he says, the same treacherous
intermissions exist that he mentioned with respect 
to yellow fever; these remissions I call
paroxysms. The bilious Pleurisy is common
in all countries subject to the plagues -
2. Purges repeated daily as in bilious fever; they should
be aided by emolient clysters -
3. vomits after bloodletting, when the stomach is affected
by nausea - [cross out] use demulcent drinks and opiates -
Typhus form; This form, [cross out] which Dr Sydenham
describes as a bilious Pleurisy forbidding bloodletting,
[cross out] is known by a quick
breathing, disposition to faint; the pulse will sometimes have
a soap bubble tenseness - The following are the remedies 

A It was attended with a chill; I have 
occasionaly seen it so
A It affects Savages, and persons who live in the 
coldest climates; it is a very ancient disease -

(229)
1 vomits - 2 purges with clysters - now Seneka make
root, opiates and bark - I have not always been equally
successful in curing this disease; I have been puzzled
being under the necessity sometimes of giving cordials with 
sizy blood - This form is sometimes chronic and sometimes
acute -
Bastard Pleurisy
This is an inflammation of the periosteum of the 
ribs; and the muscles of the side bleeding is seldom necessary here; but frictions
and cupping must be used - Dr Hillary mentions 
a kind of bastard Pleurisy in which the pain is confined
to the sternum; and back A a little bleeding will cure it and local 
remedies - 
4 Influenza -
Influenza proceeds from the insensible, Catarrah
from the sensible qualities of the atmosphere, they are 
[cross out] very much alike, both affecting the same part -
This disease sometimes affects brutes; a it traversed
Europe in 1801, and appear in 3 different forms in 

It rages in all seasons; it is not at all 
affected by the sensible qualities of the atmosphere,
as we might have supposed from 
the known influence of their causes upon all
other diseases - 

(230)
France - 1 in a Slight form, so as not to prevent [illegible]
2nd just severe enough to confine the patient to his house;
3rd In a malignant form; it is often the precursor of yellow
fever, and sometimes the signal of its departure;
It is sometimes bilious - notha - vera - and at 
other times in the form of a typhus fever - It 
sometimes runs through jails and armies; it excited
ague in those persons having it the year before according 
to Pringle; I have seen it local, not contagious -
The remedies divides themselves into 1. Preventives
and 2nd.,, Cures 
1 The Preventives, are pediluvium, diluent drinks in 
large quantities, abstinence, bodily exertion; preaching cured
it in Dr,, Whitney; he used to call it a pulpit sweat; a gentleman
from New York cured his whole family by the warm bath;
he called it parboiling - Dr Physick has prevented it by Laudanum 
in a dose of 25 drops at night -
2. When formed, bloodletting, Emetics, Blisters, gentle
purges, diluents &c should be used - Sometimes the pulse 

* Also the feet should be protected 

231
has a typhus action; here then you must use cordials -
It is fatal to very old people; 12 persons above the age
of 80 died of the Influenza in 1807; it is a bad affection,
frequently producing Consumption -
Flannels next the skin should be used to prevent catarrhs,
the neck should be kept warm X a man of 96 years of
age, died a few years ago, who overcome a predisposion
to Consumption by putting his feet in cold water
every morning; I have lately heard of a similar instance 
in new york -
5 Catarrh -
This affection often ends in Consumption; 1st it is 
generally produced when the mercury suddenly falls 
in the Thermometer; [cross out] from 90" to 80", or from 80 to 70", more 
usually produces it than from 60" to 50" - hence we 
have the reason why Catarrhs are so uncommon in Canada
and Russia, where the weather is uniformly
cold, and so common in the United states and England
where the climate is so variable - 

 


(232)
1. A Catarrh is produced when air is applied
to the whole body -
2. By a stream of cold air on the skin, by its sympathy 
with the lungs.
3. From the abstraction of a customary part of dress
4. [cross out] when applied in the shape of 
vapour or water, damp sheets or a damp room -
In these cases, it is nothing but obstructed perspiration,
thrown upon the lungs; this is generally the case 
in winter, but in summer it is thrown upon the bowels -
but if the Obstructed perspiration be thrown upon 
the lungs in Summer, it shews the cause to have acted
very violently, to have diverted it from its common course;
hence summer, are worse than Winter colds -
Circumstances which [cross out] dispose the exposure
to Cold to end in Catarrh -
1- Going into the cold after sweating -
2. When we [cross out] remain in our Study a long time in cold weather.
3. By having taken a full meal, [cross out] having feasted -
4. When we are debilitated by previous labour -
or evacuations -

5. A catarrh is sometimes produced by fear
distress or vexation -
one-fourth of all the [cross out] persons
who die in some countries, are carried
off by Pulmonary consumption -

(233)
5. By being exposed to heat and cold at the same 
time, as by sitting before a fire - by going into a 
cold Chamber -
6 By being combined with moisture; but this 
does not always obtain, for in countries uniformly moist,
as Holland, there are few instances of Catarrhs -
Catarrhs are also produced by other causes -
1- By the miasmata of a jail -
2. By the dust arising upon the exhalation upon the removal of old books
3. By a mixture of sea and land air -
4. By the breath of persons living on luxurious food;
thus Scotchmen, when they go to the little islands near 
them, [cross out] produce Catarrhs among the Inhabitants
6 Pulmonary Consumption -
This disease is nothing but a protracted Pneumony -
Its causes are either primary Secondary or sympathetic 
upon the lungs -
The Primary causes are an half cured Preumony,
badly treated Catarrh or Influenza Asthma wounds, contusions 

A Thrown upon the lungs; in this way the 
venereal poison has produced pulmonary consumption -
1st Because wounds producing abscesses, 
in the lungs never produce consumption
for this reason that the system generally is 
not brought into debility -

(234)
and mal-conformation, irritating matters taken into the lungs
The Secondary Causes are gout Rheumatism and 
repressed humours; A all kind of fevers -
The Sympathetic causes - when the lungs are affected
sympathetically with the uterus, stomach, [cross out]
[cross out]
1- It is always proceeded by general debility - this proposition
is proved 2nd by the sedentary lives of consumtive
patients, who are either Taylors, Printers, Shoemakers
&c - which neither house or ship carpenters, masons,
nor Sailors or watermen (whose employments subject
them to getting wet) are troubled by this disease; [cross out]
3. By the debilitating nature of the proceeding cough & 
4. By its alternating with general diseases, such as Mania 
and Rheumatism and gout which we know to be proceeded
by general debility -
4. Pus from the lungs as in Catarrh being discharged
from the surface of the lungs -
5. Abscesses and Tubercles, the former on the pulmonary
vessels, the latter on the bronchial vessels - no more happens
here than in the diseases of the liver, spleen and head!!!;

Thus it is perceived that it is absurd
to consider those circumstances or causes of 
disease in pulmonary consumption, which 
are admitted to be effect of disease everywhere
else!!! -

(235)
and why should we suppose an abscess in the liver to be 
the effect of Hepatitis, and consider its as the cause of a diseased 
lungs - Sometimes the disease comes on without 
premonitory symptoms -
6 In some cases Hydatids are formed, but oftener Calculi 
have been discharged but the same matters are produced
by disease else where -
But why should excitement be thrown upon
that part in preference to any other? the answer is because 
it is a flaccid viscus, being constantly exposed to predisposing
debility, from exposure to all weathers - sometimes the 
super abundant excitement is thrown upon the Trachea;
which constitutes what I would call a Tracheal Consumption;
this is not fatal, although it has existed [cross out] for 60
years; the reason patients survive is because the disease
is insulated.
3 Sometimes it assumes an intermediate [cross out] state,
between Pneumonia and Pneumonicula and kills
in 6 weeks; this called a Galloping Consumption
4. It generally takes place under 36, sometimes above 

A It is said to follow the predisposition
of the father rather than the mother -

(236)
45, but rarely above 60; between 19 and 21, when we 
cease growing, consumptions will come on - 1st an account
of a redundancy of blood; 2nd From the absorption of the 
Thymous gland, and 3rd. From a narrow chest - There are 
but few cases of this disease in childhood, yet it has 
been induced by whooping cough, but the Thymous
gland generally protects this tender age -
5. It generally occurs in persons with black eyes
or red hair; it is often hereditary; A but yet there are 
many instances in which it is a filial disease; The same 
is the case with Epilepsy Sore Cys and Deafness -
7- Moist and variable climates, when near the seashore
are apt to produce consumption; when the place 
is not situated near the sea, variableness, and not moisture,
predispose to this disease; that moisture does 
not produce it I infer, from its being unknown in Holland
and some parts of Ireland - cold and hot climates have 
few consumptions, but they are not favourable to them 

A Dr Blaine believes that countries between
the 30th and 40th degree of latitude
are most frequently to consumptive patients -
I agree with him - 

(237)
when formed A
8th- One half or at least 1/4 of all who die in 
England die of this disease - In Salem Mass. 1/3 the 
deaths are consumption, now Salem is near the sea there
9. Consumption has been divided into stages, but 
they should be called states; they are the inflammatory
hectic and Typhus - But they dont succeed in this 
order; I have had anomalous cases -2 I have seen two instances
without fever or night sweats -3 I have seen an 
instance without a cough fever or night sweats -
10 Consumption is said to be contagious; it may be Communicated
by the contagion of excretions [cross out] or 
by the breath from ulcers in the lungs; it is true that 
the idea of contagiousness is so fixed in Spain, as to 
induce them to burn the bed cloaths of consumptive
patients; but the same is done in yellow fever upon the 
same high medical authority, without proving [cross out] the latter to 
be contagious; it will not be said that its being a filial
disease proves it to be contagious because it proves

A The discharges from the bowels and 
Uterus go on regularly; the sexual appetite
remains unimpaired - 
A Both of which grades of fever produce dryness
of the tongue; that this is the explanation
I infer from Mania being attended
with a moist tongue -

(238)
too much, it would prove that deafness, sore Legs and Epilepsy
were contagious -
This disease is difficult to cure, owing to its being 
insulated, for you will find your patient well every
where but in the lungs; the Uterus is not affected,
the muscles!!!, very little, there is no headach; often a 
good appetite; A I say the strength is but little affected;
because the blood vessels rob the muscles of some of their 
excitement -
The tongue is generally moist - this arises either
from 1. the preternatural vapour from an abscess, or 2.
It may depend upon that intermediate grade of fever,
between Synocha and Typhus; A it is the same with Mania;
and this reason is made likely from the tongue
becoming dry in consumption and Mania when the system 
takes on the Typhus grade -
The colour of the tongue arises from the species of exhalation 
from the stomach, it is either yellow, black or green;
these appearances are all derived from bile; thus I reject 

A These tubercles are often suddenly formed 

(239)
the opinion, [cross out] that it is a morbid secretion
within the mouth, as Dr Darwin supposed from the gums
and teeth sometimes putting on the same appearance -
The following are the Appearances
after death -
1. no appearance of disease at all -
2 Sympathetic!!! swellings, such as polype!!! and membranes -
3. Tubercles; 4/5 the of the fatal cases of consumption arise 
from Tubercles; A they are sometimes in a scirrhus
state - They are not the cause, (as is believed in England)
but the effect of Consumption -
4. One or more abscess - either open or confined -
5. One or more superficial ulcers, thought to 
be cancerous; sometimes they exist on the Trachea -
6. Water in the substance of the lungs, also Hydatids -
7. Pus secreted by the Pleura -
8. Chalky silicious and gravelly substances -
9 Ossification of the pleura and lungs -

In one instance I have from the [cross out]
right lung entirely removed by disease;
it was a case of anomalous pnuemony
which came on which the patient was 
under treatment in hospital for a mortification
of both feet from coagulation,
the affection of the chest came on with vast
difficulty of breathing, which was soon
followed by a purplish - red flush
of the face and neck; seeming to indicate 
an imperfect oxygenation or decarbonation
of the blood; the pulse was 
very soft, but not small, and tolerably
slow; but the action of the heart, as 
ascertained by placing the panel upon
the chest, was hurried and violent
beyond measure; the case soon puzzling
which induced me to consult my mates; 

(240)
10 Matters which have been inhaled, such as flour,
flannel or flax &c -
11- Preternatural size or weight -
12. Preternatural lightness -
13. Of the hardness of smoked meat -
14. One lobe entirely gone - The left lung is 
more liable to be morbidly affected -
All these appearances are the effect of a primary 
disease in the blood vessels -
I believe this disease would not be so fatal 
were it not for the hectic fever, which so invariably
accompanies it; if there be no fever, there is not much
danger, for the lungs are a hardy viscus - even cancers
are not dangerous until they produce fever, unless
they corrode some important vein; so it would seem
that the blood vessels are not only the outposts, but 
also the citadel of the system - they are the last retreat
of vitality - Sometimes death is produced without 
Hectic fever -
The [cross out] remedies of consumption are divided into two 

I suggested the propriety of trying bloodletting
to very considerable extent as the only
chance of saving the life of the patient;
they did not approve of the preposition,
and I dropped the remedy; [cross out]
they were opposed to it on account of 
the apparent dying condition of the 
patient from the circumstance of his 
mortified feet and his being a 
notorious drunkard, there were strong
objections and they staggered on-
Upon direction as I have said the 
right lung was formed wanting,
[7- The cold or warm bath] -
and the cavity of the thorax on that 
side was 1/3rd filled with pus - this 
showed that the violent action of heart
arise, from the occurrence of pneumonic
inflammation under circumstances of 
the pulmonary system, so very unfavourable 
for the transmission of blood; there being 

(241)
kinds, 1. such as are proper in the forming states - 2. Such -
as are proper in the formed state of the disease -
1 Remedies for the forming State
Here the symtoms are flushing, sense of fatigue,
hot hands and feet, a tense pulse - The remedies are 
1- Bloodletting if the pulse be pale or tense 
2. Cold bath and Tonics, as tar; bark of aliments, Salt meat,
salt fish and eggs with beer or a little Porter and water
3. Exercise on horse back or in a carriage -
4, Change of air -
5- Rest- if produced by fatigue or labour -
6- Removing the exciting cause - It is thus
I have strangled many consumptions in their forming
state.
Some pretend there is no Consumption where there 
is no pus - but this is an error, [cross out] have cured as well 
as lost many patients in consumptions not attended with 
pus - in the same manner it was insisted upon that there 

but one lung hence the same quantity of 
blood which in what was comparatively
speaking health at with difficulty 
transmitted, became overwelming 
when altered and accellerated 
by disease and inflammation -
A we never act so in curing moral diseases,
we punish folly to prevent vice and punish 
vice to prevent crime
This Soldier died in 12 or 15 hours 
[cross out] after the accession of the chest
affection, how he was enabled to
enjoy tolerable health, and perform
his duty 1 in the ranks before 
his attack I am at a loss to explain;
but surely the lung which was found
absent must have been destroyed
by very slow degrees in order to allow it
time to the system to accommodate
itself to so great a derangement - T.K.

(242)
could be no yellow fever without a black vomits -
Of all diseases, beware of applying nosological
signs to this; for what can be so ridiculous as to let a 
terrible disease gain a strong hold of the system, in 
order to give it time to devellop itself into its genesis 
and species instead of resting on it at once, with all 
the power of medicine A -
But we have other premonitory symtoms, such 
as tightness of breast; this symptom has existed 18 months 
without confining the person -
Consumptions are either synocha Hectic or 
Typhus; but they do not always occur in the order 
here laid down -
The Synocha State of Consumption 
1 Here small and frequent bleedings are indicated; leriah
Tracey, formerly a member of congress, was cured by 96 bleedings;
and Dr Griffiths effected a cure in a young lady of this 
city by 130 bleedings in 18 months -
2. nitre in doses of 10 to 20 grains 3 times a day. 

A But by not [cross out] telling us the exact
time it which they are indicated; his 
advice has done much harm; they are 
most proper when the disease arises from 
catarrh or when the pulse is a little above 
par -
Blisters are good they should be applied
between the shoulders if from the common
causes; but if it arises from gout or Rheumatism
the blisters should be applied to the 
joints - 

(243)
3 Vomits; Dr Reid recommends them A -
4. Purges; This hint I took from nature, who sometimes
brings on a Diarrhœa, but generally too late; as
she brings on hæmorrhagy in yellow fever. let us therefore
not follow nature but go before her by inducing
an artificial diarrhœa; the purges should be sulphur 
Salts castor oil -
The next remedy is a vegetable diet with Salt meat,
but not more than a pint of fluid should be taken 
in a day, for although it might not strengthen, it would fill
the blood vessels - Milk has been used, but it is not proper
in the synocha state of consumption, except to blunt
the humours from abscess - but if the patient be bent
upon having milk, prescribe Buttermilk or whey both
of which are less nourishing than milk recollect my
expeditions mode of making Rennet whey -
Salivations act by revulsion, and remove obstructions;
this is a radical remedy; of 36 persons, who died of consumption,
one half had enlarged spleens; from this we infer 

A We often see nature in the latter stages
of the disease try to relieve himself by dropsical
swellings; may not the efficacy of arsenic
when given early depend upon its anticipating
this effort by of nature, by producing
dropsy? -

(244)
that spitting of blood does not forbid this remedy; I shall
tell you hereafter that spitting of blood depends upon
an enlarged spleen!!! - but recollect that even where Mercury -
comes, it cannot remove the predisposing debility, for 
which are Tonics to be mentioned directly - 
The Hectic State of Consumption 
Within the last year I have begun to use Arsenic here,
to produce a centrifugal effect, for as we see nature sweating
herself, let us anticipate her, and bring on sweating
some A - Small and frequent bleedings will be of service -
The Typhus State of Consumption -
Here you must use stimulants; the efficacy of opium
was discovered by accident; it acts probably by throwing
the disease upon the head, and thereby giving a respite
to the lungs; in most cases we are too tender with the 
brain, [cross out] be assured it can bear a great deal; this is 
proved by the circumstance that Drunkards retain their 
intellects frequently after habitual excess is for a member 

Tar 10 grs 3 times a day - or tar water
A By combining the effect of all these
stimulating remedies -

(245)
of years -
Tobacco has been of service when the saliva is 
swallowed, but I would not recommend it; 3 eggs with 
their skills dissolved in a pint of vinegar a wine glass
3 times a day has hour of service - Bark has been used, but 
it never does good but in the shape of Huxom's Tincture;
and here the Spirits may do all the good; garlic and 
Tar are good; the disagreeable taste if Garlic may be 
removed by honey; Tar does most good when taken in substance
now cordial food, and milk, if liked, should be given 
as also fresh Malaga [cross out] grapes, roasted apples; ardent
spirits in the shape of grog and Toddy; milk punch, porter
&c - I have been, within these few years, successful
in 5 instances in the hospital; A [cross out] mercury [cross out] given
here just to touch the mouth, but in Typhus we can
seldom excite a Salivation, and if we do we mostly do harm;
we sometimes hear of patients recovering after having been 
deserted by their Physicians, this arises from their returning 
to their healthy nourishing diet - Frictions are 
good in this state, from the inverse sympathy between 

The frictions should be made to all 
parts of the body, but especially to the 
arms and legs.
The hardships of a camp naval or agricultural 
life have often cured a consumption -

(246)
the lungs and skin; shampooing perhaps might act in 
this way; volatile liniment will render the frictions
more efficacious; exercise may be used in the 
Typhus state, it either of the passive or active kind;
but in the inflammatory stage, only the passive is required; 
but in either case to do good it must be constant
and not that kind [cross out] the patient has been accustomed to 
Do not allow your patients to go to the sea-shore
unless in the Typhus stage - Labour is often very good;
Shuttle cock, swinging by the hands, rowing, jumping the 
rope, and all exercises, which employ the arms and legs
are very good -
Change of climate to one which is neither hot
nor cold is good such as Barbadoes or Portugal; this effect
may be obtained by flying from the winters of the 
[cross out] northern states, and from the Summers of the 
Southern; this mode has the advantage of combining
travelling with your being in a temperate climate.
Dr Harison remarked that no Consumptions took 

A And also those who came there already
with the disease are generally
cured, should they be seized with a 
bilious fever - 
1- A milk diet - transfusion has been
attempted from lambs &c the same mild
state of the blood is produced by milk -

(247)
place in the marshy ferns of Linconshire A nor in Holland
since last year I have gotten two letters [cross out] of persons,
cured of Consumption by going to Ostend Marsh
Miasmata not only cures but prevents the disease -
But if neither travelling nor migration are practicable,
then by hybernate your patients in a stove room;
but in this case you must not allow them to have 
the room the whole winter; it is said that an attack
of the bilious fever will cure the disease sometimes;
we know that hemoptisis has been cured by fever; I
have known more than once an intermittent to be 
destroyed by a bilious fever
Other Remedies 
2 Sweet food has cured this disease; I think I cured
Consumption by Malaga grapes -
[cross out] 3 It has been cured by eating sweet apples, or also by 
eating bread and butter with Sugar -
4 It has been cured by large draughs of the juice of 

In a disease, from which death is in turn
if left to itself, it is not only proper to give 
uncertain remedies, but it is criminal
not to employ them; Consumption has been
cured more than once from a Pneumony
supervening

(248)
the maple -
5 Issues have been recommended; I have known a 
cure in one instance - Dr _ says they should be made
under the arm pits, because some consumptions have 
terminated in that way; but I think a blister is a 
good substitute (on the left arm, being less used) because
it is less contrary to the prejudices of [cross out] our patients -
7. Digitalis has been used, but I have no opinion of it;
it lessens the force of the pulse, it is certain; but we know opium
lessens the pulse!!!, but who would give this in Consumption!!!
6 Fumigations of resin, tar and brandy, heated
and inhaled; a cow-stable - The camp or agricultural
life - also Diuretic remedies, as the nitrous powders
and squills; but when you give these remedies you should
recollect whether the cause be primary or sympathetic;
if it be sympathetic, try to bring on the original 

A Salivation has been used with success
if disorganization has not already taken
place in the lungs; we need not be alarmed
should a spitting of blood be the consequence
for this is often an attendant upon a diseased
spleen, which disease often takes place in 
Consumption; thus Mr Praust found
our half of the spleen of a number of 
patients he examined after death from 
consumption to be greatly enlarged -

(249)
disease 
10. your patient should not be suffered to indulge
in venery- if you advise a married man to travel, forbid
his wife to accompanying him; the same restriction
is applicable to women - There is an amazing sympathy
between the lungs and the venereal appetite; I 
knew a gentleman, who declared to me that he always 
spat blood after a venereal connection with his 
wife; and Gay-Lussac declares that those cows that 
die from being deprived of intercourse [cross out] with the 
male, always have diseased!!! lungs - The venereal appetite continues
in females in this disease, hence their Catamenia
continues, and thus it is that bearing numerous children
will often keep Consumption at bay by its greater counteracting
Stimulus -
Two remedies have been used lately, the Lichen Icelandicus,
and the Alcornoque; they are mucilaginous and 

A The remedies are 1st Arsenic in pills or 
Solution

(250)
somewhat bitter - As well might we attempt to demollish 
the rock of Gibraltar by a Musket Shot, as
to cure this formadable disease by such paltry remedies - 
Paliatives 
And 1st For the cough; this is either at night
or during the day, or both night and day - To allay
it gives anodynes about six O'Clock in the evening, this 
undoubtedly is the best time, however you will explain it,
it may be necessary to give an anodyne early in the morning, 
according to Dr Sydenham - 
2. To mitigate [cross out] sweats which arise from debility
and which happen at night from the centrifugal 
action, which takes place at that time, A you must require
sleeping on a Matrass and wearing flannel, brine,
a pint of Lime water taken in a day - watter [cross out] mellons,
and lastly a shirt dipped in a decoction of bark and 
dryed; and worn bloodletting when the pulse is excited never fails
to check it; a Diarrhœa often takes place near the close 

The remedies Laudanum chalk  [cross out]
gum Kino -
1 Profuse sweats Diarrhea and faulted
legs - this is the common termination - 

(251)
of this disease; and then the moist sweats and cough
cease; but it comes too late to do good; let us therefore
anticipate nature, and bring on a Diarrhœa in 
a more early [cross out] stage of the disease:
3. General pain may be relieved by bloodletting
Death is produced in the following ways-
2 By the sudden bursting of an abscess -
3. By a rupture of a blood vessel -
4 By suffocation from water -
5. By the translation of the disease to the head
producing madness -
6. By a sore throat
7. By Pneumonia synocha or congesta
Lastly a Diarrhœa and lasting night sweats -
Some Remarks
1. Consumption when arising from Ancestors is very unfavourable -
2. When from Gout, it is unfavourable -

a Spitting of blood after the cough has 
ceased is unfavourable -

(252)
3. When there are Calcui, I never knew a recovery -
But this year heard of one -
4. When the cough suddenly ceases, unless Diarrhœa
or Madness supervene, it is a bad sign -
6 When the expectoration is water, the patient seldom 
recovers 
7 When the eyes change their colour, it is very unfavourable,
and the teeth becoming white
8. Lice and Depilation is very unfavourable -
9. I never knew a recovery after a swelled
face
10 When from repelled eruptions, it is generally
fatal
11- When from old ulcers, it is unfavourable -
Spitting of blood is favourable in the beginning
but unfavourable towards the close of the disease,
a Constant vomiting is a bad sign.
Do inference can be drawn by examining the 
expectoration; Thousands have been cured with 

It is a symptoms of consumption or a local
disease -
A Too light bed-cloaths at night -

(253)
pus, and thousands have died without it -
It will be well to meet the disease in
its forming state by cordial aliment and drinks;
bleeding and bark, as also frequent bleedings more especially
where Congestions are indicated; in this way
you may often keep the disease at bay -
As for the Preventives, long journies, change of 
climate and removal from the vicinity of the Seashore,
should be resorted to -
Cough
I shall now give you some remedies for Cough, contradistinguished 
from Catarrh, by being unattended
by fever; it is either pulmonic or Tracheal 
Its causes are direct indirect and sympathetic;
its direct causes are a current of air, A excess in eating
or drinking loud speaking &c. it is often produced
by fear and is known by a short cough -

sweet oil - Lime juice or vinegar, honey
or molasses, each equal parts; and if the
pulse will bear it spirits may be added -
A Stem them together for an hour or two 

(254)
The remedies should be regulated by the state of
pulse and system; if the patient be plethoric, bleeding
or requisite, and abstinence; when the pulse
is not active, bathing the feet every [cross out] morning in 
cold water will be found of service; it has been cured
by long journies, frequent draughs of cold water - standing 
against a wall has stopped a paroxysm of cough;
opium has done good, [cross out] the Liquorice mixture [cross out]; the 
horse radish sirup is only proper for hoarseness, it is recommended 
by Dr Cullen -
In a Languid state of the system, use a 
mixture of Elecampane Hyssop and Hoar hound, each
a handful in a gallon of water; boil it down to half 
a gallon, and add one pound of stoned raisins, A then add 2 drams
of liquorice, and 2 pounds of Loaf Sugar; now boil it down 
to a sirup - 

 


(255)

 


(256)
A Page
Arteries; cases in which they do not sympathize - 97
Affusion, as a remedy for fever - 127
Ablution as a remedy for fever - 130
Abstinence as a remedy for fever - 132
Alkali, volatile, as a remedy for fever - 147
Air pure, as a remedy for fever - 152 
Aliment in fever, rules for giving - 156
Autumnal fever; its 10 forms - 219
B
Blisters or Evacuants - 42
Blisters, rules for the use of - 42
Blisters perpetual, the best issues - 45
Baths as Tonics - 58 

 


(257)
Bloodletting, as a remedy for fever - 115
Blisters, as a remedy for fever - 125
Body; signs taken from it in Fever - 173
Bilious fever, autumnal, 6 forms of - 184
Bilious fever, inflamatory - 187
Bilious fever, mild - 187
Bilious fever, chronic - 195
Burning State of fever - 205
Bilious Cholic - 218
C
Choice of medicines - 12
Consultations - 14
Cathartics, as an evacuant in fever - 27
Cathartics, Rules for their exhibition - 28
Changing Climate, Rules for - 67
Clysters as an evacuant in fever - 30 

 


(258)
Classification of Diseases Brown's, rejected - 89
Clysters as a remedy for fever - 121
Convalescence from fever; Treatment proper during - 163
Critical days - 168
Countenance, signs taken from - 175
Chilly State of fever - 205
Colera Morbus - 217
Catarrh - 231
Cough - 253
D
Diseases, which are incurable - 6
Diseases, which it is unsafe to cure - 6
Diaphoretics - 31
Diaphoretics when indicated - 33
Diuretics - 34
Division of diseases, Darwin's rejected - 89 

 


(259)
Division of diseases, Rushis - 90
Depression, how caused - 96
Diluents, such as are proper in fever - 133
Diarrhœa, the acute form - 206
Dysentary - 207
Dysentary; premonitory signs and remedies of - 213
Dysentary, chronic - 216
Dysentary, signs favourable, or unfavourable in - 217 
E 
Excitement, grades of - 16
Excitement, how to ascertain the state of - 17
Emetics - 23
Emetics, Rules for the exhibition of - 25
Expectorants - 36

 


(260)
Emmenagogues - 36 
Errhines - 42
Exercise as a Tonic - 60 
Electricity as a Tonic - 67
Excitability, how accumulated - 95
Extinguishing fever, means of - 111
Emetics, as a remedy for fever - 118
Errors bulgar, respecting fever - 139
Emotions, invigorating, as a remedy for fever - 154
Excretions Signs taken from - 177
F
Fevers, always proceeded by general debility - 92
Fever, causes which dispose to - 94
Fevers, in what they end - 100

 


(261)
Fever, different states of - 102
Formation of fever; remedies for its prevention - 105
Fever - premonitory signs of -105
Fevers, remedies for - 115
Fevers, treatment of, cautions to be observed in the - 159
Febricula - 195 
Fainting State of fever - 204
G
Gavalnism as a Tonic - 67
H
Heat, Stimulus of, remedies abstracting the - 125
Hectic fever, Theory of the formation of - 180 
Hectic fever, the remedies for - 182
Hectic fever; Some questions on its cure - 183
Hydrophobic State of Fever - 199 

 


(262)
I
Issues - 44
Issues, when indicated - 44
Inflamation; what it depends upon - 100
Infusion; as a remedy for fever - 129
Intermittent fever - 206
Influenza - 229
L
Longevity; means of promoting - 76
M
Mixture of Medicines - 13
Mercury, means of obviating the effects of - 39
Mercury, when useful - 40

 


(263)
Mercury, when forbidden - 41
Mineral waters - 59
Mind, pleasures of, as a Tonic - 67
Medicines as Tonics - 68
Medicines, which act by removing redundant matters - 72
Medicines, which act by mixing with the offending matter - 72
Medicines, sweating, as a remedy for fever - 122
Malt Liquors, as remedies for fevers - 146
Mercury, as a remedy for fever - 152
Moon; its influence upon fevers - 169
Muscles, signs taken from the - 175
Mind, signs taken from the - 179
Mercury fever - 198
N
Nature, operations of, in curing fevers - 8
Nosology rejected - 79

 


(264)
Nerves signs taken from the - 176
O
Oils, empyreumatic, as remedies for fever - 148
Oils, aromatic, as remedies for fever - 148
Opium, as a remedy for fever - 148
Opium; rules for its exhibition - 150
Oxygen gas, as a remedy for fever - 154
Opium fever - 197
P
Preparing medicines, some rules for [cross out] - 15
Pain, remedies for the relief of - 73
Practice of Physic - 79
Phenomena of fever - 91

 


(265)
Purges as a remedy for fever - 119
Passions, invigorating, the abstraction of the;
as a remedy for fever - 132
Passions, invigorating, as a remedy for fever - 154
Prognosis of fever - 170
Plague, remarks on the - 195
Poisons, fevers produced by-205
Petechial state of fever - 206
Pulmonary states of fever - 219
Pneumonia vera, described - 220 
Pneumonia bera, the remedies for - 221
Pneumonia notha, - 225
Pneumonia Biliosa - 227
Pleurisy Bastard - 229
Pulmonary Consumption - 233
Pulmonary Consumption; appearances after death 
from - 239
Pulmonary Consumption, remedies for the forming state of - 241 

 


(266)
Pulmonary Consumption, remedies for the synocha 
state of - 242
Pulmonary Consumption, remedies for the hectic 
state of - 244
Pulmonary Consumption, remedies for the Typhus 
state of - 244
Pulmonary Consumption, Paliatives to be used in - 250 
Pulmonary Consumption; how is death produced in 251 
Pulmonary Consumption, general remarks on - 251 
R
Reaction, how caused - 96
Respiration, signs taken from the - 177
Remarks, general, on fever - 184
S
Specific remedies - 7
Sedatives, the manner of acting of - 18 

 


(267)
Sedatives direct - 19
Sedatives, indirect - 22
Sillagogues - 37
Salivation, what renders it more certain - 38
Stimulating remedies - 46
Stimulating remedies, rules for the exhibition of - 48
Stimulants, their Modus operandi - 52
Senses, pleasures of, as a Tonic - 67
Surgical operations - 76
Signs, premonitory, of fever - 105
Suppositories, as a remedy for fever - 122
Sillagogues as a remedy for fever - 124
Sedatives, translating - 136
Stimulants, such as are proper for fever - 145
Spirits, as a remedy for fever - 147
Substances, fœtid, as a remedy for fever - 148
Stimulants, external, as a remedy for fever - 156
Senses, signs taken from the Senses - 176

 


(268)
Secretions signs taken from - 177
Sweating state of fever - 204
T
Therapeutics - 1
Tendency of nature, advantage of observing the - 10
Translation, as a means of lessening Morbid excitement - 53
Tonics Rules for the exhibition of - 55
Travelling, rules for - 65
Tonics, how they act - 70
Typhoid state of fever - 138
Typhus state of fever - 139
Typhoid fever, remedies for the - 142
Typhus fever, remedies for the - 143 
Tongue, signs taken from the - 174
Tenesmus - 208 
V
Visible parts, signs taken from - 174
Vomiting, means of preventing - 186

 


(269)
W
Wine, as a remedy for fever - 146
Y
Yellow fever described - 185

 


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