Fordyce
A course of lectures on the
theory and practice of
physick.




A course of Lectur’s
on the Theory and
Practise of Phisick
Dr. Fordyce
Physician to St.
Thomas’s Hospital




Lecture 1st.
A disease is an alteration of the chemical
properties of the solids or fluids or of the
organization of the body, or of the action of the
moving power, producing an inability or a 
difficulty of performing the whole or any part
of the system; or [illegible] as preternatural 
Evacuation every effect has a cause and in
consequence of which an alteration in the human
Body takes place, the causes of many Diseases
have not yet been investigated as far as there
have been we will endeavour to point them out
to you, in general, it is some eternal and 
preternatural applications to the Body or
mind that produces a disease, for example




Cantharides applied to the skin induces an
inflammation, of the mucus membrane of the
lungs a catarrh it has happen’d that sudden fear
has been followed by a fever, it is not always so
in any of theses instances, the [illegible] not always
produce the Disease it is generally followd by it
now was from out having constant experience 
of their action we are not able to judge of them
wth certainly, external applications have been
said to be its occasional cause, not simply
because the things have been called causes, but
the occasional one is the time properly speaking	
this may act two ways, first immediately
as for example, if you apply cantharides 
to the skin, the cuticle is Raisd, and an
inflammation arises, secondly it may act
immediately the first cause may produce 


a second, whose immediate effect will be the Diseases
for example if you make wound in the skin
and apply some Variolus Matter, there will be
new parity produced, but will from an inflammation
in the wound, and that will be taken to the heart
and in to the circulation, which will produce a general
fever here than the wound is the immediate
cause, and the inflammation the intermediate cause
of the fever, tho not always throwing the cause
of the disease, has given room to some for
supposing that they always acted immediately
for example cold they say constringes the
external pores of the skin, and obstructs the
insensible perspiration, this thrown back into
the circulation, is the cause of an inflammation
now this perspiration is nothing more water, and
when to [illegible] [illegible] not that at all, this Method throes
[illegible] method of reasoning, it is evident that



it is evident that many of the known causes act
immediately and some it must be allowed act
intermediately, yet we should always be suspicious
of the latter, now we admit them but on the
Clearest evidence as in case of the variolous matter
a practitioner ought to be [illegible] wth these
causes, as far as they are thrown, it is by this
means that diseases may often be present'd 
[illegible] a hundred Die of Diseas’s
to one by the sword, where we perfectly master
of the causes of diseases, We should be able
to preserve a great number of lives, We must
observe that one part of the [illegible]
of the operation of causes depends, on the
state of the body to which they are applied
for example Let a Man that is fatigued
with an empty stomach be suddenly exposed 
to cold be shall have a fever whereas a man



in Vigour with a full stomach be exposed to the
same degree of cold, shall receive no injury from
it. Thus then in certain states of the body the
causes of diseases act more powerfully, than in
others, these are called the predisposant causes
of diseases, as they render the body more liable to be
affected by the occasional cause, therefore they are
much to be attended to, as the occasional cause 
tho. they can never produce a Disease of itself 
To remove the predisposant Cause often has 
efficacious as to prevent the application of the 
Cause itself; the Blood is sometimes more apt 
to be affected by any Cause than at another, we
we then say it is more irritable, for example a 
Man of a Sanguine temperament, Living in the 
Country is more apt to be affected wth. an 
inflammatory Disease, but as we cannot [illegible]
cases investigate the alteration, we are therefore 
apt to Reject this knowledge, for example, Let 
a Patient be brought to a man entirely Destitute


of the knowledge of Anatomy, wth a Pleuritic 
Pain in his side without knowing there is any 
such Membrane as the Pleura, he will form some
Hypothesis unwilling to appear ignorant in any 
Thing, he will judge of the Disease by its external
Appearance; from hence Practitioners have Divided
into two classes, the Dogmatics and Empirics 
the first consider the Alteration as the Disease,
the latter the external Appearance as the Disease,
We doe not know from external appearances
what Disease is Present, and We consider the 
external Appearance only, We shall not treat 
the Disease equally, as if We knew the Disease
itself but still We must always Avoid Nanmes
the Causes of Disease are Divid'd in to Proximate 
and Approximate the Proximates that wch
Products the Symptoms are internal Appearance
from which We judge of the Diseases with 

Pleura, the Inflamation of the Pleura is the 
Proximate Cause of pain, why then should we not
always take the external appearances for the 
Disease because they sometimes Prove fallacious for 
Example, and difficulty of Breathing may Arise
from Spasmodic Affection, an Inflamation of the 
Pleura and many other Causes, it is also improper
to Class Disease from their external Appearences 
as from this We shall be led to Join Diseases,
which have no Connection wth. each other, and then
are Apt to make general Application to the 
same Class so that We shall Practice very Injudiciously,
by making general tho of the same 
Application.----

Lecture 2d.
On the Diseas's of the Human 
Body----
We have already Defin'd a Disease to be an Alteration
of the Action of one or more of the Moving
Powers of the Body, Producing an Irrability
or Diminition of Performing its Functions
properly, Suppose a Persons knowledge of all 
the Parts of the Body; We ought not always
of an Alteration from external appearances,
it cannot be Denied, but it will be better to 
[illegible], the Alteration as the Disease, [??es]
there are many Material Parts, the Lungs
for Instance where the we doe not know 
material functions and many of the things

of equal importance, wth. which We are [illegible]
We cannot tell wth. perish on what Alteration has
taken Place, still tho We are not so well Acquanit'd with
those things as might be Wish'd, yet it does not follow that
We shou'd reject the Knowledge We have in our 
Power, if We confine ourselves to the Knowledge of 
Disea's as far as have been Investigated and from
no Hypothesis no Conjucture in this Case. This better
to Consider the Alteration itself as the Disease, than 
the external Appearances; if We Consider the external 
Appearances, We shall be Led to Alleviate some Urgent 
Symptom without endeavouring to Cure the Disease
itself. We shall therefore in the Persecution of this Course
in all Cases where We can Point out the internal 
Alteration that takes Place, Now we don't Call it a 
Disease without it Continues to prevent one or more 
of the functions from being Perform'd properly. Now 
a Disease does not always remain in the same State it
is always Varying. The Disease itself indeed sometimes
Varies this is but seldom for the most Part is [Cont???]
the same Let then us Consider the several different
Progressions of a Disease. I have before said it for

the most Part never Continues in the same state
it may encrease so as to cause the Death of a 
Patient, for Example in an Inflamation of the 
Brain the Presure which takes Place Causes a 
Stupor if the inflamation encreases the Stupor
will also encrease untill it kills the Patient.
Secondly a Disease may terminate in some other 
(for Example) an Inflamation takes Place in the 
Cellular Membrane in any Part after Continuing 
for sometime it is Converted into Pus and forms
an Abcess from the encrease of Inflamation 
which is the Cause of Suppuration, here then 
there is the first Disease going off in Consequence of 
the Second, it also frequently happens that 
a Disease Produces its own Cause for Instance
a Quantity of Venereal Matter Apply to the 
Urethra, thus it Converts into Matter similar to 
itself and Reduces an Irritation and in Consequence 
an encreased Secretion, which washes away the 

Venereal Salts and by this Means Cures the Disease
so in any Inflamation of the Lungs a Copious 
Expectoration is united which Carries off the Disease
now it sometimes happens where no Danger of the Disease
itself Arises, yet what was Intend'd as a Natural 
Cure stills (Example) the spilling Produc'd in a 
Peripneumony may be too Copious. and Continue
[illegible] to Darhoea, the Patient whereas if it had
been in a proper degree it would have Prov'd salutary 
so again in the Rheumatism the encreased Action
of the Heart and Arteries, may be so encreased as
as to be the Death of the Patient, when the Rheumatism
itself would not have kill'd, Thirdly the second
Disease may Prove more fatal, than the Primary
an Inflamation of the Lungs may terminate in a
Abcess on the Part, this will Prove more fatal
than the Pleurisy itself in many Instances.
From thly it often be spasms there a temporary
Weakness takes Place and this in but me. We shall
Call a Depression of Strength, this in some Measure
may be Call'd the Disease itself and it often Proves
Fatal, but the Disease may so much exhaust the

The Strength, that [cross out] shall Destroy
For Example a Patient shall have a fever wch. shall be
Extend'd to much a Degree as to prove Fatal, but futher
the Patient is Reduc'd to the lowest [illegible] of 
Weakness could We then instantly Remove the Fever
the Powers of the Body would almost as Instantly
begin to be Restor'd. It is necessary for a Practitioner
wth. the Cause of a Disease as far as we yet know
yet without knowing the History of a Disease We
shall not be Able to cure it therefore this is 
a Study which Requires the greatest Attention
to know what is likely to happen in [illegible] in the
Progress of a Disease, and the more so as without
this Knowledge We shall be Unaquainted with the 
Natural Cure likely to Arise, and at another time
we shall Pay no Attention to the most Dangerous 
Part of a Disease, it is therefore Requisite that We
shou'd be Masters of a Disease, before We can Apply
a Remedy for Instance in the Small Power
Unaquainted Practitioner would probably Endeavour

for to Put a Stop to the Disease on the 
other Hand if you understand the Disease We
shall know that the Disease will go through 
its Course, and therefore We should not Endeavour
to Put a stop to it, but forward its Progress, no
in a Fever, no in a Fever We [illegible] many Remedies
wth. wou'd put a Stop to its A Skillfull Practitioner
will never make one any but those wth. be
known will assist the Patient to go through
the Disease. Secondly where the Natural Cure do's
not take place, We must Employ Remedies
most likely for to bring on this, for Example if
we have an Inflamation wth. no spilling no envelope
of Expectoration it will probably Prove Fatal
We must therefore Endeavour to Produce this
Natural Cure, by Artificial Means, Yet we must
make Use of Remedies most likely to Produce [???d]
this Effect and thirdly We must Endeavour to Remove
the Extraneous Danger, Suppose a Fever to arise
in a young Man of a Robust Habit and that has 
[illegible] We know that Fevers in general doe not kill

but from the Robust [Natis??] general Inflamation will 
arise as for to Prove fatal; We must therefore Endeavour 
to take off as much as We can of the Inflamation
by Copious Bleeding so that by this Means and other 
Evacuations We shall Enable him to go through the 
Fever the Removing this entraneous Danger is of very 
great Consequence in Acute Diseas's particularly
[??urlkly] the last Method to be Atten'd to in 
the Cure of Diseas's is to Employ a Method of Cure
contrary to the Natural Method of Cure, at least
not all Indicated by it in this Cure We must
make immediate Application of those Medicines
which have been thrown to frame of the Disease than
in an Inflamation of the Pleura if we VS. and 
blister it will tend to Put a stop to the Inflamation
immediately and Suffer it to goe through its Natural
Progress, And this Part of Medicine We shoud
by all means make ourselves Acquainted with 
For Instance We Know Preparations of Antimony
will Cure fevers, that the Bark will Cure an

Intermittent, yet if you are not Acquainted with 
the Nature the Disease, We shall not Understand the 
proper Method of inhibiting them, and by this
Ignorance We shall render the Disease more Obstinate
for tho We know Antimonial preparations Cure
come fevers, yet a Practitioner should not farther 
Resolve to Cure every Fever by the same Method
tho Bark will not Cure all Intermittent fevers
it may be given improperly to be of more Disservice
than Service, for Instance if you give the Bark
in the Paroxysm of an Intermittent instead of Curing
the Disease it will by Degrees Come to be a Continual
here then the Disease is rendered Worse by the 
improper there/ this Remedy it is of some 
Importance in Medicine to Observe that there is
no such thing as an Infallible one.----

Lecture 3.d 
Of the General Doctrine of Inflamation
An Inflamation is a Disease Affecting
one Part only it sometimes happens indeed the general
System is Affect'd in Consequence of the Inflamation
but while the Inflamation is Confin'd to one Part only it 
is a Topical Disease not releasing the System
in general, if you apply your finger enternally
to an Inflam'd Part We shall find an encrease
of the Pulsation of the Arteries, a greater Degree
and some Heat so as to Rise to 110 Degrees of 
Farenheits Thermometer commonly however to 
102.4, or 6. Degrees, the Part becomes of a Red 
hue and then a more Florid Redness takes 
Place at first their is an throbbing to increase
Pain wth is Inconsiderably encreased and become,
a throbbing one and is still encreased from 

the Starting of the Inflam'd Part. There is also a levelling
owing in some Cases [illegible] in all to be a Distension of 
the Vessels and an [illegible] action of the Fluids Inflammation
is the [illegible] Cure/ Contraction, hence the Motion
is sometimes Imped'd, sometimes entirely Destroy'd
according to the sensibility and Irritability
of the Parts, there are the Internal Appearances wch.
take Place, You must next Inquire the Reason 
are Marker of the Alteration, wch. is the Disease
and wch. gives Occasion to there Internal Appearances
the Swelling is the first thing to be taken Notice
of and this, If we open the Imflam'd Part, We shall
find it going to a Part of the Blood thrown
out of the Vessels, this Consists of Coagulable
Lymph and Superfluous Water, sometimes
however there is no Extravasation at all, as in an 
Inflamation of the Eye the swelling is owing to 
the Distension in the small Vessels, We know by
the action of the Heart and Arteries that the 
Blood is thrown into the Capillary Veins a 
Distension it is said may arise three Ways from the 

Relaxation Obstruction and greater Quantity, of 
Fluids thrown into those vessels, first the Heart
and Arteries may Propell the fluids wth. greater
force into the vessels incl wth. [Cere??] [illegible]
will be Pres'd on more, and therefore they will become
Inflam'd and Distended. Secondly these 
small Vessels from their Disposition to Contrast
always Endeavouring to Avoid Inflamation 
If they are Relaxed they will allow Consequence
of that be Distended. Thirdly if you stop the
Passage through may be and Continue to throw
into it is will be Distended, in like manner
the Capillary Vessels will be Distended. Now
Distension from Relaxation in no case gives
Pain for Example the Bladder from being
Relax'd will contain [illegible] of [????e]
and Here shall be no Pain. If it in a Cathartic
State one Ounce wil give Pain. The Distension
that takes Place in an Inflamation is always 
Painful, this therefore is a sufficient Proof that 

The swelling in this Disease dos not arise from
[illegible] of the Vessels; neither dos it in Return 
Place Proceed from an Obstruction of them; If this
was the Case the blood would be Prevented from 
Passing. The Blood passes through the Capillary
Arteries into the Veins, Then into the Cavities and 
from them into the Secretory Ducts. When the 
Veins are Inflam'd, the Parts are always swell'd
if they are Open'd the Blood flows wth. greater
Velocity than in an Healthy State, although the 
swelling be very Considerable, when received into a
Vessel it detract Contract more, as Cool, a [illegible]
[illegible], then if it was taken from one when 
no Inflamation was Present neither is it the 
Colour of Extravasated Blood, it is evident
therefore there is a more Considerable Quantity
of Blood Circulating through an inflam'd part,
then there is a Natural Course for there can be 
no Obstruction. Secondly We find in an 
Inflamation from Obstruction, that the [Euhal??]
Vessels are not Obstructed but every [illegible] [???neass]
the Kidney as in Secretion encreased in and sam
Aart. The secretion of the Kidney is Diminished

as well from an Inflamation of a Gland as from 
an Inflamation of any of the Adjacent Vessels
but we cannot draw any Conclusion from this
gland as it is liable to be affected by every
Adjacent Inflamation. It Appears then that there
is at first no Obduction. And if there was 
it would not Produce a Swelling, there must 
be something more to Occasion it for it is known 
that there is somtimes the Quantity of fluids
that Circulate in the Body than actually do
therefore an Obstruction will not cause a swelling
the Blood is Propell'd forwards by the Heart
and Arteries of this Action is encreased a greater
Quantity/ Fluids will be Propell'd forwards
We must Observe that the Action of the Heart
is Uniform, but that of the Arteries and Veins
is not so, and it is this Variation wch. is the 
Cause/ this Alteration is the System, this is
a more frequent Cohesion, the Blood is actually
Propell'd in a greater Quantity as may be Discoved 
by the more frequent Cohesion and Pulsation

of the Arteries, as also from Principial
Observation, no that it is evident the Swelling arises
from an encreased Circulation or Relaxation [illegible]
the Cause that the Heat Arises we cannot Determine
as We doe not sufficiently know on what the 
Heat of the Body Depends, thus far We know
that when the Action is encreased it becomes
Hotter and upon discontinuing this Action it 
grows Cooler, in exercise of any Mind there is 
an encreased Degree of Heat, that the swelling 
do's not Arise from an Obstruction will be evident
If you take some Blood from an Inflam'd Part
it will Appear of a Blou'd Redness, whereas Blood
that as Stagnated will be off a deeper Colour
the pain wch. Arises in an Inflamation is owing
to the Vessels of the Part being Distended beyond
the proper Tone------

Lecture 4th
On Inflamation
We have already Shewn you that the Distension
of the Vessels Arises from a greater Quantity of 
Blood being thrown into them, and that the 
pulse is no other than the difference betwixt 
the Contraction and Dilation of the Arteries,
that Pain is Capable of being Produced in 
any Part of the Body by Distension, as if
the Stomach is over Distend'd by Food or Air
thrown into it, then Pain is Reduc'd, and also
if the Bladder is Distended Pain is Produced
and if the Ligaments are Distend'd Pain
Arises, and a fluid Discharg'd; but all 
Distension does not Produce Pain; For Example
a tumour may Arise under the Skin, as in 
the [illegible] and Prove Painful, the 
Stomach may be Distend'd to a certain Degree
without Pain, so also may the Bladder; thus

We find that Distension in certain Circumstances,
only is Capable of Producing Pain,
the Part must Endeavour to avoid Distension;
and if at this time Distending Cause 
Arises then Pain takes Place; for Example
the Stomach shall have a Disposition to 
Contrast; if at this Time a Quantity of Food or
Air is thrown into it, Pain will be Produc'd
in like Manner if the Bladder has a Disposition
to Contract, Pain will Arise if two Ounces of urine
be Contained in it; tho at other Times it will 
Contain Ten or Twelve Ounces without Pain; it is 
the Contraction wch. gives Pain, when the Blood
is Propell'd into the Capillary Vessels was 
the Distend them beyond their Disposition to 
Contract, We will call it a Distension beyond 
the Tone, and this we say Produces Pain in 
an Inflamation, but in order to excite
Inflamation it is Necessary, that the Circulation
shou'd be Encreased, and that to much
a Degree as to Distend the small vessels beyond

their Tone, if you put your Hand into Warm
Water the Circulation will be encreased and the 
Vessels be Distended, but no Inflamation will
Arise; because the Vessels are not Distended
beyond their tone; Now this Disposition is always
Altering for Instance, the Stomach or Bladder
sometimes have a Disposition to Contract
and then will Receive but a small Quantity 
whereas at another Time they will receive a much
Larger Quantity is like Manner may the 
Blood Vessels themselves be Distended. The Warm
Water Relaxes the small Vessels, they 
will then Receive an encreased Circulation
without Inflamation; some have Consider'd
the Secondary as the Primary Part of Inflamation;
that it is not is evident, because the 
small Vessels are greatly Distended beyond
their Natural Size, there wou'd be Pain, from
their Disposition to Contract, this is not an 
Inflamatory Pain but a Rheumatic one, for 
[illegible] Inflamation a Distension takes Place first

and if a Part is already Distended to as great 
a Degree as it will Allow an encreased Distension
will Cause Pain, wch. Pain Arises from and Inflamation,
in an Inflamation We meet wth. one Symptom
wch. Distinguishes it into two Species; if a 
Vessel of a Considerable Size is Affected the 
Pain will be a throbbing one, and will be more encreased
at the Relaxation, than at the Contraction
of the Arteries. But if a Membrane be 
Inflamed the small Vessels or Arteries only 
be affected, wch. have great Strength in Membranes,
and in wch. the Heart has less Influence
there; the Pain will be the same when the 
Heart is acting as not, so that the Pain will 
be Constant and equal, We must lastly Observe
that Pain is not Absolutely Necessary for 
an Inflamation; the small Vessels must be 
Distended beyond than Some and in most Inflamation
they stimulate and Cause harm it 
now and then happens that the Distension is

no small, as the Vessels only will be stimulated,
why Muscular Fibres are Contracted and
Rendered Incapable of Motion, We doe not as yet
Understand, but supposing Relaxation and 
Obstruction to be the Proximate Cause of Inflamation,
We are equaly it or less to throw out what 
Manner they act, As we are not yet acquainted
wth. the Course of Muscular Motion and flexibility
of the thin fibres, We can only beg then 
that there Alterations are in Consequence are
in Consequence of an encreased Circulation
in the next Place We are to Consider the Cause
of Inflamation, and there are most apparent
then in most of the Diseas's. An Inflamation 
is Reduced by an application to the 
Body, wch. tend to excite Motion these we
Call Internal Stimuli, meaning to take it in 
an Extensive Sense, and not [C???iethem]
to the far face of the Body, but to take every

extreme Part also, Now Ive divide these [???a]
into Restomical as Bruising or Cutting and 
Chemical there wch. Hand to Destroy the Part
Mechanically, and there wch. doe it from particular
Properties they Perhaps as the Destroying the 
Coagulum &c. Some have happen'd that Mechanical
stimuli but Acted in Consequence of that 
Pointed Spiculae running into the Rest; but We
can Demonstrate that the small Particles of 
Caustic Vegetable Alkali will not penetrate the 
Coats of any Vessel, no more than sharp instrument
of an Inch in Fig will Penatrate the Skin
when Impall'd by its own Weight, but Sub [?a??e]
wch. have no Mechanical or Chemical Action,
I say such substances Stimulate frequently, As
per Example if a Deep of Infusion of Cantharides
and one of Infusion of Common Flies, We know 
they both have the same Mechanical Properties
yet they have very different Effects. For the 
Cantharides will Combine wth. the Mucilaginous
Part of the Blood and Inflame; the Common fibres
will [crossed out] Effect at all; this then furnishes a Mind
Class of stimuli wch. We call Medical----

Lecture 5th
The Application of these Stimuli is in general very 
Obvious, some of them however Require a particular
Explanation, first the Distension of a Part whether
it be of the external or Internal Part of the Body,
whether in a Blood Vessel Muscle Nerve or 
Ligament, is Capable of Stimulating and Producing 
Inflamation, this is the only Cause 
that is universal and Capable of Outing on all 
the Parts of the Body is found [???e] per
the Distension of Blood vessel, as of 
a Membrane will [illegible]
Produce Inflamation, for Instance if [alma??]
of Water be thrown into a joint it will have
no Effect as a stimulant, yet the Disturbance
from it will Produce inflamation on the 
Ligament, We see that a Distension is 
Capable of veins Produced in every Part of 
the Body, success of the Bones in wch. it 
comes unless they are in a Diseas'd State

but all Distermind of not Stimulate any Part of 
the Body may be Distended without Pain it is 
the Resistence to the Distending Course that Produces
the Stimulus, Now there are the Powers wch. are apt
to remind the Distending Causes; first the Cohesion 
of the Partion of the Parts w/wch. the latids consist
and wch. We Call Electricity, this Power when the 
Distension is above a certain Degree tends to bring
the Parts nearer to each other, and restore them to their 
former State; this Power is nearly equal at all
times; the Second Power is Capable of Resisting
Distension; the Comparble Power of the Letids
wth. Depends on the Life, and is Inherent in all Parts
of the Body. The Bones however seems to posses
but little of this Power, this is greater than the 
Contractile Power and Varies Considerably,
so that the same stimulus will at one time Stimulate
when at another time not according to 
its Resistance, if the Distension is Slow and 
gradual it will get the better of both of these
Resistances without Stimulating; for Example

a tumour may grow gradualy, under the skin
and Distend it to a greater Degree, Now if the same 
Distension had attempted to have been made suddenly,
the skin wou'd Burst; it also unites the 
Contraction which Depends upon Life, so as
that Resists more strongly, no stimulus Arises
Distension then from both these Causes is Capable/
Stimulating so as to Produce Inflamation
for happening at Present a great Part of the 
Blood Contained and Circulating in the exterior
Parts of the Body, and if it be suddenly Exposed
to a great Degree of Cold, this Power will be 
encreased, so as to Produce Inflamation;
Division is also a stimulus, but it must be
Observed that in Order to Stimulate it must
be on a Irritable Part, that is Divided. Some 
Parts of the Body are Capable of Distension
only, others may be affected by it; for Example
a Piece of the Knife or any Sharp Instrument

has passed through the Stomach, during which 
it has [??anind] much Inflamation, it has then Passed
the Muscules and Produ'd none, then during the 
skin it has Produc'd Inflamation; if a Part not
Irritable be Divided, their will be no Inflamation,
and if a Part be Divided as in a Wound, some Part
of wch. is Imitable and some not then an Inflamation
will Arise in the Irritable Part, and extend 
to the other, if the Patient be strong, but not if he [illegible]
it has been said that an Acrimony of the Fluid
will frequently Produce Inflamation, Now it must be
Observ'd that no Stimulus will affect the Blood
Vessels but Distension, except the Heart, and this
accordingly more Irritable then any of the Blood
Vessels, and hence it is that Poisons Prove Fatal,
when they Come to the Heart, when they have not
affected the Blood Vessels in their Passage through 
them, Acrimony which for the most Part seems
Stimulus) if the Blood as Water is Incapable of 
Producing Inflamation in the Blood Vessels [Nem??]
but supposing a Stimulating Matter Contain'd them 

in Consequence of being thrown out from them
on an Irritable Part, and Inflamation will be Produc'd
A Solution of Neutro Salts when Contained in
the Blood Vessels may be sufficiently Concentrated
so as to Produce Inflamation especially
if the Natural Mucus be Remov'd from the 
Membrane, as in the Urinary Passages Intestines
&c. for Example in an Inflamation of the 
Lachrymal Duct the [M??Jeans] are more [P???fully]
Secreted, wch. Carries off the Natural Mucus
of the Part; they Stimulate so as to Produce
Inflamation, thus it happens in a latent
Dysentrey &c there then Fluids Stimulate,
it is the Natural Salt of the Blood Containes
in them wth. the [Ca??s] it, ferments also and 
in Capable of increasing the Quantity so able 
Stimulate the System in generaly as the Variolous
Matter, the Venereal Matter &c but it is the 
Neutral Salts for most Part that Stimulate

there then are the only Stimuli, it is necessary
for us to take Notice off. however in some Cases it is
very difficult to suppose a Stimulus, sometimes
also a fever arises in course of which an Inflamation 
takes Place.------

Lecture 6th
We come now to treat of the Predisposant Causes
and We shall first suppose that Inflamation is increased 
Action of the vessels, and therefore
the stronger the System in general, the more
liable it is to have an encreased Action of the 
Vessels encited, so that an Inflamation is more 
Apt to Rise in a Man of a Robust Habit
of Body, and that Living in a more Cold
Atmosphere, than one of a Weak Habit of Body
Living in a Warm Moist Atmosphere, and 
it often happens in the Spring than in the 
Autumn from the Cold of the Recceding 
Winter having encreased the Contractile Powers
of the Body as Solids, Living in a Pure
Atmosphere gives strength to the System,
therefore [cross out] Live in the Country are 
Subject to Inflamation, then there who Live

in large towns; the Body is in its greatest strength
from fifteen to twenty five during that time a 
Man is more subject to Inflamation, than of any
other time of Life; Men of a Sanguine temperament
have a greater Disposition to Inflamation than those
of a thin Spare Habit; it must be Remark'd that 
there are two species of Inflamation; the first is
Apt to Arise in the substance of Parts; and 
which we call Phlegmonans; the Second that 
wch. Arises in the Surface of a Part, wch. We Call
Erysepellatous; strong Habits are subject to the 
first Species of Inflamation; but in Weak Habits
the irritability is Commonly encreased; and 
the surface is more apt to be Affect'd from 
external application; In Warm Climates and 
in the Autumn from Living in Large towns and 
being Naturally of Irritable Habit Erisapellatous
Inflamation is Apt to Arise, but Strong and 
Weak are more Subject to Inflamatory Disease
than those of a moderate Strength; particular

Parts may also be tender more irritable by
particular applications, in Inflamation of a 
Part is Capable of Producing a Disease of the 
whole System, so that a second Disease is 
liable to be emited by it. We must first observe
that many Practitioners have us'd the term Fever
to Express a Disease in which there was a more 
frequent contraction of the Heart and Arteries;
And we must at the same Observe that it has
been made tho of differently by others; As 
by Sydenham and Hippocrates and most 
of the Ancients, and but Modern Practitioners
it is improperly us'd to signify all Disease
in wch. the frequency of the Heart is encreased
for by this Means We shall include several
Diseas's, that are properly Call'd fevers, when
the frequency of the Heart is not encreased,
and Employ the term in this sense, We shall
from a particular class of Disea's totaly
Different from one another; fever in its proper

[A??plation] is a Disease Arising Independant of 
any other, and also when Reduc'd is Independant
of its Cause, for it is not true) Physiology) that if the 
Cause be Remov'd the Vessels will Cease, We doe
not then Call the Effects Arising in the system
from Inflamation Fevers, for they frequently Depend
upon their Causes, so that if they be Removed
the Effects will Cease, they have also been called
Symptomatic fevers a Hoffman Calls it a 
Planitic Fever &c And we have said that the 
Affections Arising in the System from Inflamation
are two the one We call general Inflamation
the other symptoms of Irritation. Phlegmonary
Inflamations are Apt to be attend'd wth. The 
former, and the Erysapallatous one wth. the 
latter, but neither of these Diseas's are peculiar
to Inflamation, they may both arise from topical
Applications, the symptoms most common
in general Inflammations are Hardness of the 
Pulse, it is said to be Hard, when it feels like
a Musical Chord high Strung at a vitiating, it is also

Strong full and frequent, but none of these are
Necessary, for general Inflamation may subject
without neither as in an Inflamation of the 
Inter limb, the Pulse is small and frequent, neither
is it Necessary it should be frequent, for if the 
Inflamation be of an external Part, it is full
and hard, but not frequent. However from 70
Beats in a Minute, which is the Natural
Pulsation it Amounts to 110. It happens more
frequently also that it is more frequent at
Night then in the Morning, but in general 
Inflamation is healthy. Cinthart, the [??dass]
of the Pulse Discovers the Action is to be Cuting
Strongly, and this is the most Material Part
of it, this encreased action is attended wth.
an Alteration of the Blood, it becomes 
more Fluid. Some but those have suppos'd
this Alteration to be the Cause of the Disease,
others again have suppos'd it to be thicker, and
more Apt to Coagulate, this than they have [sa??]
to.

be the Cause, but the Blood in an Inflamation
is evidently thinner if taken from the Arm
it continues longer [illegible], so that the red Globules
fall to the bottom, the Coagulable Lymph Coagulates
afterwards more strongly; and adheres to the 
Red Part, was to some [C???] on the [??ss]
but in order to judge of this a large orifice shoud
be made in a large Vein, and receiv'd in a 
glass as nearly Spherical as Possible; the 
Coagulable Lymph in an Inflamation is something
Render'd as this, as to pass through the [illegible]
and be Extravasated, all the small vessels through
the system being Distended, and a [??nienal]
Restlessness takes Place, and being also 
fill'd wth. Blood a general redness and Heat,
and there is also a Degree and whiteness
of the tongue owing to attempt of its Secretion; In most
Affections the Mucus is encreased, here it is
generally Diminished; We are not sufficiently 
Acquainted wth. the Causes of this Appearance 
The Variation of this is a/Consequence in general

Inflamation it is more white, sometimes in an
Inflamation arising from the thorax, there is 
two yellow streaks along it; thirst do's not 
always arise from a Dryness of the Mouth
but the Reason of this as not as yet been sufficently
[illegible] for. the Redness are on a 
different state in different Inflamations,
if it Arises from a Cause that do's not give
great Pain; the mine is forbid and upon
Standing Deposiyes a [???ious] Sediment
but if there is great Pain, the Vessels of the 
[th??ies] Contract, and the urine appears
Clear sometimes a small Quantity of Mucus
Matter is Suspended in it, in form of a Cloud,
when an Inflamation Proves fatal, it is 
from an Affection of the Brain, first it may 
happen from such a Quantity of Blood
into the Brain as to Compress it, which
will cause a stupor on which the Ey's
Appears Red Inquire and Dim and a Delirium

takes Place on which the Patient Mutters
something to himself if she & he is terrible
but his Memory is entirely [illegible]. The Second
Method in which general Inflamation appears
to Destroy during its Violence, is by Producing
Wakefulness from a start of Rest he becomes
Delirious, this at first takes Place towards
Morning, if he sleeps an hour or two it then 
go's off for the whole Day, returning every Night 
in an encreased Degree, here the Eyes are Bright
the Patient is Quick in all his Motions, sinks
gradually untill at last Ravings are very Violent
till at Last he his Destroy'd, this however is 
not properly an affection of the Dream.
The Delirium some times remains after the Disease
itself is Removed, and then a Confirmed Mania is after
Produc'd------

Lecture 7.th
Inflammation greatly Depend upon this 
Cause, but not totaly Suppose an Inflamation of 
the Pleura shall arise, and in Consequence of this
the Pulse will be hard full and pregnant and 
other Symptoms of general Inflamation shall be
Present, by the application of a Blister to the side
We can sometimes Cure the Pain and other 
Symptoms and the Disease gos off; In this 
Case We have Employ'd nothing to Remove
the general Inflamation, We have only Atten'd
to the topical one, so far its Confirmation is not
Dependant on its Cause, but this is not always
the Case, in the first Place it is apt to become
Habitual, far after a Continuance of [M???ax] per
Foundage, if you carry of the Pleurisy by 
Topical Remedies, yet the symptoms if 
general Inflamation will still goe on. If the  
Patient be strong the general Inflamation will 

be great, and after Continuing for several Days
it becomes Habitual, in this Case Disease after
gos off without any Remedy, if Enhart not upon
the contact strong action of the Heart and Arteries
their Powers become Exhausted, their action consequently 
less, and the Inflamations subsides, but 
this is not always happen, for the Heart returns such
proper action the Arteris doe not, this in the 
first Disease Produced by Topical [crossed out] Application
or Inflamation Produ'd by it, we call symptoms
of Irritation, the Disease has more Commonly been
call'd never the general Inflamation yet it is 
Essentially different, or even more so, it is also 
a Disease which requires our Attention greatly 
and is to be Distinguished, both from general Inflamation
when and all other affections of the system,
it is entirely Dependant on its Cause, it continues
as long as the Irritation continues, and when
it Subsides this subsides also, there are certain
Parts of the Body which We call Irritable as 
the Internal Canal Bladder Diaphragm, Womb
when lately Impregnated. &c when Affect'd they [Rod??e]

Symptoms of Irritation, for Example the 
Mucus membrane of the Lungs is liable to be
Irritated, As the Mucus Membrane of the 
Intestines, but if it is Inflamed, the same Symptoms
doe not Arise if the Imbalance of the 
Intestin's was Affect'd, We doe not Calle a Part
Irritable because they are Subject to be 
Irritated by external Causes, but because 
when Affect'd they are Apt to produce great
Irritation in the System in general, the 
first symptom of this Disease is Depression
of Strength Arising from no Cause, We expect
for Example when a [illegible] through 
the Stomach, it happens often that there is
no pain or great loss of Blood, yet the 
Patient shall be almost immediately Incapable
of Supporting himself, and the action
of the whole system being greatly Diminished
until he Dies, have then learns to be no

great reason for the Loss of strength, but 
much it is, this is not a weakness but a Depression
of Strength, for the cause being Remov'd the 
Strength begins immediately to be restor'd if the 
Depression Arises from any Irritation that can
be Remov'd it is only then the symptom of a 
Disease at the time the Strength is Depressed
the functions are all almost Disordered the Heart
Outs more frequently, it almost always Contracting
the Pulse then becomes small Quick and frequent 
the Stomach is also Disordered, there is Sickness
Flatulency Vomiting want of appetite, the tongue
as in other affections is alter'd in its appearance
sometimes however it has no Mucus and appears
white, and sometimes it has more than in a Natural
State, the vessels of the Redmias are also Contracted
so that the Mucilaginous Part of the Urine is not 
secreted, and it appears Clear, there is Mineral 
Restlessness and sometimes Delium is 
a symptom, by generally the Patient remains
Perfectly sensible till he Dies, the symptoms 
are also Reduc'd by other causes than Inflamation

by gangrene Mortification, Spasmodic Contractions
of the Intermit's and the like, What is 
particularly to be Remark'd in this Decrease is
that it is so totaly Dependant on its Cause,
and this makes it Essentially Necessary to 
Distinguish it from a fever; for Example
in a gangrene and Mortification shall take
Place, and when these Symptoms Arise they 
have been heated as a Fever whereas no
Attention ought to be Paid; but to the 
gangrene and Mortification, a [illegible] of 
it other Inflamations may sometimes happen
in this Case the Attention should be Directed to the 
general Inflamation, for Example in an Inflamation 
of the Intestin's, there is Depression
of Strength fainting and other symptoms
of Irritation, but the Pulse is hard therefore
general Inflamation is Present, have too 
doe not Employ stimulants, to support 
the strength, but make the use of Evacuations

which will generally Remove all the other
symptoms, Now Inflamation or particular
Affections of Parts, as of the system in general, We 
now Come to the Progress of Inflamation, if 
a stimulus be applied to a Part of the Body
an Inflamation takes Place in that Part, and 
it happens sometimes upon Removal of the 
Stimulus that the Inflamation will Cease, We 
will next Consider of this Continuation, when the 
Action of the Heart is encreased, the fluids are 
Propell'd wth. greater forces, so cuts as to Distend
the small vessels beyond their Tone; this Promotes
a more frequent Action of the Arteri's, so that they
Continue a Natural Cause Acting and reacting
on each other, but the Matter of the greatest Importance
is that there two Causes shoul'd be just an Equilibrium,
if they are not an Inflamation will be always
encreasing or Diminishing, for if the Distension is
more than Equal the Inflamation will encrease, this 
Action is seldom an Equilibria and accordingly
We find an Inflamation continues longer in the 

same State, it is always either encreasing
or Diminishing, so that if We can once make
it begin to Decrease it will continue to doe so 
and Cure itself. That We must observe that 
there is a difference between the Inflamation of 
a Part or substance of a Part; and that of 
an Irritable one, in the first it is the Distension
which keeps up the Inflamation, but in the 
other, the surface is apt to be Affected by
externall Applications, the Stimulus Acts 
differently from being applied to an Irritable
Part, and by this the Action of the Arteris
is kept up once equaly, hence the Erysepellatous
Inflamation are also apt to encrease
of they are less no than Phlegomanous upon

Lecture 8.th
It has been suppos'd by some Practitioners that 
the Degree of Inflamation Depend'd on a Quantity 
of Matter Obstructing the Inflam'd Part, wch.
if Resolv'd wont'd [illegible] off. but We have made
it Appear that there is a greater Circulation through
the Part, therefore this opinion must be 
Erroneous; the first [illegible] upon Inflamation
is Resolution, by wch. is meant nothing more than
the going off of the Disease; simple Resolution
is when the Removal of the Cause of an Inflamation,
the Effect Ceases of itself; but a Cause
may Arise wch. may be sufficiant to keep up
the Inflamation, after the Original Cause is 
Remov'd, during the Progress an evacuation
may Arise, this always Weakens the System
and may therefore, Terminate the Inflamation
If a part be Preternaturally Distend'd wth. a 
Johu'd making an opening, so as to Evacuate is

may Put a Stop to the Disease; but if this
Evacuation be made suddenly and a large
Quantity such a weakness takes Place as Proves
fatal to the Patient has been Experienced in the 
Ascites; An Evacuation in taking Place Naturally
in an inflamation, will weaken the Action of the 
Arteri's and carry off the Inflamation. This 
Natural Cure happens often in the Mucus glands
than in any other Part; the glands of the skin
Secrete but a small Quantity at anytime so
that the Secretion cannot be sufficiently encreased
to Carry off an Inflamation; the sensation 
of many of the glands of the [illegible] may;
as those of the Kidnies Mouth, Nostrils, that [illegible] 
secretion from any adjacent Gland will
sometimes Remove an Inflamation; tho there
be no Communication between the two Parts;
and their Effect is much more considerable 
than that from a Part at a greater Distance
secondly it is not Necessary the Secretion
shou'd be so great, as to Weaken the whole Body

only the Part affect'd and where it is from a 
gland there is considerable variation. The appearances
of the Evacuating Matter; that which is 
first Evacuated Consists of Water, Containing
the Salts of the Blood; this carries off the 
Natural Mucus of the Part, as it contains no salts
and then it may stimulate, so as to bring on an 
Inflamation, or encrease it when Excited. Then
Watery fluids Stimulate more than Mucilaginous;
in an Inflamation of the Nostrils, there is 
first a secretion of a thin Watery Mucus; wch.
Stimulates and encreases the Inflamation; but
if the Mucus be Continued to be secreted from 
the Inflam'd Part, it soon becomes Viscid; and 
then is lessens the Inflamation, and if it was
great it Puts on a Yellow Appearance, it has 
been said to be Concerted; but it is the Mucus
undergoes these Changes, and not a Reparation
and Evacuation of Matter, as it has been supposed
to be, because the first Evacuation wch. is by much
the greatest do's not carry off the Inflamation,
this Change happens Universally [illegible]

Mucus glands is Affect'd, as for Example
As for Example if the salival glands are
Inflam'd; there is Considerable encrease of 
sensation, wch. Reserve its Natural Appearance
but is apt to Smell, and where the Inflamation
begins to cease, the encreased secretion dos the 
same, till they are both carried off. At this time
also an Hemorrhage may happen, an encreased
Action of the Heart and Arteris, fever open the 
Exhalants; and if the Inflamation be in a 
Part wch. Opens externally, the Disease often
carried off from the Hemorrhage which is 
Produc'd. It happens also that an Evacuation
Arising from Accident will carry off an Inflamation;
for Example if a Woman shou'd be 
Afflicted wth. a Pleurisy and during that 
should Menstruate, the inflamation will be 
Carried off without the Application of any 
Remedy whatever; A small Evacuation 
We must Observe will cure an Inflamation 
when a long as artificial one will not.

The most Natural Cure of an Inflamation
is by fever; but we shall only say at Present that 
a fever coming on has sometimes Cured the Disease
The most Natural Cure is by metastasis when an
Inflamation arises in another Part and Carries off
the Primary one, an Inflamtion, an Inflamation 
Occupies but a small Part of the Body, and it 
seldom happens that two Considerable [?n?s?ubrin??]
at the same time in the Body, where therefore
a second Arises, the first generally Subsides
from this Arts We are not, sufficently, Acquainted
wth. neither do's the Supposition of the 
translation of Matter forward on Account for
the sustains, we only , know that an Alteration
in the Action of Vessels will Produce an Inflamation,
this Cure by the sustains is not Confin'd
to a Natural Inflamation, for an Artificial one
will Produce the same Effect, for Instance a 
Blister applied to the Neighbouring Parts
will take off an Inflamation, when a Part is 
Inflam'd and there is no distinct Surprior,

A Quantity of Coagulable Lymph is
thrown out; wch. glues them together; as in 
and Inflamation of the Pleura it is by this Means
They Adhere to the Lungs; if it be [cross out] large
Surfaces We Call this an adhension; but 
among the Muscular Fibres, and all
other Parts of the Body, where there is
a Quantity of Coagulable Lymph, the Parts
are Naturally Soft and Play one upon 
another, Now this Coagulable Lymph
glueing them together, renders them still 
liquid &c. and this We call Callenity----

Lecture 9th
It happens that an Inflamation may Continue
for sometime, but this is Caused by a Contained
Application of New Causes, for an Inflamation
initial/never Continues long in the same 
Situation, if it did We should Empart that 
the Vessels would, Burst, so that the 
Arteri's would arise at such a Pitatio/Distension
that they could encrease no farther, and 
the Inflamation woul'd be at a stand, but neither
of these happens, for when it Arrives at a Certain
Height it Terminates in a fresh Disease, The 
first of there is Suppuration; which We shall
now Endeavour to Explain; after an Inflamation
there is Matter form'd which we Call
pus, different from all the other fluids of the 
Body not form'd in it Naturally, but only in 
Case of Disease. It is Perform'd by some Chemical
Change for it cannot be filled'd from the

Blood Vessels as it is not Contain as in
Pain; New Pus is form'd in two Cases,
sometimes in a Cavity and sometimes on 
a Surface; We never find it in the Blood
Vessels; Let us first consider the Formation
of Pus in a Cavity inside to this there must
be an Extravasation for suppuration never
happens but from Extravasation, as in 
Inflamation of some of the Membranes, where 
the Extravasation is there the Pus is 
Form'd, as in an Inflamation of the 
Pleura if it is in the Cellular Membrane
there it is that Pus is form'd; if in the 
Cavity of the Lungs it is form'd there, when 
the Matter is first Extravasated it is not 
Pus, but sometimes Coagulable Lymph 
and sometimes serum and Superfluous
Water and not Commonly the Red Part
of the Blood, an Extravasation is not always
Converted into Pus, As in Bruises in the 
Rheumatism Coagulable Lymph is Extravasated

and no Pus form'd, it is then necessary to 
Produce Pus that there shou'd be an Inflamation,
and not only more Inflamation, but it must be in
Proportion to the Extravasated matter otherwise
it will not be form'd. in an Inflamation of the 
Pleura the Cavity in which the fluids Extravasated 
is large the Pleura itself is only a small
Part of the Body, and the Inflamation 
and in general is sufficient to form Pus, but
when it happens in the Cellular Membrane
above the Pleura, the Inflamation Bears a 
Considerable Proportion to the Extravasation 
and Pus is generally Form'd; the Inflamation
then Furnishes the Circumstances for that fermentation,
wch. is to Convert the Extravasated
Fluid into Pus, it has been Contended that Pus
was from'd in a different Way from this that 
the Exhalant Vessels where so Altered as to 
Separate Pus from the Blood, but this is 
entirely Hypothasis, for We actually see a 
Fluid Contained in the Cavity wch. is Insepable

of Absorption, and instead of this We Recently
find Pus, that the Exhalants doe not become
Secretory Organs to denote Pus, is Prov'd by 
this Experiment, in an Ulcer that forms
good Pus, if you Clear it Perfectly and
Observe it wth. the Microscope, the Fluid as it 
Passes from the Vessels You will find it a
Clear transparent fluid, then lay some [t????], 
the Ulcer so that the Matter is contained there,
and you will find it will become Pus; so 
that it is evident in every Case that Pus
is form'd from an Extravasated fluid and 
not from any Power that Exhalants Acquire
of becoming Secretory Organs Where Pus 
is form'd the Extravasated fluid. The Solids also 
Ferment and are Converted into Pus, it is
pretty certain however the Mundane is first 
Converted it is worth attending to; why 
the Life of the Solids do's not Depend them 
against this fermentation as well as any other;

sometimes indeed they are Depended by their
Life, sometimes Partly and sometimes not at 
all; When Pus is form'd it is not necessary that 
the Inflamation shou'd continue any longer
for it will keep up the fermentation, and 
occasion the fermentation of a fresh Quantity of 
Matter; Now the Cellular Membrane is universally,
Diffend'd through the Solid Parts of 
the Body; the Cells of it Communicate wth. one 
Another, We must consider then how it happens
that Pus do's not Diffuse itself through the Cells
as Water do's in Adematous Patients, why a 
Quantity of Coagulable Lymph is thrown out, 
which glues the Surfaces of the Cells together;
so as to render them Impervious to one Another
and the Pus forming in the Middle of the 
Inflamation, first it is Prevented from Diffusing
itself, sometimes a kind of a Membrane is 
form'd round it; and the Pus is Contained in 
a Cyst, but this do's not happen in Common; 
tho the Pus cannot Pass through yet it acts

so Strongly that it makes itself an Opening
on the external Parts, it is remarkable however
that the Pus do's not act alone in all Parts
of the Body for in some it makes its way
Directly, and in others indirectly to the external 
surface, hence less Mischeiff happens in 
many Suppurations; then we should Enpact,
now it may happen that the Cellular Membrane
has on it its Cells glued together in 
this (are Pus will Diffuse in [illegible]to a very great
Degree, sometimes also the Matter do's not 
Destroy towards the Surface of the Skin; but 
Destroys other Parts and Commits great 
Devastation this happens but seldom but 
when form'd Destroys the tumor as well as
the internall surface, so that we have 
instead of an Inflam'd Part a Cavity inside

Lecture 10.th
We have said the Cavity Produc'd in Inflamation
is Call'd an Abcess, after Pus is Evacuated it [illegible]
We Call it an Ulcer no that instead of Inflam'd
Part We have a Cavity, that Part wch.
was Inflam'd being entirely Destroy'd, but there
is a Power in an Animal of Regenerating those
Parts wch. are [illegible] in some this Power go to
to a great Length; if you Cut them in two each
Part will Produce that which was Sort, so that
We shall have two Animals instead of one;
but this happens to few Animals, as the 
Polypus &c in Complicated Animals who 
have a great Organization, even in these
Considerable Parts may often be Regenerated,
The whole taile of a Lizard in which there are
Bones; Blood Vessels nerves and Muscles 
may all be Regenerated and if Cut down the 
Middle there will be two tails; this same Power

of Regeneration exists in a certain Degree in 
Men; but less, in quadropeds in general 
and in other Animals, however Considerable
Parts of the Body have been Regenerated when 
an Extremity has been Cut off entirely it
cannot be Regenerated [ab??] if [illegible]
be left of each Extremity it will be [lege???]
as a large piece of Bone if Taken away will 
be Regenerated how the [??or??s] by which 
Parts are Regenerated in Man, if there be
a Cavity their Arise first an Inflamation
of the Surrounding Parts, this is not a Violent 
one; there is also a redness and some Degree
of Heat and Swelling, how every Considerable
Pain from the bottom of this Ulcer, every where
there arises Little granules of fluid Substance
This We Call granulating Flesh, and these
continue to rise up until the Cavity is fill'd
where it is Covered by a fresh Skin, is that 

after an Ulcer there Arises the Parts that 
where Destroy'd, sometimes in a Part and sometimes
in the whole, however tho by this Measure of Suppuration 
the granule bring Flesh is converted
into small parts that where [??ony'd]; yet the 
Motion will not be Perfectly Restor'd still 
We consider the Patient to be in Healthy; We
may in some Degree Call Suppuration a partial
Cure, it sometimes happens that no 
Inflamation Arises than Pus is form'd in this
Care a [la??ens] Matter goes out in a large Quantity
as an Inflamation the surface of the Ulcer
may Arise, and then it is converted into [illegible],
then the Ulcer spreads, the surrounding Parts
being Destroy'd if any Membrane [???ing]
the Surface of any Cavity wch. opens externally
shou'd be Inflam'd; there is a Quantity of Fluid
thrown out on the Surface of that Membrane,
As the Skin thus seperates the Scar of Skin from
the true, and is sometimes converted into Pus

Pus in an Inflamation of the Mucous
Membrane of the [Ha??] the Secretion
increased which often Rule on the 
Appearance of Air, in the [??mes] in the 
Skin is the Scar of Skin break a Fluid is afterwards 
Secret'd, which is sometimes Converted into 
Pus, this is not always the Case it happens that
when it is form'd it Destroys the Parts below,
and has been Said to Erode, Pus will not Erode
any sooner than Water but it acts as fermant
and Converts it into Matter similar to itself
the next fermentation in Inflamation is in 
Gangrene and Mortification as in the Death
as Puts of action of the Inflam'd Part, These
two terms have been taken Indiscriminately
some have Call'd a slight Degree Gangrene and 
a greater Mortification, if there is any difference 
we shou'd Remind as the gangrene as the 
Death of a Part and Mortification the Putrefaction

of it; now an inflam'd part is apt
to Die in two Ways, first from a [illegible] Ligature
and the Veins &c. in an Inflamation of the Cellular
Membrane under the Skin, the Distension may 
be so great as to Produce gangrene and Mortification.
Secondly the Inflamation of Irritable
Parts, and Extremity is apt to terminate in 
gangrene and Mortification as an Inflamation
of the Skin, and not only such Parts were 
liable to external stimulus but such also as
have Call'd irritable in consequence of the great
Effect they Produce on the whole System, as in the 
Diaphragm &c. when irritability and [illegible]
Combine then the gangrene and Mortification generaly 
takes Place how We can easily conceive
the reason why a Part shou'd Die when an 
Inflamation Arises so as to Distend it; but 
why a very Irritable Part should Die in Consequence
of being Inflam'd We doe not as yet know,
We might indeed suppose the Nervous [???lla]
are Destroy'd; when an Inflam'd Part Dies

The Arteries can no longer Act, Strongly, the
Swelling therefore subsides the Part becomes
Pale from a less Quantity of Blood being Contained
in the Capillary Vessels, the Pain also gets off
how its to be Observ'd that a Part which is indeed
And Attach'd to the Body. Pulse is sooner
than it was [?rem?ou'd]; for Example if you 
Cut off a finger and Place it in firmely right Degree
of the Thermometer wch. is the Natural Heat
of the Human Body; and another was to Die
that was Attack'd in the Body, the Suppuration
in this woul'd come in before the other, and
it do's this in Consequence of the Hope the 
Appearance of the [illegible] exactly the same, small
Blisters Arises Round the Part, it becomes
of a Darker Colour and at last almost Black
it is heated and looses its firmness the 
Surrounding Parts afterwards becomes putrid
and Dead, when any Part of the Body dies
there is a Process Arises which Separates

one Part from Another; and this We generally
Call an Euptiation, Suppose a [illegible] of Muscle
to Die, a Fibre defient Die in its whole Length a 
Part remains sound, there is then a Part where
the Dead and the sound Part form'd together, in 
this Arises a treament wch. Converts it into, a 
fluid so that a separation takes between the 
two Parts, this we have some Reason to Expect,
in the Purulent Inflamation, but We have no
Certainty of it in a Phlegmonous Inflamation
takes Place Round the Sound Part, and in 
Consequence of this, the Fluid is mostly Converted
into Pus, the Dead Part is thrown out and 
and an Ulcer is left behind, its not that the 
gangrened Part is Destroy'd, its Edges by 
Putrefaction becoming Perfect, but the Ends of 
the Sound Parts are Converted into a Fluid,
by which they are Separated, No gangrene 
and Mortification always Produc'd one Ulcer
it woul'd be a better termination than Suppuration
As it would take Place soon and Produce
an Ulcer easier of Cure, When We kill a Part

by Caustic Alkali, the Part is separated and 
an ulcer easy of Cure is left behind, but 
a Part wch. is artificially [illegible] and one that
takes Place Naturally has by no Means
the same Effect for when the Gangrene and 
Mortification is Natural it is very apt
to Produce an Erysapellatous Inflamation 
of the Surrounding Parts, so that most
Commonly they spread very Considerably 

Lecture 11th
When a Part is ganegrened and Mortified it 
is evident that a Quantity of Putred Matter
is Absorb'd and Carried into the System, when
this has happen'd it has been Call'd a Putrid
Fever it is however only a Symptom of Irritation
As great Depression of the Strength smallness
and frequency of the Pulse, and indeed an Irrability
of all the Functions of the Body; the Brain
is sometimes Affect'd and sometimes not 
and the Patient grows gradualy and Sensibly
Weaken till he, Dies; We might Suppose it was 
owing to an Absorption, and this may indeed
in some Part Contribute, but it is the Action
of the Dead Part on the Living in general. This 
to be Depend'd upon in Absorption the Symptom
wou'd be in Proportion to the Quality of the Dead Part
but this we find is not the Case, for Example
a gangrene of the whole Leg shall not kill in as

many Days, when a Man Dies it is not in
Consequence of the Functions of a Part being 
Destroy'd but in Consequence of the Irritability
of the Part, the whole Intestinal Canal is 
very Irritable therefore a gangrene of any 
Part of this is more apt to Prove Fatal
they certainly Symptoms of Irritation,
and not Fevers, as of the the of the Bark
Species &c, We can bring on a [Enp?ia?ia???]
a Phlegmenous Inflamation and the Patients
Restor'd, if they where Symptoms a Fever
it would still continue. The last [illegible]
is in Schirrous and Cancer; properly speaking
it is not a termination it is a Disease apt
to be left after Inflamation in general. A 
Schirrous as I have first said is a hard
Tumour of a Part left after Inflamation,
so in Callous also but there broad is for
Essentially from one Another a Schirrous
may be Converted into a Cancer and in this 
Consists the Essential difference between the

Two hard Tumours left after Inflamation
a Schirrous can only Remain in a gland and
is evidently owing to an Accumulation of Matter
in the Substance of the gland, which is generally
Solid and Hard, some have been apt to Call hard
Bodies Schirrous but they are not, because
they cannot terminate in Cancer; A Schirrous 
frequently remains in the same state, and 
may Continue through the Life of the Patient,
but it more frequently encreases, and after 
a certain Time it enter a Degree of Inflamation
in wch. the Circulation being encreased, an 
Extravasation follows, which Forms Matter,
This ferments and Forms more, it is then absor'd
by the Lymphatics and Thrown into the System,
that it is a particular Matter is evident, because
when it has been Applied to any Wound it has
Produc'd a Cancer the most Part it do's not
in certain as Variolenus Matter in Venereal;
but that it do's not Act is Indisputable and 
encreases till at the last it makes an Opening thro

the skin and Forms an Ulcer extremely
difficult of Cure; Ulcers of difficult Cure have
all been Call'd Caries, We mean those only 
in which a particular Matters in form'd an is
where it is Absorb'd and Carried in to the System
System, this difficulty of Cure Proceeding 
from this Absorption, for if you cut the part off
wch. is Ulcerated it will Heal, but it will 
again Break out in some other Part of the 
Body wch. shows the Matter has got into the 
System, so as to be Able to Produce Ulcers
of the same kind in other Parts of the Body,
Now the Stimulus Occasions Pains the 
Ulcer is very Faetid and the Evacuation
Weakens the Patient, and the Constant 
Application of the Stimulus wears him 
out, till symptoms of Weakness comming 
on, he tis Cut off by a certain and Painful
Death, Schirrus Glands without a Nervous 
Inflamation, it is to be [??maty] of [illegible]

a long Time [illegible] in this Case it generally
encreases till about the Age of 40 or 50 in
Woman about the Cessation of their Menstruation
having thus endeavour'd to [illegible] to you 
the different Methods of Termination, in simple
Resolution, this Occasions the Inflamation
to Subside and be Carried off therefore We
generally Aim at it on the Treatment of the 
Disease, the [illegible] suppuration wch. if it takes
Place is follow'd by the Restoration of the Part,
but if the gangrene and Mortification Comes on
We must Endeavour to make an Exfoliation
take Place or if no Mortification Comes on, if
it be Possible We must Endeavour to Restore
the Dead Part to Life, and if a Schirrous
takes Place We must Endeavor togethe'd of
as Prevent Immediating in a Cancer, the 
Cure then in the first Place, is the Application
of such Remedis as Dispose it to Resolve,
Secondly such as are proper to bring Suppuration
and for the Management of the Ulcer [illegible]





is Form'd. Thirdly the Management of gangrene
and Mortification, in most cases simple
Resolution is best, but not Universally
there are some Cases, where it is better to
Let the Disease go on to suppuration for 
Example a Fever shall Arise and afterwards
an Inflamation, if this happens in an external
Part of the Body it is better to Let it goe
on to Suppuration, as it will Prevent a 
Return of the Fever when endeavour to 
terminate it by simple Resolution to 
shoul'd very probably Cause a Return of the 
Fever, Consequently it is better to run the 
Risque of an external Inflamation, then 
such a Disease as a Fever, in the Course
of wch. is an external one shou'd happen its
better to Let this goe on to Suppuration,
by which the Primary one will be Cured,
if We dont it will be very Apt to Return 
there being generally some few Symptoms

of the former left, and if a small gangrene
shou'd be in the Inflam'd Part, and that an 
Indolent one, it is better to let much come on to 
Suppuration it is be large it is be [illegible]
unless the whole Gangrene Suppurate there is
Danger of a Schirrous comming on in that
Part in wch. the suppuration did not place,
We are then sometimes to Endeavour [sim??]
to Resolve the Inflamation, sometimes to make 
it Suppurate, there is one great Point to be
Consider'd in the Cure of Inflamation, We 
have shown that it is an encreased Action of 
the Arteris of a Part Distending the small
Vessels beyond their tone, and whatever has 
been the Opinion of particular Practitioners
it has been almost Universally allow'd that 
the principal Part of [???ation] was the 
[S???i] Propelling the Fluids with a greater
Velocity, this therefore is to be Attend'd so that 
in any Case the strong Action of the Arteries which
is the Material Part of an Inflamation may
be united by a Cure applied, a Man can
be so Weak, but this Cause may be answer'd and

and you Cure the Inflamation if this 
Cause be left, A New Inflamation will Arise
the first and great End then is to Remove
the Original, and any other Cause that may
Arise in the Remedy of the Inflamation-

Lecture 12th
We have Shewn you that it is sometimes better
to make an Inflamation subside simply in 
Order for this We shou'd endeavour first to 
Remove the Cause which Produc'd the Disease,
or now Occasion it to Continue, it is time We can
sometimes Cure an Inflamation, tho the 
Original Cause Remains, and that must be
Afterwards sufficiant to Reproduce it, but the Cause
of Inflamation being in general capable
of Acting in Weak as well an in Strong
[illegible] its often an Inflamation is Cured as 
well as before it more frequently happens
that it takes Place again, unless the Cause 
be Removed, an Inflamation is seldom
Stational, you will find that many of the 
most Powerfull Remedies we Employ doe 
not Cure the Disease at once, they only make

it Diminish and it then gets off itself now
if the Cause be Less it will encrease by little
and little till the Disease is Reproduc'd
it is therefore of Importance to Remove the 
Cause, which first Produc'd the Inflamation, or 
any Stimulus that may Now keep it up
the Means of Removing the Cause/many
Inflamations is very Obvious, but We must 
Observe to you wth. regard to the Removal
of such Causes, that are so Obvious that 
if it shou'd Require some Violence to Remove it
so as at Present to encrease the Inflamation
yet We should always doe it, per example
in a Fracture of the Bone, a Splinter [illegible]
Stimulate and Distend the surrounding
Part, it will be better to Remove it, tho some 
Violence be Us'd, again there are some Causes
which frequently Produce and keep it up,
an Inflamation that are by no Means
Obvious, and therefore Require particular

Explanations, the first of these Causes, which
shall be taken Notice of is that which has been
Commonly Call'd Acrimony of the Fluids, We
have said there is no such Acrimony as would
Produce an Inflamation by Affecting the 
Insides of the Vessels, so that they only Acted
on the Irritable Membrane and accordingly 
whenever stimulating Fluids, are Contained
in the Body We find them always Acting 
on Surfaces, the Stimulating Fluids may
be Universally Prevented from Acting 
an Irritable Surfaces, if We can Prevent their
Touching but they are of them of the Watery
Fluids as Solution of the Neutro Salts of the 
Blood, Variolous Merbillous as Cancerous
Matter, if We rub a Quantity of [??l] over the
Membrane We shall Prevent any Watery
Stimulus from Affecting of it and if We 
[Ca??] the surface of one with any Viscous
Watery Fluid, it will be sometime be pre the 
Irritating Fluid will [illegible] itself wth. this

Mucilaginous one, and We know that the 
Stimulating Matter do's not Act so Strongly
when Dispos'd in a Viscid Fluid, thus [??r] the
Covering a Membrane wth. Vegetable Mucilage
will in a great Measure Prevent the 
Stimulus from Acting, for Example suppose
the tears run down the Cheek in a large
Quantity they will Excoriate and Raise
a Degree; of Inflamation if we rub a 
Quantity of Oil over the Part, We shall
Prevent the Stimulus from Acting and 
Cure the Inflamation in Order that an
Evapor'd Oil shou'd be Applied w th
Lungs it must be taken into the Stomach
Absorbe'd and Carried there by the Circulation
which shoul'd hardly Imagine possible that 
it shou'd be Carried in such a Proportion as to
Produce any Effect, but We actually find if We 
Show in a Quantity of Evapor'd Oil into 
the Stomach it do's Diminish the Action

of the Stimulating Matter, some other Manner
of Action has been sought for (namely that the 
Evapor'd Oils had a Power of sheathing or [Pl???]
the Particles of the Stimuli but it is Prov'd that 
they have no such Power, for the Stimuli are 
simply the Neutral Salts of the Blood, as wth.
they have no Power, so that [illegible] 
must Act by Depending the Irritable Parts
from their Stimulating Matter, Consequently
Comming into Contact wth. them; some have
suppos'd the Oil given internally slips down
the Trachea, but this it certainly do's not
for it woul'd then Stimulate more bendes Oil
Thrown into the System in a Solid from Produces
the Effect, however Let the Manner of Acting
be what it will, Evapor'd oil and Vegetable
Mucilages have a Power of Defending Irritable
Parts from Stimuli; when they are Us'd they 
shou'd not Contain a Quantity of Stimuli; for 
sometimes they Contain a Quantity of Essential
Oil, Linseed Oil Contains this, therefore it is

not proper in this (are to be Employ'd; Evapor'd
Oils are frequently known by Heat, when they 
Acquire a Degree of Empyreumatic, such is 
improper for the Vegetable Mucilages if 
kept too long are apt to [??sy], There are 
then improper to be Employ'd; when Evapor'd
Oils are made use of internally, the Heat of 
the Body Renders them Fluid, so that it 
Matters not; whether they are in a Fluid
or Solid Form; when externally Applied
they shou'd be Fluid in just the Heat of 
the Body, if they are too thin they will
Run off it too thick they will not [Rene??]
Oils of this Consistence have been Contrived
which we Call ointments, the Vegetable
Mucilage We Employ, is simply so are 
equaly Useful, but they cannot be us'd
externally because the Watery part will
Apt to Evaporate, and have the others Dos
upon the skin, then it will stimulate of 
itself; there are the Remedi's We Employ

to Cover the Surface of a Membrane as for 
to Prevent the Stimulating Matter from touching 
it; the Second Means of Preventing a Stimulating
Fluid from Acting on the Surface of Membranes
is by Destroying such Fluids. In Practical
Authors We find [illegible] deal about the 
Destroying the Acrimony of the Fluids, yet
there are but few Cases in wch. We can; if 
the Inflamation happens externally; We 
may by the Application of Caustic or Vegetable 
Alkali But when the Stimuli has 
got into the System; We only know of one 
Instance in which it can be Destroy'd, wch
is the Venereal Matter by Mercury, and its
Preparations; how it Acts We are at a Loss
to Account for; It must be Observ'd that the 
most Common Stimuli are the Nutro Salts
of the Blood these We cannot Destroy, nor
[??acuate], consequently We cannot Destroy
the Stimulating Matter; the Next Method
of taking of the Stimulating Matter, that is 
the Action of Stimulating Fluids and

other Stimuli also, is one that has not been 
sufficiently Considered, the Nutro Salts
of Fluids Applied to a Mucus Membrane in
any Part of the Body; after the Natural
Mucus is Washed off, will Stimulate and 
Inflame, but when applied to the Surface
of the Pleura or Peritoneum wch. are not 
Cover'd wth. Mucus, they do not Stimulate
at all, for Example; if by Purging the Mucus
be Wash'd off from the Inner Surface of the 
Colon or Rectum, the Stimulating fluid will 
Produce an Inflamation, but the Nutro Salts
wch. are Constantly thrown out in the Pleura
and Peritoneum doe not Stimulate throughout
these are not so apt to be Inflam'd; We
find then that the Mucus Membranes are 
not Irritable supposing We cou'd take 
off, this Disposition, they might than 
be Applied without Producing any Stimulus

The Disposition of a Part to be Stimulat'd
Depends on Life; if We cou'd then Vary the 
Life, tho the same stimulus was applied
it would not be capable of Producing an Inflamation,
We have Remedis that will render 
a Part less Irritable and Prevent much 
Fluids from Stimulating and Producing 
Inflamation, for Instance in an Inflamation
of the Skin from Heat, A Blister Arises and 
wch. Breaks, there then oozes out a Fluid containing
the Nutro Salts of the Blood, this Stimulates
and Occasions the Inflamation to Spread, Now
if you Exhibit the Center Reno tho of itself
rather tends to Produce Inflamation, it will 
alter the Power of the Life, so as to Render the Part
less Irritable. Thus when a stimulating Fluid
is Acting on a Vessel, We can by the application
of particular Remedis diminish or in some
Cases entirely take off the Inflamation in Irritable
Habits, then We can cure an Inflamation by the 
Exhibition of the Bark, tho it has a tendency 
to Inflamation-

Lecture 13th
The next Cause which Requires our particular
Attention is the Distension of the internal small
Vessels, the Quantity of Blood Circulating
in different Parts of the Body is very various
at one time somtimes the Quantity circulating
as at another, but there is a kind of general
Disposition in the Blood to Circulate in 
a large Quantity, in the Vessels of the Extremities
as in the Internal Parts as in the Thoracic
and Abdominal Viscera, so that when the 
Circulation is Diminished in one of these 
internal Parts, as in the external Parts
it generally is in the whole, so also it is wth.
the internal Parts, there is a kind of Balance
between the Internal and external Circulating
for it happens not Uncommonly that
a Contraction of the external Vessels, [gua???]
a greater Quantity of Blood being thrown 
in some of the Internal Parts, for [E??d??]

of a Man Unaccustomed to such a Practise
spend Walk Bare foot on the Cold Stoes it 
will frequently happen that a Pain will Arise
in the Abdomen, and where an Inflamation
Arises in an Internal Part of the Body, the
Stimulus Occasioned by it will encrease the 
Circulation by this Means the Vessels are
Distended and the Inflamation kept up, Now
by encreasing the Circulation in the external 
Vessels We Diminish that on the Internal
one's Consequently take off the Distension and 
Cure the Disease, the Manner of Restoring the
the Circulation to the external Part comes now 
to be Explained, first then there are certain Substances
wch. [cross out] to Relax the small vessels
through the whole system, that there are Remedis
which Produce this Effect is sufficiently evident
the Question is whether much [illegible] do's
actually take Place, Now there are certain
Remedis if Applied to the Stomach often 
[Occassion] [crossout] encrease of all the Secretions

through the Body, this Effect has,
Produce in three Ways, either by encreasing 
the Action of the Vessels themselves as the 
Secreting Vessels of the glands, or by Returning
the glands themselves, Thus if We Apply
Ipecach or Tartar Emetic to the Stomach
it shall happen in many Cares that 
tho the Skin was Dry before, it shall become
Moist as also the Tongue there shall 
likewise [illegible] something from the 
Intestin's, We Say it happens in many
Cases for no Medicine is certain not always
in its Effects, not if the encreased Secretion 
Arise from a general Stimulus, the Circulation
also wou'd be encreased; It is true sometimes
on the first Application of themselves the 
Stomach they Disorder it but encreased the 
general Action of the Vessels; Now if the
Secretory Organs for it We employ
Emetic Tartar to any Gland, it is so for

from encreasing the Secretion that it
diminishes and Acts as a Sedative, it is 
evident then that they have a Disposition
to Relax the Vessels, but this May doe more
in the external than in the Internal Vessels
Now the Medicines of this Kind We are
at Present Acquainted with, are all the 
Neutral Salts Squills, Ipacac, Rad Senica,
Preparations of Antimony and Water Rendered
Cold, is as to be nearly at the Freezing
Point, the Power of the Neutro Salts in 
Producing Relaxation is not very Considerable
the Powers of the others is much more Considerable,
When We want them to Act more 
Powerfully We must use Prepar'd Antimony
or Ipecac in this Country, in Warm Climates
are Italy Cold Water is made use off Squills
have been Employ'd only in Slow Inflamation
of the thorax, it is to be Observ'd that when [th???]

Considerable Inflamation if We Relax the
Vessels of the Skin a Profuse Sweat takes
Place, the Bed Cloaths get Wet, and if 
the Patient is Covered Close regulates
and Inflamd, if Expos'd to Cold the 
Distension and Topical Inflamation is 
much encreased, hence We are Prevented
from trying them Constantly in general
Inflamation; In these Cases We must
Confine [illegible] to make [illegible]
as Nitre and the Neutral Salts; when 
a Man is Cover'd with his ordinary
Cloathing, some Parts of the Body are 
apt to be expos'd to the Cold, and the 
Circulation is frequent by Changing
But when equally Cover'd in Bed
an equal and constant warmth is
Applied to all the Parts of the Body
and such Changes take Place therefore

in Internal Inflamations the Patient
shou'd be Confin'd to Bed, the Pratice
has Varied Considerably in the Treatment
of this Disease, owing to its not being sufficiently
Consider'd. It is evident We ought
to Confine the Patient to his Bed in an
Internal Inflamation of any Consequence
but at the same time is improper to See 
him wth. Cloaths so as to Occasion a great
Degree of Heat, for much a Constant Inflamation
or Application would Stimulate the 
whole System and encrease the Disease
treatment Means of bringing the Circulation
to the external Parts of the Body; is Warm
Water, it is not necessary to apply it
to the whole Body; The Heat only on upper
Extremities as in some Cases the Trunk 
of the Body, Warm Water of Relaxing
and Stimulating so as to encrease
the external Circulation; and has

a Power of encreasing it also; but at
not relaxing the Vessels like Warm 
Water. If this be applied to the lower
Extremities it will encrease the Circulation
in the whole System. It is to be
Remark'd that after a Part has been 
sometime immersed in Warm Water,
both the internal and external Circulation
is encreased, so that is Continued
for more than fifteen Minutes there
Appears Symptoms of an Universal
encrease of the Circulation, therefore it
shou'd not be Applied for too long
a Time in the next Place it is more 
proper to encrease the Circulation in the 
external Parts, In Inflamations of the 
Abdominal than of the thoracic Viscera;
another Method of encreasing the external
Circulation is by the the of Stimulants
there where frequently Us'd by the 

Ancients, in Employing these Remedies
We are to Consider at the same time that
they tend to Diminish the Internal they
Stimulate and encrease the general Circulation.
This Method then is now look'd
upon as improper, sometimes indeed
it may Succeed; One Stimulant yet
remains in Practise (viz) Vol. Alkali
of which we shall speak hereafter.
The Cause which Constantly tends to 
the Keeping up of all Inflamations
in the Distension of the small Vessels
beyond their Tone; there are two Ways
of Removing the Stimulus; arising
from the Distension, one by Removing
the Distension itself. The other by taking
off the Counteraction or Disposition
the Contraction of the small Vessels
or Capillaries, by the Application 
then of Relaxing Medicines to the 
Inflam'd Part, diminish the 
Disposition of the small Vessels to 
Contraction no more the stimulus 
Cure the Inflamation; by Applying

Warm Water to the Part Affected, We
are frequently Able to take of the 
Inflamation, it is to be Observ'd that
the Vapour is more Powerfully
Relaxing than the Water itself, therefore
instead of Immersing the Inflam'd 
Part in Warm Water, We apply some 
such a Substance as Cloth, Membranes
wth. the Water, and Repeated as after 
as it grows Cold; the Application
of it in this Manner We Call Formation,
we also Use it wth. Farinaceous
Substances and when Applied in 
this Manner We Call it a Poultice
sometimes We throw it on the Body
in the form of Vapour, but this is not 
to be done in Inflamation as We cannot
sufficiently Cool it before it Comes
to the Inflam'd Part; the Application
in Poultice and Fermentation are 
therefore the best and this We shall
Proceed to Explain

Lecture 14th.
We have Said that by the Application
of Warm Water we cou'd take off the 
Stimulus in an Inflamation, and that 
the Steam Arising from it as more
Powerfully Relaxing; and that therefore
We Chose to Immerse some Substance
in Water, and Apply it to the Part, We 
Come Now to make some further Observations
on the Application of Water to 
Relax the Vessels so as to take off the 
Inflamation, We must first Observe
that the Relaxation do's not Depend
on the Elasticity of the Part, it may 
happen that the external Part of the 
Skin in an Inflamation may be Dry
in this Case the Application of Warm
Water is not Confined to the Skin for 
Example if there is a stone Contained
in the Urethra, the contraction is in 
Consequence of it, suffering the Urine to 
Pass wth. difficulty, by Placing the 

Patient in Warm Water the Ureters will be
Relax'd so that the Urine will Pass more 
freely, in this Case it is evident it cannot
be Moistening the Part, there are many 
more Instances wch. We cou'd Point
out to you, where Warm Water do's
not Out in Consequence of Moistening 
the Part; this the Contractile Power
of the Vessels Depending upon Life
that We [al??arencess] when the Skin
is much Distended and Dry hence
the Fomentations and Poultices are 
Serviceable not only in Inflamations
not only of the external but of the 
Internal Parts of the Body also and
as the Balancing Power is [illegible]
on the Tone of the Vessels, it is not Necessary
the Water shou'd Penetrate to the 
Part to Produce its Effects, in the 
next Place it is to be Observ'd that the
Water shou'd be of a proper Temperature
if it be too Hot it will Act as a Stimulus

and encrease the Inflamation, it 
shou'd be made a little Hotter than the 
Inflam'd Part, and tho it may be Necessary
to Apply Cold Water to an Inflam'd
Part it has quite the Reverse Effect, We 
must Observe that in the Application of Cloth
Moistened in Warm Water, then is this 
difference that Cloth of a firm texture, is
soon Heated and soon Cold, and a Centrano
Cloth of a Loose Texture in therefore better
for the Purpose a Course Flannel
We also sometimes employ both Fomentations
and Poultices at the same time
and not Singly for this Reason, that 
Fomentations are more Powerfull as a greater
Quantity of Water is Applied in this for yet
if we Continue Constantly to Foment
a Part, We shall Wash off the Natural
Mucus and Cause an Inflamation 
on the Skin; We therefore only apply
them twice or thrice in Twenty four hours
and afterwards the Poultice and whenever

We the either, We shou'd Add some 
Mucilaginous Substances to Prevent
the Mucus from being Wash'd off
the last Observation we shall make 
is that the Application of Warm Water
encreases the Irritability of the Part
therefore in an Inflamation of the 
Skin; as in the Erysepellatous Inflamation
Warm Water will doe Mischeiff And 
Oil is held to Prevent the other
Applications from growing Dry; We 
Come next to Shew the Remedies to be 
Employ'd immediately to take off
the Inflamation; Now the most Powerfull
Means of the Weakening that We 
Know of is by Evacuation either by 
Opening a Blood Vessel, as encreasing 
the Secretion from and of the Glands
for Example the Opening an Abcess
suddenly if it be large; will often
Weaken the Patient so much as to Occasion
faintings, this happens also

in Taking Water from the Abdomen,
Thus Opening a Cavity that Contains a 
Fluid in Solid Weakens Considerably
it is wth. this Intent that We Employ
it and other Methods of Evacuation
and there We make in four several Ways
first when We want to make an 
Evacuation from any Part of the 
Body indiscriminately We open a 
Vein and this generally in the Arm
if it is easily got at; We must Observe
it there be a Topical Disease and the 
Rest of the System be Affect'd in the 
same Manner, but not in so great a 
Degree, then the Application of a Remedy
that shall Affect the System, will 
Carry off the Topical Disease; if the 
System be not Affect'd it will have
no Effect, if then the Os tenias of a Part
are Aching in the System are acting
strongly Evacuation will generally 
take off the Strong Action hence We

Cure an [illegible] woman than any 
small Inflamation of the Skin by VS
His useful there person general Inflamation
when the Pulse is full hard and strong
and frequent as also when the Habit
is strong, tho the Pulse be not full and 
Strong &c; in some Inflamation Bleeding 
is of no Use, tho the Inflamation be
Violent, for Example when the System
in general is Weak, as in a Woman after
Child Bearing, in these Cases it is often
Detrimental for where it is only the 
Arteries of a Part, which are Acting 
Strongly, and not of the System in 
general; Secondly the more suddenly
We take away the Blood, the greater
Temporary and less Permanent We
Produce; thus then it We make an opening
into a large Vessel and let the Blood
run out very fast, an Animal Die
much sooner, than if it was to follow
gradually it will therefore Produce a 

greater Degree of Weakness, than if 
taken away slowly and at different Times;
If therefore We Wish to Produce a great and 
sudden Weakness, We ought to Choose a 
large Vessel, and make a large Orifice and
also take a great Quantity at once; We 
may Bleed with Safety until the Patient
Faints; in every Strong, and when there
is a great Inflamation, We may take away
℥xxx. of Blood at one time but generally
℥xxx. is the Largest Quantity and this is 
frequently Requir'd in the Country, in some
Cases it may be necessary to be only
℥6 or even ℥iv. of the Inflamations that
happens in Large Towns, from ℥8 to ℥6.
is generally the Quantity Require'd it is 
to be Observ'd that sometimes open 
V.S. the Inflamation immediately Ceases
but this is not always the Care; nor has
it bear sufficiently Attend'd to, that the 
V.S only makes the Inflamation begin
to Diminish, We have said that an

Inflamation seldom Continues in the same
State; if by V.S we diminish the Action
of the Heart and Arteries this will begin
to make the Distension to begin to 
Diminish so that it will Continue so
to doe till the Inflamation Ceases, here
after Evacuation, shou'd Avoid every Thing
that may Stimulate so as to make the 
Inflamation to begin to encrease, for it
will then Continue to encrease as much or 
more than at the first. A Want of 
Attention to this as often Destroy'd the
Effects of V.S. We have said that 
Bleeding is of no use, We must also 
Observe that it is [???full] if no 
general Inflamation Arises, for it
encreases the Irritability, as well as
the Inflamation, thus in Pure Inflamations
of the Skin, Catarrhs Erysepallalous
Sore throat, and Autumnal Dysentery 
it is of no use, in mined Inflamations
that is of the Substances, as well as

Surfaces of Parts; Bleeding is Usefull
as it will Remove in general both that of the 
Substance and Surface also; this Evacuation
of Employ'd properly is the most
Powerfull Remedy of any in Inflamation

Lecture 15th.
The only large Evacuation We can make
from a Gland quickly enough to Cure an
Inflamation is Purging it differs from that
of Bleeding in this Circumstance if you
Open a large Vein so as to take away a 
Considerable Quantity of Blood, the 
Evacuation is justly Uniform from the 
whole System, but in Purging We Employ
a Stimulus to the Intestin's which not only
Produces a large Evacuation, but also Causes
a quicker Circulation through them, hence
in Considerable Effects of Purging, We must
not only Consider the general Weakness, but
the Partial Evacuation Arising from Purging 
is more useful in external than in 
Internal Inflamations, as it Empties
them more, We shall find that making 
an Evacuation from the Gland affect'd
is very Powerfull in Carrying off Inflamation,
hence it is useful in Inflamations

of the Intestin's in that of the thoracic Duct
it is sometimes thus full, for it Occasions
a greater Quantity of Blood to be thrown 
out on the Part, which stimulates it the 
more, but in all Inflamations it faeculent
Matters are Contained in the Prima Via
it is always Usefull; Purgatives may 
be Divid'd into three Classes; First those
that Produce their Effect by encreasing 
the Perilistaltic Motion. And Secondly
those that encrease the Secretion from them 
in Consequence of Stimulating them;
the first species Evacuate the Intestines
only Producing very little Effect from the 
Blood Vessels. The Second doe produce
an Effect from them, so that they are the 
most Usefull in Inflamations, Purgatives
may again be Divided into three classes;
first when We Exhibit the Neutral Salts
as Purges, there is Considerable Evacuation
from the Intestine's without any Alteration
of the Pulse, but it you give Jalap

Scammony and not like Reamous Purges
at the same time they Produce their Effect,
the Pulse becomes Quick and the System
in general becomes more Heat'd, hence 
the first Class are the most Usefull in 
Inflamations, the other Observations We 
made on V.S. applicable to Purging 
except that Purging is more proper in 
external Inflamations; thus it is Usefull
in Phlegmonous on's; No Erysepellatous
Inflamations this Evacuation as well
as V.S. is hurtfull; and for the same
Reason We come in the next Place to 
Consider the Effects of Topical Evacuation;
and first the opening of a Blood Vessel
in or near the Part Affect'd, after the 
Knowledge of the Circulation of the 
Blood, it was thought Topical Bleeding 
woul'd be of no Use; it being of no Consequence 
from what Part the Blood was

taken; and it is evident that if We
Want'd Blood that was improper for 
Circulation, We could only Evacuate the 
Blood that was Distributed to every Part
of the Body; but Let us Consider how 
far We can Empty the Blood Vessels
of an Inflamed Part; if We open an 
Artery of an Inflam'd Part, it will Prevent
the Blood from flowing into it; if We 
Apply Leeches to give the Blood apear
Opening to Pass out than if it was to goe
to the Heart and therefore We Evacuate the 
Vessels of the Part more; This Evacuation
may be made either wth. or without a System
the latter is generally the best, We 
must Observe from Experience that in 
whatever of these Ways, it is made from 
the Part Affected; it will doe more 
Service, than Evacuation from a distant
Parts; when We open a Vein of an Inflam'd
Part, it is not always Necessary We should
Apply a Ligature for the Vessels being

Distended, upon making an Opening
a large Quantity of Blood will flow out,
as the Blood is Passing wth. greater
Velocity to the Heart, and is in some
Degree Obstructed, if the Orifice be made
on the Side of the Vessels the Blood will 
flow the fear, Topical Bleeding is 
certainly a very Powerfull Remedy
in Carrying off of an Inflamation; Cupping
wth. Scarification is sometimes Us'd; but 
We cannot make this Application to the 
Inflam'd Part; nor is it absolutely Necessary
the Evacuation shou'd be made from the 
Vessels of the Part; provid'd it be made
near it, this good Effect will be Produc'd
even though the Vessels of the Part have 
very little or no Connection; as Bleeding 
in the Breast in an Inflamation of the 
Pleura will have more good Effect than 
Bleeding in the Arm, it is seldom that We 
can open a Vessel in the Inflam'd Part of 

a sufficient Size, for a Plentifull
Evacuation, We therefore in this Case employ
Bleeding from the System in general, Topical
Bleeding is usefull in Phlegmonous
Inflamation only; in Erysapellatous 
Inflamation it is often Hurtfull, for it
encreases the Irritability of the Part, so 
as to doe more Mischef than good,
hence Eryspallatous Inflamation of the 
Throat, Gonorrhea &c it is of no Advantage,
it is to be Observ'd that where is a Mixture
of the Inflamation, Topical Evacuation
is generally more Powerfull in Carrying 
off the Plegmonous Inflamation, than
Bleeding from the System in general

Lecture 16 th.
The Weakness or Strength of a Part and 
its Acting is being at Best, are encreasing 
different from one Another for a Part 
however Strong may be at Rest, and 
somehow Weak may exert itself, the 
bringing a Part to Rest, and the 
Weakening of it are different Effects
Application wch. bring Parts to Rest
without Weakening We Call a Sedative
Weakness is always more or less a 
Disease, it Prevents the Functions of the 
Body from being Perform'd so Perfectly
as they woul'd be, it We cou'd bring a Part 
to Rest without Weakening it. We should
Cure the Inflamation better, Consequently
We ought to Prefer the Application 
of Sedative as to the Antiphlogistic
Remedies, in all Cases they are not

sufficient to Carry off the Inflamation 
in some they are, it is therefore worth while
to Employ them as far as We can
Sedatives may be Applied to the Stomach
so as to Act on the System in general, or 
to the Part Affected, or near it, so as to 
Act more immediately on the Diseased
Part. When the System in general is Affected
as well as a particular Part; Sedatives
Applied to the System may be of Use;
Now the Sedatives that We Apply to the 
Stomach are [A??d?], the Action of these is
small, and not to be Depend'd upon; when 
there is only the Hardness of the Pulse and 
Fever turning out into general Inflamation
As in the Hectic Fever, and if Contained 
for sometime are of Use; Infusion of the 
Tea of Sarsaparilla &c, are of Use unless
the Fever runs out for a Considerable 
Length, they may be had wth. advantage
they are of no Use on Topical Inflamation 
The next Sedative We shall take Notice of 

in Warm Water which being Drank in a 
moderate Quantity, exerts a Sedative Power
it has however been Employed in Inflamations
to Produce different Effects, there has
also been Considerable Variation in its
Use,the Antients forbid it entirely, for 
three of the first Days, and allow'd it
afterwards very Moderately; while in Modern
Practise has much has been pushed down
as the Patient cou'd Swallow, it the Drink
in Acute Inflamations, As the Pleurisy 
has been given only Warm, and not a Drop
of Cold Water has been Exhibited, supposing
it wou'd prove fatal to the Patient, it was
Necessary a Man shou'd have a Natural
Appetite, for Meat and Drink, in order
for his Support; and I believe that We 
may in general trust to the Natural
Appetite as to Drink, there not Appearing 
to have been any Advantage gaind by 
forbidding Drink, [illegible] Superfluous Water,

do's not seem to Distend the Vessels in 
any Degree as little hence is Required to throw 
it out of the System it is therefore not worth
while to make the Patient Uneasy for Want
of it, as that will encrease the general
Inflamation; On the Contrary a great 
Quantity will be Detrimental as it may
in some Degree Distend the Vessels, and 
perhaps make the Inflamation to begin 
again to encrease; the Warm Water thrown
down even supposing the Distension
Depend'd in the Viscidity of the Fluids
would be of no use; as there is always
a sufficient Quantity of Superfluous Water
in the Blood Vessels; in the Second Place
if an Obstruction Arose in Consequence
of the Viscidity of the Fluids Contained
in the Vessels, the Warm Water wou'd not get 
at it to Produce any Effect, as the Circulation 
wou'd be Stop'd in a Part it is then 
certainly the best to Leave it to the 

Patient, taking Care that the Fluids
are entirely Watery, for all that Contain
Alcohol tend to encrease the Inflamation
by their Stimulus, it is a Question 
whether the Water shou'd be Us'd Warm
or Cold, the followers of Boarhaves
Doctrine, have Suppos'd that Cold
Water would Condense the Fluids, but 
it do's not at all Appear Sensibly to encrease 
the Viscidity of the Fluids, neither Can
it act on the Blood so as to Cool
it, for the Body has a Power Preventing
it from being Cool'd, hence there is no 
Disadvantage in Employing Fluids that 
are Cold, on the other Hand Cold Water
acts as a Relexant, but as We have 
more Powerfull Relaxants, We need not 
make this Use of it, the Patients Drink 
may be given either Warm or Cold; Not
has been Employ'd in Inflamations and

Considered has a very Powerfull Sedative;
but I Believe it is of very little Use if any,
for nobody in the first Place nor even its
warmest [Ada?rate] have Employ'd it alone,
neither has it been Employ'd in any particular
Dose, there is one Reason for Employing
this, or some other Neutral Salts in Acute
Inflamations as it may be given in 
the beginning of the Disease, when it is 
not proper to give any more Efficacious 
Medicine, besides the Practitioner is always
Obliged to give something in Order to 
Amuse the Patient, upon the whole We 
can doe little good in Inflamations
by Sedatives Applied to the System
in general, but Applied to the Part they 
are frequently so Powerfull as to Carry
off the Inflamation of themselves. Here 
are two kinds of Sedatives, More the have 
any Considerable Astringency, and 
those wch. has very little or none;
the Sedatives which have but little

Astringencey are [illegible] of the Plants wth.
[illegible] flowers, as Nerbum [Ab??th]
Matricania &c; some Roots also as the 
Preyenia Alba and Beets also as the 
Aryenia Alba and Poppies, as those now 
Employ'd in fomentations and Poultices
it has been suppos'd that it was the
Warm Water, that Produc'd the Effect, so
that they have reject'd every other Ingredient.
But this Opinion is extremely Erroneous
for the Application of these Substances
has been Attend'd wth very Considerable 
Effect, when Warm Water has been
Produc'd from or at least a vary Considerable
one, in external Phlegmonous Inflamations
Reppias or Opium or Decotion
of Wormwood, or some other of these
Plants of this Class; Applied in the 
form of Fomentation, and afterwards the 
Plants Beat down, so that the hardness 
is taken off; and then Applied as a 

Poultice, and are more Efficacious than
Farinaceous Substances Moistened wth. Water
but especialy Opium, so that by these means
We shall be Able to Carry off an Inflamation,
when a Simple Fomentation, or Poultice
would not; Matricaria and other Antispasmodic 
Plants, are not so Usefull in Inflamations
Lying immediately under the Skin, as in 
those that Lye deeper, as in an Inflamation
of the Womb, We shall at Present only observe
that Sedatives of small Degree of 
Astringency are not so Serviceable in 
Erysepallatous Inflamations as those 
of a greater. 

Lecture 17th.
We Come now to Consider the Action of 
Astringent Sedatives in the Cure of 
Inflamation, there where Commonly
Employ'd by the Antients and were
Call'd Repallants, they Consider'd
Inflamation as a Relaxation of the Part
and Consequently an Accumulation of 
Blood in it, Astringents they thought
therefore the most proper Applications
to Occasion the Blood to be thrown out,
but when it was suppos'd that Inflamation 
Depended an Obstruction, every 
thing that encreases the Contraction
was Hurtfull and accordingly thrown
aside in Doctrine, tho not entirely in 
Practise, We however find that they are 
frequently sufficiently Powerfull for
Carrying of an Inflamation, those who

Suppose their Action as Repellents, suppose
also a Quantity of Morbid Matter, if
therefore the Vessels they urge to Made to 
Contract, so as to throw it into the Circulation
it would Produce seem Dangerous
Disease, and on this Account they where
Rejected, they have however been always
kept in Practise, and are now more
frequently Us'd, than they where sometime
ago there are certain Cases in which
We wou'd not Wish to Cure an Inflamation
by any Topical Application at all 
first when it is a Critical one; Secondly 
if the Inflamation has been Habitual
for if We Cure such a one by any Topical
Application we shall have frequently
some Violent Disease, Attack the Internal
Parts of the Body; kindly in Phlegmonous
Inflamations Lying immediately under the 
Skin, for if you tye a Ligature over if 
gangrene and Mortification will ensue

so if You [ce??dus] the Skin evey Sense
the like will be the Consequence, to show we 
have Seen them Applied wth. Success
in these Cases, but as the Suppuration
of such Inflamation is seldom of any 
great Consequence, they ought not to be
Us'd, in all other Phlegmonous Inflamations
there is Danger of Contracting 
the Skin, so as to Press it against
the Inflam'd Part, as they likewise 
Diminish the Irritability they are 
Serviceable in Erysepallatous Inflamation
the Sedatives of this Kind We Employ
at first Vegetable Astringents as
Inter. Rosar. rub. Nurb. Agsiman. Red
Termantillec &c, when We Employ these
as Sedatives and Emollients it is 
better to Apply them Cold than Hot,
Acids Applied externally are Powerfull
Sedatives in Phlegmonous Inflamations [illegible]

Lying immediately under the Skin,
and where it is Affected also; Acids are 
not Employ'd in Consequence of their
Stimulating in Inflamations, that are 
deeper Seated, they have been Employ'd
wth. Success, they are not to be Us'd in 
Erysepallatous Inflamations, Alcohol may 
be Us'd in most Cases especially in 
Erysepallatous Inflamations it is better
however to Dilute it wth. an equal Quantity
of Water or it may be farther Dilut'd and
Produce Considerable Effect Farina Matter
is also an Astringent Sedative, it differs
however from the Farina of some Seeds 
having more Astringency than that of others
as Oatmeal Indian Wheat &c. Oatmeal 
has been Us'd in Erysepallatous Inflamation 
but [illegible] wth. Advantage 
they are however Employ'd in external
Inflamations wth. Considerable Effect, the 
last Class of Astringent Sedatives

Possess this Power in a great Degree
they are the Salts and Calxes of some
Metals; and Allum, there are too
Powerfull to be Employ'd in most
Cases, sometimes however they may 
be Us'd wth. good Effect, but as We
shall hereafter have Occasion to 
Shew you the particular Cases in 
which they are Applicable; We shall
now Proceed to Consider the next
means of Carrying off an Inflamation
which is by Raising another in a 
different Part of the Body, for two
Inflamations doe not Subsist well 
together; We have Said that we dont 
Understand in what Manner one
Inflamation Cures Another, but it dos
whether the Second be a Natural or 
an Artificial one, We doe indeed
Produce a New Disease, but it is of no 
Consequence, it may be necessary
to take Notice of some Opinions

that have been held, wth. regard to the 
Method of Cure, if in the first Place it is made
in the Inflam'd Part, that will occasion
a greater Circulation in it, if act a Distance
it was suppos'd that it Diverted the Flow
of the Humours from the Part originally
Inflam'd tho there may be something in 
this Opinion, yet We know it is not 
Actualy so, for the nearer the Second
Inflamation is to the first, the more certainly 
it will Carry it off, it was agreeable to 
this Opinion the farther it was off the 
better it would be, We most Commonly
Employ Cantharides to Procure this 
Inflamation there are two supposed [illegible]
in Cantharides first, in the
first there is a Disposition in it as to 
Raise a Blister, it has been Suppos'd
that the Flow of Mucous from this Cured
the Inflamation, but they cannot Produce
this Effect in this Manner, as We can
Expect little Advantage to Arise from 

this small Discharge, it is certainly,
not from this, for if you Raise
an Inflamation when no Discharge
is Produc'd, the Effect will be the 
same. Secondly the Particles of the 
Flies have been Suppos'd to be Sharp
and [??ide] the Obstructing Matter, This 
opinion it is to be observed to [??wire]
one, Reputation, nor dos the Juice
of Cantharides when Absorb'd into the 
Body Act as a Sedative, for [illegible]
Not from Applied to the Skin will
Produce the same Effect, so that the 
Action of Cantharides is no other
than the Power of simply Raising 
an Inflamation; there are two classes
of stimulants the first tends to [illegible]
an Inflamation of the Skin, the Second
of the Cellular Membrane, the first 
Produce no Suppuration, the Second 
doe, in this Case we would not Wish

to excite a Suppuration Cantharides
Tehadyorania, and Lilliaceas/Limmous,
Volatile and picad alkalis and Acids
are all Apt to excite an Inflamation
of the Skin only on this Account we
Employ them in Preprance to [illegible]
Substances; as they excite Suppuration
two of these are generally Us'd Volatile
Alkali and Cartharides, the first 
is a Powerful Antispasmodic and 
to be Employ'd when We Want but
a small Degree of Inflamation, and when
a great one is Requir'd We Use Cantharides
not from any Power they Posses of Carrying
the Disease, but because they Raise
an Inflamation, that is never difficult
to Cure, the Inflamation Cured by this
Means in generally external [illegible], We 
must observe that in Case there is a 
great Degree of general Inflamation 
as if there be hardness fullness and
Strength of the Pulse, We run some
Risque of encreasing it in these Cases

it is better to Use Evacuation by [?ate?ing]
and Purging first, and those
Employ these Stimulants.

Lecture 18th.
We Come now to Point out to you the
Manner of making a Topical Evacuation
by encreasing the Secretion from the Gland;
When a Gland is Inflam'd, the encreased
Action of the Arteries Propells a larger
Quantity of Fluids through that Gland, and
Occasions a greater Secretion, this is the 
Case in every Gland except the dryness
when the Substance of a Part where those
are Glands that is Inflam'd then also
there is generally, but not Constantly 
a Secretion from the Glands, sometimes
when a Part near a Gland is affected
wth. an Inflamation, there is an encreased
Secretion, but not so frequently as in 
the former Instance; It is farther to be
Observed that in the too Cast Cares
the Matter Secreted is not Alter'd; It is
thick the Mucus Part frequently

retaining its Consistence when the 
Membrane itself is not Inflam'd when 
the Secretion is more Copious it is 
thinner and Contains the Neutral Salts
of the Blood, when a Part near a 
Gland is Affected wth. Inflamation
and very little or no Secretion ensues
We employ stimulants to encrease
or Produce it, how far they can be
Applied so as to be Effectual We
must Leave to be Explain'd when We 
Come to the Treatment of Inflamation 
Requiring this particular Method of 
Cure, when the Secretion is at the first
Copious and Watery, the Salts Contain'd
frequently Stimulate the Surface of 
the Membrane along which it Flows so 
as to encrease even Cause an Inflamation 
of the Part, as it happens in 
Catarrhs, in Order to Avoid this We
must Defend the Part, by expressed Oil

and Vegetable Mucilages; It frequently
happens that after an Inflamation is
Considerably Diminished the Secretion
Continues and is sometimes more Copious,
when this is the Case it keeps up in some 
Degree the Inflamation, and Prevents
the Natural mucus from being Applied
to the Part, hence We must Apply
Remedies to Put a Stop to it; this is 
sometimes a Matter of difficulty, when
this encreased Secretion is in Consequence
of Weakness and a Relaxation of the 
Glands, We must endeavour to Strengthen
them, Now by Strengthening the System
in general, We doe not frequently Strengthen
any particular Gland, as it is only 
a Topical Weakness, and is therefore
the more difficult to Cure, when this
Proceeds from Relaxation, We may
Apply Astringents, these however
frequently fail of their Effects, for they

only Act for a time, Leaving their Part
after their Action often more Relax'd
them before; as is Inflamed in the
of Opium; except these Astringents
produce some Effect, they will 
I say frequently fail, sometimes
the Inflamation is kept up also so
that they Act as a Natural Cause,
in this Case if We put a Stop to the 
Evacuation for a few Days the Inflamation
will begin to Decrease so that 
they will both goe off gradually
together by Putting a Stop to the 
Evacuation or rather the Secretion for 
a Length of Time We Can take off the 
Weakness of a Part, tho the Remedies
may actualy Tend to Relax the Part 
afterwards; unless Astringents Produce
some such Effects as there, They 
seldom Produce a Permanent and

good Effect, it sometimes happens
that the Secretion Continues in Consequence
of Habit, here Astringents Put a Permanent
Stop to it, in general they must not
be Us'd till We have Remov'd the Stimulus
that was the Cause of the Evacuation
sometimes indeed the Application of 
Astringents Destroys the Stimulating Matter
but is always doubtfull, when this is not
the Case, the Inflamation most Commonly
Returns wth. greater Violence; We shoud
therefore Pay this Attention; when even 
Stimuli are Present, the Astringents
We Employ are Various, some of which
we apply to the part as the calces of Metals;
and some to the Stomach; As Astringent
Vegetable Substances, this Astringent
Juice Acts Strongly and Permanently,
Allum also Acts Strongly and Universally
[illegible] Astringents sometimes encrease
the Inflamation Considerably and of 
Consequence the Secretion, We must

Observe that all these different
Astringents are Applied in different
Cures, but We shall Leave these till
We Come to treat of the particular
Diseases in wch. they may be Useful 
We shall now Consider the Treatment
of Inflamations wch. Come to Suppuration,
sometimes We rather Choose
they shou'd Suppurate as when they Arise
in Fevers, and are in the external Part
of the Body, for it is better to Let the 
Inflamation goe on, than the [illegible] of
a return of the fever, and if in the small
Glands to Prevent these Indurations,
It also frequently happens that we
cannot Avoid it, for the Time of Suppuration
taking Place is very Various,
In Infants it happens Quicker than
in Adults, in the former it will
sometimes take Place in 24 Hours,
in the latter if a Phlegomonous

Inflamation Arises and goes on wth.
Violence, the Suppuration seldom begins
till the Fourth Day, in some not till the 
10th. 12th. or even a much longer Time
as in an Inflamation of the Lymphatic
Glands, Evacuation may Retard Suppuration
Considerably, when the Inflamation 
is Considerable, especially if it be
in the Internal Parts of the Body; the 
begining of Suppuration is often Indicated
by Fits of Coldness or Chilliness comming
on at irregular Intervals, and in certain
in their duration, when also Suppuration
takes Place in the Inflamation, sometimes
Contract itself so that it is not so much
Diffused, the Pain too, generally begins
to Decrease, again if the least Quantity
of Pus be form'd We cannot Put a stop
to it, We are therefore under a Necessity
of Letting it goe on, where it is doubtful
whether Suppuration to begun or not 
if it is likely to prove Dangerous

We shoud always Endeavour to Resolve
it, but if there is no Hazard of that 
kind, we shou'd Endeavour to Encourage
the Suppuration, for the Remedies We 
Employ to Prevent it, also make it 
goe on ill, if it takes Place our [illegible]
Endeavour shou'd be to make good
Pus form as soon as Possible, when 
an Inflamation Runs to a great 
Height, they often Germinate in 
gangrene and Mortification sometime also
there will be a greater Degree of 
Suppuration than is Necessary, in
that the Part will be extremly [illegible] 
the Inflamation then shou'd be kept 
up, but in a Moderate Degree, if
if it be Violent We may Diminish
it by moderate Bleeding and Purging
by the Application of Emolliant fomentations
and Poultices, and of
such Sedatives as have no Astringency

this however must not be in so great a 
Degree, as to Endeavour to take away the 
Inflamation, Emollient Fomentations and the 
Poultices, and are also Useful in Suppuration,
as they forward it Considerably
If an Inflamation be too Slight it shoud
be encreased, by the Application of a 
Stimuli; We must observe that in 
general it is better to Let the Inflamation
goe on too slowly, than encrease 
it too fast, We shou'd Wish to make
Suppuration take Place as fast as We 
can wth. Safety, for the ease of the Patient,
sometimes an Inflamation will not
Come to Suppuration, without the Use
of the Stimulants, but if We Push it on
too fast We produce a much larger 
Abscess, and sometimes Endanger the Life
of the Patient, We have Said there are
two Classes of Stimulants, therefore Employ'd 
to encrease an Inflamation, one that
Acts on the Surface, the other in [Resu??]
of a Part, there are also too kinds of 

Universal Stimulants, one that acts Quickly,
the other that are not so Quick in their Action
and these We generally Employ Internally-                             

Lecture 19th.
We Come now to Point out to you the 
Substances We Employ, to encrease Inflamation
so as to forward Suppuration, We 
must however first Observe that in
Strong Habits when there is little Irritability
Suppuration takes Place Quicker and more
Perfect; then to have the Habit is Weak and
Irritable, the Cort. Peruv. as it Strenghtens
the System and Prevents Irritability,
is a very Powerfull Remedy in Promoting
Suppuration, and also makes the Pus
Perfect, and to Confine it in the Part
is that it has been Employ'd wth. the 
greatest Advantage, if we Want a Speedy
Effect, an Ounce in 24. Hours shoud
be given, or as much as the Stomach
will Bear, such Stimulants as have a 
Disposition to Produce Hardness and
Strength together wth. some Degree of

Quickness of the Pulses, are proper as 
the [illegible] and [???mious] Substances
of Vegetables; Mercury is a Stimulant
of the same Kind, and Us'd for the 
same Purpose, but We doe not frequently
Employ these, they are not very Powerfull
and We rather Choose to Trust to the
Bark, this is a Class of Stimulants that
tend to encrease the Inflamation of a Part 
without Affecting the System, these if
taken a great Quantity Affect the Brain,
and are hence Call'd Poisons; they are
the Belladonum, Nicotiana, Cicutae, &c.
They are sometimes Useful in very tedious
Inflamations, as for the Lymphatic
glands; for they will bring it forwards
when We cannot by any other Means,
We apply Stimulants to the Part also,
there are principally of two kinds (viz)
such Farinaceous seeds as Contain
some Essential Oils as Farina Line and

Fanugri. &c. when Suppuration is taking
Place it is Useful in any Cases to Employ
Applications of this Kind, for whether
it be that they keep the Part Warm or whether
they Posses a Retaining Power Suppuration
gos on better for them, We sometimes 
Apply Resinous Substances to Stimulate
the Part and forward Suppuration, these
however are seldom necessary and sometimes
they are hurtful, as they produce a longer
Suppuration than otherways wou'd have
happened; when an Abscess is [n??m?d] it
is a Question whether an opening shou'd
be immediately be Made as to Let
out the Pus, it sometimes happens that the
Matter is Seated deep and in such a Part,
that we cannot Let it out, and when Suppuration
has taken Place there is not one
Parcel of Matter form'd but several smaller
on's by Degrees these join together, so as to 
form one Mass, if they have form'd before the
Opening of the Abscess, the Suppuration will

be of tempor Contrivance, and therefore
Surgeons Prefer N Leaving it to Nature in
general when we wou'd make an opening
the [Atuep??t] in many Cases Subsist
for a Considerable time; it is apt to be
in two States, the sides of it are perfectly
free from Inflamation, or only a small
Phlegomonous one of the surrounding Parts,
in this Case there is very little Pain,
the Internal Surface of the stone, may
be Affected wth. Symptoms of Irritation dies
wth, Erysepellatous Inflamation, have there
is great Pain, the discharge thin Watery
and Stimulating, it becomes an Abscess
of the System, and Produces general 
Restlessness, and uneasiness of the 
Body, frequency and hardness of the 
Pulse, the Pus thrown into Cavities
and produces fresh Inflamation and
in this Case it often happens that it is 
thrown upon the Lungs and Proves Fatal

here we endeavour to take off this Irritability
by the Use of the Bark; indeed it shoud be
Employ'd in all large Abscess, where it is 
out Contraindicated, other Substances which 
tend to Produce Phlegmonous Inflamation,
and good Pus, and much have been Us'd
as Wine and Spices and the like, it has 
been a Question whether the Hectic Fever
Arising from Absorption was Produc'd by
the Stimulus, or the Matter; but the Pus
in Urine and other Symptoms evidently
Show it is Pus, Absorb'd; if an Abscess
is deep but so that we can get at the 
Matter, or if it has a Chance of making
Sinus's that is Destroying or [Re???ing]
between the Muscles, or if it be very
large it is better to Evacuate the Matter
even before a Perfect Suppuration has taken
Place, for it is best to Dispart off such Parts
as are not sufficiently Destroy'd than 
the Risque of an Hectic Fever, from Absorption
when we make an Opening it should be
such a one as will Evacuate the whole

or greater Part of the Skin covering 
the Pus, it shou'd also be made in 
a Depending Part of the Abscess, it is 
a Question whether in very large Abscesses
it is Preferable to Evacuate the Pus at
once or by Degrees, as Evacuation tries 
to Produce Weakness but seldom so 
great as to Prove Fatal, it may however 
Weaken the Abscess itself, and Prevent the 
the Surrounding Phlegmonous Inflamation going 
forward hence some have thought it
better to make a small opening, but 
the Continuation of the Matter in the 
Abscess will be Attended wth. disagreable 
Consequences, on the whole then it is better
to make a large Opening, and Evacuate
the Matter at once; there are Many things
that take Place in an Abscess, first a thin
Matter Oozes out, and the Ulcer neither 
Spreads not Diminishes, Secondly an
Erysepallatous Inflamation may Arise,
a thin Matter is also Discharg'd the surface
is also Converted into Pus, and is Brown 

off in this Case, the Ulcer spreads [illegible]
there may be a Phlegomonous Inflamation not
Attended wth. any great Pain, for their is 
first form'd a Quantity of Pus without
Stimulating, and little Granulations Arise,
this Requires the Application of no Remedy
nothing more then a Defence from the Air,
by something Soft first of there is no
Inflamation at all; if the System in general
be Weak, we shou'd Endeavour to strengthen
it by Bark, and Stimulate it by Wine
and Spices, and Resinous Substances,
We make Use of Mercury for this Purpose,
We may also Apply Stimulants to the
Part, there may be Scarification on the 
Surface, Applying Resinous Substances,
or if the System in general be Strong, and 
if the Inflamation be Contained in a 
Membrane or Cyst, then destroying the 
Part, by Lunar Caustic, and Applying
a Superficial Dressing, a Suppuration
will take Place in Eresepellatous Inflamation,
There are two Ways of taking them
off, the first by Diminishing the Irritability,

of the Part, the Second by Stimulating
Remedies, to Produce a Phlegmonous Inflamation
its Room, if the Ulcer be a [illegible]
the most Powerful Means is
by taking off the Inflamation by diminishing
the Irritability of the Part, this Bark
will Perform most Powerfully and 
Effectually and also three or four
Days before the Abscess is Opened it
shou'd be Us'd as it will Cause a good
Suppuration in all these Cases we
may give it in a much less Quantity 
in the whole by giving it in large
Doses at the beginning; if the Ulcer be
not recent, then the Employing of
Stimulants will Produce the Effect;
Mercury We Use internally, and externally
such Resinnous Substances together wth.
Preparations of Mercury, as Sand to Produce
good Suppuration and Granulation; It
may happen in Erysapelletous Inflamation,
on the Surface of the Ulcer that

the Disease is not owing to an Affection of
the System, but of the Part, in this Care Remedies
Applied to the System are of much less the 
than there Applied to the Part, have the 
best Method is to Destroy the Substance of the 
Part, so as to Come to the Second Parts below,
and bring a Suppuration from the bottom
of the Ulcer; It sometimes happens that 
the Suppuration is Prevented by particular
Matter, as Venereal and Cancerous &c.
If it is Topical the Application of a Caustic
will unite wth. the Matter as well as Destroy
the Surface of the Ulcer, and so bring on
Suppuration, if the Matter has got into 
the System, We must Use such Substances
as Chemically Combine wth. it.

Lecture 20th.
It sometimes happens that the Granulation
Flesh Rises too fast, it is then of a Loose
Texture appears above the Surface of 
the Skin, and cannot be Cover'd over wth.
a Scarf Skin; when the Fonyans Flesh
Arises in an Ulcer, we are first to 
Check its growth by astringents so as
to Resent it Rising above the Surface of the 
Ulcer, the Astringents that have been
Cheifly Employ'd for this Purpose
are the Caleas of Metals, and more 
especialy Vitriol Caruli; the same
may Effect'd in some Degree by 
Pressure or Bandage, but it if shoud
have Arisan for a great quantity so as
to [illegible] greatly the Height of the 
Strain it is better to Cut it off, or applying
a Caustic; sometimes there is such 
a Disposition to form this although
We Endeavour to Prevent it by a 

Danger on Caustic they are Attended
wth. no Effect in this Case it is better to
Destroy the whole of the Granulating Flesh
and this is to be done by the first Cutting
off as much as we Can, and then Applying
a Caustic, or there Caleas of the Metals,
that give a disposition to good Suppuration
and Granulation, in the next Place we
are to Suppose, that the Ulcer is already
filled wth. granulating Flesh, we are
then to Endeavour to form a Scar of
Skin to Cover it, this generally happens
Naturally, it is however prevented principally 
by a Quantity of Putrid Matter
Adhering as being Applied to the
Edges of the Ulcer, hence we must keep 
an Ulcer very Clean, it is also disturbed
by frequent Opening, it shoud not 
therefore be Open'd oftener than is
Necessary, to Prevent the Putrefaction
of the Matter, as once in 24 Hours;
in some Cases 48 Hours; sometimes

the Edges become thick and hard, this
We Call than Callous, have the fresh skin
grows up wth. difficulty, We are therefore
to get rid of these by Cutting or Burning
them, the first method is generally the
best, supposing an Ulcer is feeling
tolerably well, yet we can forward it
greatly, by Applying gentle Astringents
as Lapis Calaminaris, this particularly
forwards the spreading of the Skin,
Oce [illegible] also as, is [illegible], when an
Ulcer is near being Heal'd, it sometimes
Circularly and will not spread entirely
over this to be Remedied by the [R??isea]
we shall now suppose then a gangrene
has taken Place, in this Case the
Putrefaction generally Arises, so last
that we have but little Chance of restoring
the Life, we are therefore to get rid of it
as fast as We Can, that the Sound Part
may begin to granulate and be 
remov'd, supposing a Part Dead and 
the Rest of the Body in Perfect

Health, and that it has no other Effect on the 
Surface of the Living Part, endeavouring
to get rid of the Dead, then a Phlegmonous
Inflamation wou'd Arise, and a Fluid
Issue which woud Serve to Separate 
the two Parts, when a gangrene takes
Place in an Inflamation it immediately
Produces an Effect on the Surrounding
Parts, to wit an Erysepallatous Inflamation,
and in the System in general
Symptoms of Irritation, when these
take Place we endeavour to Occasion
a Phlegmonous Inflamation round the
Part so that an Exfoliation may take
Place, and a Common Ulcer be Left; this
is to be Accomplished by two means
first by the Application of Stimuli as 
sepurates Parts; and Secondly by 
Preventing it from having Effect or the 
System in general, when a Gangrene
Arises the best thing that can happen
in a Phlegmonous Inflamation, No
Treatment of a gangrene [cross out] external simple 

only that the Remedies from the
Particular Habit of the Patient are
not always sufficiently Efficacious,
the Remedies We Employ to unite
Phlegmonous Inflamation as stimulants
Applied to the System in general as 
Wine Spices &c. to the Part Scarification
Essential Oils, Balsams that has
Resins Dissolv'd in them; but none
of these are so helpfull as Cart 
Power, various has been the Opinions
concerning the Action of this Remedy,
some has Suppos'd that it acted
as a Stimulant, but we have several
more spices more Stimulating than
the Carten, some have said that it
acted as an Antiputrescant this
Opinion for several Reasons [illegible]
Admitts of a Sarious Consideration
in all Cases it Diminishes the 
Irritability of the System and this 
Prevents Stimuli from acting upon it

Now if We cou'd make a gangren'd Part have [illegible]
no Effect on the Secondary one, we should always
have a Phlegmonous Inflamation take Place
the Part do's this more Powerfully, than any 
other Remedy, it shou'd be us'd in as great
a Quantity as the Stomach will Bear; some
other Medicines have been Us'd as the Cortane
Preparations of Iron Vitriol &c. when the Slough
is Exfoliated, it is to be treated as a Common
Ulcer; Inflamatory Stimulants may be Us'd
at the same time wth. the Bark, We Come
Now to the Management of the Schirrous
and Cancer if a small gland be Affected,
it is better to Let is Suppurate if a large
one we shou'd Endeavour to Avoid it, We
shall now suppose the Schirous is 
Produc'd, if it be small and Continue in
the same State or Situation it is better
to Leave it to itself, as it will often Continue
for many Years without encreasing or
[illegible]. Ot it be large and encreasing 
We are to get rid of it, as fast as Possible
if samll by a Caustic, if large by the 

Knife first and then the Caustic, we
Choose to Employ Caustics because the 
Living Power endeavours to Defend the 
Part, till a Portion of the Matter is absorb'd
so that they have a greater Disposition
to Destroy the Dead Parts, than the
Living on's, if a Cancer be Produc'd, there
is generally little good to be done, the
Cantee, Belladonum, Arsenicum &c.
have now and then Succeded in 
Producing good Pus, the Pain may
sometimes be Relax'd by Destroying
the Sensibility of the Part by Preparations
of Lead, &c. but Cancers generally Prove 
fatal after a length of time---

Lecture 21th.
We have Describ'd an Inflamation as being 
a Disease of a Part of the Body only whereas
Fever is an Affection of the whole System
This Disease has been differently Defin'd
and indeed Practitioners have act
hitherto fined a Definition, some Call
all Affections of the System [?aces]; others
all those where there is frequency of the 
Pulse, some a pain have extended it to 
Inflamation, but We must Observe that
it has been Systematick Writers, who
have Call'd all Affections of the System
Fever; all Authors that have Wrote from 
Practise as Hippocrates amongst the
Ancients; Sydenham amongst the Moderns
have Confin'd the Word Fever to one
Disease, in order to Classes it is Necessary
to have some Appearances that is always
Present in the Disease, and has been
Call'd the Pathognomic System; This 
no Superficial Practitioners that this
can be Useful [illegible] in Fevers the whole

System is Affected, neither is this 
Affection equal, it is sometimes greater
in one Part than in another, this will
Constantly make a Variety in the Appearances
of the Disease, externally; not that no one
Symptom shall be always Constant in it,
frequently when a Patient is Affected
wth. a fever he tis Hotter, but this is not
a Constant appearance for he is sometimes
Colder, sometimes he feels Colder when
he is realy Hotter, and whether We
Consider heat wth. Regard to the Patient
himself, as by the Thermometer, We
shall evidently find he is sometimes
Hotter, sometimes Colder, if then the
Disease may Arise to such a Height
as to Prove Fatal, without an encreased
Heat; this cannot be a Pathognomic
System, the Pulse is generally more
frequent, but sometimes it is Slower through
the whole fever, as Languor Weakness
Costiveness &c. and as Fever may

Subsist without Heat, and frequency of 
the Pulse so may they without Fever, We
shoud find that some Fevers Subsided
without them and some of them without
Fever, so that no Symptom is always
Constant and for this Reason, the Fever
is an Affection of the whole System, and
sometimes one Part, sometimes another
is not Affected, in order then to Define
Fever We must give a Description of the 
whole Disease in the first Place we must
Observe that a fever in general is a Complaint
Disease, if it be a simple one it never
lasts above 48 Hours, but fresh and pert
Attacks in some Cases take Place, so as
to Prolong the Disease Considerably so that
the Fever is a Compound of a Number
of small Fevers following one Another and
mining; In Order to Understand the 
Disease we must Consider one Paroxysm
as simple and Perfect, the better to 
Understand those that are Minded;
One simple Paroxysm of Fever Consists

of the Attack of the Disease a Natural
Cure Arising, and an Appearance taking
Place on its going off. We then it Consists
of three Stages, first the Attack improbably
Called the Cold fit; secondly the Hot Fit,
and Thirdly the Crisis; the Attack
Consists of two Parts, a depression of
Strength in many Parts of the Body,
and a Contraction of the small Vessels,
wth. an Accumulation of Fluids in the 
large on's; the Symptoms wch. Indicate
a Depression of Strength and Languor;
Weariness, Weakness, &c. If the Paroxysm
be a Violent one they take Place first and
in a greater Degree. Sometimes there is 
no other Appearances at all but so great
a Depression of Strength both of Body
and Mind, that the Patient Dies; As in 
the Plague the Sensibility of the Organs
of Sensation is sometimes Diminished,
the eyes doe not Perform their Office
so well, and the Skin becomes sometimes

Insensible, this takes Place only in very
Violent Attacks, when the Living Powers Act
Weakly, a less Degree of Heat Arises hence
there is a Coldness and Weakness we dont
Know, but so it is when the Stimulus Power
is Diminished, there is always a Coldness
and trembling together with Pain at the
Back, at the same time there is a Sense
of Insects Creeping over the Skin wch.
is Call'd by the Latins Neuipelatio
having no English term to Europe it
the Vessels of the Extremities in particular
and indeed all over the Body Contain a less
Quantity of Blood; so that the Parts become
Pale; the skin has its colour partly from 
the Sebacious Matter wch. is yellow when 
therefore there is less of the Blood, the Skin
becomes more a Dim Colour; the Tongue
becomes Dry and Covered wth. a Mucus
the Kidneys Contract so that the Urine
do's not Contain the separating mucilage
but remains transparent, and when the

Attack is Violent, the Quantity Diminishes
the Secretion for the Intermits is less
the Peristaltic Motion being Distended
so that the costiveness is Produc'd, if there
be any Penetrating wound, in any 
of the Muscles, the Ulcer becomes Dry
so that the Vessels of the Muscles Contracts
and in this Contractions sometimes
Affect so large an Artery as that
of the Arm, so that the Pulse becomes
small, in Consequence also of this
Contraction there is often Pain in
different Parts of the Body, as the
forehead and sometimes extending
all over the external Parts of the 
Head from some Cause; probably from a
Contraction of the Vessels of the 
Brain, there is a Delirium; It may
also be a Symptom of the Quantity 
of the Living Power but this we shall

Explain more fully here after; the Eye
is the Common the Criterion of the State
of the Brain, so that from them we shall
be Enabled to judge of the different
Species of Delirium, if the small Vessels
Contract, the large about the Heart must
be Distended from the greater Accumulation
of the Blood in them, Accordingly We find
[illegible] Oppression and Swelling about 
the Praecordia a greater Quantity of Blood
Laying about the Heart Stimulates it
to more frequent Contractions, hence
frequency of the Pulse, Quick and 
Laborious Respiration and Cough
wch. attend all difficulties of Breathing,
there is also Flatulancy and from an 
Affection of the Stomach rigor and
[illegible], this is sometimes so great
that Sickness and Vomiting take Place
it will admit of a Doubt whether

this arises in Consequence of an
Affection of the Stomach, and the
fulness of the Vessels about the
Praecordia but most probably of the
former, There are the Appearances that
take Place in the Attack of the 
Disease; and there it is that Constitute
the Disease, if [illegible] one of those Symptoms
are Present, there is no fever so
that this Attack is the Disease it self
the other Parts of the Paroxysm
bringing Consequences of the Disease
the Blood in this state is not Alter'd
but the Action of the Swing Powers,
indeed as the Disease advances it
sometimes Inflam'd and sometimes is
Verging towards Putrefaction-

Lecture 22d.
The Appearances of Fever before Enumerated
may be few and only particular Parts
Affected, the remaining Part of the 
Paroxysm in this Case not [?ueading]
We dont Call the Disease Fever, this is 
an Affection that Causes an Alteration
in the whole System, so as to Produce
a Hot Fit and we must observe that
the whole Disease depends on these
Alterations, and is always more or less
Violent according to the Degree and
Number of these Appearances, the
Causes of Inflamation We have been
Able to Point out to you; Now Fever 
Arises sometimes from Causes that
are known, and frequently from [?nton] [illegible];
they are also very Uncertain in
their operation, so that if the same
Causes be Applied to a Number of
People, only a few shall be Affected

with the Disease. The Causes we are
Acquainted wth. are first such Passions
of the Mind, as are Attended wch. Annualy,
and there must be suddenly excited
these however are not very Powerfull
amp. And secondly Fever may be
Excited by an Exposure to Cold; as
Sleeping on Damp ground &c.
Midly Putrid Infectious Matter as
Variables Marbillous, Acting upon the
Irritable Parts, will unite Fever, if
We take a Number of People in Health
Shut them up in a House just Built,
so that there is no Contagion, yet 
a Fever will very often be Produc'd; from
the Putrid Vapour Arising from the
hood and Evacuation; A strange Causing
into the same Place shall be Affected
wth. Fever; If a Number of People are
about a Man Affected wth. a Violent Fever
from any Cause, some of them will be
Affected tho the Patient has no Symptom
of Putrescence, so that a Vapour Arising
from a Man in Fever is Capable of Producing

if an Healthy Body, formly a Man
having Eat food that is not Digested but
become Putrid in the Stomach, has
been Affected wth. Fever, so that now and
then it may Arise from a Retention of the 
of certain Substances on the Primæ
Viæ; as Indigested food in the Stomach,
Fœcas in the Intestin'e. [???ly] a Number
of Men going into a Climate they have
not been Us'd to, some of them will be
Affected wth. Fever, whether this be a
Cause of itself, as only adds to the
other Power, we cannot Determine
simply half the fevers wth. take Place
Arise from Causes that we cannot
Investigate, when the Passions of the 
Mind Produce Fever, They doe not
immediately, or not at all. When they 
are brought on by Cold, it is generally
Produc'd immediately some times
however it is not, when from a Retention
of Substances in the Primæ Viæ it
Arises while they are there, When

from putrid Vapour it seldom takes Place
immediately, sometimes indeed it do's; the
Action however is by no Means at the 
same Period. Variolous and Morbitlous
Matter are Commonly Eight or Ten
Days before they Produce face. If
Varioulous Matter be Applied to a
Warmd an Inflamation will Arise and
A Pustule is form'd full of Matter
at this time it begins to be Absorb'd
and that on its first Application
to the Heart that Produces the Disease
for the Second has no Effect, for if
a Patient has Caught the natural 
Infection, and is Inoculated, this
gets on the faster and Produces the
small Pox of the Inoculation, the Natural
Infection having no Effect. So if you
Inoculate a Patient for several successive
Days, the first take Place and the
Subsequent on's has no Effect in

encreasing the Disease, in other Cases
when the Disease is not Produc'd, upon the
first Application, some Symptoms are
brought on wch. gradually encrease, so as
to Produce the Remaining Part of the 
Disease, As Putrid and Infectious Vapour
do's not appear to be Accumulated in
any Part of the Body, neither do's it
Appear to have any Effect on the Blood,
in the Course of the Fever it may; but
never on its Attack, some Symptoms give
off without being allowed by a Fever is
the encrease and Diminution depend
on some other Causes; and not on the
Accumulation of the Matter, it is to be
Remark'd that Fever when Produc'd
is Independent of its Cause, in this
it differs from Inflamation, and
Symptoms of Irritation; and hence
it was thought to Depend on an Accumulation
of Matter; It is well known that

when one Motion is Produc'd, it will
Continue without its Original in any 
other Cause, to excite it to a Continuation,
frequently also an Addition of the
Original Cause, will have no Effect 
in encreasing the Fever, after it was
once Produc'd as was Observ'd of the 
Variolous Matter---

Lecture 23d.
We have said some of these Causes
Produc'd Fever immediately, and some
not till after several Days, Now We shou'd
be extremely Cautions of Admitting
those Causes of Diseas'd wth. have
not an Immediate Effect and never
till we have formed a Number of Cases
in wch. these Causes have Produc'd the
Disease; when any Cause do's not produce
Fever till after sometime, there are 
two things happens, and Alteration of
some of the Fluids of the Body; in those
Cases where this is evident, we find
the Change Topical, as in Inoculation,
and that as soon as this gets into the
Blood Vessels, it Produces the Disease,
When Putrid Infectious Vapour is 
Applied to the Body, so as to Produce
Fever it is a Question whether it Acts
on the Fluids of a particular Part

of the Body; making some Change, so
that when they are Absorb'd into the
System they shall Produce the Disease,
or whether it makes a Change in the whole
Mass of Fluids wch. as the Circulating
Fluids, by wch. the Disease is Produc'd
it Appears rather that much Putrid
Vapour immediately brings on, for after
the Application of it, [illegible] febrile
Symptoms Appears, wch. Continue
to encrease, till the Fever is Produc'd
or is there any [illegible] of Putrid
Vapour, Producing an Alteration in a 
particular Part, for Putrid Matter will
not Produce Fever by a circulation, or
if we apply any other the Fluids of a 
Man Affected wth. a Putrid Fever, it
will not in a healthy Person Produce
a fever, it will sometimes Produce
Symptoms of Irritation or Inflamation,
We Observe it was the Distinguishing 
Mark of this Disease; that it Continued

after its Cause was Remov'd, this of great
Consequence in the Treatment of it, and it is
this that has given Me an Idea, that Fever
was an Alteration of the Fluids; However
in many Cases there is no Appearance 
of this, it is the [Re?parly] of the Moving
Parts of the Body, that it sometimes
happens, that if they are Set in 
Action there, will Continue Acting even 
tho the Cause by Remov'd; the next
Thing wth. Regard to the Action of the 
Causes of Fever, is that they are Capable
of Cooperating wth. each other; and of
thus Producing Fever when they wou'd
not Singly, those are no particular
predisposing Causes of fever; they being
in Common wth. other Applications and
hence they act more Certainly on an 
Irritable habit; the Symptoms of the 
first stage of Fever sometimes Destroys
the Patient, the most Violent Fever We
know of is the Plague, but as it do's not

happen in the Country, We are Oblig'd
to trust to the Relations for the Knowledge
of it, wch. I must Observe is very Imperfect
thus for however it extends, that those
who are [illegible] wth. it Complain of 
Languor, and such Symptoms as generally
Attend much Violent Fevers, and have
suddenly Dropt down and expired,
have thus then the Symptoms of the 
first Stage have thus Cut off wth. us
the Symptoms of Intermittent Fevers
take Place wth. more Violence, than any
other and now and then a Patient as
Expir'd in the first Stage; according
to the Description of these Cases, the 
Patient becomes extremely Cold, there
is a vast Languor, great Application
about the Præcordia, Paleness and
these wth. the Tremblings, Continue
encreasing until he seems Cut off by
Weakness it is entirely probable
that several of these People, who 
have been suppos'd to Die of

[illegible]; have Died in Consequence
of the first Attack of Fever, that this
sometimes is the Case, I have Experianc'd,
and when the Disease has not gone on
so fast as no kill the Patient the
Paroxysm has gone on the same as in
the Common Paroxysm of Fever the 
Attack then in these Cases may Destroy
the Patient, if it do's not as indeed
most Commonly happens it is 
Succeeded by Rigor and [illegible]; In 
Intermittents when those take place
it is seldom the Patient is Carried
off there Arise a Heat about the Breast,
wch. Differing shall spreads over the 
whole Body, very unequally tho and
likewise Indiscriminately, the Pulse
becomes Stronger and fuller, but it is
Obstructed, or it is frequent and small
but this Symptom do's not always 
take Place here the Heat is more Regular
we often Meet wth. Heat in Fevers

and is extremely troublesome to the
Patient, yet it is not actually encreased
there is great Pain in the Head, wch.
if it Arises in an from the first Stage
of Fever is more Distension, and frequently
in the Joints, as well as the other Parts
of the Extremities, there is Stupor and
sometimes Delirium; the Paleness that 
takes Place in the first Stage gets off
and some Parts become [illegible] but 
that the Contraction Remains in
some Parts is evident, from the Dusky
Colour of the Skin; when the Attack has
been Violent there is often great and
Universal Soreness, the Secretions are some
of them encreased, the Urine is high
Colour'd but perfectly Transparent; there
are also partial Sweatings of the Head
Breast &c these Evacuations have been
Call'd Symptomatic to Distinguish them 
from those wch. take place in the crisis

they differ in this, in the one Case they are
partial, in the other Universal [P??tectic?]
also sometimes Appear on the Skin
this Part of the Paroxysm on would serve
to Point out to us; that the fulness of the
Precordia and Stomach, occasion'd the
Living Power to be Excited, first about
the Heart, and then in the whole Body,
so that the Blood is Propelled wth. great
Fever, as to take off the Contraction the
Heat then is a Mark of a stronger Action
of the Living Power; and from hence frequency
of the Pulse, and sometimes fullness
and Strength; Propelling the fluids
forwards wth, greater Force; Occasions
greater sanctions in particular parts
of the Body, Soreness is a Symptom
of the Contraction going off; as that is
generally full after Contraction of any 
kind; thus then the Symptoms of the
first Stage goe off; as those of the Second
encrease, and there decreasing give Place to the
Symptoms of the kind stage of Fever wch. is the Crisis

Lecture 24th.
Having Pointed out the Symptoms of the 
Second Stage of Fever, we now Come to the
Morbid Stage to wit the Crisis; We cannot
Observe that it is not the Distension but 
the Relaxation, of Loss of Distention
to Contraction that Produces Crises undoubtedly
however the Hot Fit is the Natural Cure of 
the first Stage, partly from the encreased
Action of the Heart and Arteries, and
partly from some other Causes, wch. We
are not as yet Acquainted wth. at least
the small Vessels through the Body
are actually Relaxed; the Pulse becomes
free, the Skin grows soft, and Moist
and recovers its Natural Colour; the
Tongue wch. was Dry becomes likewise
Soft and Moist, the Costiveness gets
off, and the Urine is secreted in a large
Quantity, in others the Appearances of
Contraction gets off from all Parts of 

the Body, but as Relaxation takes Place
before the Symptoms of the Second Stage
entirely Disappear, it seldom happens
but that some of the Sensations are encreased
thus the Urine, is generally in a large Quantity,
and tho transparent when first discharged
after a little time becomes turbid, and
Opaque at the Depositing a copious
Sediment, and this so generally happens
that it has Led some Practitioners to 
Imagine that a Crisis came or Come on
without it; but this is Contrary to
Experience, sometimes a Copious Sweat,
and sometimes Purging Arises, they are
different from those in the hot, as there
are Symptoms of Relaxation in all 
other Parts of the Body, after the Symptoms
of this last Stage are gone through, the
Disease Leaves the Patient, he being only
Weaken'd from the Exertions wch. have
taken Place in it; A Paroxysm of Fever
may be cut off by an Inflamation 

Hemorrhage has forming some Part of the
Body; when the Symptoms of the first
Stage suddenly, disappear or a so considerably
Diminished, why this then to
happen we dont know; some have Said
that the Matter was now Deposited in a 
particular Part, and had left the System
in general nor do's at all Explain the
difficulty, in the first Place, We can 
hardly Believe that all the Matter
supposing Obstructed in the whole
System should be Confin'd in a particular
Part, besides this often an
Inconsiderable Part of the Body,
as the Pleura wch. is very small and
cannot Contain more perhaps than
ifs. of Blood and the internal Parts
of the Blood Vessels except the
Heart are not Capable of being
Stimulated, and if an Inflamation was
to arise from such a Stimulus; the 

Matter would not be Accumulated, but
Pass on the others Parts of the Body,
in what there are so many difficulties
in Supposition and no Positive Proof;
that we cannot Admit it, it is certain
that Fever do's proceed from Matter, in a
few Instances, as in the Small Pox, but
there is still no Accumulation in the
System; when the Fever go's off the same
Pustules Subsist, them whence there is
a Constant Absorption of Matter, so
that there is always more Matter in
the System then at the time that the
Fever was Produc'd, hence it is evident
that the Fever was not Cured, by passing
the System from the Matter and in many
Fevers there is not the least Reason for
Supposing that there is any Matter at
all in the System especially in Inflamatery
Fevers, in wch. Inflamation and 
Hemorrahage generally Arise, as then
We dont know in what Manner these

Cure Fevers, We Commonly take it for
granted that it do's happen, a Patient
may Die also in the Second or third
Stage of Fever, for Causes wch. We shall
afterwards Explain, now a Paroxysm
of Fever may be gone through in four
Hours, sometimes less, it cannot
last more then 36. Hours, it is most
Commonly ended in 10, 14, or 20. Hours
We can Conceive that a Paroxysm might
last a great deal longer than 36
Hours, but Circumstances take Place
in the System, that Prevents this by a
fresh one Arising, there is a Paroxysm
of Fever that happens to all Men
towards the Evening, this is Carried
off by a Crisis taking Place, in the
Morning; you find in the Evening
that the Vessels are contracted, that
the same [illegible] will not Produce
Sweat, as in the Morning, there is also
frequently thirst, the Powers of the 

Body are Depress'd, and a Degree of
Languor takes Place in Disease's. This
Evening Paroxysm, in many Cases
becoming Apparent, and also in Weak
People, it begins about five from Seven
Commonly and Continues from Hence
to five in the Morning; We might Suppose
to arise from the Fatigue of the Day,
but we find it taking Place at the same
time in People that Work at very different
Hours, so that the time is not Alter'd
by the different Modes of Life, why it
shou'd take Place at all we have not
the least Conception, it has this Effect,
that it the Paroxysm takes Place about
Twelve, it shall goe on, but if it Continues
untill the following Day, at the time
it Produces a fresh Exacerbation, so that
the Paroxysm of Fever can Continue about
thirty Six Hours sometimes; when the
Paroxysm has nearly Subsided, the
Evening Paroxysm is not sufficient 
to Produce a fresh Exacerbation, yet

in this Case it seldom Continues above
48 Hours, a Fever consisting of one
Paroxysm, we Call an Ephemera Simplex
wch. if they were to Continue they wou'd
Prove Fatal, but the Patient is generally
well before the Practitioner is Call'd
so that this Fever has for the most
Part been overlook'd. It sometimes
Comes on by Violent Paroxysm or
Symptoms of the first Stage succeed'd
by a Degree of Delirium, that Patient
afterwards falls into a Considerable
Sweat, by wch. the Disease is Carried
off a Fever that Continues longer
than 36 Hours, is generally Compound
and Consists of several Paroxysms
following one Another, and this they do
in all Ways, sometimes they are
Distinct, that is the Symptoms [illegible]
Period goe off entirely before a Second
Arises, this We Call on Intermittent
Fever, when the Patient is greatly 
Beleiv'd, but the Pulse sometimes

frequent, and several other symptoms
are not Carried off before the Second
Period begins, We Call it a Remittent
Fever, and a Continued Fever have one
Period or Evacuation begins before
the former is Considerably abated,
We shall not Consider the Causes of the 
Recurring of Fevers, or rather Paroxysm
of Fever, We shou'd Empart a Prior
that all fevers wou'd be Ephemera
Simplex, we know no Reason why
a Fever shou'd Return of its own Accord,
We shall therefore next Consider these
Causes that occasions the Acronysms
of Fever to Return

Lecture 25th.
We are now to Come to [?less] the
Causes of Recurring of Fevers, that is of the 
Paroxysms of Fevers, we have said
that when the Causes where Applied
in many Cases they Produc'd only some
Symptoms of the Disease, and that
if these Causes when Remov'd, the
Symptoms when Produc'd wou'd Continue
that these where easily encreased as to
bring on a Hot Fit, wch. is Calld the
Paroxysm, if no Hot Fit arises; We
do not Say the Patient is affected wth.
Fever, now these Symptoms may go
off themselves or be Carried off, by the
Natural Evening Paroxysm, or they 
may encrease as to Produce a Hot Fit,
when a Perfect Paroxysm will take Place;
when the Paroxysm is gone through
and Crisis takes Place, when the

Pulse is Come to its ordinary Pitch, the Heat 
gone off, and there is no longer an encrease
of any Secretion; We find that the Fever is
not entirely Cured; that it has left some
Symptoms behind, as a Slight Pain in the
Back, a foul Tongue, as Paleness or a 
Dustiness of the Skin wth. Languor; but
these Symptoms in the first Stage are
not Sufficient to form a Paroxysm; they
Continue however sometimes going off
themselves; and sometimes encreasing so
as to Produce a Second Paroxysm, this
is often the Case in Intermittent fevers
in the next Place fresh Occasional Causes
may Reproduce the Dis Paroxysm, suppose
an Ephemera Simplex, having gone through
its Natural Progress and a Perfect Crisis,
yet if the Patient be Expos'd to Cold Putrid
Vapour &c. in so slight a Degree that in
Health it wou'd have had no Effect it will be

sufficent to Occasion, the Return of the
Paroxysm, the next Cause of Recurrence
of the Paroxysm of Fever, is the Natural
Evening Paroxysm, has has already been
Explained, it is this that Produces
Exacerbations in Continued Fevers moreover
if there shou'd have been several Paroxysms
of Intermittent or Remittent Fevers
it will Continue from Habit, the last
Cause of the Returning of Fevers, is 
what we shou'd never have Imagin'd
was it not evident, from Actual
Observation (J.E) the Action of the 
Types, in Attending to the Return of 
the Paroxysms, we find that
the greatest Number of the Return
at the End of 48 Hours; why they
shou'd have a Disposition to Return
at this particular time, We dont Know;
some have Suppos'd it was in Consequence
of Fermentation taking up this 
Space; but this and many others

Suppositions of the same kind, are by no
Means Satisfactory, Fevers the next to
this are more Apt to Return at the End
of 24. Hours; and at the next to this
at the End of 72. Hours; It is seldom that
We find 8.[illegible] going longer than this
though now and then a Fever will Reoccur
at the End of 96. Hours, and at all
other Intervals; When a Paroxysm of
Fever Reccurs at the End of 24. Hours, We
Call it a Quotidian because this is a
Paroxysm every Day when at the End
of 48. Hours, We Call it a tertian, because
the 49th. Hour is the beginning of the
Third Day. and so if it Return at the 
End of 72. Hours, We call it a Quartan
and for the same Reason we seldom
Meet wth. a Quartan, [illegible]. It is farther
to be Observ'd of Intermittent Fevers;
that they seldom Continue in the [illegible]
in wch. they Arose; Quotidians are frequently

Converted into tertians, and tertians into
Quartans, in the Spring when People
are Strong Quotidians and tertians generally
take Place, in the Autumn when We
are Exhausted by the Heat of the 
preceding Summer, tertians and Quartans
are more frequent so that in some
Degree, the fever Seems to be Connected
wth. the Strength or Weakness of the
Habit. Thus the Symptoms that 
Indicate a Strong Action of the 
Vessels often happen in Quotidians,
the Symptoms of the stage are Violent
in tertians; and there of Weakness 
are frequently met wth. in Quartans;
sometimes however there different Symptoms
Occur in the Type of Fever; when the
Paroxysm takes Place every Day
and in the Intermediate Days is Weak 
is Calld a double Tertian; in a Quartan

there is often a Strong Fit has Slight on's
and then a Strong one again, and so on;
others altho the Paroxysm take Place
every Day, there are Marks of a tertian
and a Quartan; and this is Calld
a Triple Quartan; It was suppos'd by
the Antients that there be here two Tertians
And that the Patient was Affected wth.
two different Fevers at once; but the Reason
of this Appears from Weakness and 
Irritability, hence this seldom happens,
till the Fever has Continued for some
Time; In Continued Fevers we shou'd
Consider them according to the Exacerbations.
It often happens that when a 
Fever is once Produced, the Paroxysms
will Continue to Recover at some of
these Types, without any Apparent
Cause, the Manner in which they do this
we have already Shewn, the Natural Cure
of one Paroxysm do's not Cure the Disease

for this is Apt to be put a Stop to, in
two Ways, we have already Said that
Fevers frequently Continue either
because after the Crisis some Symptoms
of the first Stage, remain as no Crisis
shall takes Place before the Action
of the Natural Evening Paroxysm or
of the Types.
Intermittents seldom Appear at the 
first in their Proper Types. In Continued
Fevers the Disease go's on because the
Paroxysms doe not Terminate before
the next Evening Paroxysm of Fever
if it shou'd Terminate before this a 
perfect Crisis then happening will
Carry off the Disease; in all Fevers the
severer the Paroxysm in general
the Shorter the Duration of the Disease
and the more perfect the Crises. In
Continued Fevers, those more Violent 
Exacerbations often happen on the 4th.

5th. 7th. 9th. 11th. 13th. 14th. 17th. and 21th. Days
than on any others and are the most Part
shorter, so as to goe off about, 4 or 5. in
the Morning, and the Crisis is more Apt
to Terminate the Disease. A Crisis may
be Fatal as well as Salutary. The
Antients Consider'd it as, [???tamen]
into Morbum and Naturam. If the
Crisis is entirely Perfect the Disease
go's off altogether and, and do's not Fever
or if some small Symptoms be left they
grow less and less, till at last they goe
quite off; A Continued Fever at the 
begining is generally first a Quotidian
than a Tertian, then a Quartan and at
last very irregular, this is sometimes
very easily Observable at others not
but not so frequently in this as in
Warmer Climates, nor indeed do's Crisis
Terminate Fever so frequently, in the
former as in the latter; the more Perfect
We can Observe the Tertian Type, the more
likely there is to be a Crisis, it is to be

Observ'd that when Speak of the begining
of Fever, We mean the first Week in wch.
the Exacerbations take Place every Day,
when of the Middle of the Second Week
or while it Observes the Tertian Type,
and when the End wch. is Commonly
more Severe when it Observes the 
Quartan type or becomes irregular; after
a Fever begins to Observe the Quartan
Type, it generally begins to Diminish,
and gradually Wears itself out; and this
Two both of Continued and of Intermittent
Fevers, the time of the duration of a
Quartan of itself is Commonly, 4. or
5. Months, of a Tertian has or 3 Months
and of a Quotidian about 6. Months,
the first Symptom of the going off of the 
Disease is a Moisture about the Tongue
a Relaxation of the Skin, together wth.
the Kidneys in Consequence of wch. the
Urine often Deposits a Lateritious
Sediment, and the Pulse becomes Regular

in all Cases of Fever, The Crisis are more
Apt to be Imperfect at the begining and more
Subject to Relapses, towards the End, if an
Imperfect Crisis do's happen Relapses
seldom occur. If Seems to have been forgot
by Modern Practitioners, that Fever had
a Termination of their own, this Arises
from their Dissenting from the description
of the Disease; as Laid down by the 
Antients; Now if all Fevers where to goe
through the Course already Describ'd no
one wou'd Die, but there are Causes that
Arise in the Course, wch. frequently are
Productive of Death of the Patient and
these we shall Proceed to Explain-

Lecture 26th.
We now Come to Point out to you the
Sources of Danger in Fevers, A Patient
may in the first Place be Cut off, by
the Fever itself, the Inactivity of the
Living Power, and a Depression of
Strength, may be so great as to be 
Fatal; this happens sometimes in the
Plague, in the beginning of a Paroxysm of
the Paroxysm of an Intermittent Fever,
its also Apt to Arise from the Affection of 
the Dram, wch. takes Place in Consequence
of the Symptoms of the first stage; sometimes
in the Second Stage; the Action of the 
Heart and Arteries is so encreased that
the Patient is Cut off by the generall
Inflamation, or the Effects of the Body
during the Paroxysm may have been so
great as to Produce such a Degree of 
Weakness and Irritability as to Prove
Fatal; We shall primarily Consider
the Symptoms of Danger Arising in

The first Stage, there wch. shew the Disease
to be Violent, are great Languor Weariness
and Weakness, wch. if they Continue long
the Shew the Depression of Strength to be
very great, so that the Symptoms of the
first Stage are more Capable of exciting
a Strong Action of the Heart and Arteries,
The Attack may Come on by a great
Prostration of Strength Attending it,
wch. is very different from Weakness as
in the former Case; the Powers of the
Body are Retarded upon the going 
off of the paroxysm A Man Attack'd
wth. a Fever being Incapable of Muscular
Motion; wch. shews the great Violence
of the Fever; the Skin being Tough Dry
and Unequal, these shewing the great
Contraction of it, if an Ulcer unites
and that becomes Dry; it shews the 
Vessels amongst the Muscles are 
Contracted, it Indicates the Contraction,
not being Confin'd to the Capillary

Vessels; if the Pulse is much Contracted
it Indicates the Contraction not being
Confined to the Capillary Vessels, but
smallness of the Pulse must not be
taken for Contraction; as this may Arise
from Weakness. If it be Quick in the
Hot Fit, and neither full nor Strong
especialy if it Intermit, it shews that
the Heart is greatly Oppress'd, and the 
Depression very Considerable frequency of
the Pulse and Intermission, may also
be Consider'd as a Symptom of Weakness
and Irritability; but more especialy
if they Arise towards the End of Fever.
The tongue and Mouth being Dry shews
that the Vessels of the Mouth are
Contracted; if there is a great Quantity
of Mucus Covering the Tongue, it may 
be owing to the Violent Affection of the 
System, and hence it is all Day at
the same Time Again it may Proceed
from an Affection of the Primæ Viæ, but
here the first is very great and not

Diminished by keeping the Mouth
Moisten'd, the urine being Pale Transparent
and in small Quantities shews the
Vessels in the internal Parts of the
Body are greatly Contracted. If it is 
perfectly Transparent and high Colour'd,
the Fever is pretty Considerable; If Pale
and in Large Quantity, it is a Pergnois
of an Approach of Delirium, from the
violence of the Symptoms. The Nails
Fingers and Feet remaining Cold and
Pale, except it be towards the End of
the Disease are Symptoms of its
Violence, and permanency, so as to 
Admit of Little Relaxation between
each Paroxysm, and the Disease
Accumulates to a great Degree
the Nose being Sharp, Temples and
Eyes hollow, Skin of the Forehead
Contracted; Ears Cold and the Face
Universally Pale, or of a dusty Colour
are Symptoms that Indicate a great 
Contraction about the Head and are

Look'd upon as very Dangerous, these
Appearances may Arise from many
Causes; as from the Violence of the 
Fever itself, from Delirium from Weakness
&c and has been Calld the Facia
Hippocrates, from Hippocrates
The first Observer of it, the Breathings
being Short Quick and Laborious, the
Patient moving the Nostrils principally
the Præcordia being Tense Swelld
and hard; the Anxiety and Restlessness
great, wch. Shews that a great Quantity
of Blood is Accumulated about
the Heart, or the Præcordia, and the
Heart is not Able to Clear itself. these
are the Symptoms that Indicate great
Danger, in the first Stage of Fever
but in the Continued Fevers the Symptoms
wch. are more Dangerous is the Delirium
whether it be a Disease of the Brain
itself, or of the Living Power, throughout
the System; If has not for the most Part
been Distinguished, but Consider'd as
the same; there are however several

Species of Delirium that takes Place in
Fevers, and two if not three Arise from
the first Stage; wch. are totally different
from one Another and Require as different
Treatment; first the Vessels of the Brain
may be Contracted, that a smaller Quantity
of Blood shall Pass through, wch. shall
not be sufficient to keep up its Functions
This Species of Delirium is Attended
wth. these particular symptoms, the 
Vessels of the Eye, wch. are the general
Criterion of the State of the Vessels of the
Brain are Pale Small and Hollow, there
is no Redness and Flushing of the 
Face, but a constant Duskiness and
Paleness. Secondly the Delirium is
Considerably encreased at the Exacerbation
and go's off entirely, or is Considerably
Diminished, when the Fever itself gets
off if the Disease go's through its
Natural Course, it Diminishes at the 
Exacerbations, and at last leaves the
Patient without Stupor, Delirium also
often happens from a Relaxation of

the Vessels of the Brain, and fullness
in Consequence, the Symptoms preceding
to this Species are the Eyes being Red
and Blood Shot, the Cheeks as Red as if
Painted and not Swell'd, the Delirium
itself more Constant and equable, tho
it is a little encreased by the Evening
Exacerbation, and when the Fever go's
off, this is often the last Symptom that 
remains, and that wch. dot goe off it
Leaves a Considerable Stupor behind;
the Vessels Requiring sometime before they
regain their Proper Tone probably there
is a Third Species of Delirium wch. do's not
Arise from an Affection of the Brain
but of the System, the first Symptoms of 
both these Species of Delirium are
Watchfullness, and Restless and unrepeating
Sleep, the Patient Dreaming much and
Waking somewhat Delirious, not knowing
where his, or who is about him, the Imagination

begins to be [illegible], then the Organs of the
Senses are Affected, and there is the Appearance
of Flies before the Eyes; the Patient Picks the
Hairs from the Bed Cloaths, this is a Symptom
of great Danger as his thirst suddenly going
off the Violent Drawing on a Total Insensibility
Conceson; and the Patient is sometimes Cut
off wth. Convulsions; these two Deliriums
are the Symptoms wch. generally Prove
Fatal in Continued Fevers; the Danger of the
first Attack of an Intermittent is not so great;
We shall in the next Place proceed to the
Symptoms wch. Point out the Strong Action of 
the Vessels....

Lecture 27th.
The first Stage of Fever Occasions Symptoms
of Strong Action of the Vessels, by wch. it is
Diminish'd and Carried off, but this
encreased Action of the Heart and Arteries
may be so great as to Prove Fatal; that is
such a Degree of general Inflamation may 
be Excited in Fever as to kill the Patient,
this happens in Continued Fever only, it
cannot take Place in an Intermittent because
it would Convert it into a Continued Fever
we have Said that it is probable that the 
encreased Action of the Heart and Arteries
is the Source of Danger in the Second Stage
yet there is something also that encrease
the Symptoms, so as to prolong the Disease
till a fresh Exacerbation Arises, and it is 
by this Means Converted into a Continued
Fever; On this Account general Inflamation

is not a Dangerous Symptom in Intermittent
Fevers; We might Suppose that Fever and
general Inflamation might Subsist at the 
same time and that the Fever might be
gone through without the general Inflamation
Effecting its Progress. In this Case there
would be a Hot Fit, and a Crisis would take
Place, the small Vessels and Glands
wou'd be Relaxed, and the Inflamation
would goe off, in Consequence of the
extraordinary Secretion, but this do's not
happen but in Continued Fevers, general
Inflamation is Dangerous for the most
Part by Producing an Affection of the 
Brain, or at least Delirium, the Symptoms
that Indicate general Inflamation are
hardness of the Pulse; Now we must Observe
that Authors have made but little Distinction
between a hard and an Obstructed Pulse
but there is this Criterion of difference
the Blood in one Case throws up an
Inflamatory Crust wch. it do's not in the

other; when the Blood is Obstructed it
may be of any Appearance hence there is
certainly a difference between an hard
and an Obstructed Pulse and they Point 
out the Strong Action of the Heart and
Arteries; and the other the Blood not 
getting readily into the small Vessels there
is also a generall fulness and Strength
of the Pulse, the general Inflamation may
be Dangerous when the Arteries only 
are Acting Strongly; As in the Hectic
Fever, the Blood being Propelld wth.
great Force into the small Vessels Occasions
a Redness, its returning more frequently
into the Lungs Produces a Quick and
difficult Respiration its being very distinct
from Putrefaction, Occasions a Whiteness 
together wth. a Dryness of the Tongue in
Affections of the Thorax, and sometimes
of the Stomach it is of a Yellow Colour

the Blood being Propell'd in Considerable
Quantities into the Vessels of the Head a
Distensil Pain is felt in the Internal Parts
of it; sometimes this Kind of Pain is 
felt in the Joints and Extremities, and
from the same Cause the Strong Action
of the Heart and Arteries; the Vessels
of different Parts of the Body are forced
Open, hence Sweatings of the Head and 
Breast, and sometimes of the whole
Body, the Symptoms of Strong Action
are only Dangerous when the Brain Comes
to be Affected, in this as in the former
Case, the Eye generally gives a Criterion
of the State of the Brain, they are Swell'd
red and Blood Shot, a Stupor takes
Place at first, sometimes Continuing 
for two or three Days, at other times
a Delirium Comes on, in wch. many different
Appearances Arise, sometimes it Attacks

suddenly, and is as shortly Fatal, sometimes
the Patient Mutters to himself, and if 
excited will Speak to you, but again will
soon forget himself, this is the most Common
kind of Delirium, Arising from this 
Cause, sometimes there are Violent 
Ravings for a Considerable Time, these
are Distinguished from the others by 
proceeding and Accompanying Symptoms there
is generally a Redness of the Face wth.
Swelling; but this is not so florid as in
the former Case and spreads more universally
over the whole Face, it is by this
principally that it is Distinguished from
all others, and most Commonly before 
the Patient is Destroy'd Connections Come
on, Another Way in wch. the Patient is apt
to be Cut off by the too Strong Action
of the Vessels, and is in Consequence 
of the general Irritability that Arises,

this Causes Restlessness and afterwards
Delirium in this Species, the Mind is more Apt 
to be Agitated than in any other, Ravings are
more Violent, so that the Patient often
Attempts to Destroy himself. The Muscular
Strength is encreased, the Eyes are exceedingly 
Bright and Piercing, and the Motions of 
the Body universally Quick a though this 
kind of Delirium Arises from the 
general Inflamation, yet for the most
Part it go's off before it takes Place, this
Delirium happens but seldom in Fevers,
and most Commonly in Fevers Attended
wth. Rheumatism, general Inflamation is
in any Way mostly Dangerous in the 
first Week of the Disease there is little
Danger afterwards. We Come now to 
the last Sense of Danger in Fevers, to wit
the Symptoms of Weakness and Irritability
that some time take Place, the Powers of
the Body are much Exerted in Fevers

in Consequence of which they are Exhausted 
sometimes to such a Degree as to Prove
Fatal, Weakness Renders Fevers more 
irregular, and this Prevents a Crisis from
taking Place, it generally falls in that
Part of the Body that is Retained, and
this is Carried out to us by the particular
Evacuations, as Partial as Universal
Cold, colliquative Sweatings a Purging
wth. a Dry Skin and Tongue, and a Flow
of Tears wch. is a Symptom of great
Irritability in the System, sometimes 
there is a great Secretion of them wch.
if Pale shews a great Irritation, the
great difference between these and a
True Crisis is that; in this the inflamation
is Universal in that only Partial if
the Pulse Continues Obstructed and
at the same time moisture of the
Tongue Purging and sometimes Sweating

it is a Symptom of great Danger, for as
We have just Observ'd there must be
Symptoms of Universal Relaxation to 
form a Crisis there is a Determination
of Fluids in these Cases to the
Relaxed Parts, so that in Fevers where
such Symptoms take Place Run out
to a great Length, and sometimes the
Disease Diminishes apparently for 4
Days and then encreases for four or
5 Days and so on, the next Symptom we
shall take Notice of is one properly
speaking and Dependant on the 
Weakness but Arising from a Depression
of the Strength, to wch. it is for one and
no other. This is the Putrefaction of the
Fluids, it has lately been Consider'd as a 
Cause of Fever, when the Depression of 
Strength and great Oppression about the
Pracordia, [Sigh???] and Soreness have
been Look'd upon, as Symptoms of Fever

but they are Causes of it in reality; As
the Fever takes Place first, it is evident that 
the Putrefaction wch. follows in an Affect of it.

Lecture 28th.
Sleep is sometimes more perfect and sometimes
not so perfect, it seems that all the Operations
are suspend'd the Heart Acts frequently more
slowly and wth. less force, the Respiration
gos on but in perfect Sleep much more
slowly, there Peristaltic Motion of the 
Intestin's go's on more slowly and likewise
the Secretion but in much less Quantity
the Lymphatics Absorb and Carry their
Fluids through them into the Blood Vessels
Sleep may be imperfect, the Organs of 
the Senses may just Impress the Mind
wth. Ideas, the Operations of the Mind
may go forward as in Dreams but 
not wth. that connection of Ideas wch.
take Place when a Man is awake, the 
Muscles may frequently be first in Action
as a Man may move or toss about from one
side of the Bed to another; the Organs
of the Senses do not Impress the Mind
wth. Ideas yet may so easily be excit'd

that the least Noise shall in ther Awake a
Man, or if not Awak'd excite some Ideas of Sound
but an imperfect one; the System is more
Recounted in proportion to the soundness of 
the Sleep, Sleep may be free or prevent'd
altogether by any Thing wch. excites great
Attention or Uneasiness of the Fluid, and
so likewise uneasiness of the Body or
Pain, the Action of any part of the Body
preternaturally encreas'd as for Example
an encreas'd Action of the Heart and Arteries
in general Inflamation sometimes
there is little or no uneasiness or Pain
Contraction continuing after their Cause
is remov'd; such as happens in Fever will
also prevent Sleep, but then Sleep tending 
to Render it overcomes there the Sleep becomes
profound and the uneasiness of the Body
is diminish'd and any preternatural Contraction
is carried off, in that when once Sleep
takes Place it Tends to render itself
imperfect and still in many Cases
removes the Causes of the Imperfection; In
Mania the Patient do's not Sleep for the 

Space of Twelve Months, in this Disease
and in others there are Instances of no
Sleep having taken Place for a fortnight or
three Weeks tho these Instances are Rare
in Health a Man as been kept Awake for 
Ten Days; now in Mania the Strength is 
not dimininsh'd, there Appears not to 
be that exhausting of the Living Power
the Mind do's not exert itself but as
in a Dream and the Body as Lost 
its Irritability so the same the exertion
do's not take Place as in Health
it often happens in Mania that the 
Body requires Sleep when the Mind
Thinks on any Subject, but the Mind
in Mania do's not Act but as it
where in a Dream, the Organs of the 
Senses are not Impress'd wth. just
Ideas, the Powers of the Body are
not excit'd but as in a Dream so
we may consider as in a State of
Sleep in as far as regards the
exhausting the Living Person [cross out] in
all other Cases it Occasions such 
a Weakness to prove Fatal, but
a Man in a Delirium in a fever is

more capable of Reasoning the want of
Sleep then in a Man awake, it is then
the excertion of the Judgement wch. exhausts
the Power of the Mind and in Delirium its
not Acting more at all but its only [illegible]
and a Patient can bear the want of 
Sleep, indeed the want of Sleep will
Occasion Delirium and Mania, a Man then
no Health requires Sleep to keep up the 
Strength of the Body in perfections
when an Animal is young and the 
Powers of the Body and Facultys of the 
Mind, a Larger Quantity of Sleep is Necessary
and the Sleep is generally more perfect
In old Age the Body is wore out and is 
incapable of being recrut'd and no
Sleep takes Place on that wth. difficulty
if any and continues but for a short 
Time, in the middle age of Life the Quantity 
of Sleep Necessary seems to be about one
Third Part of Twenty four Hours; A Man may 
Sleep no more than Six or four Hours,
but he generally wears out his Body
by this Means, to Recruit the Body
about Eight Hours is necessary, indeed
Active Minds wou'd rather Wear out

the Body than loose so much of their
Time as two Hours additional Sleep; longer
Sleep than Eight Hours may take Place
through Habit but always serves to
Obtund and diminish the Powers of the
Body, the Powers of the Body shou'd
be kept in Action to be perfect and
longer Sleep tends to obtund both the
Powers of the Body and Mind as Sleep
tends to take off any preternatural 
Action but its much more efficacious
in Recruiting the System at the Time
of the Natural Evening Paroxysm of
Fever as it tends to take it off
and render the Crisis more compleat
and if we dont Sleep at that time
the Crisis is not compleat
and by that Means the Body is
Wore out. 

Lecture 28th
Its time the depression of Strength as been
Said to depend on the Putrefaction of the
Fluids and according to the Reasoning
of Practitioners it must be said as
depression taken Place for to according
too those Philosophers the Putrefaction must
be the Cause of the Depression of Strength
the Effect according to those Practitioners
must go before the Cause so the Putrefaction
must be the Cause of the consequence
to be deduc'd from this is to employ
Medicines is to take off the putrefaction
of the Fluids and this you are to do in
the beginning; The Symptoms of the putrefaction
of the Fluids are in the first Place
the Mucus of the Tongue in Fever becoming
of a blackish Colour and when the 
putrefaction Arises to a considerable
Height it then becomes quite Black
and its of a loose Texture on the Tongue
the Fever and this is often rubb'd
off by the Teeth wth. this fever and
sometimes the Roof of the Mouth when

the Putrefaction arises to a considerable
Height; in the next place Fætor of the 
Breath and the Evacuations from the
Intestines becoming Fætid Show that
putrefaction of the Fluids is Arising,
then blackish Spots or marbling of the
Skin and these have generally been
called Patechia, in fevers there is a great
many different Fluids; but there is only
one Species wch. Point out putrefaction
of the Fluids wch. are of a blackish
Red appearing through the Skin the 
breadth of any Juniper; or marbling
Purple or blue Specks as in varies an'd
Marble often is Seen, or where the
putrefaction as Arisen to a great height
it now and then happens that the 
whole Skin becomes of a Purple Colour
and in that Case generally the Patient
is Destroy'd in a short time. The others
we do not denote putrefaction of the 
Fluids are reddish Spots on the Skin
superficially, and commonly came
out about the Fifth a Day and then
go off again, this Eruption is Violent

Fever; the Fever is not at all dimminish'd
by the Eruption coming out, and on its
going off again is not more Violent,
and this do's not Afford us any Indication
of Cure, this affording no one Indication
of Cure or alteration in the Fever is not worth
Attending to, it happens generally where the
Patient is Attack'd wth. Fever wth.; considerable
force, then there is another Eruption from 
Weakness it Arises in irregular Miliary
Eruptions, a Number of little Spots on
the Skin and this merely are [illegible]
and wch. Arises from Sweating taking
Place often in consequence of Stimulating
Medicines being Employ'd and happens
more in Nervous Fevers where there is this
irregularity than in Fevers wch. are either
Inflammatory or Violent, then there is 
another Eruption wch. is at the 
Fon'd and sometimes when its gone off
entirely this Eruption is some what like
very small Worms sometimes of a 
blackish Colour, and sometimes of the 
Colour of the Skin Rising in the Skin and hard

and wch. is not Inflamation, and these happen at
the End of Violent Fevers when the Symptoms
of Putrefaction are gone off, the Petechia
dont Seem to be Alter'd by any Treatment
when putrefaction of the Fluids produce
Petechia there is no manner of Treatment
wch. will produce any good Effect
but that Treatment wch. will Cure the Fever
the little Blisters are occaseon'd often by
keeping the Patient too Hot and giving the 
Patient warm fluids wch. are Stimulating
and often they are not diminished by
any Treatment whatever; Marbling of the 
Skin and fœtid Secretions indicate to us 
putrefaction of the Blood, sometimes the 
Urine is load'd wth. Mucus and is of a
frothy Appearance by the Air being stamp'd
in it, sometimes the Red Particles of 
the Blood are formed in it but this but
seldom the Case, the Urine when this 
happens is of a Chocolate Colour a
dark brown and sometimes this Sediment
is deposit'd, there is probably 
then some Affection of the Kidneys

besides putrefaction wch. as Influence
on the Kidneys so as to produce this
Species of some,  and lastly Arises and
produces the most Fatal Symptoms
wch. Arise in the Disease that is Haemorrhage
as he is Weaken'd and cannot bear the
Loss of Blood, sometimes the Gums become
loose and Spongy and Haemorrhage happens
the most common Haemorrhage wch. happens
is from the Mouth Throat or Nose, this takes
place in consequence of the Putrefaction 
and wch. gives no Relieff at all to the
Fever, the Fever remaining as Violent as
before affording not the least Relieff in 
the Fever but tending to weaken the Patient
the Blood thrown out by any natural Hemorrhage
or Blood when taken away by
any other means hardly Coagulates when
in this state, and the Coagulum is Loose
and easily broke to Peices and the Semon
is Mix'd wth. it, it has now and then 
happen'd that the Blood as become
Fœtid, I myself never I knew or Saw it

but its Relat'd by Authors, and sometimes
Practitioners in warm Climates have
Affirm'd that they have Smelt it Fœtid
and we dont doubt but that sometimes
the putrefaction go's so far as to give
a Fœtor to the Fluids/ now this sometimes
go's as far as to Add to the Weakness
and the depression of Strength wch. Tends
to destroy the Patient, so when the Skin
becomes of a Purple Colour it Destroys
a Patient soon a Delirium comes on and
the Patient is carried off soon in the 
space of Ten or Twelve Hours, and no
such Symptoms come on except 
putrefaction of the Fluids take Place,
the putrefaction depends on the depression 
of strength if Inflammation happens
in the middle of the Fever there the
Symptoms go off and the Inflammation
Blood from an encreas'd Action
of the Heart and Arteries and so its
evident that the putrefaction depends
on the Inaction of the Vessels/ Fevers
wch. happen in Jails and in Camps

and that wch. Arises in the Barracks of
Soldier's Arising from Infection are Apt to
exhibit Symptoms of putrefaction of the Fluids

Lecture 30th.
On Fever's























Fordyce
A course of lectures on the
theory and practice of
physick.




A course of Lectur’s
on the Theory and
Practise of Phisick
Dr. Fordyce
Physician to St.
Thomas’s Hospital




Lecture 1st.
A disease is an alteration of the chemical
properties of the solids or fluids or of the
organization of the body, or of the action of the
moving power, producing an inability or a 
difficulty of performing the whole or any part
of the system; or [illegible] as preternatural 
Evacuation every effect has a cause and in
consequence of which an alteration in the human
Body takes place, the causes of many Diseases
have not yet been investigated as far as there
have been we will endeavour to point them out
to you, in general, it is some eternal and 
preternatural applications to the Body or
mind that produces a disease, for example




Cantharides applied to the skin induces an
inflammation, of the mucus membrane of the
lungs a catarrh it has happen’d that sudden fear
has been followed by a fever, it is not always so
in any of theses instances, the [illegible] not always
produce the Disease it is generally followd by it
now was from out having constant experience 
of their action we are not able to judge of them
wth certainly, external applications have been
said to be its occasional cause, not simply
because the things have been called causes, but
the occasional one is the time properly speaking	
this may act two ways, first immediately
as for example, if you apply cantharides 
to the skin, the cuticle is Raisd, and an
inflammation arises, secondly it may act
immediately the first cause may produce 


a second, whose immediate effect will be the Diseases
for example if you make wound in the skin
and apply some Variolus Matter, there will be
new parity produced, but will from an inflammation
in the wound, and that will be taken to the heart
and in to the circulation, which will produce a general
fever here than the wound is the immediate
cause, and the inflammation the intermediate cause
of the fever, tho not always throwing the cause
of the disease, has given room to some for
supposing that they always acted immediately
for example cold they say constringes the
external pores of the skin, and obstructs the
insensible perspiration, this thrown back into
the circulation, is the cause of an inflammation
now this perspiration is nothing more water, and
when to [illegible] [illegible] not that at all, this Method throes
[illegible] method of reasoning, it is evident that



it is evident that many of the known causes act
immediately and some it must be allowed act
intermediately, yet we should always be suspicious
of the latter, now we admit them but on the
Clearest evidence as in case of the variolous matter
a practitioner ought to be [illegible] wth these
causes, as far as they are thrown, it is by this
means that diseases may often be present'd 
[illegible] a hundred Die of Diseas’s
to one by the sword, where we perfectly master
of the causes of diseases, We should be able
to preserve a great number of lives, We must
observe that one part of the [illegible]
of the operation of causes depends, on the
state of the body to which they are applied
for example Let a Man that is fatigued
with an empty stomach be suddenly exposed 
to cold be shall have a fever whereas a man



in Vigour with a full stomach be exposed to the
same degree of cold, shall receive no injury from
it. Thus then in certain states of the body the
causes of diseases act more powerfully, than in
others, these are called the predisposant causes
of diseases, as they render the body more liable to be
affected by the occasional cause, therefore they are
much to be attended to, as the occasional cause 
tho. they can never produce a Disease of itself 
To remove the predisposant Cause often has 
efficacious as to prevent the application of the 
Cause itself; the Blood is sometimes more apt 
to be affected by any Cause than at another, we
we then say it is more irritable, for example a 
Man of a Sanguine temperament, Living in the 
Country is more apt to be affected wth. an 
inflammatory Disease, but as we cannot [illegible]
cases investigate the alteration, we are therefore 
apt to Reject this knowledge, for example, Let 
a Patient be brought to a man entirely Destitute


of the knowledge of Anatomy, wth a Pleuritic 
Pain in his side without knowing there is any 
such Membrane as the Pleura, he will form some
Hypothesis unwilling to appear ignorant in any 
Thing, he will judge of the Disease by its external
Appearance; from hence Practitioners have Divided
into two classes, the Dogmatics and Empirics 
the first consider the Alteration as the Disease,
the latter the external Appearance as the Disease,
We doe not know from external appearances
what Disease is Present, and We consider the 
external Appearance only, We shall not treat 
the Disease equally, as if We knew the Disease
itself but still We must always Avoid Nanmes
the Causes of Disease are Divid'd in to Proximate 
and Approximate the Proximates that wch
Products the Symptoms are internal Appearance
from which We judge of the Diseases with 

Pleura, the Inflamation of the Pleura is the 
Proximate Cause of pain, why then should we not
always take the external appearances for the 
Disease because they sometimes Prove fallacious for 
Example, and difficulty of Breathing may Arise
from Spasmodic Affection, an Inflamation of the 
Pleura and many other Causes, it is also improper
to Class Disease from their external Appearences 
as from this We shall be led to Join Diseases,
which have no Connection wth. each other, and then
are Apt to make general Application to the 
same Class so that We shall Practice very Injudiciously,
by making general tho of the same 
Application.----

Lecture 2d.
On the Diseas's of the Human 
Body----
We have already Defin'd a Disease to be an Alteration
of the Action of one or more of the Moving
Powers of the Body, Producing an Irrability
or Diminition of Performing its Functions
properly, Suppose a Persons knowledge of all 
the Parts of the Body; We ought not always
of an Alteration from external appearances,
it cannot be Denied, but it will be better to 
[illegible], the Alteration as the Disease, [??es]
there are many Material Parts, the Lungs
for Instance where the we doe not know 
material functions and many of the things

of equal importance, wth. which We are [illegible]
We cannot tell wth. perish on what Alteration has
taken Place, still tho We are not so well Acquanit'd with
those things as might be Wish'd, yet it does not follow that
We shou'd reject the Knowledge We have in our 
Power, if We confine ourselves to the Knowledge of 
Disea's as far as have been Investigated and from
no Hypothesis no Conjucture in this Case. This better
to Consider the Alteration itself as the Disease, than 
the external Appearances; if We Consider the external 
Appearances, We shall be Led to Alleviate some Urgent 
Symptom without endeavouring to Cure the Disease
itself. We shall therefore in the Persecution of this Course
in all Cases where We can Point out the internal 
Alteration that takes Place, Now we don't Call it a 
Disease without it Continues to prevent one or more 
of the functions from being Perform'd properly. Now 
a Disease does not always remain in the same State it
is always Varying. The Disease itself indeed sometimes
Varies this is but seldom for the most Part is [Cont???]
the same Let then us Consider the several different
Progressions of a Disease. I have before said it for

the most Part never Continues in the same state
it may encrease so as to cause the Death of a 
Patient, for Example in an Inflamation of the 
Brain the Presure which takes Place Causes a 
Stupor if the inflamation encreases the Stupor
will also encrease untill it kills the Patient.
Secondly a Disease may terminate in some other 
(for Example) an Inflamation takes Place in the 
Cellular Membrane in any Part after Continuing 
for sometime it is Converted into Pus and forms
an Abcess from the encrease of Inflamation 
which is the Cause of Suppuration, here then 
there is the first Disease going off in Consequence of 
the Second, it also frequently happens that 
a Disease Produces its own Cause for Instance
a Quantity of Venereal Matter Apply to the 
Urethra, thus it Converts into Matter similar to 
itself and Reduces an Irritation and in Consequence 
an encreased Secretion, which washes away the 

Venereal Salts and by this Means Cures the Disease
so in any Inflamation of the Lungs a Copious 
Expectoration is united which Carries off the Disease
now it sometimes happens where no Danger of the Disease
itself Arises, yet what was Intend'd as a Natural 
Cure stills (Example) the spilling Produc'd in a 
Peripneumony may be too Copious. and Continue
[illegible] to Darhoea, the Patient whereas if it had
been in a proper degree it would have Prov'd salutary 
so again in the Rheumatism the encreased Action
of the Heart and Arteries, may be so encreased as
as to be the Death of the Patient, when the Rheumatism
itself would not have kill'd, Thirdly the second
Disease may Prove more fatal, than the Primary
an Inflamation of the Lungs may terminate in a
Abcess on the Part, this will Prove more fatal
than the Pleurisy itself in many Instances.
From thly it often be spasms there a temporary
Weakness takes Place and this in but me. We shall
Call a Depression of Strength, this in some Measure
may be Call'd the Disease itself and it often Proves
Fatal, but the Disease may so much exhaust the

The Strength, that [cross out] shall Destroy
For Example a Patient shall have a fever wch. shall be
Extend'd to much a Degree as to prove Fatal, but futher
the Patient is Reduc'd to the lowest [illegible] of 
Weakness could We then instantly Remove the Fever
the Powers of the Body would almost as Instantly
begin to be Restor'd. It is necessary for a Practitioner
wth. the Cause of a Disease as far as we yet know
yet without knowing the History of a Disease We
shall not be Able to cure it therefore this is 
a Study which Requires the greatest Attention
to know what is likely to happen in [illegible] in the
Progress of a Disease, and the more so as without
this Knowledge We shall be Unaquainted with the 
Natural Cure likely to Arise, and at another time
we shall Pay no Attention to the most Dangerous 
Part of a Disease, it is therefore Requisite that We
shou'd be Masters of a Disease, before We can Apply
a Remedy for Instance in the Small Power
Unaquainted Practitioner would probably Endeavour

for to Put a Stop to the Disease on the 
other Hand if you understand the Disease We
shall know that the Disease will go through 
its Course, and therefore We should not Endeavour
to Put a stop to it, but forward its Progress, no
in a Fever, no in a Fever We [illegible] many Remedies
wth. wou'd put a Stop to its A Skillfull Practitioner
will never make one any but those wth. be
known will assist the Patient to go through
the Disease. Secondly where the Natural Cure do's
not take place, We must Employ Remedies
most likely for to bring on this, for Example if
we have an Inflamation wth. no spilling no envelope
of Expectoration it will probably Prove Fatal
We must therefore Endeavour to Produce this
Natural Cure, by Artificial Means, Yet we must
make Use of Remedies most likely to Produce [???d]
this Effect and thirdly We must Endeavour to Remove
the Extraneous Danger, Suppose a Fever to arise
in a young Man of a Robust Habit and that has 
[illegible] We know that Fevers in general doe not kill

but from the Robust [Natis??] general Inflamation will 
arise as for to Prove fatal; We must therefore Endeavour 
to take off as much as We can of the Inflamation
by Copious Bleeding so that by this Means and other 
Evacuations We shall Enable him to go through the 
Fever the Removing this entraneous Danger is of very 
great Consequence in Acute Diseas's particularly
[??urlkly] the last Method to be Atten'd to in 
the Cure of Diseas's is to Employ a Method of Cure
contrary to the Natural Method of Cure, at least
not all Indicated by it in this Cure We must
make immediate Application of those Medicines
which have been thrown to frame of the Disease than
in an Inflamation of the Pleura if we VS. and 
blister it will tend to Put a stop to the Inflamation
immediately and Suffer it to goe through its Natural
Progress, And this Part of Medicine We shoud
by all means make ourselves Acquainted with 
For Instance We Know Preparations of Antimony
will Cure fevers, that the Bark will Cure an

Intermittent, yet if you are not Acquainted with 
the Nature the Disease, We shall not Understand the 
proper Method of inhibiting them, and by this
Ignorance We shall render the Disease more Obstinate
for tho We know Antimonial preparations Cure
come fevers, yet a Practitioner should not farther 
Resolve to Cure every Fever by the same Method
tho Bark will not Cure all Intermittent fevers
it may be given improperly to be of more Disservice
than Service, for Instance if you give the Bark
in the Paroxysm of an Intermittent instead of Curing
the Disease it will by Degrees Come to be a Continual
here then the Disease is rendered Worse by the 
improper there/ this Remedy it is of some 
Importance in Medicine to Observe that there is
no such thing as an Infallible one.----

Lecture 3.d 
Of the General Doctrine of Inflamation
An Inflamation is a Disease Affecting
one Part only it sometimes happens indeed the general
System is Affect'd in Consequence of the Inflamation
but while the Inflamation is Confin'd to one Part only it 
is a Topical Disease not releasing the System
in general, if you apply your finger enternally
to an Inflam'd Part We shall find an encrease
of the Pulsation of the Arteries, a greater Degree
and some Heat so as to Rise to 110 Degrees of 
Farenheits Thermometer commonly however to 
102.4, or 6. Degrees, the Part becomes of a Red 
hue and then a more Florid Redness takes 
Place at first their is an throbbing to increase
Pain wth is Inconsiderably encreased and become,
a throbbing one and is still encreased from 

the Starting of the Inflam'd Part. There is also a levelling
owing in some Cases [illegible] in all to be a Distension of 
the Vessels and an [illegible] action of the Fluids Inflammation
is the [illegible] Cure/ Contraction, hence the Motion
is sometimes Imped'd, sometimes entirely Destroy'd
according to the sensibility and Irritability
of the Parts, there are the Internal Appearances wch.
take Place, You must next Inquire the Reason 
are Marker of the Alteration, wch. is the Disease
and wch. gives Occasion to there Internal Appearances
the Swelling is the first thing to be taken Notice
of and this, If we open the Imflam'd Part, We shall
find it going to a Part of the Blood thrown
out of the Vessels, this Consists of Coagulable
Lymph and Superfluous Water, sometimes
however there is no Extravasation at all, as in an 
Inflamation of the Eye the swelling is owing to 
the Distension in the small Vessels, We know by
the action of the Heart and Arteries that the 
Blood is thrown into the Capillary Veins a 
Distension it is said may arise three Ways from the 

Relaxation Obstruction and greater Quantity, of 
Fluids thrown into those vessels, first the Heart
and Arteries may Propell the fluids wth. greater
force into the vessels incl wth. [Cere??] [illegible]
will be Pres'd on more, and therefore they will become
Inflam'd and Distended. Secondly these 
small Vessels from their Disposition to Contrast
always Endeavouring to Avoid Inflamation 
If they are Relaxed they will allow Consequence
of that be Distended. Thirdly if you stop the
Passage through may be and Continue to throw
into it is will be Distended, in like manner
the Capillary Vessels will be Distended. Now
Distension from Relaxation in no case gives
Pain for Example the Bladder from being
Relax'd will contain [illegible] of [????e]
and Here shall be no Pain. If it in a Cathartic
State one Ounce wil give Pain. The Distension
that takes Place in an Inflamation is always 
Painful, this therefore is a sufficient Proof that 

The swelling in this Disease dos not arise from
[illegible] of the Vessels; neither dos it in Return 
Place Proceed from an Obstruction of them; If this
was the Case the blood would be Prevented from 
Passing. The Blood passes through the Capillary
Arteries into the Veins, Then into the Cavities and 
from them into the Secretory Ducts. When the 
Veins are Inflam'd, the Parts are always swell'd
if they are Open'd the Blood flows wth. greater
Velocity than in an Healthy State, although the 
swelling be very Considerable, when received into a
Vessel it detract Contract more, as Cool, a [illegible]
[illegible], then if it was taken from one when 
no Inflamation was Present neither is it the 
Colour of Extravasated Blood, it is evident
therefore there is a more Considerable Quantity
of Blood Circulating through an inflam'd part,
then there is a Natural Course for there can be 
no Obstruction. Secondly We find in an 
Inflamation from Obstruction, that the [Euhal??]
Vessels are not Obstructed but every [illegible] [???neass]
the Kidney as in Secretion encreased in and sam
Aart. The secretion of the Kidney is Diminished

as well from an Inflamation of a Gland as from 
an Inflamation of any of the Adjacent Vessels
but we cannot draw any Conclusion from this
gland as it is liable to be affected by every
Adjacent Inflamation. It Appears then that there
is at first no Obduction. And if there was 
it would not Produce a Swelling, there must 
be something more to Occasion it for it is known 
that there is somtimes the Quantity of fluids
that Circulate in the Body than actually do
therefore an Obstruction will not cause a swelling
the Blood is Propell'd forwards by the Heart
and Arteries of this Action is encreased a greater
Quantity/ Fluids will be Propell'd forwards
We must Observe that the Action of the Heart
is Uniform, but that of the Arteries and Veins
is not so, and it is this Variation wch. is the 
Cause/ this Alteration is the System, this is
a more frequent Cohesion, the Blood is actually
Propell'd in a greater Quantity as may be Discoved 
by the more frequent Cohesion and Pulsation

of the Arteries, as also from Principial
Observation, no that it is evident the Swelling arises
from an encreased Circulation or Relaxation [illegible]
the Cause that the Heat Arises we cannot Determine
as We doe not sufficiently know on what the 
Heat of the Body Depends, thus far We know
that when the Action is encreased it becomes
Hotter and upon discontinuing this Action it 
grows Cooler, in exercise of any Mind there is 
an encreased Degree of Heat, that the swelling 
do's not Arise from an Obstruction will be evident
If you take some Blood from an Inflam'd Part
it will Appear of a Blou'd Redness, whereas Blood
that as Stagnated will be off a deeper Colour
the pain wch. Arises in an Inflamation is owing
to the Vessels of the Part being Distended beyond
the proper Tone------

Lecture 4th
On Inflamation
We have already Shewn you that the Distension
of the Vessels Arises from a greater Quantity of 
Blood being thrown into them, and that the 
pulse is no other than the difference betwixt 
the Contraction and Dilation of the Arteries,
that Pain is Capable of being Produced in 
any Part of the Body by Distension, as if
the Stomach is over Distend'd by Food or Air
thrown into it, then Pain is Reduc'd, and also
if the Bladder is Distended Pain is Produced
and if the Ligaments are Distend'd Pain
Arises, and a fluid Discharg'd; but all 
Distension does not Produce Pain; For Example
a tumour may Arise under the Skin, as in 
the [illegible] and Prove Painful, the 
Stomach may be Distend'd to a certain Degree
without Pain, so also may the Bladder; thus

We find that Distension in certain Circumstances,
only is Capable of Producing Pain,
the Part must Endeavour to avoid Distension;
and if at this time Distending Cause 
Arises then Pain takes Place; for Example
the Stomach shall have a Disposition to 
Contrast; if at this Time a Quantity of Food or
Air is thrown into it, Pain will be Produc'd
in like Manner if the Bladder has a Disposition
to Contract, Pain will Arise if two Ounces of urine
be Contained in it; tho at other Times it will 
Contain Ten or Twelve Ounces without Pain; it is 
the Contraction wch. gives Pain, when the Blood
is Propell'd into the Capillary Vessels was 
the Distend them beyond their Disposition to 
Contract, We will call it a Distension beyond 
the Tone, and this we say Produces Pain in 
an Inflamation, but in order to excite
Inflamation it is Necessary, that the Circulation
shou'd be Encreased, and that to much
a Degree as to Distend the small vessels beyond

their Tone, if you put your Hand into Warm
Water the Circulation will be encreased and the 
Vessels be Distended, but no Inflamation will
Arise; because the Vessels are not Distended
beyond their tone; Now this Disposition is always
Altering for Instance, the Stomach or Bladder
sometimes have a Disposition to Contract
and then will Receive but a small Quantity 
whereas at another Time they will receive a much
Larger Quantity is like Manner may the 
Blood Vessels themselves be Distended. The Warm
Water Relaxes the small Vessels, they 
will then Receive an encreased Circulation
without Inflamation; some have Consider'd
the Secondary as the Primary Part of Inflamation;
that it is not is evident, because the 
small Vessels are greatly Distended beyond
their Natural Size, there wou'd be Pain, from
their Disposition to Contract, this is not an 
Inflamatory Pain but a Rheumatic one, for 
[illegible] Inflamation a Distension takes Place first

and if a Part is already Distended to as great 
a Degree as it will Allow an encreased Distension
will Cause Pain, wch. Pain Arises from and Inflamation,
in an Inflamation We meet wth. one Symptom
wch. Distinguishes it into two Species; if a 
Vessel of a Considerable Size is Affected the 
Pain will be a throbbing one, and will be more encreased
at the Relaxation, than at the Contraction
of the Arteries. But if a Membrane be 
Inflamed the small Vessels or Arteries only 
be affected, wch. have great Strength in Membranes,
and in wch. the Heart has less Influence
there; the Pain will be the same when the 
Heart is acting as not, so that the Pain will 
be Constant and equal, We must lastly Observe
that Pain is not Absolutely Necessary for 
an Inflamation; the small Vessels must be 
Distended beyond than Some and in most Inflamation
they stimulate and Cause harm it 
now and then happens that the Distension is

no small, as the Vessels only will be stimulated,
why Muscular Fibres are Contracted and
Rendered Incapable of Motion, We doe not as yet
Understand, but supposing Relaxation and 
Obstruction to be the Proximate Cause of Inflamation,
We are equaly it or less to throw out what 
Manner they act, As we are not yet acquainted
wth. the Course of Muscular Motion and flexibility
of the thin fibres, We can only beg then 
that there Alterations are in Consequence are
in Consequence of an encreased Circulation
in the next Place We are to Consider the Cause
of Inflamation, and there are most apparent
then in most of the Diseas's. An Inflamation 
is Reduced by an application to the 
Body, wch. tend to excite Motion these we
Call Internal Stimuli, meaning to take it in 
an Extensive Sense, and not [C???iethem]
to the far face of the Body, but to take every

extreme Part also, Now Ive divide these [???a]
into Restomical as Bruising or Cutting and 
Chemical there wch. Hand to Destroy the Part
Mechanically, and there wch. doe it from particular
Properties they Perhaps as the Destroying the 
Coagulum &c. Some have happen'd that Mechanical
stimuli but Acted in Consequence of that 
Pointed Spiculae running into the Rest; but We
can Demonstrate that the small Particles of 
Caustic Vegetable Alkali will not penetrate the 
Coats of any Vessel, no more than sharp instrument
of an Inch in Fig will Penatrate the Skin
when Impall'd by its own Weight, but Sub [?a??e]
wch. have no Mechanical or Chemical Action,
I say such substances Stimulate frequently, As
per Example if a Deep of Infusion of Cantharides
and one of Infusion of Common Flies, We know 
they both have the same Mechanical Properties
yet they have very different Effects. For the 
Cantharides will Combine wth. the Mucilaginous
Part of the Blood and Inflame; the Common fibres
will [crossed out] Effect at all; this then furnishes a Mind
Class of stimuli wch. We call Medical----

Lecture 5th
The Application of these Stimuli is in general very 
Obvious, some of them however Require a particular
Explanation, first the Distension of a Part whether
it be of the external or Internal Part of the Body,
whether in a Blood Vessel Muscle Nerve or 
Ligament, is Capable of Stimulating and Producing 
Inflamation, this is the only Cause 
that is universal and Capable of Outing on all 
the Parts of the Body is found [???e] per
the Distension of Blood vessel, as of 
a Membrane will [illegible]
Produce Inflamation, for Instance if [alma??]
of Water be thrown into a joint it will have
no Effect as a stimulant, yet the Disturbance
from it will Produce inflamation on the 
Ligament, We see that a Distension is 
Capable of veins Produced in every Part of 
the Body, success of the Bones in wch. it 
comes unless they are in a Diseas'd State

but all Distermind of not Stimulate any Part of 
the Body may be Distended without Pain it is 
the Resistence to the Distending Course that Produces
the Stimulus, Now there are the Powers wch. are apt
to remind the Distending Causes; first the Cohesion 
of the Partion of the Parts w/wch. the latids consist
and wch. We Call Electricity, this Power when the 
Distension is above a certain Degree tends to bring
the Parts nearer to each other, and restore them to their 
former State; this Power is nearly equal at all
times; the Second Power is Capable of Resisting
Distension; the Comparble Power of the Letids
wth. Depends on the Life, and is Inherent in all Parts
of the Body. The Bones however seems to posses
but little of this Power, this is greater than the 
Contractile Power and Varies Considerably,
so that the same stimulus will at one time Stimulate
when at another time not according to 
its Resistance, if the Distension is Slow and 
gradual it will get the better of both of these
Resistances without Stimulating; for Example

a tumour may grow gradualy, under the skin
and Distend it to a greater Degree, Now if the same 
Distension had attempted to have been made suddenly,
the skin wou'd Burst; it also unites the 
Contraction which Depends upon Life, so as
that Resists more strongly, no stimulus Arises
Distension then from both these Causes is Capable/
Stimulating so as to Produce Inflamation
for happening at Present a great Part of the 
Blood Contained and Circulating in the exterior
Parts of the Body, and if it be suddenly Exposed
to a great Degree of Cold, this Power will be 
encreased, so as to Produce Inflamation;
Division is also a stimulus, but it must be
Observed that in Order to Stimulate it must
be on a Irritable Part, that is Divided. Some 
Parts of the Body are Capable of Distension
only, others may be affected by it; for Example
a Piece of the Knife or any Sharp Instrument

has passed through the Stomach, during which 
it has [??anind] much Inflamation, it has then Passed
the Muscules and Produ'd none, then during the 
skin it has Produc'd Inflamation; if a Part not
Irritable be Divided, their will be no Inflamation,
and if a Part be Divided as in a Wound, some Part
of wch. is Imitable and some not then an Inflamation
will Arise in the Irritable Part, and extend 
to the other, if the Patient be strong, but not if he [illegible]
it has been said that an Acrimony of the Fluid
will frequently Produce Inflamation, Now it must be
Observ'd that no Stimulus will affect the Blood
Vessels but Distension, except the Heart, and this
accordingly more Irritable then any of the Blood
Vessels, and hence it is that Poisons Prove Fatal,
when they Come to the Heart, when they have not
affected the Blood Vessels in their Passage through 
them, Acrimony which for the most Part seems
Stimulus) if the Blood as Water is Incapable of 
Producing Inflamation in the Blood Vessels [Nem??]
but supposing a Stimulating Matter Contain'd them 

in Consequence of being thrown out from them
on an Irritable Part, and Inflamation will be Produc'd
A Solution of Neutro Salts when Contained in
the Blood Vessels may be sufficiently Concentrated
so as to Produce Inflamation especially
if the Natural Mucus be Remov'd from the 
Membrane, as in the Urinary Passages Intestines
&c. for Example in an Inflamation of the 
Lachrymal Duct the [M??Jeans] are more [P???fully]
Secreted, wch. Carries off the Natural Mucus
of the Part; they Stimulate so as to Produce
Inflamation, thus it happens in a latent
Dysentrey &c there then Fluids Stimulate,
it is the Natural Salt of the Blood Containes
in them wth. the [Ca??s] it, ferments also and 
in Capable of increasing the Quantity so able 
Stimulate the System in generaly as the Variolous
Matter, the Venereal Matter &c but it is the 
Neutral Salts for most Part that Stimulate

there then are the only Stimuli, it is necessary
for us to take Notice off. however in some Cases it is
very difficult to suppose a Stimulus, sometimes
also a fever arises in course of which an Inflamation 
takes Place.------

Lecture 6th
We come now to treat of the Predisposant Causes
and We shall first suppose that Inflamation is increased 
Action of the vessels, and therefore
the stronger the System in general, the more
liable it is to have an encreased Action of the 
Vessels encited, so that an Inflamation is more 
Apt to Rise in a Man of a Robust Habit
of Body, and that Living in a more Cold
Atmosphere, than one of a Weak Habit of Body
Living in a Warm Moist Atmosphere, and 
it often happens in the Spring than in the 
Autumn from the Cold of the Recceding 
Winter having encreased the Contractile Powers
of the Body as Solids, Living in a Pure
Atmosphere gives strength to the System,
therefore [cross out] Live in the Country are 
Subject to Inflamation, then there who Live

in large towns; the Body is in its greatest strength
from fifteen to twenty five during that time a 
Man is more subject to Inflamation, than of any
other time of Life; Men of a Sanguine temperament
have a greater Disposition to Inflamation than those
of a thin Spare Habit; it must be Remark'd that 
there are two species of Inflamation; the first is
Apt to Arise in the substance of Parts; and 
which we call Phlegmonans; the Second that 
wch. Arises in the Surface of a Part, wch. We Call
Erysepellatous; strong Habits are subject to the 
first Species of Inflamation; but in Weak Habits
the irritability is Commonly encreased; and 
the surface is more apt to be Affect'd from 
external application; In Warm Climates and 
in the Autumn from Living in Large towns and 
being Naturally of Irritable Habit Erisapellatous
Inflamation is Apt to Arise, but Strong and 
Weak are more Subject to Inflamatory Disease
than those of a moderate Strength; particular

Parts may also be tender more irritable by
particular applications, in Inflamation of a 
Part is Capable of Producing a Disease of the 
whole System, so that a second Disease is 
liable to be emited by it. We must first observe
that many Practitioners have us'd the term Fever
to Express a Disease in which there was a more 
frequent contraction of the Heart and Arteries;
And we must at the same Observe that it has
been made tho of differently by others; As 
by Sydenham and Hippocrates and most 
of the Ancients, and but Modern Practitioners
it is improperly us'd to signify all Disease
in wch. the frequency of the Heart is encreased
for by this Means We shall include several
Diseas's, that are properly Call'd fevers, when
the frequency of the Heart is not encreased,
and Employ the term in this sense, We shall
from a particular class of Disea's totaly
Different from one another; fever in its proper

[A??plation] is a Disease Arising Independant of 
any other, and also when Reduc'd is Independant
of its Cause, for it is not true) Physiology) that if the 
Cause be Remov'd the Vessels will Cease, We doe
not then Call the Effects Arising in the system
from Inflamation Fevers, for they frequently Depend
upon their Causes, so that if they be Removed
the Effects will Cease, they have also been called
Symptomatic fevers a Hoffman Calls it a 
Planitic Fever &c And we have said that the 
Affections Arising in the System from Inflamation
are two the one We call general Inflamation
the other symptoms of Irritation. Phlegmonary
Inflamations are Apt to be attend'd wth. The 
former, and the Erysapallatous one wth. the 
latter, but neither of these Diseas's are peculiar
to Inflamation, they may both arise from topical
Applications, the symptoms most common
in general Inflammations are Hardness of the 
Pulse, it is said to be Hard, when it feels like
a Musical Chord high Strung at a vitiating, it is also

Strong full and frequent, but none of these are
Necessary, for general Inflamation may subject
without neither as in an Inflamation of the 
Inter limb, the Pulse is small and frequent, neither
is it Necessary it should be frequent, for if the 
Inflamation be of an external Part, it is full
and hard, but not frequent. However from 70
Beats in a Minute, which is the Natural
Pulsation it Amounts to 110. It happens more
frequently also that it is more frequent at
Night then in the Morning, but in general 
Inflamation is healthy. Cinthart, the [??dass]
of the Pulse Discovers the Action is to be Cuting
Strongly, and this is the most Material Part
of it, this encreased action is attended wth.
an Alteration of the Blood, it becomes 
more Fluid. Some but those have suppos'd
this Alteration to be the Cause of the Disease,
others again have suppos'd it to be thicker, and
more Apt to Coagulate, this than they have [sa??]
to.

be the Cause, but the Blood in an Inflamation
is evidently thinner if taken from the Arm
it continues longer [illegible], so that the red Globules
fall to the bottom, the Coagulable Lymph Coagulates
afterwards more strongly; and adheres to the 
Red Part, was to some [C???] on the [??ss]
but in order to judge of this a large orifice shoud
be made in a large Vein, and receiv'd in a 
glass as nearly Spherical as Possible; the 
Coagulable Lymph in an Inflamation is something
Render'd as this, as to pass through the [illegible]
and be Extravasated, all the small vessels through
the system being Distended, and a [??nienal]
Restlessness takes Place, and being also 
fill'd wth. Blood a general redness and Heat,
and there is also a Degree and whiteness
of the tongue owing to attempt of its Secretion; In most
Affections the Mucus is encreased, here it is
generally Diminished; We are not sufficiently 
Acquainted wth. the Causes of this Appearance 
The Variation of this is a/Consequence in general

Inflamation it is more white, sometimes in an
Inflamation arising from the thorax, there is 
two yellow streaks along it; thirst do's not 
always arise from a Dryness of the Mouth
but the Reason of this as not as yet been sufficently
[illegible] for. the Redness are on a 
different state in different Inflamations,
if it Arises from a Cause that do's not give
great Pain; the mine is forbid and upon
Standing Deposiyes a [???ious] Sediment
but if there is great Pain, the Vessels of the 
[th??ies] Contract, and the urine appears
Clear sometimes a small Quantity of Mucus
Matter is Suspended in it, in form of a Cloud,
when an Inflamation Proves fatal, it is 
from an Affection of the Brain, first it may 
happen from such a Quantity of Blood
into the Brain as to Compress it, which
will cause a stupor on which the Ey's
Appears Red Inquire and Dim and a Delirium

takes Place on which the Patient Mutters
something to himself if she & he is terrible
but his Memory is entirely [illegible]. The Second
Method in which general Inflamation appears
to Destroy during its Violence, is by Producing
Wakefulness from a start of Rest he becomes
Delirious, this at first takes Place towards
Morning, if he sleeps an hour or two it then 
go's off for the whole Day, returning every Night 
in an encreased Degree, here the Eyes are Bright
the Patient is Quick in all his Motions, sinks
gradually untill at last Ravings are very Violent
till at Last he his Destroy'd, this however is 
not properly an affection of the Dream.
The Delirium some times remains after the Disease
itself is Removed, and then a Confirmed Mania is after
Produc'd------

Lecture 7.th
Inflammation greatly Depend upon this 
Cause, but not totaly Suppose an Inflamation of 
the Pleura shall arise, and in Consequence of this
the Pulse will be hard full and pregnant and 
other Symptoms of general Inflamation shall be
Present, by the application of a Blister to the side
We can sometimes Cure the Pain and other 
Symptoms and the Disease gos off; In this 
Case We have Employ'd nothing to Remove
the general Inflamation, We have only Atten'd
to the topical one, so far its Confirmation is not
Dependant on its Cause, but this is not always
the Case, in the first Place it is apt to become
Habitual, far after a Continuance of [M???ax] per
Foundage, if you carry of the Pleurisy by 
Topical Remedies, yet the symptoms if 
general Inflamation will still goe on. If the  
Patient be strong the general Inflamation will 

be great, and after Continuing for several Days
it becomes Habitual, in this Case Disease after
gos off without any Remedy, if Enhart not upon
the contact strong action of the Heart and Arteries
their Powers become Exhausted, their action consequently 
less, and the Inflamations subsides, but 
this is not always happen, for the Heart returns such
proper action the Arteris doe not, this in the 
first Disease Produced by Topical [crossed out] Application
or Inflamation Produ'd by it, we call symptoms
of Irritation, the Disease has more Commonly been
call'd never the general Inflamation yet it is 
Essentially different, or even more so, it is also 
a Disease which requires our Attention greatly 
and is to be Distinguished, both from general Inflamation
when and all other affections of the system,
it is entirely Dependant on its Cause, it continues
as long as the Irritation continues, and when
it Subsides this subsides also, there are certain
Parts of the Body which We call Irritable as 
the Internal Canal Bladder Diaphragm, Womb
when lately Impregnated. &c when Affect'd they [Rod??e]

Symptoms of Irritation, for Example the 
Mucus membrane of the Lungs is liable to be
Irritated, As the Mucus Membrane of the 
Intestines, but if it is Inflamed, the same Symptoms
doe not Arise if the Imbalance of the 
Intestin's was Affect'd, We doe not Calle a Part
Irritable because they are Subject to be 
Irritated by external Causes, but because 
when Affect'd they are Apt to produce great
Irritation in the System in general, the 
first symptom of this Disease is Depression
of Strength Arising from no Cause, We expect
for Example when a [illegible] through 
the Stomach, it happens often that there is
no pain or great loss of Blood, yet the 
Patient shall be almost immediately Incapable
of Supporting himself, and the action
of the whole system being greatly Diminished
until he Dies, have then learns to be no

great reason for the Loss of strength, but 
much it is, this is not a weakness but a Depression
of Strength, for the cause being Remov'd the 
Strength begins immediately to be restor'd if the 
Depression Arises from any Irritation that can
be Remov'd it is only then the symptom of a 
Disease at the time the Strength is Depressed
the functions are all almost Disordered the Heart
Outs more frequently, it almost always Contracting
the Pulse then becomes small Quick and frequent 
the Stomach is also Disordered, there is Sickness
Flatulency Vomiting want of appetite, the tongue
as in other affections is alter'd in its appearance
sometimes however it has no Mucus and appears
white, and sometimes it has more than in a Natural
State, the vessels of the Redmias are also Contracted
so that the Mucilaginous Part of the Urine is not 
secreted, and it appears Clear, there is Mineral 
Restlessness and sometimes Delium is 
a symptom, by generally the Patient remains
Perfectly sensible till he Dies, the symptoms 
are also Reduc'd by other causes than Inflamation

by gangrene Mortification, Spasmodic Contractions
of the Intermit's and the like, What is 
particularly to be Remark'd in this Decrease is
that it is so totaly Dependant on its Cause,
and this makes it Essentially Necessary to 
Distinguish it from a fever; for Example
in a gangrene and Mortification shall take
Place, and when these Symptoms Arise they 
have been heated as a Fever whereas no
Attention ought to be Paid; but to the 
gangrene and Mortification, a [illegible] of 
it other Inflamations may sometimes happen
in this Case the Attention should be Directed to the 
general Inflamation, for Example in an Inflamation 
of the Intestin's, there is Depression
of Strength fainting and other symptoms
of Irritation, but the Pulse is hard therefore
general Inflamation is Present, have too 
doe not Employ stimulants, to support 
the strength, but make the use of Evacuations

which will generally Remove all the other
symptoms, Now Inflamation or particular
Affections of Parts, as of the system in general, We 
now Come to the Progress of Inflamation, if 
a stimulus be applied to a Part of the Body
an Inflamation takes Place in that Part, and 
it happens sometimes upon Removal of the 
Stimulus that the Inflamation will Cease, We 
will next Consider of this Continuation, when the 
Action of the Heart is encreased, the fluids are 
Propell'd wth. greater forces, so cuts as to Distend
the small vessels beyond their Tone; this Promotes
a more frequent Action of the Arteri's, so that they
Continue a Natural Cause Acting and reacting
on each other, but the Matter of the greatest Importance
is that there two Causes shoul'd be just an Equilibrium,
if they are not an Inflamation will be always
encreasing or Diminishing, for if the Distension is
more than Equal the Inflamation will encrease, this 
Action is seldom an Equilibria and accordingly
We find an Inflamation continues longer in the 

same State, it is always either encreasing
or Diminishing, so that if We can once make
it begin to Decrease it will continue to doe so 
and Cure itself. That We must observe that 
there is a difference between the Inflamation of 
a Part or substance of a Part; and that of 
an Irritable one, in the first it is the Distension
which keeps up the Inflamation, but in the 
other, the surface is apt to be Affected by
externall Applications, the Stimulus Acts 
differently from being applied to an Irritable
Part, and by this the Action of the Arteris
is kept up once equaly, hence the Erysepellatous
Inflamation are also apt to encrease
of they are less no than Phlegomanous upon

Lecture 8.th
It has been suppos'd by some Practitioners that 
the Degree of Inflamation Depend'd on a Quantity 
of Matter Obstructing the Inflam'd Part, wch.
if Resolv'd wont'd [illegible] off. but We have made
it Appear that there is a greater Circulation through
the Part, therefore this opinion must be 
Erroneous; the first [illegible] upon Inflamation
is Resolution, by wch. is meant nothing more than
the going off of the Disease; simple Resolution
is when the Removal of the Cause of an Inflamation,
the Effect Ceases of itself; but a Cause
may Arise wch. may be sufficiant to keep up
the Inflamation, after the Original Cause is 
Remov'd, during the Progress an evacuation
may Arise, this always Weakens the System
and may therefore, Terminate the Inflamation
If a part be Preternaturally Distend'd wth. a 
Johu'd making an opening, so as to Evacuate is

may Put a Stop to the Disease; but if this
Evacuation be made suddenly and a large
Quantity such a weakness takes Place as Proves
fatal to the Patient has been Experienced in the 
Ascites; An Evacuation in taking Place Naturally
in an inflamation, will weaken the Action of the 
Arteri's and carry off the Inflamation. This 
Natural Cure happens often in the Mucus glands
than in any other Part; the glands of the skin
Secrete but a small Quantity at anytime so
that the Secretion cannot be sufficiently encreased
to Carry off an Inflamation; the sensation 
of many of the glands of the [illegible] may;
as those of the Kidnies Mouth, Nostrils, that [illegible] 
secretion from any adjacent Gland will
sometimes Remove an Inflamation; tho there
be no Communication between the two Parts;
and their Effect is much more considerable 
than that from a Part at a greater Distance
secondly it is not Necessary the Secretion
shou'd be so great, as to Weaken the whole Body

only the Part affect'd and where it is from a 
gland there is considerable variation. The appearances
of the Evacuating Matter; that which is 
first Evacuated Consists of Water, Containing
the Salts of the Blood; this carries off the 
Natural Mucus of the Part, as it contains no salts
and then it may stimulate, so as to bring on an 
Inflamation, or encrease it when Excited. Then
Watery fluids Stimulate more than Mucilaginous;
in an Inflamation of the Nostrils, there is 
first a secretion of a thin Watery Mucus; wch.
Stimulates and encreases the Inflamation; but
if the Mucus be Continued to be secreted from 
the Inflam'd Part, it soon becomes Viscid; and 
then is lessens the Inflamation, and if it was
great it Puts on a Yellow Appearance, it has 
been said to be Concerted; but it is the Mucus
undergoes these Changes, and not a Reparation
and Evacuation of Matter, as it has been supposed
to be, because the first Evacuation wch. is by much
the greatest do's not carry off the Inflamation,
this Change happens Universally [illegible]

Mucus glands is Affect'd, as for Example
As for Example if the salival glands are
Inflam'd; there is Considerable encrease of 
sensation, wch. Reserve its Natural Appearance
but is apt to Smell, and where the Inflamation
begins to cease, the encreased secretion dos the 
same, till they are both carried off. At this time
also an Hemorrhage may happen, an encreased
Action of the Heart and Arteris, fever open the 
Exhalants; and if the Inflamation be in a 
Part wch. Opens externally, the Disease often
carried off from the Hemorrhage which is 
Produc'd. It happens also that an Evacuation
Arising from Accident will carry off an Inflamation;
for Example if a Woman shou'd be 
Afflicted wth. a Pleurisy and during that 
should Menstruate, the inflamation will be 
Carried off without the Application of any 
Remedy whatever; A small Evacuation 
We must Observe will cure an Inflamation 
when a long as artificial one will not.

The most Natural Cure of an Inflamation
is by fever; but we shall only say at Present that 
a fever coming on has sometimes Cured the Disease
The most Natural Cure is by metastasis when an
Inflamation arises in another Part and Carries off
the Primary one, an Inflamtion, an Inflamation 
Occupies but a small Part of the Body, and it 
seldom happens that two Considerable [?n?s?ubrin??]
at the same time in the Body, where therefore
a second Arises, the first generally Subsides
from this Arts We are not, sufficently, Acquainted
wth. neither do's the Supposition of the 
translation of Matter forward on Account for
the sustains, we only , know that an Alteration
in the Action of Vessels will Produce an Inflamation,
this Cure by the sustains is not Confin'd
to a Natural Inflamation, for an Artificial one
will Produce the same Effect, for Instance a 
Blister applied to the Neighbouring Parts
will take off an Inflamation, when a Part is 
Inflam'd and there is no distinct Surprior,

A Quantity of Coagulable Lymph is
thrown out; wch. glues them together; as in 
and Inflamation of the Pleura it is by this Means
They Adhere to the Lungs; if it be [cross out] large
Surfaces We Call this an adhension; but 
among the Muscular Fibres, and all
other Parts of the Body, where there is
a Quantity of Coagulable Lymph, the Parts
are Naturally Soft and Play one upon 
another, Now this Coagulable Lymph
glueing them together, renders them still 
liquid &c. and this We call Callenity----

Lecture 9th
It happens that an Inflamation may Continue
for sometime, but this is Caused by a Contained
Application of New Causes, for an Inflamation
initial/never Continues long in the same 
Situation, if it did We should Empart that 
the Vessels would, Burst, so that the 
Arteri's would arise at such a Pitatio/Distension
that they could encrease no farther, and 
the Inflamation woul'd be at a stand, but neither
of these happens, for when it Arrives at a Certain
Height it Terminates in a fresh Disease, The 
first of there is Suppuration; which We shall
now Endeavour to Explain; after an Inflamation
there is Matter form'd which we Call
pus, different from all the other fluids of the 
Body not form'd in it Naturally, but only in 
Case of Disease. It is Perform'd by some Chemical
Change for it cannot be filled'd from the

Blood Vessels as it is not Contain as in
Pain; New Pus is form'd in two Cases,
sometimes in a Cavity and sometimes on 
a Surface; We never find it in the Blood
Vessels; Let us first consider the Formation
of Pus in a Cavity inside to this there must
be an Extravasation for suppuration never
happens but from Extravasation, as in 
Inflamation of some of the Membranes, where 
the Extravasation is there the Pus is 
Form'd, as in an Inflamation of the 
Pleura if it is in the Cellular Membrane
there it is that Pus is form'd; if in the 
Cavity of the Lungs it is form'd there, when 
the Matter is first Extravasated it is not 
Pus, but sometimes Coagulable Lymph 
and sometimes serum and Superfluous
Water and not Commonly the Red Part
of the Blood, an Extravasation is not always
Converted into Pus, As in Bruises in the 
Rheumatism Coagulable Lymph is Extravasated

and no Pus form'd, it is then necessary to 
Produce Pus that there shou'd be an Inflamation,
and not only more Inflamation, but it must be in
Proportion to the Extravasated matter otherwise
it will not be form'd. in an Inflamation of the 
Pleura the Cavity in which the fluids Extravasated 
is large the Pleura itself is only a small
Part of the Body, and the Inflamation 
and in general is sufficient to form Pus, but
when it happens in the Cellular Membrane
above the Pleura, the Inflamation Bears a 
Considerable Proportion to the Extravasation 
and Pus is generally Form'd; the Inflamation
then Furnishes the Circumstances for that fermentation,
wch. is to Convert the Extravasated
Fluid into Pus, it has been Contended that Pus
was from'd in a different Way from this that 
the Exhalant Vessels where so Altered as to 
Separate Pus from the Blood, but this is 
entirely Hypothasis, for We actually see a 
Fluid Contained in the Cavity wch. is Insepable

of Absorption, and instead of this We Recently
find Pus, that the Exhalants doe not become
Secretory Organs to denote Pus, is Prov'd by 
this Experiment, in an Ulcer that forms
good Pus, if you Clear it Perfectly and
Observe it wth. the Microscope, the Fluid as it 
Passes from the Vessels You will find it a
Clear transparent fluid, then lay some [t????], 
the Ulcer so that the Matter is contained there,
and you will find it will become Pus; so 
that it is evident in every Case that Pus
is form'd from an Extravasated fluid and 
not from any Power that Exhalants Acquire
of becoming Secretory Organs Where Pus 
is form'd the Extravasated fluid. The Solids also 
Ferment and are Converted into Pus, it is
pretty certain however the Mundane is first 
Converted it is worth attending to; why 
the Life of the Solids do's not Depend them 
against this fermentation as well as any other;

sometimes indeed they are Depended by their
Life, sometimes Partly and sometimes not at 
all; When Pus is form'd it is not necessary that 
the Inflamation shou'd continue any longer
for it will keep up the fermentation, and 
occasion the fermentation of a fresh Quantity of 
Matter; Now the Cellular Membrane is universally,
Diffend'd through the Solid Parts of 
the Body; the Cells of it Communicate wth. one 
Another, We must consider then how it happens
that Pus do's not Diffuse itself through the Cells
as Water do's in Adematous Patients, why a 
Quantity of Coagulable Lymph is thrown out, 
which glues the Surfaces of the Cells together;
so as to render them Impervious to one Another
and the Pus forming in the Middle of the 
Inflamation, first it is Prevented from Diffusing
itself, sometimes a kind of a Membrane is 
form'd round it; and the Pus is Contained in 
a Cyst, but this do's not happen in Common; 
tho the Pus cannot Pass through yet it acts

so Strongly that it makes itself an Opening
on the external Parts, it is remarkable however
that the Pus do's not act alone in all Parts
of the Body for in some it makes its way
Directly, and in others indirectly to the external 
surface, hence less Mischeiff happens in 
many Suppurations; then we should Enpact,
now it may happen that the Cellular Membrane
has on it its Cells glued together in 
this (are Pus will Diffuse in [illegible]to a very great
Degree, sometimes also the Matter do's not 
Destroy towards the Surface of the Skin; but 
Destroys other Parts and Commits great 
Devastation this happens but seldom but 
when form'd Destroys the tumor as well as
the internall surface, so that we have 
instead of an Inflam'd Part a Cavity inside

Lecture 10.th
We have said the Cavity Produc'd in Inflamation
is Call'd an Abcess, after Pus is Evacuated it [illegible]
We Call it an Ulcer no that instead of Inflam'd
Part We have a Cavity, that Part wch.
was Inflam'd being entirely Destroy'd, but there
is a Power in an Animal of Regenerating those
Parts wch. are [illegible] in some this Power go to
to a great Length; if you Cut them in two each
Part will Produce that which was Sort, so that
We shall have two Animals instead of one;
but this happens to few Animals, as the 
Polypus &c in Complicated Animals who 
have a great Organization, even in these
Considerable Parts may often be Regenerated,
The whole taile of a Lizard in which there are
Bones; Blood Vessels nerves and Muscles 
may all be Regenerated and if Cut down the 
Middle there will be two tails; this same Power

of Regeneration exists in a certain Degree in 
Men; but less, in quadropeds in general 
and in other Animals, however Considerable
Parts of the Body have been Regenerated when 
an Extremity has been Cut off entirely it
cannot be Regenerated [ab??] if [illegible]
be left of each Extremity it will be [lege???]
as a large piece of Bone if Taken away will 
be Regenerated how the [??or??s] by which 
Parts are Regenerated in Man, if there be
a Cavity their Arise first an Inflamation
of the Surrounding Parts, this is not a Violent 
one; there is also a redness and some Degree
of Heat and Swelling, how every Considerable
Pain from the bottom of this Ulcer, every where
there arises Little granules of fluid Substance
This We Call granulating Flesh, and these
continue to rise up until the Cavity is fill'd
where it is Covered by a fresh Skin, is that 

after an Ulcer there Arises the Parts that 
where Destroy'd, sometimes in a Part and sometimes
in the whole, however tho by this Measure of Suppuration 
the granule bring Flesh is converted
into small parts that where [??ony'd]; yet the 
Motion will not be Perfectly Restor'd still 
We consider the Patient to be in Healthy; We
may in some Degree Call Suppuration a partial
Cure, it sometimes happens that no 
Inflamation Arises than Pus is form'd in this
Care a [la??ens] Matter goes out in a large Quantity
as an Inflamation the surface of the Ulcer
may Arise, and then it is converted into [illegible],
then the Ulcer spreads, the surrounding Parts
being Destroy'd if any Membrane [???ing]
the Surface of any Cavity wch. opens externally
shou'd be Inflam'd; there is a Quantity of Fluid
thrown out on the Surface of that Membrane,
As the Skin thus seperates the Scar of Skin from
the true, and is sometimes converted into Pus

Pus in an Inflamation of the Mucous
Membrane of the [Ha??] the Secretion
increased which often Rule on the 
Appearance of Air, in the [??mes] in the 
Skin is the Scar of Skin break a Fluid is afterwards 
Secret'd, which is sometimes Converted into 
Pus, this is not always the Case it happens that
when it is form'd it Destroys the Parts below,
and has been Said to Erode, Pus will not Erode
any sooner than Water but it acts as fermant
and Converts it into Matter similar to itself
the next fermentation in Inflamation is in 
Gangrene and Mortification as in the Death
as Puts of action of the Inflam'd Part, These
two terms have been taken Indiscriminately
some have Call'd a slight Degree Gangrene and 
a greater Mortification, if there is any difference 
we shou'd Remind as the gangrene as the 
Death of a Part and Mortification the Putrefaction

of it; now an inflam'd part is apt
to Die in two Ways, first from a [illegible] Ligature
and the Veins &c. in an Inflamation of the Cellular
Membrane under the Skin, the Distension may 
be so great as to Produce gangrene and Mortification.
Secondly the Inflamation of Irritable
Parts, and Extremity is apt to terminate in 
gangrene and Mortification as an Inflamation
of the Skin, and not only such Parts were 
liable to external stimulus but such also as
have Call'd irritable in consequence of the great
Effect they Produce on the whole System, as in the 
Diaphragm &c. when irritability and [illegible]
Combine then the gangrene and Mortification generaly 
takes Place how We can easily conceive
the reason why a Part shou'd Die when an 
Inflamation Arises so as to Distend it; but 
why a very Irritable Part should Die in Consequence
of being Inflam'd We doe not as yet know,
We might indeed suppose the Nervous [???lla]
are Destroy'd; when an Inflam'd Part Dies

The Arteries can no longer Act, Strongly, the
Swelling therefore subsides the Part becomes
Pale from a less Quantity of Blood being Contained
in the Capillary Vessels, the Pain also gets off
how its to be Observ'd that a Part which is indeed
And Attach'd to the Body. Pulse is sooner
than it was [?rem?ou'd]; for Example if you 
Cut off a finger and Place it in firmely right Degree
of the Thermometer wch. is the Natural Heat
of the Human Body; and another was to Die
that was Attack'd in the Body, the Suppuration
in this woul'd come in before the other, and
it do's this in Consequence of the Hope the 
Appearance of the [illegible] exactly the same, small
Blisters Arises Round the Part, it becomes
of a Darker Colour and at last almost Black
it is heated and looses its firmness the 
Surrounding Parts afterwards becomes putrid
and Dead, when any Part of the Body dies
there is a Process Arises which Separates

one Part from Another; and this We generally
Call an Euptiation, Suppose a [illegible] of Muscle
to Die, a Fibre defient Die in its whole Length a 
Part remains sound, there is then a Part where
the Dead and the sound Part form'd together, in 
this Arises a treament wch. Converts it into, a 
fluid so that a separation takes between the 
two Parts, this we have some Reason to Expect,
in the Purulent Inflamation, but We have no
Certainty of it in a Phlegmonous Inflamation
takes Place Round the Sound Part, and in 
Consequence of this, the Fluid is mostly Converted
into Pus, the Dead Part is thrown out and 
and an Ulcer is left behind, its not that the 
gangrened Part is Destroy'd, its Edges by 
Putrefaction becoming Perfect, but the Ends of 
the Sound Parts are Converted into a Fluid,
by which they are Separated, No gangrene 
and Mortification always Produc'd one Ulcer
it woul'd be a better termination than Suppuration
As it would take Place soon and Produce
an Ulcer easier of Cure, When We kill a Part

by Caustic Alkali, the Part is separated and 
an ulcer easy of Cure is left behind, but 
a Part wch. is artificially [illegible] and one that
takes Place Naturally has by no Means
the same Effect for when the Gangrene and 
Mortification is Natural it is very apt
to Produce an Erysapellatous Inflamation 
of the Surrounding Parts, so that most
Commonly they spread very Considerably 

Lecture 11th
When a Part is ganegrened and Mortified it 
is evident that a Quantity of Putred Matter
is Absorb'd and Carried into the System, when
this has happen'd it has been Call'd a Putrid
Fever it is however only a Symptom of Irritation
As great Depression of the Strength smallness
and frequency of the Pulse, and indeed an Irrability
of all the Functions of the Body; the Brain
is sometimes Affect'd and sometimes not 
and the Patient grows gradualy and Sensibly
Weaken till he, Dies; We might Suppose it was 
owing to an Absorption, and this may indeed
in some Part Contribute, but it is the Action
of the Dead Part on the Living in general. This 
to be Depend'd upon in Absorption the Symptom
wou'd be in Proportion to the Quality of the Dead Part
but this we find is not the Case, for Example
a gangrene of the whole Leg shall not kill in as

many Days, when a Man Dies it is not in
Consequence of the Functions of a Part being 
Destroy'd but in Consequence of the Irritability
of the Part, the whole Intestinal Canal is 
very Irritable therefore a gangrene of any 
Part of this is more apt to Prove Fatal
they certainly Symptoms of Irritation,
and not Fevers, as of the the of the Bark
Species &c, We can bring on a [Enp?ia?ia???]
a Phlegmenous Inflamation and the Patients
Restor'd, if they where Symptoms a Fever
it would still continue. The last [illegible]
is in Schirrous and Cancer; properly speaking
it is not a termination it is a Disease apt
to be left after Inflamation in general. A 
Schirrous as I have first said is a hard
Tumour of a Part left after Inflamation,
so in Callous also but there broad is for
Essentially from one Another a Schirrous
may be Converted into a Cancer and in this 
Consists the Essential difference between the

Two hard Tumours left after Inflamation
a Schirrous can only Remain in a gland and
is evidently owing to an Accumulation of Matter
in the Substance of the gland, which is generally
Solid and Hard, some have been apt to Call hard
Bodies Schirrous but they are not, because
they cannot terminate in Cancer; A Schirrous 
frequently remains in the same state, and 
may Continue through the Life of the Patient,
but it more frequently encreases, and after 
a certain Time it enter a Degree of Inflamation
in wch. the Circulation being encreased, an 
Extravasation follows, which Forms Matter,
This ferments and Forms more, it is then absor'd
by the Lymphatics and Thrown into the System,
that it is a particular Matter is evident, because
when it has been Applied to any Wound it has
Produc'd a Cancer the most Part it do's not
in certain as Variolenus Matter in Venereal;
but that it do's not Act is Indisputable and 
encreases till at the last it makes an Opening thro

the skin and Forms an Ulcer extremely
difficult of Cure; Ulcers of difficult Cure have
all been Call'd Caries, We mean those only 
in which a particular Matters in form'd an is
where it is Absorb'd and Carried in to the System
System, this difficulty of Cure Proceeding 
from this Absorption, for if you cut the part off
wch. is Ulcerated it will Heal, but it will 
again Break out in some other Part of the 
Body wch. shows the Matter has got into the 
System, so as to be Able to Produce Ulcers
of the same kind in other Parts of the Body,
Now the Stimulus Occasions Pains the 
Ulcer is very Faetid and the Evacuation
Weakens the Patient, and the Constant 
Application of the Stimulus wears him 
out, till symptoms of Weakness comming 
on, he tis Cut off by a certain and Painful
Death, Schirrus Glands without a Nervous 
Inflamation, it is to be [??maty] of [illegible]

a long Time [illegible] in this Case it generally
encreases till about the Age of 40 or 50 in
Woman about the Cessation of their Menstruation
having thus endeavour'd to [illegible] to you 
the different Methods of Termination, in simple
Resolution, this Occasions the Inflamation
to Subside and be Carried off therefore We
generally Aim at it on the Treatment of the 
Disease, the [illegible] suppuration wch. if it takes
Place is follow'd by the Restoration of the Part,
but if the gangrene and Mortification Comes on
We must Endeavour to make an Exfoliation
take Place or if no Mortification Comes on, if
it be Possible We must Endeavour to Restore
the Dead Part to Life, and if a Schirrous
takes Place We must Endeavor togethe'd of
as Prevent Immediating in a Cancer, the 
Cure then in the first Place, is the Application
of such Remedis as Dispose it to Resolve,
Secondly such as are proper to bring Suppuration
and for the Management of the Ulcer [illegible]





is Form'd. Thirdly the Management of gangrene
and Mortification, in most cases simple
Resolution is best, but not Universally
there are some Cases, where it is better to
Let the Disease go on to suppuration for 
Example a Fever shall Arise and afterwards
an Inflamation, if this happens in an external
Part of the Body it is better to Let it goe
on to Suppuration, as it will Prevent a 
Return of the Fever when endeavour to 
terminate it by simple Resolution to 
shoul'd very probably Cause a Return of the 
Fever, Consequently it is better to run the 
Risque of an external Inflamation, then 
such a Disease as a Fever, in the Course
of wch. is an external one shou'd happen its
better to Let this goe on to Suppuration,
by which the Primary one will be Cured,
if We dont it will be very Apt to Return 
there being generally some few Symptoms

of the former left, and if a small gangrene
shou'd be in the Inflam'd Part, and that an 
Indolent one, it is better to let much come on to 
Suppuration it is be large it is be [illegible]
unless the whole Gangrene Suppurate there is
Danger of a Schirrous comming on in that
Part in wch. the suppuration did not place,
We are then sometimes to Endeavour [sim??]
to Resolve the Inflamation, sometimes to make 
it Suppurate, there is one great Point to be
Consider'd in the Cure of Inflamation, We 
have shown that it is an encreased Action of 
the Arteris of a Part Distending the small
Vessels beyond their tone, and whatever has 
been the Opinion of particular Practitioners
it has been almost Universally allow'd that 
the principal Part of [???ation] was the 
[S???i] Propelling the Fluids with a greater
Velocity, this therefore is to be Attend'd so that 
in any Case the strong Action of the Arteries which
is the Material Part of an Inflamation may
be united by a Cure applied, a Man can
be so Weak, but this Cause may be answer'd and

and you Cure the Inflamation if this 
Cause be left, A New Inflamation will Arise
the first and great End then is to Remove
the Original, and any other Cause that may
Arise in the Remedy of the Inflamation-

Lecture 12th
We have Shewn you that it is sometimes better
to make an Inflamation subside simply in 
Order for this We shou'd endeavour first to 
Remove the Cause which Produc'd the Disease,
or now Occasion it to Continue, it is time We can
sometimes Cure an Inflamation, tho the 
Original Cause Remains, and that must be
Afterwards sufficiant to Reproduce it, but the Cause
of Inflamation being in general capable
of Acting in Weak as well an in Strong
[illegible] its often an Inflamation is Cured as 
well as before it more frequently happens
that it takes Place again, unless the Cause 
be Removed, an Inflamation is seldom
Stational, you will find that many of the 
most Powerfull Remedies we Employ doe 
not Cure the Disease at once, they only make

it Diminish and it then gets off itself now
if the Cause be Less it will encrease by little
and little till the Disease is Reproduc'd
it is therefore of Importance to Remove the 
Cause, which first Produc'd the Inflamation, or 
any Stimulus that may Now keep it up
the Means of Removing the Cause/many
Inflamations is very Obvious, but We must 
Observe to you wth. regard to the Removal
of such Causes, that are so Obvious that 
if it shou'd Require some Violence to Remove it
so as at Present to encrease the Inflamation
yet We should always doe it, per example
in a Fracture of the Bone, a Splinter [illegible]
Stimulate and Distend the surrounding
Part, it will be better to Remove it, tho some 
Violence be Us'd, again there are some Causes
which frequently Produce and keep it up,
an Inflamation that are by no Means
Obvious, and therefore Require particular

Explanations, the first of these Causes, which
shall be taken Notice of is that which has been
Commonly Call'd Acrimony of the Fluids, We
have said there is no such Acrimony as would
Produce an Inflamation by Affecting the 
Insides of the Vessels, so that they only Acted
on the Irritable Membrane and accordingly 
whenever stimulating Fluids, are Contained
in the Body We find them always Acting 
on Surfaces, the Stimulating Fluids may
be Universally Prevented from Acting 
an Irritable Surfaces, if We can Prevent their
Touching but they are of them of the Watery
Fluids as Solution of the Neutro Salts of the 
Blood, Variolous Merbillous as Cancerous
Matter, if We rub a Quantity of [??l] over the
Membrane We shall Prevent any Watery
Stimulus from Affecting of it and if We 
[Ca??] the surface of one with any Viscous
Watery Fluid, it will be sometime be pre the 
Irritating Fluid will [illegible] itself wth. this

Mucilaginous one, and We know that the 
Stimulating Matter do's not Act so Strongly
when Dispos'd in a Viscid Fluid, thus [??r] the
Covering a Membrane wth. Vegetable Mucilage
will in a great Measure Prevent the 
Stimulus from Acting, for Example suppose
the tears run down the Cheek in a large
Quantity they will Excoriate and Raise
a Degree; of Inflamation if we rub a 
Quantity of Oil over the Part, We shall
Prevent the Stimulus from Acting and 
Cure the Inflamation in Order that an
Evapor'd Oil shou'd be Applied w th
Lungs it must be taken into the Stomach
Absorbe'd and Carried there by the Circulation
which shoul'd hardly Imagine possible that 
it shou'd be Carried in such a Proportion as to
Produce any Effect, but We actually find if We 
Show in a Quantity of Evapor'd Oil into 
the Stomach it do's Diminish the Action

of the Stimulating Matter, some other Manner
of Action has been sought for (namely that the 
Evapor'd Oils had a Power of sheathing or [Pl???]
the Particles of the Stimuli but it is Prov'd that 
they have no such Power, for the Stimuli are 
simply the Neutral Salts of the Blood, as wth.
they have no Power, so that [illegible] 
must Act by Depending the Irritable Parts
from their Stimulating Matter, Consequently
Comming into Contact wth. them; some have
suppos'd the Oil given internally slips down
the Trachea, but this it certainly do's not
for it woul'd then Stimulate more bendes Oil
Thrown into the System in a Solid from Produces
the Effect, however Let the Manner of Acting
be what it will, Evapor'd oil and Vegetable
Mucilages have a Power of Defending Irritable
Parts from Stimuli; when they are Us'd they 
shou'd not Contain a Quantity of Stimuli; for 
sometimes they Contain a Quantity of Essential
Oil, Linseed Oil Contains this, therefore it is

not proper in this (are to be Employ'd; Evapor'd
Oils are frequently known by Heat, when they 
Acquire a Degree of Empyreumatic, such is 
improper for the Vegetable Mucilages if 
kept too long are apt to [??sy], There are 
then improper to be Employ'd; when Evapor'd
Oils are made use of internally, the Heat of 
the Body Renders them Fluid, so that it 
Matters not; whether they are in a Fluid
or Solid Form; when externally Applied
they shou'd be Fluid in just the Heat of 
the Body, if they are too thin they will
Run off it too thick they will not [Rene??]
Oils of this Consistence have been Contrived
which we Call ointments, the Vegetable
Mucilage We Employ, is simply so are 
equaly Useful, but they cannot be us'd
externally because the Watery part will
Apt to Evaporate, and have the others Dos
upon the skin, then it will stimulate of 
itself; there are the Remedi's We Employ

to Cover the Surface of a Membrane as for 
to Prevent the Stimulating Matter from touching 
it; the Second Means of Preventing a Stimulating
Fluid from Acting on the Surface of Membranes
is by Destroying such Fluids. In Practical
Authors We find [illegible] deal about the 
Destroying the Acrimony of the Fluids, yet
there are but few Cases in wch. We can; if 
the Inflamation happens externally; We 
may by the Application of Caustic or Vegetable 
Alkali But when the Stimuli has 
got into the System; We only know of one 
Instance in which it can be Destroy'd, wch
is the Venereal Matter by Mercury, and its
Preparations; how it Acts We are at a Loss
to Account for; It must be Observ'd that the 
most Common Stimuli are the Nutro Salts
of the Blood these We cannot Destroy, nor
[??acuate], consequently We cannot Destroy
the Stimulating Matter; the Next Method
of taking of the Stimulating Matter, that is 
the Action of Stimulating Fluids and

other Stimuli also, is one that has not been 
sufficiently Considered, the Nutro Salts
of Fluids Applied to a Mucus Membrane in
any Part of the Body; after the Natural
Mucus is Washed off, will Stimulate and 
Inflame, but when applied to the Surface
of the Pleura or Peritoneum wch. are not 
Cover'd wth. Mucus, they do not Stimulate
at all, for Example; if by Purging the Mucus
be Wash'd off from the Inner Surface of the 
Colon or Rectum, the Stimulating fluid will 
Produce an Inflamation, but the Nutro Salts
wch. are Constantly thrown out in the Pleura
and Peritoneum doe not Stimulate throughout
these are not so apt to be Inflam'd; We
find then that the Mucus Membranes are 
not Irritable supposing We cou'd take 
off, this Disposition, they might than 
be Applied without Producing any Stimulus

The Disposition of a Part to be Stimulat'd
Depends on Life; if We cou'd then Vary the 
Life, tho the same stimulus was applied
it would not be capable of Producing an Inflamation,
We have Remedis that will render 
a Part less Irritable and Prevent much 
Fluids from Stimulating and Producing 
Inflamation, for Instance in an Inflamation
of the Skin from Heat, A Blister Arises and 
wch. Breaks, there then oozes out a Fluid containing
the Nutro Salts of the Blood, this Stimulates
and Occasions the Inflamation to Spread, Now
if you Exhibit the Center Reno tho of itself
rather tends to Produce Inflamation, it will 
alter the Power of the Life, so as to Render the Part
less Irritable. Thus when a stimulating Fluid
is Acting on a Vessel, We can by the application
of particular Remedis diminish or in some
Cases entirely take off the Inflamation in Irritable
Habits, then We can cure an Inflamation by the 
Exhibition of the Bark, tho it has a tendency 
to Inflamation-

Lecture 13th
The next Cause which Requires our particular
Attention is the Distension of the internal small
Vessels, the Quantity of Blood Circulating
in different Parts of the Body is very various
at one time somtimes the Quantity circulating
as at another, but there is a kind of general
Disposition in the Blood to Circulate in 
a large Quantity, in the Vessels of the Extremities
as in the Internal Parts as in the Thoracic
and Abdominal Viscera, so that when the 
Circulation is Diminished in one of these 
internal Parts, as in the external Parts
it generally is in the whole, so also it is wth.
the internal Parts, there is a kind of Balance
between the Internal and external Circulating
for it happens not Uncommonly that
a Contraction of the external Vessels, [gua???]
a greater Quantity of Blood being thrown 
in some of the Internal Parts, for [E??d??]

of a Man Unaccustomed to such a Practise
spend Walk Bare foot on the Cold Stoes it 
will frequently happen that a Pain will Arise
in the Abdomen, and where an Inflamation
Arises in an Internal Part of the Body, the
Stimulus Occasioned by it will encrease the 
Circulation by this Means the Vessels are
Distended and the Inflamation kept up, Now
by encreasing the Circulation in the external 
Vessels We Diminish that on the Internal
one's Consequently take off the Distension and 
Cure the Disease, the Manner of Restoring the
the Circulation to the external Part comes now 
to be Explained, first then there are certain Substances
wch. [cross out] to Relax the small vessels
through the whole system, that there are Remedis
which Produce this Effect is sufficiently evident
the Question is whether much [illegible] do's
actually take Place, Now there are certain
Remedis if Applied to the Stomach often 
[Occassion] [crossout] encrease of all the Secretions

through the Body, this Effect has,
Produce in three Ways, either by encreasing 
the Action of the Vessels themselves as the 
Secreting Vessels of the glands, or by Returning
the glands themselves, Thus if We Apply
Ipecach or Tartar Emetic to the Stomach
it shall happen in many Cares that 
tho the Skin was Dry before, it shall become
Moist as also the Tongue there shall 
likewise [illegible] something from the 
Intestin's, We Say it happens in many
Cases for no Medicine is certain not always
in its Effects, not if the encreased Secretion 
Arise from a general Stimulus, the Circulation
also wou'd be encreased; It is true sometimes
on the first Application of themselves the 
Stomach they Disorder it but encreased the 
general Action of the Vessels; Now if the
Secretory Organs for it We employ
Emetic Tartar to any Gland, it is so for

from encreasing the Secretion that it
diminishes and Acts as a Sedative, it is 
evident then that they have a Disposition
to Relax the Vessels, but this May doe more
in the external than in the Internal Vessels
Now the Medicines of this Kind We are
at Present Acquainted with, are all the 
Neutral Salts Squills, Ipacac, Rad Senica,
Preparations of Antimony and Water Rendered
Cold, is as to be nearly at the Freezing
Point, the Power of the Neutro Salts in 
Producing Relaxation is not very Considerable
the Powers of the others is much more Considerable,
When We want them to Act more 
Powerfully We must use Prepar'd Antimony
or Ipecac in this Country, in Warm Climates
are Italy Cold Water is made use off Squills
have been Employ'd only in Slow Inflamation
of the thorax, it is to be Observ'd that when [th???]

Considerable Inflamation if We Relax the
Vessels of the Skin a Profuse Sweat takes
Place, the Bed Cloaths get Wet, and if 
the Patient is Covered Close regulates
and Inflamd, if Expos'd to Cold the 
Distension and Topical Inflamation is 
much encreased, hence We are Prevented
from trying them Constantly in general
Inflamation; In these Cases We must
Confine [illegible] to make [illegible]
as Nitre and the Neutral Salts; when 
a Man is Cover'd with his ordinary
Cloathing, some Parts of the Body are 
apt to be expos'd to the Cold, and the 
Circulation is frequent by Changing
But when equally Cover'd in Bed
an equal and constant warmth is
Applied to all the Parts of the Body
and such Changes take Place therefore

in Internal Inflamations the Patient
shou'd be Confin'd to Bed, the Pratice
has Varied Considerably in the Treatment
of this Disease, owing to its not being sufficiently
Consider'd. It is evident We ought
to Confine the Patient to his Bed in an
Internal Inflamation of any Consequence
but at the same time is improper to See 
him wth. Cloaths so as to Occasion a great
Degree of Heat, for much a Constant Inflamation
or Application would Stimulate the 
whole System and encrease the Disease
treatment Means of bringing the Circulation
to the external Parts of the Body; is Warm
Water, it is not necessary to apply it
to the whole Body; The Heat only on upper
Extremities as in some Cases the Trunk 
of the Body, Warm Water of Relaxing
and Stimulating so as to encrease
the external Circulation; and has

a Power of encreasing it also; but at
not relaxing the Vessels like Warm 
Water. If this be applied to the lower
Extremities it will encrease the Circulation
in the whole System. It is to be
Remark'd that after a Part has been 
sometime immersed in Warm Water,
both the internal and external Circulation
is encreased, so that is Continued
for more than fifteen Minutes there
Appears Symptoms of an Universal
encrease of the Circulation, therefore it
shou'd not be Applied for too long
a Time in the next Place it is more 
proper to encrease the Circulation in the 
external Parts, In Inflamations of the 
Abdominal than of the thoracic Viscera;
another Method of encreasing the external
Circulation is by the the of Stimulants
there where frequently Us'd by the 

Ancients, in Employing these Remedies
We are to Consider at the same time that
they tend to Diminish the Internal they
Stimulate and encrease the general Circulation.
This Method then is now look'd
upon as improper, sometimes indeed
it may Succeed; One Stimulant yet
remains in Practise (viz) Vol. Alkali
of which we shall speak hereafter.
The Cause which Constantly tends to 
the Keeping up of all Inflamations
in the Distension of the small Vessels
beyond their Tone; there are two Ways
of Removing the Stimulus; arising
from the Distension, one by Removing
the Distension itself. The other by taking
off the Counteraction or Disposition
the Contraction of the small Vessels
or Capillaries, by the Application 
then of Relaxing Medicines to the 
Inflam'd Part, diminish the 
Disposition of the small Vessels to 
Contraction no more the stimulus 
Cure the Inflamation; by Applying

Warm Water to the Part Affected, We
are frequently Able to take of the 
Inflamation, it is to be Observ'd that
the Vapour is more Powerfully
Relaxing than the Water itself, therefore
instead of Immersing the Inflam'd 
Part in Warm Water, We apply some 
such a Substance as Cloth, Membranes
wth. the Water, and Repeated as after 
as it grows Cold; the Application
of it in this Manner We Call Formation,
we also Use it wth. Farinaceous
Substances and when Applied in 
this Manner We Call it a Poultice
sometimes We throw it on the Body
in the form of Vapour, but this is not 
to be done in Inflamation as We cannot
sufficiently Cool it before it Comes
to the Inflam'd Part; the Application
in Poultice and Fermentation are 
therefore the best and this We shall
Proceed to Explain

Lecture 14th.
We have Said that by the Application
of Warm Water we cou'd take off the 
Stimulus in an Inflamation, and that 
the Steam Arising from it as more
Powerfully Relaxing; and that therefore
We Chose to Immerse some Substance
in Water, and Apply it to the Part, We 
Come Now to make some further Observations
on the Application of Water to 
Relax the Vessels so as to take off the 
Inflamation, We must first Observe
that the Relaxation do's not Depend
on the Elasticity of the Part, it may 
happen that the external Part of the 
Skin in an Inflamation may be Dry
in this Case the Application of Warm
Water is not Confined to the Skin for 
Example if there is a stone Contained
in the Urethra, the contraction is in 
Consequence of it, suffering the Urine to 
Pass wth. difficulty, by Placing the 

Patient in Warm Water the Ureters will be
Relax'd so that the Urine will Pass more 
freely, in this Case it is evident it cannot
be Moistening the Part, there are many 
more Instances wch. We cou'd Point
out to you, where Warm Water do's
not Out in Consequence of Moistening 
the Part; this the Contractile Power
of the Vessels Depending upon Life
that We [al??arencess] when the Skin
is much Distended and Dry hence
the Fomentations and Poultices are 
Serviceable not only in Inflamations
not only of the external but of the 
Internal Parts of the Body also and
as the Balancing Power is [illegible]
on the Tone of the Vessels, it is not Necessary
the Water shou'd Penetrate to the 
Part to Produce its Effects, in the 
next Place it is to be Observ'd that the
Water shou'd be of a proper Temperature
if it be too Hot it will Act as a Stimulus

and encrease the Inflamation, it 
shou'd be made a little Hotter than the 
Inflam'd Part, and tho it may be Necessary
to Apply Cold Water to an Inflam'd
Part it has quite the Reverse Effect, We 
must Observe that in the Application of Cloth
Moistened in Warm Water, then is this 
difference that Cloth of a firm texture, is
soon Heated and soon Cold, and a Centrano
Cloth of a Loose Texture in therefore better
for the Purpose a Course Flannel
We also sometimes employ both Fomentations
and Poultices at the same time
and not Singly for this Reason, that 
Fomentations are more Powerfull as a greater
Quantity of Water is Applied in this for yet
if we Continue Constantly to Foment
a Part, We shall Wash off the Natural
Mucus and Cause an Inflamation 
on the Skin; We therefore only apply
them twice or thrice in Twenty four hours
and afterwards the Poultice and whenever

We the either, We shou'd Add some 
Mucilaginous Substances to Prevent
the Mucus from being Wash'd off
the last Observation we shall make 
is that the Application of Warm Water
encreases the Irritability of the Part
therefore in an Inflamation of the 
Skin; as in the Erysepellatous Inflamation
Warm Water will doe Mischeiff And 
Oil is held to Prevent the other
Applications from growing Dry; We 
Come next to Shew the Remedies to be 
Employ'd immediately to take off
the Inflamation; Now the most Powerfull
Means of the Weakening that We 
Know of is by Evacuation either by 
Opening a Blood Vessel, as encreasing 
the Secretion from and of the Glands
for Example the Opening an Abcess
suddenly if it be large; will often
Weaken the Patient so much as to Occasion
faintings, this happens also

in Taking Water from the Abdomen,
Thus Opening a Cavity that Contains a 
Fluid in Solid Weakens Considerably
it is wth. this Intent that We Employ
it and other Methods of Evacuation
and there We make in four several Ways
first when We want to make an 
Evacuation from any Part of the 
Body indiscriminately We open a 
Vein and this generally in the Arm
if it is easily got at; We must Observe
it there be a Topical Disease and the 
Rest of the System be Affect'd in the 
same Manner, but not in so great a 
Degree, then the Application of a Remedy
that shall Affect the System, will 
Carry off the Topical Disease; if the 
System be not Affect'd it will have
no Effect, if then the Os tenias of a Part
are Aching in the System are acting
strongly Evacuation will generally 
take off the Strong Action hence We

Cure an [illegible] woman than any 
small Inflamation of the Skin by VS
His useful there person general Inflamation
when the Pulse is full hard and strong
and frequent as also when the Habit
is strong, tho the Pulse be not full and 
Strong &c; in some Inflamation Bleeding 
is of no Use, tho the Inflamation be
Violent, for Example when the System
in general is Weak, as in a Woman after
Child Bearing, in these Cases it is often
Detrimental for where it is only the 
Arteries of a Part, which are Acting 
Strongly, and not of the System in 
general; Secondly the more suddenly
We take away the Blood, the greater
Temporary and less Permanent We
Produce; thus then it We make an opening
into a large Vessel and let the Blood
run out very fast, an Animal Die
much sooner, than if it was to follow
gradually it will therefore Produce a 

greater Degree of Weakness, than if 
taken away slowly and at different Times;
If therefore We Wish to Produce a great and 
sudden Weakness, We ought to Choose a 
large Vessel, and make a large Orifice and
also take a great Quantity at once; We 
may Bleed with Safety until the Patient
Faints; in every Strong, and when there
is a great Inflamation, We may take away
℥xxx. of Blood at one time but generally
℥xxx. is the Largest Quantity and this is 
frequently Requir'd in the Country, in some
Cases it may be necessary to be only
℥6 or even ℥iv. of the Inflamations that
happens in Large Towns, from ℥8 to ℥6.
is generally the Quantity Require'd it is 
to be Observ'd that sometimes open 
V.S. the Inflamation immediately Ceases
but this is not always the Care; nor has
it bear sufficiently Attend'd to, that the 
V.S only makes the Inflamation begin
to Diminish, We have said that an

Inflamation seldom Continues in the same
State; if by V.S we diminish the Action
of the Heart and Arteries this will begin
to make the Distension to begin to 
Diminish so that it will Continue so
to doe till the Inflamation Ceases, here
after Evacuation, shou'd Avoid every Thing
that may Stimulate so as to make the 
Inflamation to begin to encrease, for it
will then Continue to encrease as much or 
more than at the first. A Want of 
Attention to this as often Destroy'd the
Effects of V.S. We have said that 
Bleeding is of no use, We must also 
Observe that it is [???full] if no 
general Inflamation Arises, for it
encreases the Irritability, as well as
the Inflamation, thus in Pure Inflamations
of the Skin, Catarrhs Erysepallalous
Sore throat, and Autumnal Dysentery 
it is of no use, in mined Inflamations
that is of the Substances, as well as

Surfaces of Parts; Bleeding is Usefull
as it will Remove in general both that of the 
Substance and Surface also; this Evacuation
of Employ'd properly is the most
Powerfull Remedy of any in Inflamation

Lecture 15th.
The only large Evacuation We can make
from a Gland quickly enough to Cure an
Inflamation is Purging it differs from that
of Bleeding in this Circumstance if you
Open a large Vein so as to take away a 
Considerable Quantity of Blood, the 
Evacuation is justly Uniform from the 
whole System, but in Purging We Employ
a Stimulus to the Intestin's which not only
Produces a large Evacuation, but also Causes
a quicker Circulation through them, hence
in Considerable Effects of Purging, We must
not only Consider the general Weakness, but
the Partial Evacuation Arising from Purging 
is more useful in external than in 
Internal Inflamations, as it Empties
them more, We shall find that making 
an Evacuation from the Gland affect'd
is very Powerfull in Carrying off Inflamation,
hence it is useful in Inflamations

of the Intestin's in that of the thoracic Duct
it is sometimes thus full, for it Occasions
a greater Quantity of Blood to be thrown 
out on the Part, which stimulates it the 
more, but in all Inflamations it faeculent
Matters are Contained in the Prima Via
it is always Usefull; Purgatives may 
be Divid'd into three Classes; First those
that Produce their Effect by encreasing 
the Perilistaltic Motion. And Secondly
those that encrease the Secretion from them 
in Consequence of Stimulating them;
the first species Evacuate the Intestines
only Producing very little Effect from the 
Blood Vessels. The Second doe produce
an Effect from them, so that they are the 
most Usefull in Inflamations, Purgatives
may again be Divided into three classes;
first when We Exhibit the Neutral Salts
as Purges, there is Considerable Evacuation
from the Intestine's without any Alteration
of the Pulse, but it you give Jalap

Scammony and not like Reamous Purges
at the same time they Produce their Effect,
the Pulse becomes Quick and the System
in general becomes more Heat'd, hence 
the first Class are the most Usefull in 
Inflamations, the other Observations We 
made on V.S. applicable to Purging 
except that Purging is more proper in 
external Inflamations; thus it is Usefull
in Phlegmonous on's; No Erysepellatous
Inflamations this Evacuation as well
as V.S. is hurtfull; and for the same
Reason We come in the next Place to 
Consider the Effects of Topical Evacuation;
and first the opening of a Blood Vessel
in or near the Part Affect'd, after the 
Knowledge of the Circulation of the 
Blood, it was thought Topical Bleeding 
woul'd be of no Use; it being of no Consequence 
from what Part the Blood was

taken; and it is evident that if We
Want'd Blood that was improper for 
Circulation, We could only Evacuate the 
Blood that was Distributed to every Part
of the Body; but Let us Consider how 
far We can Empty the Blood Vessels
of an Inflamed Part; if We open an 
Artery of an Inflam'd Part, it will Prevent
the Blood from flowing into it; if We 
Apply Leeches to give the Blood apear
Opening to Pass out than if it was to goe
to the Heart and therefore We Evacuate the 
Vessels of the Part more; This Evacuation
may be made either wth. or without a System
the latter is generally the best, We 
must Observe from Experience that in 
whatever of these Ways, it is made from 
the Part Affected; it will doe more 
Service, than Evacuation from a distant
Parts; when We open a Vein of an Inflam'd
Part, it is not always Necessary We should
Apply a Ligature for the Vessels being

Distended, upon making an Opening
a large Quantity of Blood will flow out,
as the Blood is Passing wth. greater
Velocity to the Heart, and is in some
Degree Obstructed, if the Orifice be made
on the Side of the Vessels the Blood will 
flow the fear, Topical Bleeding is 
certainly a very Powerfull Remedy
in Carrying off of an Inflamation; Cupping
wth. Scarification is sometimes Us'd; but 
We cannot make this Application to the 
Inflam'd Part; nor is it absolutely Necessary
the Evacuation shou'd be made from the 
Vessels of the Part; provid'd it be made
near it, this good Effect will be Produc'd
even though the Vessels of the Part have 
very little or no Connection; as Bleeding 
in the Breast in an Inflamation of the 
Pleura will have more good Effect than 
Bleeding in the Arm, it is seldom that We 
can open a Vessel in the Inflam'd Part of 

a sufficient Size, for a Plentifull
Evacuation, We therefore in this Case employ
Bleeding from the System in general, Topical
Bleeding is usefull in Phlegmonous
Inflamation only; in Erysapellatous 
Inflamation it is often Hurtfull, for it
encreases the Irritability of the Part, so 
as to doe more Mischef than good,
hence Eryspallatous Inflamation of the 
Throat, Gonorrhea &c it is of no Advantage,
it is to be Observ'd that where is a Mixture
of the Inflamation, Topical Evacuation
is generally more Powerfull in Carrying 
off the Plegmonous Inflamation, than
Bleeding from the System in general

Lecture 16 th.
The Weakness or Strength of a Part and 
its Acting is being at Best, are encreasing 
different from one Another for a Part 
however Strong may be at Rest, and 
somehow Weak may exert itself, the 
bringing a Part to Rest, and the 
Weakening of it are different Effects
Application wch. bring Parts to Rest
without Weakening We Call a Sedative
Weakness is always more or less a 
Disease, it Prevents the Functions of the 
Body from being Perform'd so Perfectly
as they woul'd be, it We cou'd bring a Part 
to Rest without Weakening it. We should
Cure the Inflamation better, Consequently
We ought to Prefer the Application 
of Sedative as to the Antiphlogistic
Remedies, in all Cases they are not

sufficient to Carry off the Inflamation 
in some they are, it is therefore worth while
to Employ them as far as We can
Sedatives may be Applied to the Stomach
so as to Act on the System in general, or 
to the Part Affected, or near it, so as to 
Act more immediately on the Diseased
Part. When the System in general is Affected
as well as a particular Part; Sedatives
Applied to the System may be of Use;
Now the Sedatives that We Apply to the 
Stomach are [A??d?], the Action of these is
small, and not to be Depend'd upon; when 
there is only the Hardness of the Pulse and 
Fever turning out into general Inflamation
As in the Hectic Fever, and if Contained 
for sometime are of Use; Infusion of the 
Tea of Sarsaparilla &c, are of Use unless
the Fever runs out for a Considerable 
Length, they may be had wth. advantage
they are of no Use on Topical Inflamation 
The next Sedative We shall take Notice of 

in Warm Water which being Drank in a 
moderate Quantity, exerts a Sedative Power
it has however been Employed in Inflamations
to Produce different Effects, there has
also been Considerable Variation in its
Use,the Antients forbid it entirely, for 
three of the first Days, and allow'd it
afterwards very Moderately; while in Modern
Practise has much has been pushed down
as the Patient cou'd Swallow, it the Drink
in Acute Inflamations, As the Pleurisy 
has been given only Warm, and not a Drop
of Cold Water has been Exhibited, supposing
it wou'd prove fatal to the Patient, it was
Necessary a Man shou'd have a Natural
Appetite, for Meat and Drink, in order
for his Support; and I believe that We 
may in general trust to the Natural
Appetite as to Drink, there not Appearing 
to have been any Advantage gaind by 
forbidding Drink, [illegible] Superfluous Water,

do's not seem to Distend the Vessels in 
any Degree as little hence is Required to throw 
it out of the System it is therefore not worth
while to make the Patient Uneasy for Want
of it, as that will encrease the general
Inflamation; On the Contrary a great 
Quantity will be Detrimental as it may
in some Degree Distend the Vessels, and 
perhaps make the Inflamation to begin 
again to encrease; the Warm Water thrown
down even supposing the Distension
Depend'd in the Viscidity of the Fluids
would be of no use; as there is always
a sufficient Quantity of Superfluous Water
in the Blood Vessels; in the Second Place
if an Obstruction Arose in Consequence
of the Viscidity of the Fluids Contained
in the Vessels, the Warm Water wou'd not get 
at it to Produce any Effect, as the Circulation 
wou'd be Stop'd in a Part it is then 
certainly the best to Leave it to the 

Patient, taking Care that the Fluids
are entirely Watery, for all that Contain
Alcohol tend to encrease the Inflamation
by their Stimulus, it is a Question 
whether the Water shou'd be Us'd Warm
or Cold, the followers of Boarhaves
Doctrine, have Suppos'd that Cold
Water would Condense the Fluids, but 
it do's not at all Appear Sensibly to encrease 
the Viscidity of the Fluids, neither Can
it act on the Blood so as to Cool
it, for the Body has a Power Preventing
it from being Cool'd, hence there is no 
Disadvantage in Employing Fluids that 
are Cold, on the other Hand Cold Water
acts as a Relexant, but as We have 
more Powerfull Relaxants, We need not 
make this Use of it, the Patients Drink 
may be given either Warm or Cold; Not
has been Employ'd in Inflamations and

Considered has a very Powerfull Sedative;
but I Believe it is of very little Use if any,
for nobody in the first Place nor even its
warmest [Ada?rate] have Employ'd it alone,
neither has it been Employ'd in any particular
Dose, there is one Reason for Employing
this, or some other Neutral Salts in Acute
Inflamations as it may be given in 
the beginning of the Disease, when it is 
not proper to give any more Efficacious 
Medicine, besides the Practitioner is always
Obliged to give something in Order to 
Amuse the Patient, upon the whole We 
can doe little good in Inflamations
by Sedatives Applied to the System
in general, but Applied to the Part they 
are frequently so Powerfull as to Carry
off the Inflamation of themselves. Here 
are two kinds of Sedatives, More the have 
any Considerable Astringency, and 
those wch. has very little or none;
the Sedatives which have but little

Astringencey are [illegible] of the Plants wth.
[illegible] flowers, as Nerbum [Ab??th]
Matricania &c; some Roots also as the 
Preyenia Alba and Beets also as the 
Aryenia Alba and Poppies, as those now 
Employ'd in fomentations and Poultices
it has been suppos'd that it was the
Warm Water, that Produc'd the Effect, so
that they have reject'd every other Ingredient.
But this Opinion is extremely Erroneous
for the Application of these Substances
has been Attend'd wth very Considerable 
Effect, when Warm Water has been
Produc'd from or at least a vary Considerable
one, in external Phlegmonous Inflamations
Reppias or Opium or Decotion
of Wormwood, or some other of these
Plants of this Class; Applied in the 
form of Fomentation, and afterwards the 
Plants Beat down, so that the hardness 
is taken off; and then Applied as a 

Poultice, and are more Efficacious than
Farinaceous Substances Moistened wth. Water
but especialy Opium, so that by these means
We shall be Able to Carry off an Inflamation,
when a Simple Fomentation, or Poultice
would not; Matricaria and other Antispasmodic 
Plants, are not so Usefull in Inflamations
Lying immediately under the Skin, as in 
those that Lye deeper, as in an Inflamation
of the Womb, We shall at Present only observe
that Sedatives of small Degree of 
Astringency are not so Serviceable in 
Erysepallatous Inflamations as those 
of a greater. 

Lecture 17th.
We Come now to Consider the Action of 
Astringent Sedatives in the Cure of 
Inflamation, there where Commonly
Employ'd by the Antients and were
Call'd Repallants, they Consider'd
Inflamation as a Relaxation of the Part
and Consequently an Accumulation of 
Blood in it, Astringents they thought
therefore the most proper Applications
to Occasion the Blood to be thrown out,
but when it was suppos'd that Inflamation 
Depended an Obstruction, every 
thing that encreases the Contraction
was Hurtfull and accordingly thrown
aside in Doctrine, tho not entirely in 
Practise, We however find that they are 
frequently sufficiently Powerfull for
Carrying of an Inflamation, those who

Suppose their Action as Repellents, suppose
also a Quantity of Morbid Matter, if
therefore the Vessels they urge to Made to 
Contract, so as to throw it into the Circulation
it would Produce seem Dangerous
Disease, and on this Account they where
Rejected, they have however been always
kept in Practise, and are now more
frequently Us'd, than they where sometime
ago there are certain Cases in which
We wou'd not Wish to Cure an Inflamation
by any Topical Application at all 
first when it is a Critical one; Secondly 
if the Inflamation has been Habitual
for if We Cure such a one by any Topical
Application we shall have frequently
some Violent Disease, Attack the Internal
Parts of the Body; kindly in Phlegmonous
Inflamations Lying immediately under the 
Skin, for if you tye a Ligature over if 
gangrene and Mortification will ensue

so if You [ce??dus] the Skin evey Sense
the like will be the Consequence, to show we 
have Seen them Applied wth. Success
in these Cases, but as the Suppuration
of such Inflamation is seldom of any 
great Consequence, they ought not to be
Us'd, in all other Phlegmonous Inflamations
there is Danger of Contracting 
the Skin, so as to Press it against
the Inflam'd Part, as they likewise 
Diminish the Irritability they are 
Serviceable in Erysepallatous Inflamation
the Sedatives of this Kind We Employ
at first Vegetable Astringents as
Inter. Rosar. rub. Nurb. Agsiman. Red
Termantillec &c, when We Employ these
as Sedatives and Emollients it is 
better to Apply them Cold than Hot,
Acids Applied externally are Powerfull
Sedatives in Phlegmonous Inflamations [illegible]

Lying immediately under the Skin,
and where it is Affected also; Acids are 
not Employ'd in Consequence of their
Stimulating in Inflamations, that are 
deeper Seated, they have been Employ'd
wth. Success, they are not to be Us'd in 
Erysepallatous Inflamations, Alcohol may 
be Us'd in most Cases especially in 
Erysepallatous Inflamations it is better
however to Dilute it wth. an equal Quantity
of Water or it may be farther Dilut'd and
Produce Considerable Effect Farina Matter
is also an Astringent Sedative, it differs
however from the Farina of some Seeds 
having more Astringency than that of others
as Oatmeal Indian Wheat &c. Oatmeal 
has been Us'd in Erysepallatous Inflamation 
but [illegible] wth. Advantage 
they are however Employ'd in external
Inflamations wth. Considerable Effect, the 
last Class of Astringent Sedatives

Possess this Power in a great Degree
they are the Salts and Calxes of some
Metals; and Allum, there are too
Powerfull to be Employ'd in most
Cases, sometimes however they may 
be Us'd wth. good Effect, but as We
shall hereafter have Occasion to 
Shew you the particular Cases in 
which they are Applicable; We shall
now Proceed to Consider the next
means of Carrying off an Inflamation
which is by Raising another in a 
different Part of the Body, for two
Inflamations doe not Subsist well 
together; We have Said that we dont 
Understand in what Manner one
Inflamation Cures Another, but it dos
whether the Second be a Natural or 
an Artificial one, We doe indeed
Produce a New Disease, but it is of no 
Consequence, it may be necessary
to take Notice of some Opinions

that have been held, wth. regard to the 
Method of Cure, if in the first Place it is made
in the Inflam'd Part, that will occasion
a greater Circulation in it, if act a Distance
it was suppos'd that it Diverted the Flow
of the Humours from the Part originally
Inflam'd tho there may be something in 
this Opinion, yet We know it is not 
Actualy so, for the nearer the Second
Inflamation is to the first, the more certainly 
it will Carry it off, it was agreeable to 
this Opinion the farther it was off the 
better it would be, We most Commonly
Employ Cantharides to Procure this 
Inflamation there are two supposed [illegible]
in Cantharides first, in the
first there is a Disposition in it as to 
Raise a Blister, it has been Suppos'd
that the Flow of Mucous from this Cured
the Inflamation, but they cannot Produce
this Effect in this Manner, as We can
Expect little Advantage to Arise from 

this small Discharge, it is certainly,
not from this, for if you Raise
an Inflamation when no Discharge
is Produc'd, the Effect will be the 
same. Secondly the Particles of the 
Flies have been Suppos'd to be Sharp
and [??ide] the Obstructing Matter, This 
opinion it is to be observed to [??wire]
one, Reputation, nor dos the Juice
of Cantharides when Absorb'd into the 
Body Act as a Sedative, for [illegible]
Not from Applied to the Skin will
Produce the same Effect, so that the 
Action of Cantharides is no other
than the Power of simply Raising 
an Inflamation; there are two classes
of stimulants the first tends to [illegible]
an Inflamation of the Skin, the Second
of the Cellular Membrane, the first 
Produce no Suppuration, the Second 
doe, in this Case we would not Wish

to excite a Suppuration Cantharides
Tehadyorania, and Lilliaceas/Limmous,
Volatile and picad alkalis and Acids
are all Apt to excite an Inflamation
of the Skin only on this Account we
Employ them in Preprance to [illegible]
Substances; as they excite Suppuration
two of these are generally Us'd Volatile
Alkali and Cartharides, the first 
is a Powerful Antispasmodic and 
to be Employ'd when We Want but
a small Degree of Inflamation, and when
a great one is Requir'd We Use Cantharides
not from any Power they Posses of Carrying
the Disease, but because they Raise
an Inflamation, that is never difficult
to Cure, the Inflamation Cured by this
Means in generally external [illegible], We 
must observe that in Case there is a 
great Degree of general Inflamation 
as if there be hardness fullness and
Strength of the Pulse, We run some
Risque of encreasing it in these Cases

it is better to Use Evacuation by [?ate?ing]
and Purging first, and those
Employ these Stimulants.

Lecture 18th.
We Come now to Point out to you the
Manner of making a Topical Evacuation
by encreasing the Secretion from the Gland;
When a Gland is Inflam'd, the encreased
Action of the Arteries Propells a larger
Quantity of Fluids through that Gland, and
Occasions a greater Secretion, this is the 
Case in every Gland except the dryness
when the Substance of a Part where those
are Glands that is Inflam'd then also
there is generally, but not Constantly 
a Secretion from the Glands, sometimes
when a Part near a Gland is affected
wth. an Inflamation, there is an encreased
Secretion, but not so frequently as in 
the former Instance; It is farther to be
Observed that in the too Cast Cares
the Matter Secreted is not Alter'd; It is
thick the Mucus Part frequently

retaining its Consistence when the 
Membrane itself is not Inflam'd when 
the Secretion is more Copious it is 
thinner and Contains the Neutral Salts
of the Blood, when a Part near a 
Gland is Affected wth. Inflamation
and very little or no Secretion ensues
We employ stimulants to encrease
or Produce it, how far they can be
Applied so as to be Effectual We
must Leave to be Explain'd when We 
Come to the Treatment of Inflamation 
Requiring this particular Method of 
Cure, when the Secretion is at the first
Copious and Watery, the Salts Contain'd
frequently Stimulate the Surface of 
the Membrane along which it Flows so 
as to encrease even Cause an Inflamation 
of the Part, as it happens in 
Catarrhs, in Order to Avoid this We
must Defend the Part, by expressed Oil

and Vegetable Mucilages; It frequently
happens that after an Inflamation is
Considerably Diminished the Secretion
Continues and is sometimes more Copious,
when this is the Case it keeps up in some 
Degree the Inflamation, and Prevents
the Natural mucus from being Applied
to the Part, hence We must Apply
Remedies to Put a Stop to it; this is 
sometimes a Matter of difficulty, when
this encreased Secretion is in Consequence
of Weakness and a Relaxation of the 
Glands, We must endeavour to Strengthen
them, Now by Strengthening the System
in general, We doe not frequently Strengthen
any particular Gland, as it is only 
a Topical Weakness, and is therefore
the more difficult to Cure, when this
Proceeds from Relaxation, We may
Apply Astringents, these however
frequently fail of their Effects, for they

only Act for a time, Leaving their Part
after their Action often more Relax'd
them before; as is Inflamed in the
of Opium; except these Astringents
produce some Effect, they will 
I say frequently fail, sometimes
the Inflamation is kept up also so
that they Act as a Natural Cause,
in this Case if We put a Stop to the 
Evacuation for a few Days the Inflamation
will begin to Decrease so that 
they will both goe off gradually
together by Putting a Stop to the 
Evacuation or rather the Secretion for 
a Length of Time We Can take off the 
Weakness of a Part, tho the Remedies
may actualy Tend to Relax the Part 
afterwards; unless Astringents Produce
some such Effects as there, They 
seldom Produce a Permanent and

good Effect, it sometimes happens
that the Secretion Continues in Consequence
of Habit, here Astringents Put a Permanent
Stop to it, in general they must not
be Us'd till We have Remov'd the Stimulus
that was the Cause of the Evacuation
sometimes indeed the Application of 
Astringents Destroys the Stimulating Matter
but is always doubtfull, when this is not
the Case, the Inflamation most Commonly
Returns wth. greater Violence; We shoud
therefore Pay this Attention; when even 
Stimuli are Present, the Astringents
We Employ are Various, some of which
we apply to the part as the calces of Metals;
and some to the Stomach; As Astringent
Vegetable Substances, this Astringent
Juice Acts Strongly and Permanently,
Allum also Acts Strongly and Universally
[illegible] Astringents sometimes encrease
the Inflamation Considerably and of 
Consequence the Secretion, We must

Observe that all these different
Astringents are Applied in different
Cures, but We shall Leave these till
We Come to treat of the particular
Diseases in wch. they may be Useful 
We shall now Consider the Treatment
of Inflamations wch. Come to Suppuration,
sometimes We rather Choose
they shou'd Suppurate as when they Arise
in Fevers, and are in the external Part
of the Body, for it is better to Let the 
Inflamation goe on, than the [illegible] of
a return of the fever, and if in the small
Glands to Prevent these Indurations,
It also frequently happens that we
cannot Avoid it, for the Time of Suppuration
taking Place is very Various,
In Infants it happens Quicker than
in Adults, in the former it will
sometimes take Place in 24 Hours,
in the latter if a Phlegomonous

Inflamation Arises and goes on wth.
Violence, the Suppuration seldom begins
till the Fourth Day, in some not till the 
10th. 12th. or even a much longer Time
as in an Inflamation of the Lymphatic
Glands, Evacuation may Retard Suppuration
Considerably, when the Inflamation 
is Considerable, especially if it be
in the Internal Parts of the Body; the 
begining of Suppuration is often Indicated
by Fits of Coldness or Chilliness comming
on at irregular Intervals, and in certain
in their duration, when also Suppuration
takes Place in the Inflamation, sometimes
Contract itself so that it is not so much
Diffused, the Pain too, generally begins
to Decrease, again if the least Quantity
of Pus be form'd We cannot Put a stop
to it, We are therefore under a Necessity
of Letting it goe on, where it is doubtful
whether Suppuration to begun or not 
if it is likely to prove Dangerous

We shoud always Endeavour to Resolve
it, but if there is no Hazard of that 
kind, we shou'd Endeavour to Encourage
the Suppuration, for the Remedies We 
Employ to Prevent it, also make it 
goe on ill, if it takes Place our [illegible]
Endeavour shou'd be to make good
Pus form as soon as Possible, when 
an Inflamation Runs to a great 
Height, they often Germinate in 
gangrene and Mortification sometime also
there will be a greater Degree of 
Suppuration than is Necessary, in
that the Part will be extremly [illegible] 
the Inflamation then shou'd be kept 
up, but in a Moderate Degree, if
if it be Violent We may Diminish
it by moderate Bleeding and Purging
by the Application of Emolliant fomentations
and Poultices, and of
such Sedatives as have no Astringency

this however must not be in so great a 
Degree, as to Endeavour to take away the 
Inflamation, Emollient Fomentations and the 
Poultices, and are also Useful in Suppuration,
as they forward it Considerably
If an Inflamation be too Slight it shoud
be encreased, by the Application of a 
Stimuli; We must observe that in 
general it is better to Let the Inflamation
goe on too slowly, than encrease 
it too fast, We shou'd Wish to make
Suppuration take Place as fast as We 
can wth. Safety, for the ease of the Patient,
sometimes an Inflamation will not
Come to Suppuration, without the Use
of the Stimulants, but if We Push it on
too fast We produce a much larger 
Abscess, and sometimes Endanger the Life
of the Patient, We have Said there are
two Classes of Stimulants, therefore Employ'd 
to encrease an Inflamation, one that
Acts on the Surface, the other in [Resu??]
of a Part, there are also too kinds of 

Universal Stimulants, one that acts Quickly,
the other that are not so Quick in their Action
and these We generally Employ Internally-                             

Lecture 19th.
We Come now to Point out to you the 
Substances We Employ, to encrease Inflamation
so as to forward Suppuration, We 
must however first Observe that in
Strong Habits when there is little Irritability
Suppuration takes Place Quicker and more
Perfect; then to have the Habit is Weak and
Irritable, the Cort. Peruv. as it Strenghtens
the System and Prevents Irritability,
is a very Powerfull Remedy in Promoting
Suppuration, and also makes the Pus
Perfect, and to Confine it in the Part
is that it has been Employ'd wth. the 
greatest Advantage, if we Want a Speedy
Effect, an Ounce in 24. Hours shoud
be given, or as much as the Stomach
will Bear, such Stimulants as have a 
Disposition to Produce Hardness and
Strength together wth. some Degree of

Quickness of the Pulses, are proper as 
the [illegible] and [???mious] Substances
of Vegetables; Mercury is a Stimulant
of the same Kind, and Us'd for the 
same Purpose, but We doe not frequently
Employ these, they are not very Powerfull
and We rather Choose to Trust to the
Bark, this is a Class of Stimulants that
tend to encrease the Inflamation of a Part 
without Affecting the System, these if
taken a great Quantity Affect the Brain,
and are hence Call'd Poisons; they are
the Belladonum, Nicotiana, Cicutae, &c.
They are sometimes Useful in very tedious
Inflamations, as for the Lymphatic
glands; for they will bring it forwards
when We cannot by any other Means,
We apply Stimulants to the Part also,
there are principally of two kinds (viz)
such Farinaceous seeds as Contain
some Essential Oils as Farina Line and

Fanugri. &c. when Suppuration is taking
Place it is Useful in any Cases to Employ
Applications of this Kind, for whether
it be that they keep the Part Warm or whether
they Posses a Retaining Power Suppuration
gos on better for them, We sometimes 
Apply Resinous Substances to Stimulate
the Part and forward Suppuration, these
however are seldom necessary and sometimes
they are hurtful, as they produce a longer
Suppuration than otherways wou'd have
happened; when an Abscess is [n??m?d] it
is a Question whether an opening shou'd
be immediately be Made as to Let
out the Pus, it sometimes happens that the
Matter is Seated deep and in such a Part,
that we cannot Let it out, and when Suppuration
has taken Place there is not one
Parcel of Matter form'd but several smaller
on's by Degrees these join together, so as to 
form one Mass, if they have form'd before the
Opening of the Abscess, the Suppuration will

be of tempor Contrivance, and therefore
Surgeons Prefer N Leaving it to Nature in
general when we wou'd make an opening
the [Atuep??t] in many Cases Subsist
for a Considerable time; it is apt to be
in two States, the sides of it are perfectly
free from Inflamation, or only a small
Phlegomonous one of the surrounding Parts,
in this Case there is very little Pain,
the Internal Surface of the stone, may
be Affected wth. Symptoms of Irritation dies
wth, Erysepellatous Inflamation, have there
is great Pain, the discharge thin Watery
and Stimulating, it becomes an Abscess
of the System, and Produces general 
Restlessness, and uneasiness of the 
Body, frequency and hardness of the 
Pulse, the Pus thrown into Cavities
and produces fresh Inflamation and
in this Case it often happens that it is 
thrown upon the Lungs and Proves Fatal

here we endeavour to take off this Irritability
by the Use of the Bark; indeed it shoud be
Employ'd in all large Abscess, where it is 
out Contraindicated, other Substances which 
tend to Produce Phlegmonous Inflamation,
and good Pus, and much have been Us'd
as Wine and Spices and the like, it has 
been a Question whether the Hectic Fever
Arising from Absorption was Produc'd by
the Stimulus, or the Matter; but the Pus
in Urine and other Symptoms evidently
Show it is Pus, Absorb'd; if an Abscess
is deep but so that we can get at the 
Matter, or if it has a Chance of making
Sinus's that is Destroying or [Re???ing]
between the Muscles, or if it be very
large it is better to Evacuate the Matter
even before a Perfect Suppuration has taken
Place, for it is best to Dispart off such Parts
as are not sufficiently Destroy'd than 
the Risque of an Hectic Fever, from Absorption
when we make an Opening it should be
such a one as will Evacuate the whole

or greater Part of the Skin covering 
the Pus, it shou'd also be made in 
a Depending Part of the Abscess, it is 
a Question whether in very large Abscesses
it is Preferable to Evacuate the Pus at
once or by Degrees, as Evacuation tries 
to Produce Weakness but seldom so 
great as to Prove Fatal, it may however 
Weaken the Abscess itself, and Prevent the 
the Surrounding Phlegmonous Inflamation going 
forward hence some have thought it
better to make a small opening, but 
the Continuation of the Matter in the 
Abscess will be Attended wth. disagreable 
Consequences, on the whole then it is better
to make a large Opening, and Evacuate
the Matter at once; there are Many things
that take Place in an Abscess, first a thin
Matter Oozes out, and the Ulcer neither 
Spreads not Diminishes, Secondly an
Erysepallatous Inflamation may Arise,
a thin Matter is also Discharg'd the surface
is also Converted into Pus, and is Brown 

off in this Case, the Ulcer spreads [illegible]
there may be a Phlegomonous Inflamation not
Attended wth. any great Pain, for their is 
first form'd a Quantity of Pus without
Stimulating, and little Granulations Arise,
this Requires the Application of no Remedy
nothing more then a Defence from the Air,
by something Soft first of there is no
Inflamation at all; if the System in general
be Weak, we shou'd Endeavour to strengthen
it by Bark, and Stimulate it by Wine
and Spices, and Resinous Substances,
We make Use of Mercury for this Purpose,
We may also Apply Stimulants to the
Part, there may be Scarification on the 
Surface, Applying Resinous Substances,
or if the System in general be Strong, and 
if the Inflamation be Contained in a 
Membrane or Cyst, then destroying the 
Part, by Lunar Caustic, and Applying
a Superficial Dressing, a Suppuration
will take Place in Eresepellatous Inflamation,
There are two Ways of taking them
off, the first by Diminishing the Irritability,

of the Part, the Second by Stimulating
Remedies, to Produce a Phlegmonous Inflamation
its Room, if the Ulcer be a [illegible]
the most Powerful Means is
by taking off the Inflamation by diminishing
the Irritability of the Part, this Bark
will Perform most Powerfully and 
Effectually and also three or four
Days before the Abscess is Opened it
shou'd be Us'd as it will Cause a good
Suppuration in all these Cases we
may give it in a much less Quantity 
in the whole by giving it in large
Doses at the beginning; if the Ulcer be
not recent, then the Employing of
Stimulants will Produce the Effect;
Mercury We Use internally, and externally
such Resinnous Substances together wth.
Preparations of Mercury, as Sand to Produce
good Suppuration and Granulation; It
may happen in Erysapelletous Inflamation,
on the Surface of the Ulcer that

the Disease is not owing to an Affection of
the System, but of the Part, in this Care Remedies
Applied to the System are of much less the 
than there Applied to the Part, have the 
best Method is to Destroy the Substance of the 
Part, so as to Come to the Second Parts below,
and bring a Suppuration from the bottom
of the Ulcer; It sometimes happens that 
the Suppuration is Prevented by particular
Matter, as Venereal and Cancerous &c.
If it is Topical the Application of a Caustic
will unite wth. the Matter as well as Destroy
the Surface of the Ulcer, and so bring on
Suppuration, if the Matter has got into 
the System, We must Use such Substances
as Chemically Combine wth. it.

Lecture 20th.
It sometimes happens that the Granulation
Flesh Rises too fast, it is then of a Loose
Texture appears above the Surface of 
the Skin, and cannot be Cover'd over wth.
a Scarf Skin; when the Fonyans Flesh
Arises in an Ulcer, we are first to 
Check its growth by astringents so as
to Resent it Rising above the Surface of the 
Ulcer, the Astringents that have been
Cheifly Employ'd for this Purpose
are the Caleas of Metals, and more 
especialy Vitriol Caruli; the same
may Effect'd in some Degree by 
Pressure or Bandage, but it if shoud
have Arisan for a great quantity so as
to [illegible] greatly the Height of the 
Strain it is better to Cut it off, or applying
a Caustic; sometimes there is such 
a Disposition to form this although
We Endeavour to Prevent it by a 

Danger on Caustic they are Attended
wth. no Effect in this Case it is better to
Destroy the whole of the Granulating Flesh
and this is to be done by the first Cutting
off as much as we Can, and then Applying
a Caustic, or there Caleas of the Metals,
that give a disposition to good Suppuration
and Granulation, in the next Place we
are to Suppose, that the Ulcer is already
filled wth. granulating Flesh, we are
then to Endeavour to form a Scar of
Skin to Cover it, this generally happens
Naturally, it is however prevented principally 
by a Quantity of Putrid Matter
Adhering as being Applied to the
Edges of the Ulcer, hence we must keep 
an Ulcer very Clean, it is also disturbed
by frequent Opening, it shoud not 
therefore be Open'd oftener than is
Necessary, to Prevent the Putrefaction
of the Matter, as once in 24 Hours;
in some Cases 48 Hours; sometimes

the Edges become thick and hard, this
We Call than Callous, have the fresh skin
grows up wth. difficulty, We are therefore
to get rid of these by Cutting or Burning
them, the first method is generally the
best, supposing an Ulcer is feeling
tolerably well, yet we can forward it
greatly, by Applying gentle Astringents
as Lapis Calaminaris, this particularly
forwards the spreading of the Skin,
Oce [illegible] also as, is [illegible], when an
Ulcer is near being Heal'd, it sometimes
Circularly and will not spread entirely
over this to be Remedied by the [R??isea]
we shall now suppose then a gangrene
has taken Place, in this Case the
Putrefaction generally Arises, so last
that we have but little Chance of restoring
the Life, we are therefore to get rid of it
as fast as We Can, that the Sound Part
may begin to granulate and be 
remov'd, supposing a Part Dead and 
the Rest of the Body in Perfect

Health, and that it has no other Effect on the 
Surface of the Living Part, endeavouring
to get rid of the Dead, then a Phlegmonous
Inflamation wou'd Arise, and a Fluid
Issue which woud Serve to Separate 
the two Parts, when a gangrene takes
Place in an Inflamation it immediately
Produces an Effect on the Surrounding
Parts, to wit an Erysepallatous Inflamation,
and in the System in general
Symptoms of Irritation, when these
take Place we endeavour to Occasion
a Phlegmonous Inflamation round the
Part so that an Exfoliation may take
Place, and a Common Ulcer be Left; this
is to be Accomplished by two means
first by the Application of Stimuli as 
sepurates Parts; and Secondly by 
Preventing it from having Effect or the 
System in general, when a Gangrene
Arises the best thing that can happen
in a Phlegmonous Inflamation, No
Treatment of a gangrene [cross out] external simple 

only that the Remedies from the
Particular Habit of the Patient are
not always sufficiently Efficacious,
the Remedies We Employ to unite
Phlegmonous Inflamation as stimulants
Applied to the System in general as 
Wine Spices &c. to the Part Scarification
Essential Oils, Balsams that has
Resins Dissolv'd in them; but none
of these are so helpfull as Cart 
Power, various has been the Opinions
concerning the Action of this Remedy,
some has Suppos'd that it acted
as a Stimulant, but we have several
more spices more Stimulating than
the Carten, some have said that it
acted as an Antiputrescant this
Opinion for several Reasons [illegible]
Admitts of a Sarious Consideration
in all Cases it Diminishes the 
Irritability of the System and this 
Prevents Stimuli from acting upon it

Now if We cou'd make a gangren'd Part have [illegible]
no Effect on the Secondary one, we should always
have a Phlegmonous Inflamation take Place
the Part do's this more Powerfully, than any 
other Remedy, it shou'd be us'd in as great
a Quantity as the Stomach will Bear; some
other Medicines have been Us'd as the Cortane
Preparations of Iron Vitriol &c. when the Slough
is Exfoliated, it is to be treated as a Common
Ulcer; Inflamatory Stimulants may be Us'd
at the same time wth. the Bark, We Come
Now to the Management of the Schirrous
and Cancer if a small gland be Affected,
it is better to Let is Suppurate if a large
one we shou'd Endeavour to Avoid it, We
shall now suppose the Schirous is 
Produc'd, if it be small and Continue in
the same State or Situation it is better
to Leave it to itself, as it will often Continue
for many Years without encreasing or
[illegible]. Ot it be large and encreasing 
We are to get rid of it, as fast as Possible
if samll by a Caustic, if large by the 

Knife first and then the Caustic, we
Choose to Employ Caustics because the 
Living Power endeavours to Defend the 
Part, till a Portion of the Matter is absorb'd
so that they have a greater Disposition
to Destroy the Dead Parts, than the
Living on's, if a Cancer be Produc'd, there
is generally little good to be done, the
Cantee, Belladonum, Arsenicum &c.
have now and then Succeded in 
Producing good Pus, the Pain may
sometimes be Relax'd by Destroying
the Sensibility of the Part by Preparations
of Lead, &c. but Cancers generally Prove 
fatal after a length of time---

Lecture 21th.
We have Describ'd an Inflamation as being 
a Disease of a Part of the Body only whereas
Fever is an Affection of the whole System
This Disease has been differently Defin'd
and indeed Practitioners have act
hitherto fined a Definition, some Call
all Affections of the System [?aces]; others
all those where there is frequency of the 
Pulse, some a pain have extended it to 
Inflamation, but We must Observe that
it has been Systematick Writers, who
have Call'd all Affections of the System
Fever; all Authors that have Wrote from 
Practise as Hippocrates amongst the
Ancients; Sydenham amongst the Moderns
have Confin'd the Word Fever to one
Disease, in order to Classes it is Necessary
to have some Appearances that is always
Present in the Disease, and has been
Call'd the Pathognomic System; This 
no Superficial Practitioners that this
can be Useful [illegible] in Fevers the whole

System is Affected, neither is this 
Affection equal, it is sometimes greater
in one Part than in another, this will
Constantly make a Variety in the Appearances
of the Disease, externally; not that no one
Symptom shall be always Constant in it,
frequently when a Patient is Affected
wth. a fever he tis Hotter, but this is not
a Constant appearance for he is sometimes
Colder, sometimes he feels Colder when
he is realy Hotter, and whether We
Consider heat wth. Regard to the Patient
himself, as by the Thermometer, We
shall evidently find he is sometimes
Hotter, sometimes Colder, if then the
Disease may Arise to such a Height
as to Prove Fatal, without an encreased
Heat; this cannot be a Pathognomic
System, the Pulse is generally more
frequent, but sometimes it is Slower through
the whole fever, as Languor Weakness
Costiveness &c. and as Fever may

Subsist without Heat, and frequency of 
the Pulse so may they without Fever, We
shoud find that some Fevers Subsided
without them and some of them without
Fever, so that no Symptom is always
Constant and for this Reason, the Fever
is an Affection of the whole System, and
sometimes one Part, sometimes another
is not Affected, in order then to Define
Fever We must give a Description of the 
whole Disease in the first Place we must
Observe that a fever in general is a Complaint
Disease, if it be a simple one it never
lasts above 48 Hours, but fresh and pert
Attacks in some Cases take Place, so as
to Prolong the Disease Considerably so that
the Fever is a Compound of a Number
of small Fevers following one Another and
mining; In Order to Understand the 
Disease we must Consider one Paroxysm
as simple and Perfect, the better to 
Understand those that are Minded;
One simple Paroxysm of Fever Consists

of the Attack of the Disease a Natural
Cure Arising, and an Appearance taking
Place on its going off. We then it Consists
of three Stages, first the Attack improbably
Called the Cold fit; secondly the Hot Fit,
and Thirdly the Crisis; the Attack
Consists of two Parts, a depression of
Strength in many Parts of the Body,
and a Contraction of the small Vessels,
wth. an Accumulation of Fluids in the 
large on's; the Symptoms wch. Indicate
a Depression of Strength and Languor;
Weariness, Weakness, &c. If the Paroxysm
be a Violent one they take Place first and
in a greater Degree. Sometimes there is 
no other Appearances at all but so great
a Depression of Strength both of Body
and Mind, that the Patient Dies; As in 
the Plague the Sensibility of the Organs
of Sensation is sometimes Diminished,
the eyes doe not Perform their Office
so well, and the Skin becomes sometimes

Insensible, this takes Place only in very
Violent Attacks, when the Living Powers Act
Weakly, a less Degree of Heat Arises hence
there is a Coldness and Weakness we dont
Know, but so it is when the Stimulus Power
is Diminished, there is always a Coldness
and trembling together with Pain at the
Back, at the same time there is a Sense
of Insects Creeping over the Skin wch.
is Call'd by the Latins Neuipelatio
having no English term to Europe it
the Vessels of the Extremities in particular
and indeed all over the Body Contain a less
Quantity of Blood; so that the Parts become
Pale; the skin has its colour partly from 
the Sebacious Matter wch. is yellow when 
therefore there is less of the Blood, the Skin
becomes more a Dim Colour; the Tongue
becomes Dry and Covered wth. a Mucus
the Kidneys Contract so that the Urine
do's not Contain the separating mucilage
but remains transparent, and when the

Attack is Violent, the Quantity Diminishes
the Secretion for the Intermits is less
the Peristaltic Motion being Distended
so that the costiveness is Produc'd, if there
be any Penetrating wound, in any 
of the Muscles, the Ulcer becomes Dry
so that the Vessels of the Muscles Contracts
and in this Contractions sometimes
Affect so large an Artery as that
of the Arm, so that the Pulse becomes
small, in Consequence also of this
Contraction there is often Pain in
different Parts of the Body, as the
forehead and sometimes extending
all over the external Parts of the 
Head from some Cause; probably from a
Contraction of the Vessels of the 
Brain, there is a Delirium; It may
also be a Symptom of the Quantity 
of the Living Power but this we shall

Explain more fully here after; the Eye
is the Common the Criterion of the State
of the Brain, so that from them we shall
be Enabled to judge of the different
Species of Delirium, if the small Vessels
Contract, the large about the Heart must
be Distended from the greater Accumulation
of the Blood in them, Accordingly We find
[illegible] Oppression and Swelling about 
the Praecordia a greater Quantity of Blood
Laying about the Heart Stimulates it
to more frequent Contractions, hence
frequency of the Pulse, Quick and 
Laborious Respiration and Cough
wch. attend all difficulties of Breathing,
there is also Flatulancy and from an 
Affection of the Stomach rigor and
[illegible], this is sometimes so great
that Sickness and Vomiting take Place
it will admit of a Doubt whether

this arises in Consequence of an
Affection of the Stomach, and the
fulness of the Vessels about the
Praecordia but most probably of the
former, There are the Appearances that
take Place in the Attack of the 
Disease; and there it is that Constitute
the Disease, if [illegible] one of those Symptoms
are Present, there is no fever so
that this Attack is the Disease it self
the other Parts of the Paroxysm
bringing Consequences of the Disease
the Blood in this state is not Alter'd
but the Action of the Swing Powers,
indeed as the Disease advances it
sometimes Inflam'd and sometimes is
Verging towards Putrefaction-

Lecture 22d.
The Appearances of Fever before Enumerated
may be few and only particular Parts
Affected, the remaining Part of the 
Paroxysm in this Case not [?ueading]
We dont Call the Disease Fever, this is 
an Affection that Causes an Alteration
in the whole System, so as to Produce
a Hot Fit and we must observe that
the whole Disease depends on these
Alterations, and is always more or less
Violent according to the Degree and
Number of these Appearances, the
Causes of Inflamation We have been
Able to Point out to you; Now Fever 
Arises sometimes from Causes that
are known, and frequently from [?nton] [illegible];
they are also very Uncertain in
their operation, so that if the same
Causes be Applied to a Number of
People, only a few shall be Affected

with the Disease. The Causes we are
Acquainted wth. are first such Passions
of the Mind, as are Attended wch. Annualy,
and there must be suddenly excited
these however are not very Powerfull
amp. And secondly Fever may be
Excited by an Exposure to Cold; as
Sleeping on Damp ground &c.
Midly Putrid Infectious Matter as
Variables Marbillous, Acting upon the
Irritable Parts, will unite Fever, if
We take a Number of People in Health
Shut them up in a House just Built,
so that there is no Contagion, yet 
a Fever will very often be Produc'd; from
the Putrid Vapour Arising from the
hood and Evacuation; A strange Causing
into the same Place shall be Affected
wth. Fever; If a Number of People are
about a Man Affected wth. a Violent Fever
from any Cause, some of them will be
Affected tho the Patient has no Symptom
of Putrescence, so that a Vapour Arising
from a Man in Fever is Capable of Producing

if an Healthy Body, formly a Man
having Eat food that is not Digested but
become Putrid in the Stomach, has
been Affected wth. Fever, so that now and
then it may Arise from a Retention of the 
of certain Substances on the Primæ
Viæ; as Indigested food in the Stomach,
Fœcas in the Intestin'e. [???ly] a Number
of Men going into a Climate they have
not been Us'd to, some of them will be
Affected wth. Fever, whether this be a
Cause of itself, as only adds to the
other Power, we cannot Determine
simply half the fevers wth. take Place
Arise from Causes that we cannot
Investigate, when the Passions of the 
Mind Produce Fever, They doe not
immediately, or not at all. When they 
are brought on by Cold, it is generally
Produc'd immediately some times
however it is not, when from a Retention
of Substances in the Primæ Viæ it
Arises while they are there, When

from putrid Vapour it seldom takes Place
immediately, sometimes indeed it do's; the
Action however is by no Means at the 
same Period. Variolous and Morbitlous
Matter are Commonly Eight or Ten
Days before they Produce face. If
Varioulous Matter be Applied to a
Warmd an Inflamation will Arise and
A Pustule is form'd full of Matter
at this time it begins to be Absorb'd
and that on its first Application
to the Heart that Produces the Disease
for the Second has no Effect, for if
a Patient has Caught the natural 
Infection, and is Inoculated, this
gets on the faster and Produces the
small Pox of the Inoculation, the Natural
Infection having no Effect. So if you
Inoculate a Patient for several successive
Days, the first take Place and the
Subsequent on's has no Effect in

encreasing the Disease, in other Cases
when the Disease is not Produc'd, upon the
first Application, some Symptoms are
brought on wch. gradually encrease, so as
to Produce the Remaining Part of the 
Disease, As Putrid and Infectious Vapour
do's not appear to be Accumulated in
any Part of the Body, neither do's it
Appear to have any Effect on the Blood,
in the Course of the Fever it may; but
never on its Attack, some Symptoms give
off without being allowed by a Fever is
the encrease and Diminution depend
on some other Causes; and not on the
Accumulation of the Matter, it is to be
Remark'd that Fever when Produc'd
is Independent of its Cause, in this
it differs from Inflamation, and
Symptoms of Irritation; and hence
it was thought to Depend on an Accumulation
of Matter; It is well known that

when one Motion is Produc'd, it will
Continue without its Original in any 
other Cause, to excite it to a Continuation,
frequently also an Addition of the
Original Cause, will have no Effect 
in encreasing the Fever, after it was
once Produc'd as was Observ'd of the 
Variolous Matter---

Lecture 23d.
We have said some of these Causes
Produc'd Fever immediately, and some
not till after several Days, Now We shou'd
be extremely Cautions of Admitting
those Causes of Diseas'd wth. have
not an Immediate Effect and never
till we have formed a Number of Cases
in wch. these Causes have Produc'd the
Disease; when any Cause do's not produce
Fever till after sometime, there are 
two things happens, and Alteration of
some of the Fluids of the Body; in those
Cases where this is evident, we find
the Change Topical, as in Inoculation,
and that as soon as this gets into the
Blood Vessels, it Produces the Disease,
When Putrid Infectious Vapour is 
Applied to the Body, so as to Produce
Fever it is a Question whether it Acts
on the Fluids of a particular Part

of the Body; making some Change, so
that when they are Absorb'd into the
System they shall Produce the Disease,
or whether it makes a Change in the whole
Mass of Fluids wch. as the Circulating
Fluids, by wch. the Disease is Produc'd
it Appears rather that much Putrid
Vapour immediately brings on, for after
the Application of it, [illegible] febrile
Symptoms Appears, wch. Continue
to encrease, till the Fever is Produc'd
or is there any [illegible] of Putrid
Vapour, Producing an Alteration in a 
particular Part, for Putrid Matter will
not Produce Fever by a circulation, or
if we apply any other the Fluids of a 
Man Affected wth. a Putrid Fever, it
will not in a healthy Person Produce
a fever, it will sometimes Produce
Symptoms of Irritation or Inflamation,
We Observe it was the Distinguishing 
Mark of this Disease; that it Continued

after its Cause was Remov'd, this of great
Consequence in the Treatment of it, and it is
this that has given Me an Idea, that Fever
was an Alteration of the Fluids; However
in many Cases there is no Appearance 
of this, it is the [Re?parly] of the Moving
Parts of the Body, that it sometimes
happens, that if they are Set in 
Action there, will Continue Acting even 
tho the Cause by Remov'd; the next
Thing wth. Regard to the Action of the 
Causes of Fever, is that they are Capable
of Cooperating wth. each other; and of
thus Producing Fever when they wou'd
not Singly, those are no particular
predisposing Causes of fever; they being
in Common wth. other Applications and
hence they act more Certainly on an 
Irritable habit; the Symptoms of the 
first stage of Fever sometimes Destroys
the Patient, the most Violent Fever We
know of is the Plague, but as it do's not

happen in the Country, We are Oblig'd
to trust to the Relations for the Knowledge
of it, wch. I must Observe is very Imperfect
thus for however it extends, that those
who are [illegible] wth. it Complain of 
Languor, and such Symptoms as generally
Attend much Violent Fevers, and have
suddenly Dropt down and expired,
have thus then the Symptoms of the 
first Stage have thus Cut off wth. us
the Symptoms of Intermittent Fevers
take Place wth. more Violence, than any
other and now and then a Patient as
Expir'd in the first Stage; according
to the Description of these Cases, the 
Patient becomes extremely Cold, there
is a vast Languor, great Application
about the Præcordia, Paleness and
these wth. the Tremblings, Continue
encreasing until he seems Cut off by
Weakness it is entirely probable
that several of these People, who 
have been suppos'd to Die of

[illegible]; have Died in Consequence
of the first Attack of Fever, that this
sometimes is the Case, I have Experianc'd,
and when the Disease has not gone on
so fast as no kill the Patient the
Paroxysm has gone on the same as in
the Common Paroxysm of Fever the 
Attack then in these Cases may Destroy
the Patient, if it do's not as indeed
most Commonly happens it is 
Succeeded by Rigor and [illegible]; In 
Intermittents when those take place
it is seldom the Patient is Carried
off there Arise a Heat about the Breast,
wch. Differing shall spreads over the 
whole Body, very unequally tho and
likewise Indiscriminately, the Pulse
becomes Stronger and fuller, but it is
Obstructed, or it is frequent and small
but this Symptom do's not always 
take Place here the Heat is more Regular
we often Meet wth. Heat in Fevers

and is extremely troublesome to the
Patient, yet it is not actually encreased
there is great Pain in the Head, wch.
if it Arises in an from the first Stage
of Fever is more Distension, and frequently
in the Joints, as well as the other Parts
of the Extremities, there is Stupor and
sometimes Delirium; the Paleness that 
takes Place in the first Stage gets off
and some Parts become [illegible] but 
that the Contraction Remains in
some Parts is evident, from the Dusky
Colour of the Skin; when the Attack has
been Violent there is often great and
Universal Soreness, the Secretions are some
of them encreased, the Urine is high
Colour'd but perfectly Transparent; there
are also partial Sweatings of the Head
Breast &c these Evacuations have been
Call'd Symptomatic to Distinguish them 
from those wch. take place in the crisis

they differ in this, in the one Case they are
partial, in the other Universal [P??tectic?]
also sometimes Appear on the Skin
this Part of the Paroxysm on would serve
to Point out to us; that the fulness of the
Precordia and Stomach, occasion'd the
Living Power to be Excited, first about
the Heart, and then in the whole Body,
so that the Blood is Propelled wth. great
Fever, as to take off the Contraction the
Heat then is a Mark of a stronger Action
of the Living Power; and from hence frequency
of the Pulse, and sometimes fullness
and Strength; Propelling the fluids
forwards wth, greater Force; Occasions
greater sanctions in particular parts
of the Body, Soreness is a Symptom
of the Contraction going off; as that is
generally full after Contraction of any 
kind; thus then the Symptoms of the
first Stage goe off; as those of the Second
encrease, and there decreasing give Place to the
Symptoms of the kind stage of Fever wch. is the Crisis

Lecture 24th.
Having Pointed out the Symptoms of the 
Second Stage of Fever, we now Come to the
Morbid Stage to wit the Crisis; We cannot
Observe that it is not the Distension but 
the Relaxation, of Loss of Distention
to Contraction that Produces Crises undoubtedly
however the Hot Fit is the Natural Cure of 
the first Stage, partly from the encreased
Action of the Heart and Arteries, and
partly from some other Causes, wch. We
are not as yet Acquainted wth. at least
the small Vessels through the Body
are actually Relaxed; the Pulse becomes
free, the Skin grows soft, and Moist
and recovers its Natural Colour; the
Tongue wch. was Dry becomes likewise
Soft and Moist, the Costiveness gets
off, and the Urine is secreted in a large
Quantity, in others the Appearances of
Contraction gets off from all Parts of 

the Body, but as Relaxation takes Place
before the Symptoms of the Second Stage
entirely Disappear, it seldom happens
but that some of the Sensations are encreased
thus the Urine, is generally in a large Quantity,
and tho transparent when first discharged
after a little time becomes turbid, and
Opaque at the Depositing a copious
Sediment, and this so generally happens
that it has Led some Practitioners to 
Imagine that a Crisis came or Come on
without it; but this is Contrary to
Experience, sometimes a Copious Sweat,
and sometimes Purging Arises, they are
different from those in the hot, as there
are Symptoms of Relaxation in all 
other Parts of the Body, after the Symptoms
of this last Stage are gone through, the
Disease Leaves the Patient, he being only
Weaken'd from the Exertions wch. have
taken Place in it; A Paroxysm of Fever
may be cut off by an Inflamation 

Hemorrhage has forming some Part of the
Body; when the Symptoms of the first
Stage suddenly, disappear or a so considerably
Diminished, why this then to
happen we dont know; some have Said
that the Matter was now Deposited in a 
particular Part, and had left the System
in general nor do's at all Explain the
difficulty, in the first Place, We can 
hardly Believe that all the Matter
supposing Obstructed in the whole
System should be Confin'd in a particular
Part, besides this often an
Inconsiderable Part of the Body,
as the Pleura wch. is very small and
cannot Contain more perhaps than
ifs. of Blood and the internal Parts
of the Blood Vessels except the
Heart are not Capable of being
Stimulated, and if an Inflamation was
to arise from such a Stimulus; the 

Matter would not be Accumulated, but
Pass on the others Parts of the Body,
in what there are so many difficulties
in Supposition and no Positive Proof;
that we cannot Admit it, it is certain
that Fever do's proceed from Matter, in a
few Instances, as in the Small Pox, but
there is still no Accumulation in the
System; when the Fever go's off the same
Pustules Subsist, them whence there is
a Constant Absorption of Matter, so
that there is always more Matter in
the System then at the time that the
Fever was Produc'd, hence it is evident
that the Fever was not Cured, by passing
the System from the Matter and in many
Fevers there is not the least Reason for
Supposing that there is any Matter at
all in the System especially in Inflamatery
Fevers, in wch. Inflamation and 
Hemorrahage generally Arise, as then
We dont know in what Manner these

Cure Fevers, We Commonly take it for
granted that it do's happen, a Patient
may Die also in the Second or third
Stage of Fever, for Causes wch. We shall
afterwards Explain, now a Paroxysm
of Fever may be gone through in four
Hours, sometimes less, it cannot
last more then 36. Hours, it is most
Commonly ended in 10, 14, or 20. Hours
We can Conceive that a Paroxysm might
last a great deal longer than 36
Hours, but Circumstances take Place
in the System, that Prevents this by a
fresh one Arising, there is a Paroxysm
of Fever that happens to all Men
towards the Evening, this is Carried
off by a Crisis taking Place, in the
Morning; you find in the Evening
that the Vessels are contracted, that
the same [illegible] will not Produce
Sweat, as in the Morning, there is also
frequently thirst, the Powers of the 

Body are Depress'd, and a Degree of
Languor takes Place in Disease's. This
Evening Paroxysm, in many Cases
becoming Apparent, and also in Weak
People, it begins about five from Seven
Commonly and Continues from Hence
to five in the Morning; We might Suppose
to arise from the Fatigue of the Day,
but we find it taking Place at the same
time in People that Work at very different
Hours, so that the time is not Alter'd
by the different Modes of Life, why it
shou'd take Place at all we have not
the least Conception, it has this Effect,
that it the Paroxysm takes Place about
Twelve, it shall goe on, but if it Continues
untill the following Day, at the time
it Produces a fresh Exacerbation, so that
the Paroxysm of Fever can Continue about
thirty Six Hours sometimes; when the
Paroxysm has nearly Subsided, the
Evening Paroxysm is not sufficient 
to Produce a fresh Exacerbation, yet

in this Case it seldom Continues above
48 Hours, a Fever consisting of one
Paroxysm, we Call an Ephemera Simplex
wch. if they were to Continue they wou'd
Prove Fatal, but the Patient is generally
well before the Practitioner is Call'd
so that this Fever has for the most
Part been overlook'd. It sometimes
Comes on by Violent Paroxysm or
Symptoms of the first Stage succeed'd
by a Degree of Delirium, that Patient
afterwards falls into a Considerable
Sweat, by wch. the Disease is Carried
off a Fever that Continues longer
than 36 Hours, is generally Compound
and Consists of several Paroxysms
following one Another, and this they do
in all Ways, sometimes they are
Distinct, that is the Symptoms [illegible]
Period goe off entirely before a Second
Arises, this We Call on Intermittent
Fever, when the Patient is greatly 
Beleiv'd, but the Pulse sometimes

frequent, and several other symptoms
are not Carried off before the Second
Period begins, We Call it a Remittent
Fever, and a Continued Fever have one
Period or Evacuation begins before
the former is Considerably abated,
We shall not Consider the Causes of the 
Recurring of Fevers, or rather Paroxysm
of Fever, We shou'd Empart a Prior
that all fevers wou'd be Ephemera
Simplex, we know no Reason why
a Fever shou'd Return of its own Accord,
We shall therefore next Consider these
Causes that occasions the Acronysms
of Fever to Return

Lecture 25th.
We are now to Come to [?less] the
Causes of Recurring of Fevers, that is of the 
Paroxysms of Fevers, we have said
that when the Causes where Applied
in many Cases they Produc'd only some
Symptoms of the Disease, and that
if these Causes when Remov'd, the
Symptoms when Produc'd wou'd Continue
that these where easily encreased as to
bring on a Hot Fit, wch. is Calld the
Paroxysm, if no Hot Fit arises; We
do not Say the Patient is affected wth.
Fever, now these Symptoms may go
off themselves or be Carried off, by the
Natural Evening Paroxysm, or they 
may encrease as to Produce a Hot Fit,
when a Perfect Paroxysm will take Place;
when the Paroxysm is gone through
and Crisis takes Place, when the

Pulse is Come to its ordinary Pitch, the Heat 
gone off, and there is no longer an encrease
of any Secretion; We find that the Fever is
not entirely Cured; that it has left some
Symptoms behind, as a Slight Pain in the
Back, a foul Tongue, as Paleness or a 
Dustiness of the Skin wth. Languor; but
these Symptoms in the first Stage are
not Sufficient to form a Paroxysm; they
Continue however sometimes going off
themselves; and sometimes encreasing so
as to Produce a Second Paroxysm, this
is often the Case in Intermittent fevers
in the next Place fresh Occasional Causes
may Reproduce the Dis Paroxysm, suppose
an Ephemera Simplex, having gone through
its Natural Progress and a Perfect Crisis,
yet if the Patient be Expos'd to Cold Putrid
Vapour &c. in so slight a Degree that in
Health it wou'd have had no Effect it will be

sufficent to Occasion, the Return of the
Paroxysm, the next Cause of Recurrence
of the Paroxysm of Fever, is the Natural
Evening Paroxysm, has has already been
Explained, it is this that Produces
Exacerbations in Continued Fevers moreover
if there shou'd have been several Paroxysms
of Intermittent or Remittent Fevers
it will Continue from Habit, the last
Cause of the Returning of Fevers, is 
what we shou'd never have Imagin'd
was it not evident, from Actual
Observation (J.E) the Action of the 
Types, in Attending to the Return of 
the Paroxysms, we find that
the greatest Number of the Return
at the End of 48 Hours; why they
shou'd have a Disposition to Return
at this particular time, We dont Know;
some have Suppos'd it was in Consequence
of Fermentation taking up this 
Space; but this and many others

Suppositions of the same kind, are by no
Means Satisfactory, Fevers the next to
this are more Apt to Return at the End
of 24. Hours; and at the next to this
at the End of 72. Hours; It is seldom that
We find 8.[illegible] going longer than this
though now and then a Fever will Reoccur
at the End of 96. Hours, and at all
other Intervals; When a Paroxysm of
Fever Reccurs at the End of 24. Hours, We
Call it a Quotidian because this is a
Paroxysm every Day when at the End
of 48. Hours, We Call it a tertian, because
the 49th. Hour is the beginning of the
Third Day. and so if it Return at the 
End of 72. Hours, We call it a Quartan
and for the same Reason we seldom
Meet wth. a Quartan, [illegible]. It is farther
to be Observ'd of Intermittent Fevers;
that they seldom Continue in the [illegible]
in wch. they Arose; Quotidians are frequently

Converted into tertians, and tertians into
Quartans, in the Spring when People
are Strong Quotidians and tertians generally
take Place, in the Autumn when We
are Exhausted by the Heat of the 
preceding Summer, tertians and Quartans
are more frequent so that in some
Degree, the fever Seems to be Connected
wth. the Strength or Weakness of the
Habit. Thus the Symptoms that 
Indicate a Strong Action of the 
Vessels often happen in Quotidians,
the Symptoms of the stage are Violent
in tertians; and there of Weakness 
are frequently met wth. in Quartans;
sometimes however there different Symptoms
Occur in the Type of Fever; when the
Paroxysm takes Place every Day
and in the Intermediate Days is Weak 
is Calld a double Tertian; in a Quartan

there is often a Strong Fit has Slight on's
and then a Strong one again, and so on;
others altho the Paroxysm take Place
every Day, there are Marks of a tertian
and a Quartan; and this is Calld
a Triple Quartan; It was suppos'd by
the Antients that there be here two Tertians
And that the Patient was Affected wth.
two different Fevers at once; but the Reason
of this Appears from Weakness and 
Irritability, hence this seldom happens,
till the Fever has Continued for some
Time; In Continued Fevers we shou'd
Consider them according to the Exacerbations.
It often happens that when a 
Fever is once Produced, the Paroxysms
will Continue to Recover at some of
these Types, without any Apparent
Cause, the Manner in which they do this
we have already Shewn, the Natural Cure
of one Paroxysm do's not Cure the Disease

for this is Apt to be put a Stop to, in
two Ways, we have already Said that
Fevers frequently Continue either
because after the Crisis some Symptoms
of the first Stage, remain as no Crisis
shall takes Place before the Action
of the Natural Evening Paroxysm or
of the Types.
Intermittents seldom Appear at the 
first in their Proper Types. In Continued
Fevers the Disease go's on because the
Paroxysms doe not Terminate before
the next Evening Paroxysm of Fever
if it shou'd Terminate before this a 
perfect Crisis then happening will
Carry off the Disease; in all Fevers the
severer the Paroxysm in general
the Shorter the Duration of the Disease
and the more perfect the Crises. In
Continued Fevers, those more Violent 
Exacerbations often happen on the 4th.

5th. 7th. 9th. 11th. 13th. 14th. 17th. and 21th. Days
than on any others and are the most Part
shorter, so as to goe off about, 4 or 5. in
the Morning, and the Crisis is more Apt
to Terminate the Disease. A Crisis may
be Fatal as well as Salutary. The
Antients Consider'd it as, [???tamen]
into Morbum and Naturam. If the
Crisis is entirely Perfect the Disease
go's off altogether and, and do's not Fever
or if some small Symptoms be left they
grow less and less, till at last they goe
quite off; A Continued Fever at the 
begining is generally first a Quotidian
than a Tertian, then a Quartan and at
last very irregular, this is sometimes
very easily Observable at others not
but not so frequently in this as in
Warmer Climates, nor indeed do's Crisis
Terminate Fever so frequently, in the
former as in the latter; the more Perfect
We can Observe the Tertian Type, the more
likely there is to be a Crisis, it is to be

Observ'd that when Speak of the begining
of Fever, We mean the first Week in wch.
the Exacerbations take Place every Day,
when of the Middle of the Second Week
or while it Observes the Tertian Type,
and when the End wch. is Commonly
more Severe when it Observes the 
Quartan type or becomes irregular; after
a Fever begins to Observe the Quartan
Type, it generally begins to Diminish,
and gradually Wears itself out; and this
Two both of Continued and of Intermittent
Fevers, the time of the duration of a
Quartan of itself is Commonly, 4. or
5. Months, of a Tertian has or 3 Months
and of a Quotidian about 6. Months,
the first Symptom of the going off of the 
Disease is a Moisture about the Tongue
a Relaxation of the Skin, together wth.
the Kidneys in Consequence of wch. the
Urine often Deposits a Lateritious
Sediment, and the Pulse becomes Regular

in all Cases of Fever, The Crisis are more
Apt to be Imperfect at the begining and more
Subject to Relapses, towards the End, if an
Imperfect Crisis do's happen Relapses
seldom occur. If Seems to have been forgot
by Modern Practitioners, that Fever had
a Termination of their own, this Arises
from their Dissenting from the description
of the Disease; as Laid down by the 
Antients; Now if all Fevers where to goe
through the Course already Describ'd no
one wou'd Die, but there are Causes that
Arise in the Course, wch. frequently are
Productive of Death of the Patient and
these we shall Proceed to Explain-

Lecture 26th.
We now Come to Point out to you the
Sources of Danger in Fevers, A Patient
may in the first Place be Cut off, by
the Fever itself, the Inactivity of the
Living Power, and a Depression of
Strength, may be so great as to be 
Fatal; this happens sometimes in the
Plague, in the beginning of a Paroxysm of
the Paroxysm of an Intermittent Fever,
its also Apt to Arise from the Affection of 
the Dram, wch. takes Place in Consequence
of the Symptoms of the first stage; sometimes
in the Second Stage; the Action of the 
Heart and Arteries is so encreased that
the Patient is Cut off by the generall
Inflamation, or the Effects of the Body
during the Paroxysm may have been so
great as to Produce such a Degree of 
Weakness and Irritability as to Prove
Fatal; We shall primarily Consider
the Symptoms of Danger Arising in

The first Stage, there wch. shew the Disease
to be Violent, are great Languor Weariness
and Weakness, wch. if they Continue long
the Shew the Depression of Strength to be
very great, so that the Symptoms of the
first Stage are more Capable of exciting
a Strong Action of the Heart and Arteries,
The Attack may Come on by a great
Prostration of Strength Attending it,
wch. is very different from Weakness as
in the former Case; the Powers of the
Body are Retarded upon the going 
off of the paroxysm A Man Attack'd
wth. a Fever being Incapable of Muscular
Motion; wch. shews the great Violence
of the Fever; the Skin being Tough Dry
and Unequal, these shewing the great
Contraction of it, if an Ulcer unites
and that becomes Dry; it shews the 
Vessels amongst the Muscles are 
Contracted, it Indicates the Contraction,
not being Confin'd to the Capillary

Vessels; if the Pulse is much Contracted
it Indicates the Contraction not being
Confined to the Capillary Vessels, but
smallness of the Pulse must not be
taken for Contraction; as this may Arise
from Weakness. If it be Quick in the
Hot Fit, and neither full nor Strong
especialy if it Intermit, it shews that
the Heart is greatly Oppress'd, and the 
Depression very Considerable frequency of
the Pulse and Intermission, may also
be Consider'd as a Symptom of Weakness
and Irritability; but more especialy
if they Arise towards the End of Fever.
The tongue and Mouth being Dry shews
that the Vessels of the Mouth are
Contracted; if there is a great Quantity
of Mucus Covering the Tongue, it may 
be owing to the Violent Affection of the 
System, and hence it is all Day at
the same Time Again it may Proceed
from an Affection of the Primæ Viæ, but
here the first is very great and not

Diminished by keeping the Mouth
Moisten'd, the urine being Pale Transparent
and in small Quantities shews the
Vessels in the internal Parts of the
Body are greatly Contracted. If it is 
perfectly Transparent and high Colour'd,
the Fever is pretty Considerable; If Pale
and in Large Quantity, it is a Pergnois
of an Approach of Delirium, from the
violence of the Symptoms. The Nails
Fingers and Feet remaining Cold and
Pale, except it be towards the End of
the Disease are Symptoms of its
Violence, and permanency, so as to 
Admit of Little Relaxation between
each Paroxysm, and the Disease
Accumulates to a great Degree
the Nose being Sharp, Temples and
Eyes hollow, Skin of the Forehead
Contracted; Ears Cold and the Face
Universally Pale, or of a dusty Colour
are Symptoms that Indicate a great 
Contraction about the Head and are

Look'd upon as very Dangerous, these
Appearances may Arise from many
Causes; as from the Violence of the 
Fever itself, from Delirium from Weakness
&c and has been Calld the Facia
Hippocrates, from Hippocrates
The first Observer of it, the Breathings
being Short Quick and Laborious, the
Patient moving the Nostrils principally
the Præcordia being Tense Swelld
and hard; the Anxiety and Restlessness
great, wch. Shews that a great Quantity
of Blood is Accumulated about
the Heart, or the Præcordia, and the
Heart is not Able to Clear itself. these
are the Symptoms that Indicate great
Danger, in the first Stage of Fever
but in the Continued Fevers the Symptoms
wch. are more Dangerous is the Delirium
whether it be a Disease of the Brain
itself, or of the Living Power, throughout
the System; If has not for the most Part
been Distinguished, but Consider'd as
the same; there are however several

Species of Delirium that takes Place in
Fevers, and two if not three Arise from
the first Stage; wch. are totally different
from one Another and Require as different
Treatment; first the Vessels of the Brain
may be Contracted, that a smaller Quantity
of Blood shall Pass through, wch. shall
not be sufficient to keep up its Functions
This Species of Delirium is Attended
wth. these particular symptoms, the 
Vessels of the Eye, wch. are the general
Criterion of the State of the Vessels of the
Brain are Pale Small and Hollow, there
is no Redness and Flushing of the 
Face, but a constant Duskiness and
Paleness. Secondly the Delirium is
Considerably encreased at the Exacerbation
and go's off entirely, or is Considerably
Diminished, when the Fever itself gets
off if the Disease go's through its
Natural Course, it Diminishes at the 
Exacerbations, and at last leaves the
Patient without Stupor, Delirium also
often happens from a Relaxation of

the Vessels of the Brain, and fullness
in Consequence, the Symptoms preceding
to this Species are the Eyes being Red
and Blood Shot, the Cheeks as Red as if
Painted and not Swell'd, the Delirium
itself more Constant and equable, tho
it is a little encreased by the Evening
Exacerbation, and when the Fever go's
off, this is often the last Symptom that 
remains, and that wch. dot goe off it
Leaves a Considerable Stupor behind;
the Vessels Requiring sometime before they
regain their Proper Tone probably there
is a Third Species of Delirium wch. do's not
Arise from an Affection of the Brain
but of the System, the first Symptoms of 
both these Species of Delirium are
Watchfullness, and Restless and unrepeating
Sleep, the Patient Dreaming much and
Waking somewhat Delirious, not knowing
where his, or who is about him, the Imagination

begins to be [illegible], then the Organs of the
Senses are Affected, and there is the Appearance
of Flies before the Eyes; the Patient Picks the
Hairs from the Bed Cloaths, this is a Symptom
of great Danger as his thirst suddenly going
off the Violent Drawing on a Total Insensibility
Conceson; and the Patient is sometimes Cut
off wth. Convulsions; these two Deliriums
are the Symptoms wch. generally Prove
Fatal in Continued Fevers; the Danger of the
first Attack of an Intermittent is not so great;
We shall in the next Place proceed to the
Symptoms wch. Point out the Strong Action of 
the Vessels....

Lecture 27th.
The first Stage of Fever Occasions Symptoms
of Strong Action of the Vessels, by wch. it is
Diminish'd and Carried off, but this
encreased Action of the Heart and Arteries
may be so great as to Prove Fatal; that is
such a Degree of general Inflamation may 
be Excited in Fever as to kill the Patient,
this happens in Continued Fever only, it
cannot take Place in an Intermittent because
it would Convert it into a Continued Fever
we have Said that it is probable that the 
encreased Action of the Heart and Arteries
is the Source of Danger in the Second Stage
yet there is something also that encrease
the Symptoms, so as to prolong the Disease
till a fresh Exacerbation Arises, and it is 
by this Means Converted into a Continued
Fever; On this Account general Inflamation

is not a Dangerous Symptom in Intermittent
Fevers; We might Suppose that Fever and
general Inflamation might Subsist at the 
same time and that the Fever might be
gone through without the general Inflamation
Effecting its Progress. In this Case there
would be a Hot Fit, and a Crisis would take
Place, the small Vessels and Glands
wou'd be Relaxed, and the Inflamation
would goe off, in Consequence of the
extraordinary Secretion, but this do's not
happen but in Continued Fevers, general
Inflamation is Dangerous for the most
Part by Producing an Affection of the 
Brain, or at least Delirium, the Symptoms
that Indicate general Inflamation are
hardness of the Pulse; Now we must Observe
that Authors have made but little Distinction
between a hard and an Obstructed Pulse
but there is this Criterion of difference
the Blood in one Case throws up an
Inflamatory Crust wch. it do's not in the

other; when the Blood is Obstructed it
may be of any Appearance hence there is
certainly a difference between an hard
and an Obstructed Pulse and they Point 
out the Strong Action of the Heart and
Arteries; and the other the Blood not 
getting readily into the small Vessels there
is also a generall fulness and Strength
of the Pulse, the general Inflamation may
be Dangerous when the Arteries only 
are Acting Strongly; As in the Hectic
Fever, the Blood being Propelld wth.
great Force into the small Vessels Occasions
a Redness, its returning more frequently
into the Lungs Produces a Quick and
difficult Respiration its being very distinct
from Putrefaction, Occasions a Whiteness 
together wth. a Dryness of the Tongue in
Affections of the Thorax, and sometimes
of the Stomach it is of a Yellow Colour

the Blood being Propell'd in Considerable
Quantities into the Vessels of the Head a
Distensil Pain is felt in the Internal Parts
of it; sometimes this Kind of Pain is 
felt in the Joints and Extremities, and
from the same Cause the Strong Action
of the Heart and Arteries; the Vessels
of different Parts of the Body are forced
Open, hence Sweatings of the Head and 
Breast, and sometimes of the whole
Body, the Symptoms of Strong Action
are only Dangerous when the Brain Comes
to be Affected, in this as in the former
Case, the Eye generally gives a Criterion
of the State of the Brain, they are Swell'd
red and Blood Shot, a Stupor takes
Place at first, sometimes Continuing 
for two or three Days, at other times
a Delirium Comes on, in wch. many different
Appearances Arise, sometimes it Attacks

suddenly, and is as shortly Fatal, sometimes
the Patient Mutters to himself, and if 
excited will Speak to you, but again will
soon forget himself, this is the most Common
kind of Delirium, Arising from this 
Cause, sometimes there are Violent 
Ravings for a Considerable Time, these
are Distinguished from the others by 
proceeding and Accompanying Symptoms there
is generally a Redness of the Face wth.
Swelling; but this is not so florid as in
the former Case and spreads more universally
over the whole Face, it is by this
principally that it is Distinguished from
all others, and most Commonly before 
the Patient is Destroy'd Connections Come
on, Another Way in wch. the Patient is apt
to be Cut off by the too Strong Action
of the Vessels, and is in Consequence 
of the general Irritability that Arises,

this Causes Restlessness and afterwards
Delirium in this Species, the Mind is more Apt 
to be Agitated than in any other, Ravings are
more Violent, so that the Patient often
Attempts to Destroy himself. The Muscular
Strength is encreased, the Eyes are exceedingly 
Bright and Piercing, and the Motions of 
the Body universally Quick a though this 
kind of Delirium Arises from the 
general Inflamation, yet for the most
Part it go's off before it takes Place, this
Delirium happens but seldom in Fevers,
and most Commonly in Fevers Attended
wth. Rheumatism, general Inflamation is
in any Way mostly Dangerous in the 
first Week of the Disease there is little
Danger afterwards. We Come now to 
the last Sense of Danger in Fevers, to wit
the Symptoms of Weakness and Irritability
that some time take Place, the Powers of
the Body are much Exerted in Fevers

in Consequence of which they are Exhausted 
sometimes to such a Degree as to Prove
Fatal, Weakness Renders Fevers more 
irregular, and this Prevents a Crisis from
taking Place, it generally falls in that
Part of the Body that is Retained, and
this is Carried out to us by the particular
Evacuations, as Partial as Universal
Cold, colliquative Sweatings a Purging
wth. a Dry Skin and Tongue, and a Flow
of Tears wch. is a Symptom of great
Irritability in the System, sometimes 
there is a great Secretion of them wch.
if Pale shews a great Irritation, the
great difference between these and a
True Crisis is that; in this the inflamation
is Universal in that only Partial if
the Pulse Continues Obstructed and
at the same time moisture of the
Tongue Purging and sometimes Sweating

it is a Symptom of great Danger, for as
We have just Observ'd there must be
Symptoms of Universal Relaxation to 
form a Crisis there is a Determination
of Fluids in these Cases to the
Relaxed Parts, so that in Fevers where
such Symptoms take Place Run out
to a great Length, and sometimes the
Disease Diminishes apparently for 4
Days and then encreases for four or
5 Days and so on, the next Symptom we
shall take Notice of is one properly
speaking and Dependant on the 
Weakness but Arising from a Depression
of the Strength, to wch. it is for one and
no other. This is the Putrefaction of the
Fluids, it has lately been Consider'd as a 
Cause of Fever, when the Depression of 
Strength and great Oppression about the
Pracordia, [Sigh???] and Soreness have
been Look'd upon, as Symptoms of Fever

but they are Causes of it in reality; As
the Fever takes Place first, it is evident that 
the Putrefaction wch. follows in an Affect of it.

Lecture 28th.
Sleep is sometimes more perfect and sometimes
not so perfect, it seems that all the Operations
are suspend'd the Heart Acts frequently more
slowly and wth. less force, the Respiration
gos on but in perfect Sleep much more
slowly, there Peristaltic Motion of the 
Intestin's go's on more slowly and likewise
the Secretion but in much less Quantity
the Lymphatics Absorb and Carry their
Fluids through them into the Blood Vessels
Sleep may be imperfect, the Organs of 
the Senses may just Impress the Mind
wth. Ideas, the Operations of the Mind
may go forward as in Dreams but 
not wth. that connection of Ideas wch.
take Place when a Man is awake, the 
Muscles may frequently be first in Action
as a Man may move or toss about from one
side of the Bed to another; the Organs
of the Senses do not Impress the Mind
wth. Ideas yet may so easily be excit'd

that the least Noise shall in ther Awake a
Man, or if not Awak'd excite some Ideas of Sound
but an imperfect one; the System is more
Recounted in proportion to the soundness of 
the Sleep, Sleep may be free or prevent'd
altogether by any Thing wch. excites great
Attention or Uneasiness of the Fluid, and
so likewise uneasiness of the Body or
Pain, the Action of any part of the Body
preternaturally encreas'd as for Example
an encreas'd Action of the Heart and Arteries
in general Inflamation sometimes
there is little or no uneasiness or Pain
Contraction continuing after their Cause
is remov'd; such as happens in Fever will
also prevent Sleep, but then Sleep tending 
to Render it overcomes there the Sleep becomes
profound and the uneasiness of the Body
is diminish'd and any preternatural Contraction
is carried off, in that when once Sleep
takes Place it Tends to render itself
imperfect and still in many Cases
removes the Causes of the Imperfection; In
Mania the Patient do's not Sleep for the 

Space of Twelve Months, in this Disease
and in others there are Instances of no
Sleep having taken Place for a fortnight or
three Weeks tho these Instances are Rare
in Health a Man as been kept Awake for 
Ten Days; now in Mania the Strength is 
not dimininsh'd, there Appears not to 
be that exhausting of the Living Power
the Mind do's not exert itself but as
in a Dream and the Body as Lost 
its Irritability so the same the exertion
do's not take Place as in Health
it often happens in Mania that the 
Body requires Sleep when the Mind
Thinks on any Subject, but the Mind
in Mania do's not Act but as it
where in a Dream, the Organs of the 
Senses are not Impress'd wth. just
Ideas, the Powers of the Body are
not excit'd but as in a Dream so
we may consider as in a State of
Sleep in as far as regards the
exhausting the Living Person [cross out] in
all other Cases it Occasions such 
a Weakness to prove Fatal, but
a Man in a Delirium in a fever is

more capable of Reasoning the want of
Sleep then in a Man awake, it is then
the excertion of the Judgement wch. exhausts
the Power of the Mind and in Delirium its
not Acting more at all but its only [illegible]
and a Patient can bear the want of 
Sleep, indeed the want of Sleep will
Occasion Delirium and Mania, a Man then
no Health requires Sleep to keep up the 
Strength of the Body in perfections
when an Animal is young and the 
Powers of the Body and Facultys of the 
Mind, a Larger Quantity of Sleep is Necessary
and the Sleep is generally more perfect
In old Age the Body is wore out and is 
incapable of being recrut'd and no
Sleep takes Place on that wth. difficulty
if any and continues but for a short 
Time, in the middle age of Life the Quantity 
of Sleep Necessary seems to be about one
Third Part of Twenty four Hours; A Man may 
Sleep no more than Six or four Hours,
but he generally wears out his Body
by this Means, to Recruit the Body
about Eight Hours is necessary, indeed
Active Minds wou'd rather Wear out

the Body than loose so much of their
Time as two Hours additional Sleep; longer
Sleep than Eight Hours may take Place
through Habit but always serves to
Obtund and diminish the Powers of the
Body, the Powers of the Body shou'd
be kept in Action to be perfect and
longer Sleep tends to obtund both the
Powers of the Body and Mind as Sleep
tends to take off any preternatural 
Action but its much more efficacious
in Recruiting the System at the Time
of the Natural Evening Paroxysm of
Fever as it tends to take it off
and render the Crisis more compleat
and if we dont Sleep at that time
the Crisis is not compleat
and by that Means the Body is
Wore out. 

Lecture 28th
Its time the depression of Strength as been
Said to depend on the Putrefaction of the
Fluids and according to the Reasoning
of Practitioners it must be said as
depression taken Place for to according
too those Philosophers the Putrefaction must
be the Cause of the Depression of Strength
the Effect according to those Practitioners
must go before the Cause so the Putrefaction
must be the Cause of the consequence
to be deduc'd from this is to employ
Medicines is to take off the putrefaction
of the Fluids and this you are to do in
the beginning; The Symptoms of the putrefaction
of the Fluids are in the first Place
the Mucus of the Tongue in Fever becoming
of a blackish Colour and when the 
putrefaction Arises to a considerable
Height it then becomes quite Black
and its of a loose Texture on the Tongue
the Fever and this is often rubb'd
off by the Teeth wth. this fever and
sometimes the Roof of the Mouth when

the Putrefaction arises to a considerable
Height; in the next place Fætor of the 
Breath and the Evacuations from the
Intestines becoming Fætid Show that
putrefaction of the Fluids is Arising,
then blackish Spots or marbling of the
Skin and these have generally been
called Patechia, in fevers there is a great
many different Fluids; but there is only
one Species wch. Point out putrefaction
of the Fluids wch. are of a blackish
Red appearing through the Skin the 
breadth of any Juniper; or marbling
Purple or blue Specks as in varies an'd
Marble often is Seen, or where the
putrefaction as Arisen to a great height
it now and then happens that the 
whole Skin becomes of a Purple Colour
and in that Case generally the Patient
is Destroy'd in a short time. The others
we do not denote putrefaction of the 
Fluids are reddish Spots on the Skin
superficially, and commonly came
out about the Fifth a Day and then
go off again, this Eruption is Violent

Fever; the Fever is not at all dimminish'd
by the Eruption coming out, and on its
going off again is not more Violent,
and this do's not Afford us any Indication
of Cure, this affording no one Indication
of Cure or alteration in the Fever is not worth
Attending to, it happens generally where the
Patient is Attack'd wth. Fever wth.; considerable
force, then there is another Eruption from 
Weakness it Arises in irregular Miliary
Eruptions, a Number of little Spots on
the Skin and this merely are [illegible]
and wch. Arises from Sweating taking
Place often in consequence of Stimulating
Medicines being Employ'd and happens
more in Nervous Fevers where there is this
irregularity than in Fevers wch. are either
Inflammatory or Violent, then there is 
another Eruption wch. is at the 
Fon'd and sometimes when its gone off
entirely this Eruption is some what like
very small Worms sometimes of a 
blackish Colour, and sometimes of the 
Colour of the Skin Rising in the Skin and hard

and wch. is not Inflamation, and these happen at
the End of Violent Fevers when the Symptoms
of Putrefaction are gone off, the Petechia
dont Seem to be Alter'd by any Treatment
when putrefaction of the Fluids produce
Petechia there is no manner of Treatment
wch. will produce any good Effect
but that Treatment wch. will Cure the Fever
the little Blisters are occaseon'd often by
keeping the Patient too Hot and giving the 
Patient warm fluids wch. are Stimulating
and often they are not diminished by
any Treatment whatever; Marbling of the 
Skin and fœtid Secretions indicate to us 
putrefaction of the Blood, sometimes the 
Urine is load'd wth. Mucus and is of a
frothy Appearance by the Air being stamp'd
in it, sometimes the Red Particles of 
the Blood are formed in it but this but
seldom the Case, the Urine when this 
happens is of a Chocolate Colour a
dark brown and sometimes this Sediment
is deposit'd, there is probably 
then some Affection of the Kidneys

besides putrefaction wch. as Influence
on the Kidneys so as to produce this
Species of some,  and lastly Arises and
produces the most Fatal Symptoms
wch. Arise in the Disease that is Haemorrhage
as he is Weaken'd and cannot bear the
Loss of Blood, sometimes the Gums become
loose and Spongy and Haemorrhage happens
the most common Haemorrhage wch. happens
is from the Mouth Throat or Nose, this takes
place in consequence of the Putrefaction 
and wch. gives no Relieff at all to the
Fever, the Fever remaining as Violent as
before affording not the least Relieff in 
the Fever but tending to weaken the Patient
the Blood thrown out by any natural Hemorrhage
or Blood when taken away by
any other means hardly Coagulates when
in this state, and the Coagulum is Loose
and easily broke to Peices and the Semon
is Mix'd wth. it, it has now and then 
happen'd that the Blood as become
Fœtid, I myself never I knew or Saw it

but its Relat'd by Authors, and sometimes
Practitioners in warm Climates have
Affirm'd that they have Smelt it Fœtid
and we dont doubt but that sometimes
the putrefaction go's so far as to give
a Fœtor to the Fluids/ now this sometimes
go's as far as to Add to the Weakness
and the depression of Strength wch. Tends
to destroy the Patient, so when the Skin
becomes of a Purple Colour it Destroys
a Patient soon a Delirium comes on and
the Patient is carried off soon in the 
space of Ten or Twelve Hours, and no
such Symptoms come on except 
putrefaction of the Fluids take Place,
the putrefaction depends on the depression 
of strength if Inflammation happens
in the middle of the Fever there the
Symptoms go off and the Inflammation
Blood from an encreas'd Action
of the Heart and Arteries and so its
evident that the putrefaction depends
on the Inaction of the Vessels/ Fevers
wch. happen in Jails and in Camps

and that wch. Arises in the Barracks of
Soldier's Arising from Infection are Apt to
exhibit Symptoms of putrefaction of the Fluids

Lecture 30th.
On Fever's























Fordyce
A course of lectures on the
theory and practice of
physick.




A course of Lectur’s
on the Theory and
Practise of Phisick
Dr. Fordyce
Physician to St.
Thomas’s Hospital




Lecture 1st.
A disease is an alteration of the chemical
properties of the solids or fluids or of the
organization of the body, or of the action of the
moving power, producing an inability or a 
difficulty of performing the whole or any part
of the system; or [illegible] as preternatural 
Evacuation every effect has a cause and in
consequence of which an alteration in the human
Body takes place, the causes of many Diseases
have not yet been investigated as far as there
have been we will endeavour to point them out
to you, in general, it is some eternal and 
preternatural applications to the Body or
mind that produces a disease, for example




Cantharides applied to the skin induces an
inflammation, of the mucus membrane of the
lungs a catarrh it has happen’d that sudden fear
has been followed by a fever, it is not always so
in any of theses instances, the [illegible] not always
produce the Disease it is generally followd by it
now was from out having constant experience 
of their action we are not able to judge of them
wth certainly, external applications have been
said to be its occasional cause, not simply
because the things have been called causes, but
the occasional one is the time properly speaking	
this may act two ways, first immediately
as for example, if you apply cantharides 
to the skin, the cuticle is Raisd, and an
inflammation arises, secondly it may act
immediately the first cause may produce 


a second, whose immediate effect will be the Diseases
for example if you make wound in the skin
and apply some Variolus Matter, there will be
new parity produced, but will from an inflammation
in the wound, and that will be taken to the heart
and in to the circulation, which will produce a general
fever here than the wound is the immediate
cause, and the inflammation the intermediate cause
of the fever, tho not always throwing the cause
of the disease, has given room to some for
supposing that they always acted immediately
for example cold they say constringes the
external pores of the skin, and obstructs the
insensible perspiration, this thrown back into
the circulation, is the cause of an inflammation
now this perspiration is nothing more water, and
when to [illegible] [illegible] not that at all, this Method throes
[illegible] method of reasoning, it is evident that



it is evident that many of the known causes act
immediately and some it must be allowed act
intermediately, yet we should always be suspicious
of the latter, now we admit them but on the
Clearest evidence as in case of the variolous matter
a practitioner ought to be [illegible] wth these
causes, as far as they are thrown, it is by this
means that diseases may often be present'd 
[illegible] a hundred Die of Diseas’s
to one by the sword, where we perfectly master
of the causes of diseases, We should be able
to preserve a great number of lives, We must
observe that one part of the [illegible]
of the operation of causes depends, on the
state of the body to which they are applied
for example Let a Man that is fatigued
with an empty stomach be suddenly exposed 
to cold be shall have a fever whereas a man



in Vigour with a full stomach be exposed to the
same degree of cold, shall receive no injury from
it. Thus then in certain states of the body the
causes of diseases act more powerfully, than in
others, these are called the predisposant causes
of diseases, as they render the body more liable to be
affected by the occasional cause, therefore they are
much to be attended to, as the occasional cause 
tho. they can never produce a Disease of itself 
To remove the predisposant Cause often has 
efficacious as to prevent the application of the 
Cause itself; the Blood is sometimes more apt 
to be affected by any Cause than at another, we
we then say it is more irritable, for example a 
Man of a Sanguine temperament, Living in the 
Country is more apt to be affected wth. an 
inflammatory Disease, but as we cannot [illegible]
cases investigate the alteration, we are therefore 
apt to Reject this knowledge, for example, Let 
a Patient be brought to a man entirely Destitute


of the knowledge of Anatomy, wth a Pleuritic 
Pain in his side without knowing there is any 
such Membrane as the Pleura, he will form some
Hypothesis unwilling to appear ignorant in any 
Thing, he will judge of the Disease by its external
Appearance; from hence Practitioners have Divided
into two classes, the Dogmatics and Empirics 
the first consider the Alteration as the Disease,
the latter the external Appearance as the Disease,
We doe not know from external appearances
what Disease is Present, and We consider the 
external Appearance only, We shall not treat 
the Disease equally, as if We knew the Disease
itself but still We must always Avoid Nanmes
the Causes of Disease are Divid'd in to Proximate 
and Approximate the Proximates that wch
Products the Symptoms are internal Appearance
from which We judge of the Diseases with 

Pleura, the Inflamation of the Pleura is the 
Proximate Cause of pain, why then should we not
always take the external appearances for the 
Disease because they sometimes Prove fallacious for 
Example, and difficulty of Breathing may Arise
from Spasmodic Affection, an Inflamation of the 
Pleura and many other Causes, it is also improper
to Class Disease from their external Appearences 
as from this We shall be led to Join Diseases,
which have no Connection wth. each other, and then
are Apt to make general Application to the 
same Class so that We shall Practice very Injudiciously,
by making general tho of the same 
Application.----

Lecture 2d.
On the Diseas's of the Human 
Body----
We have already Defin'd a Disease to be an Alteration
of the Action of one or more of the Moving
Powers of the Body, Producing an Irrability
or Diminition of Performing its Functions
properly, Suppose a Persons knowledge of all 
the Parts of the Body; We ought not always
of an Alteration from external appearances,
it cannot be Denied, but it will be better to 
[illegible], the Alteration as the Disease, [??es]
there are many Material Parts, the Lungs
for Instance where the we doe not know 
material functions and many of the things

of equal importance, wth. which We are [illegible]
We cannot tell wth. perish on what Alteration has
taken Place, still tho We are not so well Acquanit'd with
those things as might be Wish'd, yet it does not follow that
We shou'd reject the Knowledge We have in our 
Power, if We confine ourselves to the Knowledge of 
Disea's as far as have been Investigated and from
no Hypothesis no Conjucture in this Case. This better
to Consider the Alteration itself as the Disease, than 
the external Appearances; if We Consider the external 
Appearances, We shall be Led to Alleviate some Urgent 
Symptom without endeavouring to Cure the Disease
itself. We shall therefore in the Persecution of this Course
in all Cases where We can Point out the internal 
Alteration that takes Place, Now we don't Call it a 
Disease without it Continues to prevent one or more 
of the functions from being Perform'd properly. Now 
a Disease does not always remain in the same State it
is always Varying. The Disease itself indeed sometimes
Varies this is but seldom for the most Part is [Cont???]
the same Let then us Consider the several different
Progressions of a Disease. I have before said it for

the most Part never Continues in the same state
it may encrease so as to cause the Death of a 
Patient, for Example in an Inflamation of the 
Brain the Presure which takes Place Causes a 
Stupor if the inflamation encreases the Stupor
will also encrease untill it kills the Patient.
Secondly a Disease may terminate in some other 
(for Example) an Inflamation takes Place in the 
Cellular Membrane in any Part after Continuing 
for sometime it is Converted into Pus and forms
an Abcess from the encrease of Inflamation 
which is the Cause of Suppuration, here then 
there is the first Disease going off in Consequence of 
the Second, it also frequently happens that 
a Disease Produces its own Cause for Instance
a Quantity of Venereal Matter Apply to the 
Urethra, thus it Converts into Matter similar to 
itself and Reduces an Irritation and in Consequence 
an encreased Secretion, which washes away the 

Venereal Salts and by this Means Cures the Disease
so in any Inflamation of the Lungs a Copious 
Expectoration is united which Carries off the Disease
now it sometimes happens where no Danger of the Disease
itself Arises, yet what was Intend'd as a Natural 
Cure stills (Example) the spilling Produc'd in a 
Peripneumony may be too Copious. and Continue
[illegible] to Darhoea, the Patient whereas if it had
been in a proper degree it would have Prov'd salutary 
so again in the Rheumatism the encreased Action
of the Heart and Arteries, may be so encreased as
as to be the Death of the Patient, when the Rheumatism
itself would not have kill'd, Thirdly the second
Disease may Prove more fatal, than the Primary
an Inflamation of the Lungs may terminate in a
Abcess on the Part, this will Prove more fatal
than the Pleurisy itself in many Instances.
From thly it often be spasms there a temporary
Weakness takes Place and this in but me. We shall
Call a Depression of Strength, this in some Measure
may be Call'd the Disease itself and it often Proves
Fatal, but the Disease may so much exhaust the

The Strength, that [cross out] shall Destroy
For Example a Patient shall have a fever wch. shall be
Extend'd to much a Degree as to prove Fatal, but futher
the Patient is Reduc'd to the lowest [illegible] of 
Weakness could We then instantly Remove the Fever
the Powers of the Body would almost as Instantly
begin to be Restor'd. It is necessary for a Practitioner
wth. the Cause of a Disease as far as we yet know
yet without knowing the History of a Disease We
shall not be Able to cure it therefore this is 
a Study which Requires the greatest Attention
to know what is likely to happen in [illegible] in the
Progress of a Disease, and the more so as without
this Knowledge We shall be Unaquainted with the 
Natural Cure likely to Arise, and at another time
we shall Pay no Attention to the most Dangerous 
Part of a Disease, it is therefore Requisite that We
shou'd be Masters of a Disease, before We can Apply
a Remedy for Instance in the Small Power
Unaquainted Practitioner would probably Endeavour

for to Put a Stop to the Disease on the 
other Hand if you understand the Disease We
shall know that the Disease will go through 
its Course, and therefore We should not Endeavour
to Put a stop to it, but forward its Progress, no
in a Fever, no in a Fever We [illegible] many Remedies
wth. wou'd put a Stop to its A Skillfull Practitioner
will never make one any but those wth. be
known will assist the Patient to go through
the Disease. Secondly where the Natural Cure do's
not take place, We must Employ Remedies
most likely for to bring on this, for Example if
we have an Inflamation wth. no spilling no envelope
of Expectoration it will probably Prove Fatal
We must therefore Endeavour to Produce this
Natural Cure, by Artificial Means, Yet we must
make Use of Remedies most likely to Produce [???d]
this Effect and thirdly We must Endeavour to Remove
the Extraneous Danger, Suppose a Fever to arise
in a young Man of a Robust Habit and that has 
[illegible] We know that Fevers in general doe not kill

but from the Robust [Natis??] general Inflamation will 
arise as for to Prove fatal; We must therefore Endeavour 
to take off as much as We can of the Inflamation
by Copious Bleeding so that by this Means and other 
Evacuations We shall Enable him to go through the 
Fever the Removing this entraneous Danger is of very 
great Consequence in Acute Diseas's particularly
[??urlkly] the last Method to be Atten'd to in 
the Cure of Diseas's is to Employ a Method of Cure
contrary to the Natural Method of Cure, at least
not all Indicated by it in this Cure We must
make immediate Application of those Medicines
which have been thrown to frame of the Disease than
in an Inflamation of the Pleura if we VS. and 
blister it will tend to Put a stop to the Inflamation
immediately and Suffer it to goe through its Natural
Progress, And this Part of Medicine We shoud
by all means make ourselves Acquainted with 
For Instance We Know Preparations of Antimony
will Cure fevers, that the Bark will Cure an

Intermittent, yet if you are not Acquainted with 
the Nature the Disease, We shall not Understand the 
proper Method of inhibiting them, and by this
Ignorance We shall render the Disease more Obstinate
for tho We know Antimonial preparations Cure
come fevers, yet a Practitioner should not farther 
Resolve to Cure every Fever by the same Method
tho Bark will not Cure all Intermittent fevers
it may be given improperly to be of more Disservice
than Service, for Instance if you give the Bark
in the Paroxysm of an Intermittent instead of Curing
the Disease it will by Degrees Come to be a Continual
here then the Disease is rendered Worse by the 
improper there/ this Remedy it is of some 
Importance in Medicine to Observe that there is
no such thing as an Infallible one.----

Lecture 3.d 
Of the General Doctrine of Inflamation
An Inflamation is a Disease Affecting
one Part only it sometimes happens indeed the general
System is Affect'd in Consequence of the Inflamation
but while the Inflamation is Confin'd to one Part only it 
is a Topical Disease not releasing the System
in general, if you apply your finger enternally
to an Inflam'd Part We shall find an encrease
of the Pulsation of the Arteries, a greater Degree
and some Heat so as to Rise to 110 Degrees of 
Farenheits Thermometer commonly however to 
102.4, or 6. Degrees, the Part becomes of a Red 
hue and then a more Florid Redness takes 
Place at first their is an throbbing to increase
Pain wth is Inconsiderably encreased and become,
a throbbing one and is still encreased from 

the Starting of the Inflam'd Part. There is also a levelling
owing in some Cases [illegible] in all to be a Distension of 
the Vessels and an [illegible] action of the Fluids Inflammation
is the [illegible] Cure/ Contraction, hence the Motion
is sometimes Imped'd, sometimes entirely Destroy'd
according to the sensibility and Irritability
of the Parts, there are the Internal Appearances wch.
take Place, You must next Inquire the Reason 
are Marker of the Alteration, wch. is the Disease
and wch. gives Occasion to there Internal Appearances
the Swelling is the first thing to be taken Notice
of and this, If we open the Imflam'd Part, We shall
find it going to a Part of the Blood thrown
out of the Vessels, this Consists of Coagulable
Lymph and Superfluous Water, sometimes
however there is no Extravasation at all, as in an 
Inflamation of the Eye the swelling is owing to 
the Distension in the small Vessels, We know by
the action of the Heart and Arteries that the 
Blood is thrown into the Capillary Veins a 
Distension it is said may arise three Ways from the 

Relaxation Obstruction and greater Quantity, of 
Fluids thrown into those vessels, first the Heart
and Arteries may Propell the fluids wth. greater
force into the vessels incl wth. [Cere??] [illegible]
will be Pres'd on more, and therefore they will become
Inflam'd and Distended. Secondly these 
small Vessels from their Disposition to Contrast
always Endeavouring to Avoid Inflamation 
If they are Relaxed they will allow Consequence
of that be Distended. Thirdly if you stop the
Passage through may be and Continue to throw
into it is will be Distended, in like manner
the Capillary Vessels will be Distended. Now
Distension from Relaxation in no case gives
Pain for Example the Bladder from being
Relax'd will contain [illegible] of [????e]
and Here shall be no Pain. If it in a Cathartic
State one Ounce wil give Pain. The Distension
that takes Place in an Inflamation is always 
Painful, this therefore is a sufficient Proof that 

The swelling in this Disease dos not arise from
[illegible] of the Vessels; neither dos it in Return 
Place Proceed from an Obstruction of them; If this
was the Case the blood would be Prevented from 
Passing. The Blood passes through the Capillary
Arteries into the Veins, Then into the Cavities and 
from them into the Secretory Ducts. When the 
Veins are Inflam'd, the Parts are always swell'd
if they are Open'd the Blood flows wth. greater
Velocity than in an Healthy State, although the 
swelling be very Considerable, when received into a
Vessel it detract Contract more, as Cool, a [illegible]
[illegible], then if it was taken from one when 
no Inflamation was Present neither is it the 
Colour of Extravasated Blood, it is evident
therefore there is a more Considerable Quantity
of Blood Circulating through an inflam'd part,
then there is a Natural Course for there can be 
no Obstruction. Secondly We find in an 
Inflamation from Obstruction, that the [Euhal??]
Vessels are not Obstructed but every [illegible] [???neass]
the Kidney as in Secretion encreased in and sam
Aart. The secretion of the Kidney is Diminished

as well from an Inflamation of a Gland as from 
an Inflamation of any of the Adjacent Vessels
but we cannot draw any Conclusion from this
gland as it is liable to be affected by every
Adjacent Inflamation. It Appears then that there
is at first no Obduction. And if there was 
it would not Produce a Swelling, there must 
be something more to Occasion it for it is known 
that there is somtimes the Quantity of fluids
that Circulate in the Body than actually do
therefore an Obstruction will not cause a swelling
the Blood is Propell'd forwards by the Heart
and Arteries of this Action is encreased a greater
Quantity/ Fluids will be Propell'd forwards
We must Observe that the Action of the Heart
is Uniform, but that of the Arteries and Veins
is not so, and it is this Variation wch. is the 
Cause/ this Alteration is the System, this is
a more frequent Cohesion, the Blood is actually
Propell'd in a greater Quantity as may be Discoved 
by the more frequent Cohesion and Pulsation

of the Arteries, as also from Principial
Observation, no that it is evident the Swelling arises
from an encreased Circulation or Relaxation [illegible]
the Cause that the Heat Arises we cannot Determine
as We doe not sufficiently know on what the 
Heat of the Body Depends, thus far We know
that when the Action is encreased it becomes
Hotter and upon discontinuing this Action it 
grows Cooler, in exercise of any Mind there is 
an encreased Degree of Heat, that the swelling 
do's not Arise from an Obstruction will be evident
If you take some Blood from an Inflam'd Part
it will Appear of a Blou'd Redness, whereas Blood
that as Stagnated will be off a deeper Colour
the pain wch. Arises in an Inflamation is owing
to the Vessels of the Part being Distended beyond
the proper Tone------

Lecture 4th
On Inflamation
We have already Shewn you that the Distension
of the Vessels Arises from a greater Quantity of 
Blood being thrown into them, and that the 
pulse is no other than the difference betwixt 
the Contraction and Dilation of the Arteries,
that Pain is Capable of being Produced in 
any Part of the Body by Distension, as if
the Stomach is over Distend'd by Food or Air
thrown into it, then Pain is Reduc'd, and also
if the Bladder is Distended Pain is Produced
and if the Ligaments are Distend'd Pain
Arises, and a fluid Discharg'd; but all 
Distension does not Produce Pain; For Example
a tumour may Arise under the Skin, as in 
the [illegible] and Prove Painful, the 
Stomach may be Distend'd to a certain Degree
without Pain, so also may the Bladder; thus

We find that Distension in certain Circumstances,
only is Capable of Producing Pain,
the Part must Endeavour to avoid Distension;
and if at this time Distending Cause 
Arises then Pain takes Place; for Example
the Stomach shall have a Disposition to 
Contrast; if at this Time a Quantity of Food or
Air is thrown into it, Pain will be Produc'd
in like Manner if the Bladder has a Disposition
to Contract, Pain will Arise if two Ounces of urine
be Contained in it; tho at other Times it will 
Contain Ten or Twelve Ounces without Pain; it is 
the Contraction wch. gives Pain, when the Blood
is Propell'd into the Capillary Vessels was 
the Distend them beyond their Disposition to 
Contract, We will call it a Distension beyond 
the Tone, and this we say Produces Pain in 
an Inflamation, but in order to excite
Inflamation it is Necessary, that the Circulation
shou'd be Encreased, and that to much
a Degree as to Distend the small vessels beyond

their Tone, if you put your Hand into Warm
Water the Circulation will be encreased and the 
Vessels be Distended, but no Inflamation will
Arise; because the Vessels are not Distended
beyond their tone; Now this Disposition is always
Altering for Instance, the Stomach or Bladder
sometimes have a Disposition to Contract
and then will Receive but a small Quantity 
whereas at another Time they will receive a much
Larger Quantity is like Manner may the 
Blood Vessels themselves be Distended. The Warm
Water Relaxes the small Vessels, they 
will then Receive an encreased Circulation
without Inflamation; some have Consider'd
the Secondary as the Primary Part of Inflamation;
that it is not is evident, because the 
small Vessels are greatly Distended beyond
their Natural Size, there wou'd be Pain, from
their Disposition to Contract, this is not an 
Inflamatory Pain but a Rheumatic one, for 
[illegible] Inflamation a Distension takes Place first

and if a Part is already Distended to as great 
a Degree as it will Allow an encreased Distension
will Cause Pain, wch. Pain Arises from and Inflamation,
in an Inflamation We meet wth. one Symptom
wch. Distinguishes it into two Species; if a 
Vessel of a Considerable Size is Affected the 
Pain will be a throbbing one, and will be more encreased
at the Relaxation, than at the Contraction
of the Arteries. But if a Membrane be 
Inflamed the small Vessels or Arteries only 
be affected, wch. have great Strength in Membranes,
and in wch. the Heart has less Influence
there; the Pain will be the same when the 
Heart is acting as not, so that the Pain will 
be Constant and equal, We must lastly Observe
that Pain is not Absolutely Necessary for 
an Inflamation; the small Vessels must be 
Distended beyond than Some and in most Inflamation
they stimulate and Cause harm it 
now and then happens that the Distension is

no small, as the Vessels only will be stimulated,
why Muscular Fibres are Contracted and
Rendered Incapable of Motion, We doe not as yet
Understand, but supposing Relaxation and 
Obstruction to be the Proximate Cause of Inflamation,
We are equaly it or less to throw out what 
Manner they act, As we are not yet acquainted
wth. the Course of Muscular Motion and flexibility
of the thin fibres, We can only beg then 
that there Alterations are in Consequence are
in Consequence of an encreased Circulation
in the next Place We are to Consider the Cause
of Inflamation, and there are most apparent
then in most of the Diseas's. An Inflamation 
is Reduced by an application to the 
Body, wch. tend to excite Motion these we
Call Internal Stimuli, meaning to take it in 
an Extensive Sense, and not [C???iethem]
to the far face of the Body, but to take every

extreme Part also, Now Ive divide these [???a]
into Restomical as Bruising or Cutting and 
Chemical there wch. Hand to Destroy the Part
Mechanically, and there wch. doe it from particular
Properties they Perhaps as the Destroying the 
Coagulum &c. Some have happen'd that Mechanical
stimuli but Acted in Consequence of that 
Pointed Spiculae running into the Rest; but We
can Demonstrate that the small Particles of 
Caustic Vegetable Alkali will not penetrate the 
Coats of any Vessel, no more than sharp instrument
of an Inch in Fig will Penatrate the Skin
when Impall'd by its own Weight, but Sub [?a??e]
wch. have no Mechanical or Chemical Action,
I say such substances Stimulate frequently, As
per Example if a Deep of Infusion of Cantharides
and one of Infusion of Common Flies, We know 
they both have the same Mechanical Properties
yet they have very different Effects. For the 
Cantharides will Combine wth. the Mucilaginous
Part of the Blood and Inflame; the Common fibres
will [crossed out] Effect at all; this then furnishes a Mind
Class of stimuli wch. We call Medical----

Lecture 5th
The Application of these Stimuli is in general very 
Obvious, some of them however Require a particular
Explanation, first the Distension of a Part whether
it be of the external or Internal Part of the Body,
whether in a Blood Vessel Muscle Nerve or 
Ligament, is Capable of Stimulating and Producing 
Inflamation, this is the only Cause 
that is universal and Capable of Outing on all 
the Parts of the Body is found [???e] per
the Distension of Blood vessel, as of 
a Membrane will [illegible]
Produce Inflamation, for Instance if [alma??]
of Water be thrown into a joint it will have
no Effect as a stimulant, yet the Disturbance
from it will Produce inflamation on the 
Ligament, We see that a Distension is 
Capable of veins Produced in every Part of 
the Body, success of the Bones in wch. it 
comes unless they are in a Diseas'd State

but all Distermind of not Stimulate any Part of 
the Body may be Distended without Pain it is 
the Resistence to the Distending Course that Produces
the Stimulus, Now there are the Powers wch. are apt
to remind the Distending Causes; first the Cohesion 
of the Partion of the Parts w/wch. the latids consist
and wch. We Call Electricity, this Power when the 
Distension is above a certain Degree tends to bring
the Parts nearer to each other, and restore them to their 
former State; this Power is nearly equal at all
times; the Second Power is Capable of Resisting
Distension; the Comparble Power of the Letids
wth. Depends on the Life, and is Inherent in all Parts
of the Body. The Bones however seems to posses
but little of this Power, this is greater than the 
Contractile Power and Varies Considerably,
so that the same stimulus will at one time Stimulate
when at another time not according to 
its Resistance, if the Distension is Slow and 
gradual it will get the better of both of these
Resistances without Stimulating; for Example

a tumour may grow gradualy, under the skin
and Distend it to a greater Degree, Now if the same 
Distension had attempted to have been made suddenly,
the skin wou'd Burst; it also unites the 
Contraction which Depends upon Life, so as
that Resists more strongly, no stimulus Arises
Distension then from both these Causes is Capable/
Stimulating so as to Produce Inflamation
for happening at Present a great Part of the 
Blood Contained and Circulating in the exterior
Parts of the Body, and if it be suddenly Exposed
to a great Degree of Cold, this Power will be 
encreased, so as to Produce Inflamation;
Division is also a stimulus, but it must be
Observed that in Order to Stimulate it must
be on a Irritable Part, that is Divided. Some 
Parts of the Body are Capable of Distension
only, others may be affected by it; for Example
a Piece of the Knife or any Sharp Instrument

has passed through the Stomach, during which 
it has [??anind] much Inflamation, it has then Passed
the Muscules and Produ'd none, then during the 
skin it has Produc'd Inflamation; if a Part not
Irritable be Divided, their will be no Inflamation,
and if a Part be Divided as in a Wound, some Part
of wch. is Imitable and some not then an Inflamation
will Arise in the Irritable Part, and extend 
to the other, if the Patient be strong, but not if he [illegible]
it has been said that an Acrimony of the Fluid
will frequently Produce Inflamation, Now it must be
Observ'd that no Stimulus will affect the Blood
Vessels but Distension, except the Heart, and this
accordingly more Irritable then any of the Blood
Vessels, and hence it is that Poisons Prove Fatal,
when they Come to the Heart, when they have not
affected the Blood Vessels in their Passage through 
them, Acrimony which for the most Part seems
Stimulus) if the Blood as Water is Incapable of 
Producing Inflamation in the Blood Vessels [Nem??]
but supposing a Stimulating Matter Contain'd them 

in Consequence of being thrown out from them
on an Irritable Part, and Inflamation will be Produc'd
A Solution of Neutro Salts when Contained in
the Blood Vessels may be sufficiently Concentrated
so as to Produce Inflamation especially
if the Natural Mucus be Remov'd from the 
Membrane, as in the Urinary Passages Intestines
&c. for Example in an Inflamation of the 
Lachrymal Duct the [M??Jeans] are more [P???fully]
Secreted, wch. Carries off the Natural Mucus
of the Part; they Stimulate so as to Produce
Inflamation, thus it happens in a latent
Dysentrey &c there then Fluids Stimulate,
it is the Natural Salt of the Blood Containes
in them wth. the [Ca??s] it, ferments also and 
in Capable of increasing the Quantity so able 
Stimulate the System in generaly as the Variolous
Matter, the Venereal Matter &c but it is the 
Neutral Salts for most Part that Stimulate

there then are the only Stimuli, it is necessary
for us to take Notice off. however in some Cases it is
very difficult to suppose a Stimulus, sometimes
also a fever arises in course of which an Inflamation 
takes Place.------

Lecture 6th
We come now to treat of the Predisposant Causes
and We shall first suppose that Inflamation is increased 
Action of the vessels, and therefore
the stronger the System in general, the more
liable it is to have an encreased Action of the 
Vessels encited, so that an Inflamation is more 
Apt to Rise in a Man of a Robust Habit
of Body, and that Living in a more Cold
Atmosphere, than one of a Weak Habit of Body
Living in a Warm Moist Atmosphere, and 
it often happens in the Spring than in the 
Autumn from the Cold of the Recceding 
Winter having encreased the Contractile Powers
of the Body as Solids, Living in a Pure
Atmosphere gives strength to the System,
therefore [cross out] Live in the Country are 
Subject to Inflamation, then there who Live

in large towns; the Body is in its greatest strength
from fifteen to twenty five during that time a 
Man is more subject to Inflamation, than of any
other time of Life; Men of a Sanguine temperament
have a greater Disposition to Inflamation than those
of a thin Spare Habit; it must be Remark'd that 
there are two species of Inflamation; the first is
Apt to Arise in the substance of Parts; and 
which we call Phlegmonans; the Second that 
wch. Arises in the Surface of a Part, wch. We Call
Erysepellatous; strong Habits are subject to the 
first Species of Inflamation; but in Weak Habits
the irritability is Commonly encreased; and 
the surface is more apt to be Affect'd from 
external application; In Warm Climates and 
in the Autumn from Living in Large towns and 
being Naturally of Irritable Habit Erisapellatous
Inflamation is Apt to Arise, but Strong and 
Weak are more Subject to Inflamatory Disease
than those of a moderate Strength; particular

Parts may also be tender more irritable by
particular applications, in Inflamation of a 
Part is Capable of Producing a Disease of the 
whole System, so that a second Disease is 
liable to be emited by it. We must first observe
that many Practitioners have us'd the term Fever
to Express a Disease in which there was a more 
frequent contraction of the Heart and Arteries;
And we must at the same Observe that it has
been made tho of differently by others; As 
by Sydenham and Hippocrates and most 
of the Ancients, and but Modern Practitioners
it is improperly us'd to signify all Disease
in wch. the frequency of the Heart is encreased
for by this Means We shall include several
Diseas's, that are properly Call'd fevers, when
the frequency of the Heart is not encreased,
and Employ the term in this sense, We shall
from a particular class of Disea's totaly
Different from one another; fever in its proper

[A??plation] is a Disease Arising Independant of 
any other, and also when Reduc'd is Independant
of its Cause, for it is not true) Physiology) that if the 
Cause be Remov'd the Vessels will Cease, We doe
not then Call the Effects Arising in the system
from Inflamation Fevers, for they frequently Depend
upon their Causes, so that if they be Removed
the Effects will Cease, they have also been called
Symptomatic fevers a Hoffman Calls it a 
Planitic Fever &c And we have said that the 
Affections Arising in the System from Inflamation
are two the one We call general Inflamation
the other symptoms of Irritation. Phlegmonary
Inflamations are Apt to be attend'd wth. The 
former, and the Erysapallatous one wth. the 
latter, but neither of these Diseas's are peculiar
to Inflamation, they may both arise from topical
Applications, the symptoms most common
in general Inflammations are Hardness of the 
Pulse, it is said to be Hard, when it feels like
a Musical Chord high Strung at a vitiating, it is also

Strong full and frequent, but none of these are
Necessary, for general Inflamation may subject
without neither as in an Inflamation of the 
Inter limb, the Pulse is small and frequent, neither
is it Necessary it should be frequent, for if the 
Inflamation be of an external Part, it is full
and hard, but not frequent. However from 70
Beats in a Minute, which is the Natural
Pulsation it Amounts to 110. It happens more
frequently also that it is more frequent at
Night then in the Morning, but in general 
Inflamation is healthy. Cinthart, the [??dass]
of the Pulse Discovers the Action is to be Cuting
Strongly, and this is the most Material Part
of it, this encreased action is attended wth.
an Alteration of the Blood, it becomes 
more Fluid. Some but those have suppos'd
this Alteration to be the Cause of the Disease,
others again have suppos'd it to be thicker, and
more Apt to Coagulate, this than they have [sa??]
to.

be the Cause, but the Blood in an Inflamation
is evidently thinner if taken from the Arm
it continues longer [illegible], so that the red Globules
fall to the bottom, the Coagulable Lymph Coagulates
afterwards more strongly; and adheres to the 
Red Part, was to some [C???] on the [??ss]
but in order to judge of this a large orifice shoud
be made in a large Vein, and receiv'd in a 
glass as nearly Spherical as Possible; the 
Coagulable Lymph in an Inflamation is something
Render'd as this, as to pass through the [illegible]
and be Extravasated, all the small vessels through
the system being Distended, and a [??nienal]
Restlessness takes Place, and being also 
fill'd wth. Blood a general redness and Heat,
and there is also a Degree and whiteness
of the tongue owing to attempt of its Secretion; In most
Affections the Mucus is encreased, here it is
generally Diminished; We are not sufficiently 
Acquainted wth. the Causes of this Appearance 
The Variation of this is a/Consequence in general

Inflamation it is more white, sometimes in an
Inflamation arising from the thorax, there is 
two yellow streaks along it; thirst do's not 
always arise from a Dryness of the Mouth
but the Reason of this as not as yet been sufficently
[illegible] for. the Redness are on a 
different state in different Inflamations,
if it Arises from a Cause that do's not give
great Pain; the mine is forbid and upon
Standing Deposiyes a [???ious] Sediment
but if there is great Pain, the Vessels of the 
[th??ies] Contract, and the urine appears
Clear sometimes a small Quantity of Mucus
Matter is Suspended in it, in form of a Cloud,
when an Inflamation Proves fatal, it is 
from an Affection of the Brain, first it may 
happen from such a Quantity of Blood
into the Brain as to Compress it, which
will cause a stupor on which the Ey's
Appears Red Inquire and Dim and a Delirium

takes Place on which the Patient Mutters
something to himself if she & he is terrible
but his Memory is entirely [illegible]. The Second
Method in which general Inflamation appears
to Destroy during its Violence, is by Producing
Wakefulness from a start of Rest he becomes
Delirious, this at first takes Place towards
Morning, if he sleeps an hour or two it then 
go's off for the whole Day, returning every Night 
in an encreased Degree, here the Eyes are Bright
the Patient is Quick in all his Motions, sinks
gradually untill at last Ravings are very Violent
till at Last he his Destroy'd, this however is 
not properly an affection of the Dream.
The Delirium some times remains after the Disease
itself is Removed, and then a Confirmed Mania is after
Produc'd------

Lecture 7.th
Inflammation greatly Depend upon this 
Cause, but not totaly Suppose an Inflamation of 
the Pleura shall arise, and in Consequence of this
the Pulse will be hard full and pregnant and 
other Symptoms of general Inflamation shall be
Present, by the application of a Blister to the side
We can sometimes Cure the Pain and other 
Symptoms and the Disease gos off; In this 
Case We have Employ'd nothing to Remove
the general Inflamation, We have only Atten'd
to the topical one, so far its Confirmation is not
Dependant on its Cause, but this is not always
the Case, in the first Place it is apt to become
Habitual, far after a Continuance of [M???ax] per
Foundage, if you carry of the Pleurisy by 
Topical Remedies, yet the symptoms if 
general Inflamation will still goe on. If the  
Patient be strong the general Inflamation will 

be great, and after Continuing for several Days
it becomes Habitual, in this Case Disease after
gos off without any Remedy, if Enhart not upon
the contact strong action of the Heart and Arteries
their Powers become Exhausted, their action consequently 
less, and the Inflamations subsides, but 
this is not always happen, for the Heart returns such
proper action the Arteris doe not, this in the 
first Disease Produced by Topical [crossed out] Application
or Inflamation Produ'd by it, we call symptoms
of Irritation, the Disease has more Commonly been
call'd never the general Inflamation yet it is 
Essentially different, or even more so, it is also 
a Disease which requires our Attention greatly 
and is to be Distinguished, both from general Inflamation
when and all other affections of the system,
it is entirely Dependant on its Cause, it continues
as long as the Irritation continues, and when
it Subsides this subsides also, there are certain
Parts of the Body which We call Irritable as 
the Internal Canal Bladder Diaphragm, Womb
when lately Impregnated. &c when Affect'd they [Rod??e]

Symptoms of Irritation, for Example the 
Mucus membrane of the Lungs is liable to be
Irritated, As the Mucus Membrane of the 
Intestines, but if it is Inflamed, the same Symptoms
doe not Arise if the Imbalance of the 
Intestin's was Affect'd, We doe not Calle a Part
Irritable because they are Subject to be 
Irritated by external Causes, but because 
when Affect'd they are Apt to produce great
Irritation in the System in general, the 
first symptom of this Disease is Depression
of Strength Arising from no Cause, We expect
for Example when a [illegible] through 
the Stomach, it happens often that there is
no pain or great loss of Blood, yet the 
Patient shall be almost immediately Incapable
of Supporting himself, and the action
of the whole system being greatly Diminished
until he Dies, have then learns to be no

great reason for the Loss of strength, but 
much it is, this is not a weakness but a Depression
of Strength, for the cause being Remov'd the 
Strength begins immediately to be restor'd if the 
Depression Arises from any Irritation that can
be Remov'd it is only then the symptom of a 
Disease at the time the Strength is Depressed
the functions are all almost Disordered the Heart
Outs more frequently, it almost always Contracting
the Pulse then becomes small Quick and frequent 
the Stomach is also Disordered, there is Sickness
Flatulency Vomiting want of appetite, the tongue
as in other affections is alter'd in its appearance
sometimes however it has no Mucus and appears
white, and sometimes it has more than in a Natural
State, the vessels of the Redmias are also Contracted
so that the Mucilaginous Part of the Urine is not 
secreted, and it appears Clear, there is Mineral 
Restlessness and sometimes Delium is 
a symptom, by generally the Patient remains
Perfectly sensible till he Dies, the symptoms 
are also Reduc'd by other causes than Inflamation

by gangrene Mortification, Spasmodic Contractions
of the Intermit's and the like, What is 
particularly to be Remark'd in this Decrease is
that it is so totaly Dependant on its Cause,
and this makes it Essentially Necessary to 
Distinguish it from a fever; for Example
in a gangrene and Mortification shall take
Place, and when these Symptoms Arise they 
have been heated as a Fever whereas no
Attention ought to be Paid; but to the 
gangrene and Mortification, a [illegible] of 
it other Inflamations may sometimes happen
in this Case the Attention should be Directed to the 
general Inflamation, for Example in an Inflamation 
of the Intestin's, there is Depression
of Strength fainting and other symptoms
of Irritation, but the Pulse is hard therefore
general Inflamation is Present, have too 
doe not Employ stimulants, to support 
the strength, but make the use of Evacuations

which will generally Remove all the other
symptoms, Now Inflamation or particular
Affections of Parts, as of the system in general, We 
now Come to the Progress of Inflamation, if 
a stimulus be applied to a Part of the Body
an Inflamation takes Place in that Part, and 
it happens sometimes upon Removal of the 
Stimulus that the Inflamation will Cease, We 
will next Consider of this Continuation, when the 
Action of the Heart is encreased, the fluids are 
Propell'd wth. greater forces, so cuts as to Distend
the small vessels beyond their Tone; this Promotes
a more frequent Action of the Arteri's, so that they
Continue a Natural Cause Acting and reacting
on each other, but the Matter of the greatest Importance
is that there two Causes shoul'd be just an Equilibrium,
if they are not an Inflamation will be always
encreasing or Diminishing, for if the Distension is
more than Equal the Inflamation will encrease, this 
Action is seldom an Equilibria and accordingly
We find an Inflamation continues longer in the 

same State, it is always either encreasing
or Diminishing, so that if We can once make
it begin to Decrease it will continue to doe so 
and Cure itself. That We must observe that 
there is a difference between the Inflamation of 
a Part or substance of a Part; and that of 
an Irritable one, in the first it is the Distension
which keeps up the Inflamation, but in the 
other, the surface is apt to be Affected by
externall Applications, the Stimulus Acts 
differently from being applied to an Irritable
Part, and by this the Action of the Arteris
is kept up once equaly, hence the Erysepellatous
Inflamation are also apt to encrease
of they are less no than Phlegomanous upon

Lecture 8.th
It has been suppos'd by some Practitioners that 
the Degree of Inflamation Depend'd on a Quantity 
of Matter Obstructing the Inflam'd Part, wch.
if Resolv'd wont'd [illegible] off. but We have made
it Appear that there is a greater Circulation through
the Part, therefore this opinion must be 
Erroneous; the first [illegible] upon Inflamation
is Resolution, by wch. is meant nothing more than
the going off of the Disease; simple Resolution
is when the Removal of the Cause of an Inflamation,
the Effect Ceases of itself; but a Cause
may Arise wch. may be sufficiant to keep up
the Inflamation, after the Original Cause is 
Remov'd, during the Progress an evacuation
may Arise, this always Weakens the System
and may therefore, Terminate the Inflamation
If a part be Preternaturally Distend'd wth. a 
Johu'd making an opening, so as to Evacuate is

may Put a Stop to the Disease; but if this
Evacuation be made suddenly and a large
Quantity such a weakness takes Place as Proves
fatal to the Patient has been Experienced in the 
Ascites; An Evacuation in taking Place Naturally
in an inflamation, will weaken the Action of the 
Arteri's and carry off the Inflamation. This 
Natural Cure happens often in the Mucus glands
than in any other Part; the glands of the skin
Secrete but a small Quantity at anytime so
that the Secretion cannot be sufficiently encreased
to Carry off an Inflamation; the sensation 
of many of the glands of the [illegible] may;
as those of the Kidnies Mouth, Nostrils, that [illegible] 
secretion from any adjacent Gland will
sometimes Remove an Inflamation; tho there
be no Communication between the two Parts;
and their Effect is much more considerable 
than that from a Part at a greater Distance
secondly it is not Necessary the Secretion
shou'd be so great, as to Weaken the whole Body

only the Part affect'd and where it is from a 
gland there is considerable variation. The appearances
of the Evacuating Matter; that which is 
first Evacuated Consists of Water, Containing
the Salts of the Blood; this carries off the 
Natural Mucus of the Part, as it contains no salts
and then it may stimulate, so as to bring on an 
Inflamation, or encrease it when Excited. Then
Watery fluids Stimulate more than Mucilaginous;
in an Inflamation of the Nostrils, there is 
first a secretion of a thin Watery Mucus; wch.
Stimulates and encreases the Inflamation; but
if the Mucus be Continued to be secreted from 
the Inflam'd Part, it soon becomes Viscid; and 
then is lessens the Inflamation, and if it was
great it Puts on a Yellow Appearance, it has 
been said to be Concerted; but it is the Mucus
undergoes these Changes, and not a Reparation
and Evacuation of Matter, as it has been supposed
to be, because the first Evacuation wch. is by much
the greatest do's not carry off the Inflamation,
this Change happens Universally [illegible]

Mucus glands is Affect'd, as for Example
As for Example if the salival glands are
Inflam'd; there is Considerable encrease of 
sensation, wch. Reserve its Natural Appearance
but is apt to Smell, and where the Inflamation
begins to cease, the encreased secretion dos the 
same, till they are both carried off. At this time
also an Hemorrhage may happen, an encreased
Action of the Heart and Arteris, fever open the 
Exhalants; and if the Inflamation be in a 
Part wch. Opens externally, the Disease often
carried off from the Hemorrhage which is 
Produc'd. It happens also that an Evacuation
Arising from Accident will carry off an Inflamation;
for Example if a Woman shou'd be 
Afflicted wth. a Pleurisy and during that 
should Menstruate, the inflamation will be 
Carried off without the Application of any 
Remedy whatever; A small Evacuation 
We must Observe will cure an Inflamation 
when a long as artificial one will not.

The most Natural Cure of an Inflamation
is by fever; but we shall only say at Present that 
a fever coming on has sometimes Cured the Disease
The most Natural Cure is by metastasis when an
Inflamation arises in another Part and Carries off
the Primary one, an Inflamtion, an Inflamation 
Occupies but a small Part of the Body, and it 
seldom happens that two Considerable [?n?s?ubrin??]
at the same time in the Body, where therefore
a second Arises, the first generally Subsides
from this Arts We are not, sufficently, Acquainted
wth. neither do's the Supposition of the 
translation of Matter forward on Account for
the sustains, we only , know that an Alteration
in the Action of Vessels will Produce an Inflamation,
this Cure by the sustains is not Confin'd
to a Natural Inflamation, for an Artificial one
will Produce the same Effect, for Instance a 
Blister applied to the Neighbouring Parts
will take off an Inflamation, when a Part is 
Inflam'd and there is no distinct Surprior,

A Quantity of Coagulable Lymph is
thrown out; wch. glues them together; as in 
and Inflamation of the Pleura it is by this Means
They Adhere to the Lungs; if it be [cross out] large
Surfaces We Call this an adhension; but 
among the Muscular Fibres, and all
other Parts of the Body, where there is
a Quantity of Coagulable Lymph, the Parts
are Naturally Soft and Play one upon 
another, Now this Coagulable Lymph
glueing them together, renders them still 
liquid &c. and this We call Callenity----

Lecture 9th
It happens that an Inflamation may Continue
for sometime, but this is Caused by a Contained
Application of New Causes, for an Inflamation
initial/never Continues long in the same 
Situation, if it did We should Empart that 
the Vessels would, Burst, so that the 
Arteri's would arise at such a Pitatio/Distension
that they could encrease no farther, and 
the Inflamation woul'd be at a stand, but neither
of these happens, for when it Arrives at a Certain
Height it Terminates in a fresh Disease, The 
first of there is Suppuration; which We shall
now Endeavour to Explain; after an Inflamation
there is Matter form'd which we Call
pus, different from all the other fluids of the 
Body not form'd in it Naturally, but only in 
Case of Disease. It is Perform'd by some Chemical
Change for it cannot be filled'd from the

Blood Vessels as it is not Contain as in
Pain; New Pus is form'd in two Cases,
sometimes in a Cavity and sometimes on 
a Surface; We never find it in the Blood
Vessels; Let us first consider the Formation
of Pus in a Cavity inside to this there must
be an Extravasation for suppuration never
happens but from Extravasation, as in 
Inflamation of some of the Membranes, where 
the Extravasation is there the Pus is 
Form'd, as in an Inflamation of the 
Pleura if it is in the Cellular Membrane
there it is that Pus is form'd; if in the 
Cavity of the Lungs it is form'd there, when 
the Matter is first Extravasated it is not 
Pus, but sometimes Coagulable Lymph 
and sometimes serum and Superfluous
Water and not Commonly the Red Part
of the Blood, an Extravasation is not always
Converted into Pus, As in Bruises in the 
Rheumatism Coagulable Lymph is Extravasated

and no Pus form'd, it is then necessary to 
Produce Pus that there shou'd be an Inflamation,
and not only more Inflamation, but it must be in
Proportion to the Extravasated matter otherwise
it will not be form'd. in an Inflamation of the 
Pleura the Cavity in which the fluids Extravasated 
is large the Pleura itself is only a small
Part of the Body, and the Inflamation 
and in general is sufficient to form Pus, but
when it happens in the Cellular Membrane
above the Pleura, the Inflamation Bears a 
Considerable Proportion to the Extravasation 
and Pus is generally Form'd; the Inflamation
then Furnishes the Circumstances for that fermentation,
wch. is to Convert the Extravasated
Fluid into Pus, it has been Contended that Pus
was from'd in a different Way from this that 
the Exhalant Vessels where so Altered as to 
Separate Pus from the Blood, but this is 
entirely Hypothasis, for We actually see a 
Fluid Contained in the Cavity wch. is Insepable

of Absorption, and instead of this We Recently
find Pus, that the Exhalants doe not become
Secretory Organs to denote Pus, is Prov'd by 
this Experiment, in an Ulcer that forms
good Pus, if you Clear it Perfectly and
Observe it wth. the Microscope, the Fluid as it 
Passes from the Vessels You will find it a
Clear transparent fluid, then lay some [t????], 
the Ulcer so that the Matter is contained there,
and you will find it will become Pus; so 
that it is evident in every Case that Pus
is form'd from an Extravasated fluid and 
not from any Power that Exhalants Acquire
of becoming Secretory Organs Where Pus 
is form'd the Extravasated fluid. The Solids also 
Ferment and are Converted into Pus, it is
pretty certain however the Mundane is first 
Converted it is worth attending to; why 
the Life of the Solids do's not Depend them 
against this fermentation as well as any other;

sometimes indeed they are Depended by their
Life, sometimes Partly and sometimes not at 
all; When Pus is form'd it is not necessary that 
the Inflamation shou'd continue any longer
for it will keep up the fermentation, and 
occasion the fermentation of a fresh Quantity of 
Matter; Now the Cellular Membrane is universally,
Diffend'd through the Solid Parts of 
the Body; the Cells of it Communicate wth. one 
Another, We must consider then how it happens
that Pus do's not Diffuse itself through the Cells
as Water do's in Adematous Patients, why a 
Quantity of Coagulable Lymph is thrown out, 
which glues the Surfaces of the Cells together;
so as to render them Impervious to one Another
and the Pus forming in the Middle of the 
Inflamation, first it is Prevented from Diffusing
itself, sometimes a kind of a Membrane is 
form'd round it; and the Pus is Contained in 
a Cyst, but this do's not happen in Common; 
tho the Pus cannot Pass through yet it acts

so Strongly that it makes itself an Opening
on the external Parts, it is remarkable however
that the Pus do's not act alone in all Parts
of the Body for in some it makes its way
Directly, and in others indirectly to the external 
surface, hence less Mischeiff happens in 
many Suppurations; then we should Enpact,
now it may happen that the Cellular Membrane
has on it its Cells glued together in 
this (are Pus will Diffuse in [illegible]to a very great
Degree, sometimes also the Matter do's not 
Destroy towards the Surface of the Skin; but 
Destroys other Parts and Commits great 
Devastation this happens but seldom but 
when form'd Destroys the tumor as well as
the internall surface, so that we have 
instead of an Inflam'd Part a Cavity inside

Lecture 10.th
We have said the Cavity Produc'd in Inflamation
is Call'd an Abcess, after Pus is Evacuated it [illegible]
We Call it an Ulcer no that instead of Inflam'd
Part We have a Cavity, that Part wch.
was Inflam'd being entirely Destroy'd, but there
is a Power in an Animal of Regenerating those
Parts wch. are [illegible] in some this Power go to
to a great Length; if you Cut them in two each
Part will Produce that which was Sort, so that
We shall have two Animals instead of one;
but this happens to few Animals, as the 
Polypus &c in Complicated Animals who 
have a great Organization, even in these
Considerable Parts may often be Regenerated,
The whole taile of a Lizard in which there are
Bones; Blood Vessels nerves and Muscles 
may all be Regenerated and if Cut down the 
Middle there will be two tails; this same Power

of Regeneration exists in a certain Degree in 
Men; but less, in quadropeds in general 
and in other Animals, however Considerable
Parts of the Body have been Regenerated when 
an Extremity has been Cut off entirely it
cannot be Regenerated [ab??] if [illegible]
be left of each Extremity it will be [lege???]
as a large piece of Bone if Taken away will 
be Regenerated how the [??or??s] by which 
Parts are Regenerated in Man, if there be
a Cavity their Arise first an Inflamation
of the Surrounding Parts, this is not a Violent 
one; there is also a redness and some Degree
of Heat and Swelling, how every Considerable
Pain from the bottom of this Ulcer, every where
there arises Little granules of fluid Substance
This We Call granulating Flesh, and these
continue to rise up until the Cavity is fill'd
where it is Covered by a fresh Skin, is that 

after an Ulcer there Arises the Parts that 
where Destroy'd, sometimes in a Part and sometimes
in the whole, however tho by this Measure of Suppuration 
the granule bring Flesh is converted
into small parts that where [??ony'd]; yet the 
Motion will not be Perfectly Restor'd still 
We consider the Patient to be in Healthy; We
may in some Degree Call Suppuration a partial
Cure, it sometimes happens that no 
Inflamation Arises than Pus is form'd in this
Care a [la??ens] Matter goes out in a large Quantity
as an Inflamation the surface of the Ulcer
may Arise, and then it is converted into [illegible],
then the Ulcer spreads, the surrounding Parts
being Destroy'd if any Membrane [???ing]
the Surface of any Cavity wch. opens externally
shou'd be Inflam'd; there is a Quantity of Fluid
thrown out on the Surface of that Membrane,
As the Skin thus seperates the Scar of Skin from
the true, and is sometimes converted into Pus

Pus in an Inflamation of the Mucous
Membrane of the [Ha??] the Secretion
increased which often Rule on the 
Appearance of Air, in the [??mes] in the 
Skin is the Scar of Skin break a Fluid is afterwards 
Secret'd, which is sometimes Converted into 
Pus, this is not always the Case it happens that
when it is form'd it Destroys the Parts below,
and has been Said to Erode, Pus will not Erode
any sooner than Water but it acts as fermant
and Converts it into Matter similar to itself
the next fermentation in Inflamation is in 
Gangrene and Mortification as in the Death
as Puts of action of the Inflam'd Part, These
two terms have been taken Indiscriminately
some have Call'd a slight Degree Gangrene and 
a greater Mortification, if there is any difference 
we shou'd Remind as the gangrene as the 
Death of a Part and Mortification the Putrefaction

of it; now an inflam'd part is apt
to Die in two Ways, first from a [illegible] Ligature
and the Veins &c. in an Inflamation of the Cellular
Membrane under the Skin, the Distension may 
be so great as to Produce gangrene and Mortification.
Secondly the Inflamation of Irritable
Parts, and Extremity is apt to terminate in 
gangrene and Mortification as an Inflamation
of the Skin, and not only such Parts were 
liable to external stimulus but such also as
have Call'd irritable in consequence of the great
Effect they Produce on the whole System, as in the 
Diaphragm &c. when irritability and [illegible]
Combine then the gangrene and Mortification generaly 
takes Place how We can easily conceive
the reason why a Part shou'd Die when an 
Inflamation Arises so as to Distend it; but 
why a very Irritable Part should Die in Consequence
of being Inflam'd We doe not as yet know,
We might indeed suppose the Nervous [???lla]
are Destroy'd; when an Inflam'd Part Dies

The Arteries can no longer Act, Strongly, the
Swelling therefore subsides the Part becomes
Pale from a less Quantity of Blood being Contained
in the Capillary Vessels, the Pain also gets off
how its to be Observ'd that a Part which is indeed
And Attach'd to the Body. Pulse is sooner
than it was [?rem?ou'd]; for Example if you 
Cut off a finger and Place it in firmely right Degree
of the Thermometer wch. is the Natural Heat
of the Human Body; and another was to Die
that was Attack'd in the Body, the Suppuration
in this woul'd come in before the other, and
it do's this in Consequence of the Hope the 
Appearance of the [illegible] exactly the same, small
Blisters Arises Round the Part, it becomes
of a Darker Colour and at last almost Black
it is heated and looses its firmness the 
Surrounding Parts afterwards becomes putrid
and Dead, when any Part of the Body dies
there is a Process Arises which Separates

one Part from Another; and this We generally
Call an Euptiation, Suppose a [illegible] of Muscle
to Die, a Fibre defient Die in its whole Length a 
Part remains sound, there is then a Part where
the Dead and the sound Part form'd together, in 
this Arises a treament wch. Converts it into, a 
fluid so that a separation takes between the 
two Parts, this we have some Reason to Expect,
in the Purulent Inflamation, but We have no
Certainty of it in a Phlegmonous Inflamation
takes Place Round the Sound Part, and in 
Consequence of this, the Fluid is mostly Converted
into Pus, the Dead Part is thrown out and 
and an Ulcer is left behind, its not that the 
gangrened Part is Destroy'd, its Edges by 
Putrefaction becoming Perfect, but the Ends of 
the Sound Parts are Converted into a Fluid,
by which they are Separated, No gangrene 
and Mortification always Produc'd one Ulcer
it woul'd be a better termination than Suppuration
As it would take Place soon and Produce
an Ulcer easier of Cure, When We kill a Part

by Caustic Alkali, the Part is separated and 
an ulcer easy of Cure is left behind, but 
a Part wch. is artificially [illegible] and one that
takes Place Naturally has by no Means
the same Effect for when the Gangrene and 
Mortification is Natural it is very apt
to Produce an Erysapellatous Inflamation 
of the Surrounding Parts, so that most
Commonly they spread very Considerably 

Lecture 11th
When a Part is ganegrened and Mortified it 
is evident that a Quantity of Putred Matter
is Absorb'd and Carried into the System, when
this has happen'd it has been Call'd a Putrid
Fever it is however only a Symptom of Irritation
As great Depression of the Strength smallness
and frequency of the Pulse, and indeed an Irrability
of all the Functions of the Body; the Brain
is sometimes Affect'd and sometimes not 
and the Patient grows gradualy and Sensibly
Weaken till he, Dies; We might Suppose it was 
owing to an Absorption, and this may indeed
in some Part Contribute, but it is the Action
of the Dead Part on the Living in general. This 
to be Depend'd upon in Absorption the Symptom
wou'd be in Proportion to the Quality of the Dead Part
but this we find is not the Case, for Example
a gangrene of the whole Leg shall not kill in as

many Days, when a Man Dies it is not in
Consequence of the Functions of a Part being 
Destroy'd but in Consequence of the Irritability
of the Part, the whole Intestinal Canal is 
very Irritable therefore a gangrene of any 
Part of this is more apt to Prove Fatal
they certainly Symptoms of Irritation,
and not Fevers, as of the the of the Bark
Species &c, We can bring on a [Enp?ia?ia???]
a Phlegmenous Inflamation and the Patients
Restor'd, if they where Symptoms a Fever
it would still continue. The last [illegible]
is in Schirrous and Cancer; properly speaking
it is not a termination it is a Disease apt
to be left after Inflamation in general. A 
Schirrous as I have first said is a hard
Tumour of a Part left after Inflamation,
so in Callous also but there broad is for
Essentially from one Another a Schirrous
may be Converted into a Cancer and in this 
Consists the Essential difference between the

Two hard Tumours left after Inflamation
a Schirrous can only Remain in a gland and
is evidently owing to an Accumulation of Matter
in the Substance of the gland, which is generally
Solid and Hard, some have been apt to Call hard
Bodies Schirrous but they are not, because
they cannot terminate in Cancer; A Schirrous 
frequently remains in the same state, and 
may Continue through the Life of the Patient,
but it more frequently encreases, and after 
a certain Time it enter a Degree of Inflamation
in wch. the Circulation being encreased, an 
Extravasation follows, which Forms Matter,
This ferments and Forms more, it is then absor'd
by the Lymphatics and Thrown into the System,
that it is a particular Matter is evident, because
when it has been Applied to any Wound it has
Produc'd a Cancer the most Part it do's not
in certain as Variolenus Matter in Venereal;
but that it do's not Act is Indisputable and 
encreases till at the last it makes an Opening thro

the skin and Forms an Ulcer extremely
difficult of Cure; Ulcers of difficult Cure have
all been Call'd Caries, We mean those only 
in which a particular Matters in form'd an is
where it is Absorb'd and Carried in to the System
System, this difficulty of Cure Proceeding 
from this Absorption, for if you cut the part off
wch. is Ulcerated it will Heal, but it will 
again Break out in some other Part of the 
Body wch. shows the Matter has got into the 
System, so as to be Able to Produce Ulcers
of the same kind in other Parts of the Body,
Now the Stimulus Occasions Pains the 
Ulcer is very Faetid and the Evacuation
Weakens the Patient, and the Constant 
Application of the Stimulus wears him 
out, till symptoms of Weakness comming 
on, he tis Cut off by a certain and Painful
Death, Schirrus Glands without a Nervous 
Inflamation, it is to be [??maty] of [illegible]

a long Time [illegible] in this Case it generally
encreases till about the Age of 40 or 50 in
Woman about the Cessation of their Menstruation
having thus endeavour'd to [illegible] to you 
the different Methods of Termination, in simple
Resolution, this Occasions the Inflamation
to Subside and be Carried off therefore We
generally Aim at it on the Treatment of the 
Disease, the [illegible] suppuration wch. if it takes
Place is follow'd by the Restoration of the Part,
but if the gangrene and Mortification Comes on
We must Endeavour to make an Exfoliation
take Place or if no Mortification Comes on, if
it be Possible We must Endeavour to Restore
the Dead Part to Life, and if a Schirrous
takes Place We must Endeavor togethe'd of
as Prevent Immediating in a Cancer, the 
Cure then in the first Place, is the Application
of such Remedis as Dispose it to Resolve,
Secondly such as are proper to bring Suppuration
and for the Management of the Ulcer [illegible]





is Form'd. Thirdly the Management of gangrene
and Mortification, in most cases simple
Resolution is best, but not Universally
there are some Cases, where it is better to
Let the Disease go on to suppuration for 
Example a Fever shall Arise and afterwards
an Inflamation, if this happens in an external
Part of the Body it is better to Let it goe
on to Suppuration, as it will Prevent a 
Return of the Fever when endeavour to 
terminate it by simple Resolution to 
shoul'd very probably Cause a Return of the 
Fever, Consequently it is better to run the 
Risque of an external Inflamation, then 
such a Disease as a Fever, in the Course
of wch. is an external one shou'd happen its
better to Let this goe on to Suppuration,
by which the Primary one will be Cured,
if We dont it will be very Apt to Return 
there being generally some few Symptoms

of the former left, and if a small gangrene
shou'd be in the Inflam'd Part, and that an 
Indolent one, it is better to let much come on to 
Suppuration it is be large it is be [illegible]
unless the whole Gangrene Suppurate there is
Danger of a Schirrous comming on in that
Part in wch. the suppuration did not place,
We are then sometimes to Endeavour [sim??]
to Resolve the Inflamation, sometimes to make 
it Suppurate, there is one great Point to be
Consider'd in the Cure of Inflamation, We 
have shown that it is an encreased Action of 
the Arteris of a Part Distending the small
Vessels beyond their tone, and whatever has 
been the Opinion of particular Practitioners
it has been almost Universally allow'd that 
the principal Part of [???ation] was the 
[S???i] Propelling the Fluids with a greater
Velocity, this therefore is to be Attend'd so that 
in any Case the strong Action of the Arteries which
is the Material Part of an Inflamation may
be united by a Cure applied, a Man can
be so Weak, but this Cause may be answer'd and

and you Cure the Inflamation if this 
Cause be left, A New Inflamation will Arise
the first and great End then is to Remove
the Original, and any other Cause that may
Arise in the Remedy of the Inflamation-

Lecture 12th
We have Shewn you that it is sometimes better
to make an Inflamation subside simply in 
Order for this We shou'd endeavour first to 
Remove the Cause which Produc'd the Disease,
or now Occasion it to Continue, it is time We can
sometimes Cure an Inflamation, tho the 
Original Cause Remains, and that must be
Afterwards sufficiant to Reproduce it, but the Cause
of Inflamation being in general capable
of Acting in Weak as well an in Strong
[illegible] its often an Inflamation is Cured as 
well as before it more frequently happens
that it takes Place again, unless the Cause 
be Removed, an Inflamation is seldom
Stational, you will find that many of the 
most Powerfull Remedies we Employ doe 
not Cure the Disease at once, they only make

it Diminish and it then gets off itself now
if the Cause be Less it will encrease by little
and little till the Disease is Reproduc'd
it is therefore of Importance to Remove the 
Cause, which first Produc'd the Inflamation, or 
any Stimulus that may Now keep it up
the Means of Removing the Cause/many
Inflamations is very Obvious, but We must 
Observe to you wth. regard to the Removal
of such Causes, that are so Obvious that 
if it shou'd Require some Violence to Remove it
so as at Present to encrease the Inflamation
yet We should always doe it, per example
in a Fracture of the Bone, a Splinter [illegible]
Stimulate and Distend the surrounding
Part, it will be better to Remove it, tho some 
Violence be Us'd, again there are some Causes
which frequently Produce and keep it up,
an Inflamation that are by no Means
Obvious, and therefore Require particular

Explanations, the first of these Causes, which
shall be taken Notice of is that which has been
Commonly Call'd Acrimony of the Fluids, We
have said there is no such Acrimony as would
Produce an Inflamation by Affecting the 
Insides of the Vessels, so that they only Acted
on the Irritable Membrane and accordingly 
whenever stimulating Fluids, are Contained
in the Body We find them always Acting 
on Surfaces, the Stimulating Fluids may
be Universally Prevented from Acting 
an Irritable Surfaces, if We can Prevent their
Touching but they are of them of the Watery
Fluids as Solution of the Neutro Salts of the 
Blood, Variolous Merbillous as Cancerous
Matter, if We rub a Quantity of [??l] over the
Membrane We shall Prevent any Watery
Stimulus from Affecting of it and if We 
[Ca??] the surface of one with any Viscous
Watery Fluid, it will be sometime be pre the 
Irritating Fluid will [illegible] itself wth. this

Mucilaginous one, and We know that the 
Stimulating Matter do's not Act so Strongly
when Dispos'd in a Viscid Fluid, thus [??r] the
Covering a Membrane wth. Vegetable Mucilage
will in a great Measure Prevent the 
Stimulus from Acting, for Example suppose
the tears run down the Cheek in a large
Quantity they will Excoriate and Raise
a Degree; of Inflamation if we rub a 
Quantity of Oil over the Part, We shall
Prevent the Stimulus from Acting and 
Cure the Inflamation in Order that an
Evapor'd Oil shou'd be Applied w th
Lungs it must be taken into the Stomach
Absorbe'd and Carried there by the Circulation
which shoul'd hardly Imagine possible that 
it shou'd be Carried in such a Proportion as to
Produce any Effect, but We actually find if We 
Show in a Quantity of Evapor'd Oil into 
the Stomach it do's Diminish the Action

of the Stimulating Matter, some other Manner
of Action has been sought for (namely that the 
Evapor'd Oils had a Power of sheathing or [Pl???]
the Particles of the Stimuli but it is Prov'd that 
they have no such Power, for the Stimuli are 
simply the Neutral Salts of the Blood, as wth.
they have no Power, so that [illegible] 
must Act by Depending the Irritable Parts
from their Stimulating Matter, Consequently
Comming into Contact wth. them; some have
suppos'd the Oil given internally slips down
the Trachea, but this it certainly do's not
for it woul'd then Stimulate more bendes Oil
Thrown into the System in a Solid from Produces
the Effect, however Let the Manner of Acting
be what it will, Evapor'd oil and Vegetable
Mucilages have a Power of Defending Irritable
Parts from Stimuli; when they are Us'd they 
shou'd not Contain a Quantity of Stimuli; for 
sometimes they Contain a Quantity of Essential
Oil, Linseed Oil Contains this, therefore it is

not proper in this (are to be Employ'd; Evapor'd
Oils are frequently known by Heat, when they 
Acquire a Degree of Empyreumatic, such is 
improper for the Vegetable Mucilages if 
kept too long are apt to [??sy], There are 
then improper to be Employ'd; when Evapor'd
Oils are made use of internally, the Heat of 
the Body Renders them Fluid, so that it 
Matters not; whether they are in a Fluid
or Solid Form; when externally Applied
they shou'd be Fluid in just the Heat of 
the Body, if they are too thin they will
Run off it too thick they will not [Rene??]
Oils of this Consistence have been Contrived
which we Call ointments, the Vegetable
Mucilage We Employ, is simply so are 
equaly Useful, but they cannot be us'd
externally because the Watery part will
Apt to Evaporate, and have the others Dos
upon the skin, then it will stimulate of 
itself; there are the Remedi's We Employ

to Cover the Surface of a Membrane as for 
to Prevent the Stimulating Matter from touching 
it; the Second Means of Preventing a Stimulating
Fluid from Acting on the Surface of Membranes
is by Destroying such Fluids. In Practical
Authors We find [illegible] deal about the 
Destroying the Acrimony of the Fluids, yet
there are but few Cases in wch. We can; if 
the Inflamation happens externally; We 
may by the Application of Caustic or Vegetable 
Alkali But when the Stimuli has 
got into the System; We only know of one 
Instance in which it can be Destroy'd, wch
is the Venereal Matter by Mercury, and its
Preparations; how it Acts We are at a Loss
to Account for; It must be Observ'd that the 
most Common Stimuli are the Nutro Salts
of the Blood these We cannot Destroy, nor
[??acuate], consequently We cannot Destroy
the Stimulating Matter; the Next Method
of taking of the Stimulating Matter, that is 
the Action of Stimulating Fluids and

other Stimuli also, is one that has not been 
sufficiently Considered, the Nutro Salts
of Fluids Applied to a Mucus Membrane in
any Part of the Body; after the Natural
Mucus is Washed off, will Stimulate and 
Inflame, but when applied to the Surface
of the Pleura or Peritoneum wch. are not 
Cover'd wth. Mucus, they do not Stimulate
at all, for Example; if by Purging the Mucus
be Wash'd off from the Inner Surface of the 
Colon or Rectum, the Stimulating fluid will 
Produce an Inflamation, but the Nutro Salts
wch. are Constantly thrown out in the Pleura
and Peritoneum doe not Stimulate throughout
these are not so apt to be Inflam'd; We
find then that the Mucus Membranes are 
not Irritable supposing We cou'd take 
off, this Disposition, they might than 
be Applied without Producing any Stimulus

The Disposition of a Part to be Stimulat'd
Depends on Life; if We cou'd then Vary the 
Life, tho the same stimulus was applied
it would not be capable of Producing an Inflamation,
We have Remedis that will render 
a Part less Irritable and Prevent much 
Fluids from Stimulating and Producing 
Inflamation, for Instance in an Inflamation
of the Skin from Heat, A Blister Arises and 
wch. Breaks, there then oozes out a Fluid containing
the Nutro Salts of the Blood, this Stimulates
and Occasions the Inflamation to Spread, Now
if you Exhibit the Center Reno tho of itself
rather tends to Produce Inflamation, it will 
alter the Power of the Life, so as to Render the Part
less Irritable. Thus when a stimulating Fluid
is Acting on a Vessel, We can by the application
of particular Remedis diminish or in some
Cases entirely take off the Inflamation in Irritable
Habits, then We can cure an Inflamation by the 
Exhibition of the Bark, tho it has a tendency 
to Inflamation-

Lecture 13th
The next Cause which Requires our particular
Attention is the Distension of the internal small
Vessels, the Quantity of Blood Circulating
in different Parts of the Body is very various
at one time somtimes the Quantity circulating
as at another, but there is a kind of general
Disposition in the Blood to Circulate in 
a large Quantity, in the Vessels of the Extremities
as in the Internal Parts as in the Thoracic
and Abdominal Viscera, so that when the 
Circulation is Diminished in one of these 
internal Parts, as in the external Parts
it generally is in the whole, so also it is wth.
the internal Parts, there is a kind of Balance
between the Internal and external Circulating
for it happens not Uncommonly that
a Contraction of the external Vessels, [gua???]
a greater Quantity of Blood being thrown 
in some of the Internal Parts, for [E??d??]

of a Man Unaccustomed to such a Practise
spend Walk Bare foot on the Cold Stoes it 
will frequently happen that a Pain will Arise
in the Abdomen, and where an Inflamation
Arises in an Internal Part of the Body, the
Stimulus Occasioned by it will encrease the 
Circulation by this Means the Vessels are
Distended and the Inflamation kept up, Now
by encreasing the Circulation in the external 
Vessels We Diminish that on the Internal
one's Consequently take off the Distension and 
Cure the Disease, the Manner of Restoring the
the Circulation to the external Part comes now 
to be Explained, first then there are certain Substances
wch. [cross out] to Relax the small vessels
through the whole system, that there are Remedis
which Produce this Effect is sufficiently evident
the Question is whether much [illegible] do's
actually take Place, Now there are certain
Remedis if Applied to the Stomach often 
[Occassion] [crossout] encrease of all the Secretions

through the Body, this Effect has,
Produce in three Ways, either by encreasing 
the Action of the Vessels themselves as the 
Secreting Vessels of the glands, or by Returning
the glands themselves, Thus if We Apply
Ipecach or Tartar Emetic to the Stomach
it shall happen in many Cares that 
tho the Skin was Dry before, it shall become
Moist as also the Tongue there shall 
likewise [illegible] something from the 
Intestin's, We Say it happens in many
Cases for no Medicine is certain not always
in its Effects, not if the encreased Secretion 
Arise from a general Stimulus, the Circulation
also wou'd be encreased; It is true sometimes
on the first Application of themselves the 
Stomach they Disorder it but encreased the 
general Action of the Vessels; Now if the
Secretory Organs for it We employ
Emetic Tartar to any Gland, it is so for

from encreasing the Secretion that it
diminishes and Acts as a Sedative, it is 
evident then that they have a Disposition
to Relax the Vessels, but this May doe more
in the external than in the Internal Vessels
Now the Medicines of this Kind We are
at Present Acquainted with, are all the 
Neutral Salts Squills, Ipacac, Rad Senica,
Preparations of Antimony and Water Rendered
Cold, is as to be nearly at the Freezing
Point, the Power of the Neutro Salts in 
Producing Relaxation is not very Considerable
the Powers of the others is much more Considerable,
When We want them to Act more 
Powerfully We must use Prepar'd Antimony
or Ipecac in this Country, in Warm Climates
are Italy Cold Water is made use off Squills
have been Employ'd only in Slow Inflamation
of the thorax, it is to be Observ'd that when [th???]

Considerable Inflamation if We Relax the
Vessels of the Skin a Profuse Sweat takes
Place, the Bed Cloaths get Wet, and if 
the Patient is Covered Close regulates
and Inflamd, if Expos'd to Cold the 
Distension and Topical Inflamation is 
much encreased, hence We are Prevented
from trying them Constantly in general
Inflamation; In these Cases We must
Confine [illegible] to make [illegible]
as Nitre and the Neutral Salts; when 
a Man is Cover'd with his ordinary
Cloathing, some Parts of the Body are 
apt to be expos'd to the Cold, and the 
Circulation is frequent by Changing
But when equally Cover'd in Bed
an equal and constant warmth is
Applied to all the Parts of the Body
and such Changes take Place therefore

in Internal Inflamations the Patient
shou'd be Confin'd to Bed, the Pratice
has Varied Considerably in the Treatment
of this Disease, owing to its not being sufficiently
Consider'd. It is evident We ought
to Confine the Patient to his Bed in an
Internal Inflamation of any Consequence
but at the same time is improper to See 
him wth. Cloaths so as to Occasion a great
Degree of Heat, for much a Constant Inflamation
or Application would Stimulate the 
whole System and encrease the Disease
treatment Means of bringing the Circulation
to the external Parts of the Body; is Warm
Water, it is not necessary to apply it
to the whole Body; The Heat only on upper
Extremities as in some Cases the Trunk 
of the Body, Warm Water of Relaxing
and Stimulating so as to encrease
the external Circulation; and has

a Power of encreasing it also; but at
not relaxing the Vessels like Warm 
Water. If this be applied to the lower
Extremities it will encrease the Circulation
in the whole System. It is to be
Remark'd that after a Part has been 
sometime immersed in Warm Water,
both the internal and external Circulation
is encreased, so that is Continued
for more than fifteen Minutes there
Appears Symptoms of an Universal
encrease of the Circulation, therefore it
shou'd not be Applied for too long
a Time in the next Place it is more 
proper to encrease the Circulation in the 
external Parts, In Inflamations of the 
Abdominal than of the thoracic Viscera;
another Method of encreasing the external
Circulation is by the the of Stimulants
there where frequently Us'd by the 

Ancients, in Employing these Remedies
We are to Consider at the same time that
they tend to Diminish the Internal they
Stimulate and encrease the general Circulation.
This Method then is now look'd
upon as improper, sometimes indeed
it may Succeed; One Stimulant yet
remains in Practise (viz) Vol. Alkali
of which we shall speak hereafter.
The Cause which Constantly tends to 
the Keeping up of all Inflamations
in the Distension of the small Vessels
beyond their Tone; there are two Ways
of Removing the Stimulus; arising
from the Distension, one by Removing
the Distension itself. The other by taking
off the Counteraction or Disposition
the Contraction of the small Vessels
or Capillaries, by the Application 
then of Relaxing Medicines to the 
Inflam'd Part, diminish the 
Disposition of the small Vessels to 
Contraction no more the stimulus 
Cure the Inflamation; by Applying

Warm Water to the Part Affected, We
are frequently Able to take of the 
Inflamation, it is to be Observ'd that
the Vapour is more Powerfully
Relaxing than the Water itself, therefore
instead of Immersing the Inflam'd 
Part in Warm Water, We apply some 
such a Substance as Cloth, Membranes
wth. the Water, and Repeated as after 
as it grows Cold; the Application
of it in this Manner We Call Formation,
we also Use it wth. Farinaceous
Substances and when Applied in 
this Manner We Call it a Poultice
sometimes We throw it on the Body
in the form of Vapour, but this is not 
to be done in Inflamation as We cannot
sufficiently Cool it before it Comes
to the Inflam'd Part; the Application
in Poultice and Fermentation are 
therefore the best and this We shall
Proceed to Explain

Lecture 14th.
We have Said that by the Application
of Warm Water we cou'd take off the 
Stimulus in an Inflamation, and that 
the Steam Arising from it as more
Powerfully Relaxing; and that therefore
We Chose to Immerse some Substance
in Water, and Apply it to the Part, We 
Come Now to make some further Observations
on the Application of Water to 
Relax the Vessels so as to take off the 
Inflamation, We must first Observe
that the Relaxation do's not Depend
on the Elasticity of the Part, it may 
happen that the external Part of the 
Skin in an Inflamation may be Dry
in this Case the Application of Warm
Water is not Confined to the Skin for 
Example if there is a stone Contained
in the Urethra, the contraction is in 
Consequence of it, suffering the Urine to 
Pass wth. difficulty, by Placing the 

Patient in Warm Water the Ureters will be
Relax'd so that the Urine will Pass more 
freely, in this Case it is evident it cannot
be Moistening the Part, there are many 
more Instances wch. We cou'd Point
out to you, where Warm Water do's
not Out in Consequence of Moistening 
the Part; this the Contractile Power
of the Vessels Depending upon Life
that We [al??arencess] when the Skin
is much Distended and Dry hence
the Fomentations and Poultices are 
Serviceable not only in Inflamations
not only of the external but of the 
Internal Parts of the Body also and
as the Balancing Power is [illegible]
on the Tone of the Vessels, it is not Necessary
the Water shou'd Penetrate to the 
Part to Produce its Effects, in the 
next Place it is to be Observ'd that the
Water shou'd be of a proper Temperature
if it be too Hot it will Act as a Stimulus

and encrease the Inflamation, it 
shou'd be made a little Hotter than the 
Inflam'd Part, and tho it may be Necessary
to Apply Cold Water to an Inflam'd
Part it has quite the Reverse Effect, We 
must Observe that in the Application of Cloth
Moistened in Warm Water, then is this 
difference that Cloth of a firm texture, is
soon Heated and soon Cold, and a Centrano
Cloth of a Loose Texture in therefore better
for the Purpose a Course Flannel
We also sometimes employ both Fomentations
and Poultices at the same time
and not Singly for this Reason, that 
Fomentations are more Powerfull as a greater
Quantity of Water is Applied in this for yet
if we Continue Constantly to Foment
a Part, We shall Wash off the Natural
Mucus and Cause an Inflamation 
on the Skin; We therefore only apply
them twice or thrice in Twenty four hours
and afterwards the Poultice and whenever

We the either, We shou'd Add some 
Mucilaginous Substances to Prevent
the Mucus from being Wash'd off
the last Observation we shall make 
is that the Application of Warm Water
encreases the Irritability of the Part
therefore in an Inflamation of the 
Skin; as in the Erysepellatous Inflamation
Warm Water will doe Mischeiff And 
Oil is held to Prevent the other
Applications from growing Dry; We 
Come next to Shew the Remedies to be 
Employ'd immediately to take off
the Inflamation; Now the most Powerfull
Means of the Weakening that We 
Know of is by Evacuation either by 
Opening a Blood Vessel, as encreasing 
the Secretion from and of the Glands
for Example the Opening an Abcess
suddenly if it be large; will often
Weaken the Patient so much as to Occasion
faintings, this happens also

in Taking Water from the Abdomen,
Thus Opening a Cavity that Contains a 
Fluid in Solid Weakens Considerably
it is wth. this Intent that We Employ
it and other Methods of Evacuation
and there We make in four several Ways
first when We want to make an 
Evacuation from any Part of the 
Body indiscriminately We open a 
Vein and this generally in the Arm
if it is easily got at; We must Observe
it there be a Topical Disease and the 
Rest of the System be Affect'd in the 
same Manner, but not in so great a 
Degree, then the Application of a Remedy
that shall Affect the System, will 
Carry off the Topical Disease; if the 
System be not Affect'd it will have
no Effect, if then the Os tenias of a Part
are Aching in the System are acting
strongly Evacuation will generally 
take off the Strong Action hence We

Cure an [illegible] woman than any 
small Inflamation of the Skin by VS
His useful there person general Inflamation
when the Pulse is full hard and strong
and frequent as also when the Habit
is strong, tho the Pulse be not full and 
Strong &c; in some Inflamation Bleeding 
is of no Use, tho the Inflamation be
Violent, for Example when the System
in general is Weak, as in a Woman after
Child Bearing, in these Cases it is often
Detrimental for where it is only the 
Arteries of a Part, which are Acting 
Strongly, and not of the System in 
general; Secondly the more suddenly
We take away the Blood, the greater
Temporary and less Permanent We
Produce; thus then it We make an opening
into a large Vessel and let the Blood
run out very fast, an Animal Die
much sooner, than if it was to follow
gradually it will therefore Produce a 

greater Degree of Weakness, than if 
taken away slowly and at different Times;
If therefore We Wish to Produce a great and 
sudden Weakness, We ought to Choose a 
large Vessel, and make a large Orifice and
also take a great Quantity at once; We 
may Bleed with Safety until the Patient
Faints; in every Strong, and when there
is a great Inflamation, We may take away
℥xxx. of Blood at one time but generally
℥xxx. is the Largest Quantity and this is 
frequently Requir'd in the Country, in some
Cases it may be necessary to be only
℥6 or even ℥iv. of the Inflamations that
happens in Large Towns, from ℥8 to ℥6.
is generally the Quantity Require'd it is 
to be Observ'd that sometimes open 
V.S. the Inflamation immediately Ceases
but this is not always the Care; nor has
it bear sufficiently Attend'd to, that the 
V.S only makes the Inflamation begin
to Diminish, We have said that an

Inflamation seldom Continues in the same
State; if by V.S we diminish the Action
of the Heart and Arteries this will begin
to make the Distension to begin to 
Diminish so that it will Continue so
to doe till the Inflamation Ceases, here
after Evacuation, shou'd Avoid every Thing
that may Stimulate so as to make the 
Inflamation to begin to encrease, for it
will then Continue to encrease as much or 
more than at the first. A Want of 
Attention to this as often Destroy'd the
Effects of V.S. We have said that 
Bleeding is of no use, We must also 
Observe that it is [???full] if no 
general Inflamation Arises, for it
encreases the Irritability, as well as
the Inflamation, thus in Pure Inflamations
of the Skin, Catarrhs Erysepallalous
Sore throat, and Autumnal Dysentery 
it is of no use, in mined Inflamations
that is of the Substances, as well as

Surfaces of Parts; Bleeding is Usefull
as it will Remove in general both that of the 
Substance and Surface also; this Evacuation
of Employ'd properly is the most
Powerfull Remedy of any in Inflamation

Lecture 15th.
The only large Evacuation We can make
from a Gland quickly enough to Cure an
Inflamation is Purging it differs from that
of Bleeding in this Circumstance if you
Open a large Vein so as to take away a 
Considerable Quantity of Blood, the 
Evacuation is justly Uniform from the 
whole System, but in Purging We Employ
a Stimulus to the Intestin's which not only
Produces a large Evacuation, but also Causes
a quicker Circulation through them, hence
in Considerable Effects of Purging, We must
not only Consider the general Weakness, but
the Partial Evacuation Arising from Purging 
is more useful in external than in 
Internal Inflamations, as it Empties
them more, We shall find that making 
an Evacuation from the Gland affect'd
is very Powerfull in Carrying off Inflamation,
hence it is useful in Inflamations

of the Intestin's in that of the thoracic Duct
it is sometimes thus full, for it Occasions
a greater Quantity of Blood to be thrown 
out on the Part, which stimulates it the 
more, but in all Inflamations it faeculent
Matters are Contained in the Prima Via
it is always Usefull; Purgatives may 
be Divid'd into three Classes; First those
that Produce their Effect by encreasing 
the Perilistaltic Motion. And Secondly
those that encrease the Secretion from them 
in Consequence of Stimulating them;
the first species Evacuate the Intestines
only Producing very little Effect from the 
Blood Vessels. The Second doe produce
an Effect from them, so that they are the 
most Usefull in Inflamations, Purgatives
may again be Divided into three classes;
first when We Exhibit the Neutral Salts
as Purges, there is Considerable Evacuation
from the Intestine's without any Alteration
of the Pulse, but it you give Jalap

Scammony and not like Reamous Purges
at the same time they Produce their Effect,
the Pulse becomes Quick and the System
in general becomes more Heat'd, hence 
the first Class are the most Usefull in 
Inflamations, the other Observations We 
made on V.S. applicable to Purging 
except that Purging is more proper in 
external Inflamations; thus it is Usefull
in Phlegmonous on's; No Erysepellatous
Inflamations this Evacuation as well
as V.S. is hurtfull; and for the same
Reason We come in the next Place to 
Consider the Effects of Topical Evacuation;
and first the opening of a Blood Vessel
in or near the Part Affect'd, after the 
Knowledge of the Circulation of the 
Blood, it was thought Topical Bleeding 
woul'd be of no Use; it being of no Consequence 
from what Part the Blood was

taken; and it is evident that if We
Want'd Blood that was improper for 
Circulation, We could only Evacuate the 
Blood that was Distributed to every Part
of the Body; but Let us Consider how 
far We can Empty the Blood Vessels
of an Inflamed Part; if We open an 
Artery of an Inflam'd Part, it will Prevent
the Blood from flowing into it; if We 
Apply Leeches to give the Blood apear
Opening to Pass out than if it was to goe
to the Heart and therefore We Evacuate the 
Vessels of the Part more; This Evacuation
may be made either wth. or without a System
the latter is generally the best, We 
must Observe from Experience that in 
whatever of these Ways, it is made from 
the Part Affected; it will doe more 
Service, than Evacuation from a distant
Parts; when We open a Vein of an Inflam'd
Part, it is not always Necessary We should
Apply a Ligature for the Vessels being

Distended, upon making an Opening
a large Quantity of Blood will flow out,
as the Blood is Passing wth. greater
Velocity to the Heart, and is in some
Degree Obstructed, if the Orifice be made
on the Side of the Vessels the Blood will 
flow the fear, Topical Bleeding is 
certainly a very Powerfull Remedy
in Carrying off of an Inflamation; Cupping
wth. Scarification is sometimes Us'd; but 
We cannot make this Application to the 
Inflam'd Part; nor is it absolutely Necessary
the Evacuation shou'd be made from the 
Vessels of the Part; provid'd it be made
near it, this good Effect will be Produc'd
even though the Vessels of the Part have 
very little or no Connection; as Bleeding 
in the Breast in an Inflamation of the 
Pleura will have more good Effect than 
Bleeding in the Arm, it is seldom that We 
can open a Vessel in the Inflam'd Part of 

a sufficient Size, for a Plentifull
Evacuation, We therefore in this Case employ
Bleeding from the System in general, Topical
Bleeding is usefull in Phlegmonous
Inflamation only; in Erysapellatous 
Inflamation it is often Hurtfull, for it
encreases the Irritability of the Part, so 
as to doe more Mischef than good,
hence Eryspallatous Inflamation of the 
Throat, Gonorrhea &c it is of no Advantage,
it is to be Observ'd that where is a Mixture
of the Inflamation, Topical Evacuation
is generally more Powerfull in Carrying 
off the Plegmonous Inflamation, than
Bleeding from the System in general

Lecture 16 th.
The Weakness or Strength of a Part and 
its Acting is being at Best, are encreasing 
different from one Another for a Part 
however Strong may be at Rest, and 
somehow Weak may exert itself, the 
bringing a Part to Rest, and the 
Weakening of it are different Effects
Application wch. bring Parts to Rest
without Weakening We Call a Sedative
Weakness is always more or less a 
Disease, it Prevents the Functions of the 
Body from being Perform'd so Perfectly
as they woul'd be, it We cou'd bring a Part 
to Rest without Weakening it. We should
Cure the Inflamation better, Consequently
We ought to Prefer the Application 
of Sedative as to the Antiphlogistic
Remedies, in all Cases they are not

sufficient to Carry off the Inflamation 
in some they are, it is therefore worth while
to Employ them as far as We can
Sedatives may be Applied to the Stomach
so as to Act on the System in general, or 
to the Part Affected, or near it, so as to 
Act more immediately on the Diseased
Part. When the System in general is Affected
as well as a particular Part; Sedatives
Applied to the System may be of Use;
Now the Sedatives that We Apply to the 
Stomach are [A??d?], the Action of these is
small, and not to be Depend'd upon; when 
there is only the Hardness of the Pulse and 
Fever turning out into general Inflamation
As in the Hectic Fever, and if Contained 
for sometime are of Use; Infusion of the 
Tea of Sarsaparilla &c, are of Use unless
the Fever runs out for a Considerable 
Length, they may be had wth. advantage
they are of no Use on Topical Inflamation 
The next Sedative We shall take Notice of 

in Warm Water which being Drank in a 
moderate Quantity, exerts a Sedative Power
it has however been Employed in Inflamations
to Produce different Effects, there has
also been Considerable Variation in its
Use,the Antients forbid it entirely, for 
three of the first Days, and allow'd it
afterwards very Moderately; while in Modern
Practise has much has been pushed down
as the Patient cou'd Swallow, it the Drink
in Acute Inflamations, As the Pleurisy 
has been given only Warm, and not a Drop
of Cold Water has been Exhibited, supposing
it wou'd prove fatal to the Patient, it was
Necessary a Man shou'd have a Natural
Appetite, for Meat and Drink, in order
for his Support; and I believe that We 
may in general trust to the Natural
Appetite as to Drink, there not Appearing 
to have been any Advantage gaind by 
forbidding Drink, [illegible] Superfluous Water,

do's not seem to Distend the Vessels in 
any Degree as little hence is Required to throw 
it out of the System it is therefore not worth
while to make the Patient Uneasy for Want
of it, as that will encrease the general
Inflamation; On the Contrary a great 
Quantity will be Detrimental as it may
in some Degree Distend the Vessels, and 
perhaps make the Inflamation to begin 
again to encrease; the Warm Water thrown
down even supposing the Distension
Depend'd in the Viscidity of the Fluids
would be of no use; as there is always
a sufficient Quantity of Superfluous Water
in the Blood Vessels; in the Second Place
if an Obstruction Arose in Consequence
of the Viscidity of the Fluids Contained
in the Vessels, the Warm Water wou'd not get 
at it to Produce any Effect, as the Circulation 
wou'd be Stop'd in a Part it is then 
certainly the best to Leave it to the 

Patient, taking Care that the Fluids
are entirely Watery, for all that Contain
Alcohol tend to encrease the Inflamation
by their Stimulus, it is a Question 
whether the Water shou'd be Us'd Warm
or Cold, the followers of Boarhaves
Doctrine, have Suppos'd that Cold
Water would Condense the Fluids, but 
it do's not at all Appear Sensibly to encrease 
the Viscidity of the Fluids, neither Can
it act on the Blood so as to Cool
it, for the Body has a Power Preventing
it from being Cool'd, hence there is no 
Disadvantage in Employing Fluids that 
are Cold, on the other Hand Cold Water
acts as a Relexant, but as We have 
more Powerfull Relaxants, We need not 
make this Use of it, the Patients Drink 
may be given either Warm or Cold; Not
has been Employ'd in Inflamations and

Considered has a very Powerfull Sedative;
but I Believe it is of very little Use if any,
for nobody in the first Place nor even its
warmest [Ada?rate] have Employ'd it alone,
neither has it been Employ'd in any particular
Dose, there is one Reason for Employing
this, or some other Neutral Salts in Acute
Inflamations as it may be given in 
the beginning of the Disease, when it is 
not proper to give any more Efficacious 
Medicine, besides the Practitioner is always
Obliged to give something in Order to 
Amuse the Patient, upon the whole We 
can doe little good in Inflamations
by Sedatives Applied to the System
in general, but Applied to the Part they 
are frequently so Powerfull as to Carry
off the Inflamation of themselves. Here 
are two kinds of Sedatives, More the have 
any Considerable Astringency, and 
those wch. has very little or none;
the Sedatives which have but little

Astringencey are [illegible] of the Plants wth.
[illegible] flowers, as Nerbum [Ab??th]
Matricania &c; some Roots also as the 
Preyenia Alba and Beets also as the 
Aryenia Alba and Poppies, as those now 
Employ'd in fomentations and Poultices
it has been suppos'd that it was the
Warm Water, that Produc'd the Effect, so
that they have reject'd every other Ingredient.
But this Opinion is extremely Erroneous
for the Application of these Substances
has been Attend'd wth very Considerable 
Effect, when Warm Water has been
Produc'd from or at least a vary Considerable
one, in external Phlegmonous Inflamations
Reppias or Opium or Decotion
of Wormwood, or some other of these
Plants of this Class; Applied in the 
form of Fomentation, and afterwards the 
Plants Beat down, so that the hardness 
is taken off; and then Applied as a 

Poultice, and are more Efficacious than
Farinaceous Substances Moistened wth. Water
but especialy Opium, so that by these means
We shall be Able to Carry off an Inflamation,
when a Simple Fomentation, or Poultice
would not; Matricaria and other Antispasmodic 
Plants, are not so Usefull in Inflamations
Lying immediately under the Skin, as in 
those that Lye deeper, as in an Inflamation
of the Womb, We shall at Present only observe
that Sedatives of small Degree of 
Astringency are not so Serviceable in 
Erysepallatous Inflamations as those 
of a greater. 

Lecture 17th.
We Come now to Consider the Action of 
Astringent Sedatives in the Cure of 
Inflamation, there where Commonly
Employ'd by the Antients and were
Call'd Repallants, they Consider'd
Inflamation as a Relaxation of the Part
and Consequently an Accumulation of 
Blood in it, Astringents they thought
therefore the most proper Applications
to Occasion the Blood to be thrown out,
but when it was suppos'd that Inflamation 
Depended an Obstruction, every 
thing that encreases the Contraction
was Hurtfull and accordingly thrown
aside in Doctrine, tho not entirely in 
Practise, We however find that they are 
frequently sufficiently Powerfull for
Carrying of an Inflamation, those who

Suppose their Action as Repellents, suppose
also a Quantity of Morbid Matter, if
therefore the Vessels they urge to Made to 
Contract, so as to throw it into the Circulation
it would Produce seem Dangerous
Disease, and on this Account they where
Rejected, they have however been always
kept in Practise, and are now more
frequently Us'd, than they where sometime
ago there are certain Cases in which
We wou'd not Wish to Cure an Inflamation
by any Topical Application at all 
first when it is a Critical one; Secondly 
if the Inflamation has been Habitual
for if We Cure such a one by any Topical
Application we shall have frequently
some Violent Disease, Attack the Internal
Parts of the Body; kindly in Phlegmonous
Inflamations Lying immediately under the 
Skin, for if you tye a Ligature over if 
gangrene and Mortification will ensue

so if You [ce??dus] the Skin evey Sense
the like will be the Consequence, to show we 
have Seen them Applied wth. Success
in these Cases, but as the Suppuration
of such Inflamation is seldom of any 
great Consequence, they ought not to be
Us'd, in all other Phlegmonous Inflamations
there is Danger of Contracting 
the Skin, so as to Press it against
the Inflam'd Part, as they likewise 
Diminish the Irritability they are 
Serviceable in Erysepallatous Inflamation
the Sedatives of this Kind We Employ
at first Vegetable Astringents as
Inter. Rosar. rub. Nurb. Agsiman. Red
Termantillec &c, when We Employ these
as Sedatives and Emollients it is 
better to Apply them Cold than Hot,
Acids Applied externally are Powerfull
Sedatives in Phlegmonous Inflamations [illegible]

Lying immediately under the Skin,
and where it is Affected also; Acids are 
not Employ'd in Consequence of their
Stimulating in Inflamations, that are 
deeper Seated, they have been Employ'd
wth. Success, they are not to be Us'd in 
Erysepallatous Inflamations, Alcohol may 
be Us'd in most Cases especially in 
Erysepallatous Inflamations it is better
however to Dilute it wth. an equal Quantity
of Water or it may be farther Dilut'd and
Produce Considerable Effect Farina Matter
is also an Astringent Sedative, it differs
however from the Farina of some Seeds 
having more Astringency than that of others
as Oatmeal Indian Wheat &c. Oatmeal 
has been Us'd in Erysepallatous Inflamation 
but [illegible] wth. Advantage 
they are however Employ'd in external
Inflamations wth. Considerable Effect, the 
last Class of Astringent Sedatives

Possess this Power in a great Degree
they are the Salts and Calxes of some
Metals; and Allum, there are too
Powerfull to be Employ'd in most
Cases, sometimes however they may 
be Us'd wth. good Effect, but as We
shall hereafter have Occasion to 
Shew you the particular Cases in 
which they are Applicable; We shall
now Proceed to Consider the next
means of Carrying off an Inflamation
which is by Raising another in a 
different Part of the Body, for two
Inflamations doe not Subsist well 
together; We have Said that we dont 
Understand in what Manner one
Inflamation Cures Another, but it dos
whether the Second be a Natural or 
an Artificial one, We doe indeed
Produce a New Disease, but it is of no 
Consequence, it may be necessary
to take Notice of some Opinions

that have been held, wth. regard to the 
Method of Cure, if in the first Place it is made
in the Inflam'd Part, that will occasion
a greater Circulation in it, if act a Distance
it was suppos'd that it Diverted the Flow
of the Humours from the Part originally
Inflam'd tho there may be something in 
this Opinion, yet We know it is not 
Actualy so, for the nearer the Second
Inflamation is to the first, the more certainly 
it will Carry it off, it was agreeable to 
this Opinion the farther it was off the 
better it would be, We most Commonly
Employ Cantharides to Procure this 
Inflamation there are two supposed [illegible]
in Cantharides first, in the
first there is a Disposition in it as to 
Raise a Blister, it has been Suppos'd
that the Flow of Mucous from this Cured
the Inflamation, but they cannot Produce
this Effect in this Manner, as We can
Expect little Advantage to Arise from 

this small Discharge, it is certainly,
not from this, for if you Raise
an Inflamation when no Discharge
is Produc'd, the Effect will be the 
same. Secondly the Particles of the 
Flies have been Suppos'd to be Sharp
and [??ide] the Obstructing Matter, This 
opinion it is to be observed to [??wire]
one, Reputation, nor dos the Juice
of Cantharides when Absorb'd into the 
Body Act as a Sedative, for [illegible]
Not from Applied to the Skin will
Produce the same Effect, so that the 
Action of Cantharides is no other
than the Power of simply Raising 
an Inflamation; there are two classes
of stimulants the first tends to [illegible]
an Inflamation of the Skin, the Second
of the Cellular Membrane, the first 
Produce no Suppuration, the Second 
doe, in this Case we would not Wish

to excite a Suppuration Cantharides
Tehadyorania, and Lilliaceas/Limmous,
Volatile and picad alkalis and Acids
are all Apt to excite an Inflamation
of the Skin only on this Account we
Employ them in Preprance to [illegible]
Substances; as they excite Suppuration
two of these are generally Us'd Volatile
Alkali and Cartharides, the first 
is a Powerful Antispasmodic and 
to be Employ'd when We Want but
a small Degree of Inflamation, and when
a great one is Requir'd We Use Cantharides
not from any Power they Posses of Carrying
the Disease, but because they Raise
an Inflamation, that is never difficult
to Cure, the Inflamation Cured by this
Means in generally external [illegible], We 
must observe that in Case there is a 
great Degree of general Inflamation 
as if there be hardness fullness and
Strength of the Pulse, We run some
Risque of encreasing it in these Cases

it is better to Use Evacuation by [?ate?ing]
and Purging first, and those
Employ these Stimulants.

Lecture 18th.
We Come now to Point out to you the
Manner of making a Topical Evacuation
by encreasing the Secretion from the Gland;
When a Gland is Inflam'd, the encreased
Action of the Arteries Propells a larger
Quantity of Fluids through that Gland, and
Occasions a greater Secretion, this is the 
Case in every Gland except the dryness
when the Substance of a Part where those
are Glands that is Inflam'd then also
there is generally, but not Constantly 
a Secretion from the Glands, sometimes
when a Part near a Gland is affected
wth. an Inflamation, there is an encreased
Secretion, but not so frequently as in 
the former Instance; It is farther to be
Observed that in the too Cast Cares
the Matter Secreted is not Alter'd; It is
thick the Mucus Part frequently

retaining its Consistence when the 
Membrane itself is not Inflam'd when 
the Secretion is more Copious it is 
thinner and Contains the Neutral Salts
of the Blood, when a Part near a 
Gland is Affected wth. Inflamation
and very little or no Secretion ensues
We employ stimulants to encrease
or Produce it, how far they can be
Applied so as to be Effectual We
must Leave to be Explain'd when We 
Come to the Treatment of Inflamation 
Requiring this particular Method of 
Cure, when the Secretion is at the first
Copious and Watery, the Salts Contain'd
frequently Stimulate the Surface of 
the Membrane along which it Flows so 
as to encrease even Cause an Inflamation 
of the Part, as it happens in 
Catarrhs, in Order to Avoid this We
must Defend the Part, by expressed Oil

and Vegetable Mucilages; It frequently
happens that after an Inflamation is
Considerably Diminished the Secretion
Continues and is sometimes more Copious,
when this is the Case it keeps up in some 
Degree the Inflamation, and Prevents
the Natural mucus from being Applied
to the Part, hence We must Apply
Remedies to Put a Stop to it; this is 
sometimes a Matter of difficulty, when
this encreased Secretion is in Consequence
of Weakness and a Relaxation of the 
Glands, We must endeavour to Strengthen
them, Now by Strengthening the System
in general, We doe not frequently Strengthen
any particular Gland, as it is only 
a Topical Weakness, and is therefore
the more difficult to Cure, when this
Proceeds from Relaxation, We may
Apply Astringents, these however
frequently fail of their Effects, for they

only Act for a time, Leaving their Part
after their Action often more Relax'd
them before; as is Inflamed in the
of Opium; except these Astringents
produce some Effect, they will 
I say frequently fail, sometimes
the Inflamation is kept up also so
that they Act as a Natural Cause,
in this Case if We put a Stop to the 
Evacuation for a few Days the Inflamation
will begin to Decrease so that 
they will both goe off gradually
together by Putting a Stop to the 
Evacuation or rather the Secretion for 
a Length of Time We Can take off the 
Weakness of a Part, tho the Remedies
may actualy Tend to Relax the Part 
afterwards; unless Astringents Produce
some such Effects as there, They 
seldom Produce a Permanent and

good Effect, it sometimes happens
that the Secretion Continues in Consequence
of Habit, here Astringents Put a Permanent
Stop to it, in general they must not
be Us'd till We have Remov'd the Stimulus
that was the Cause of the Evacuation
sometimes indeed the Application of 
Astringents Destroys the Stimulating Matter
but is always doubtfull, when this is not
the Case, the Inflamation most Commonly
Returns wth. greater Violence; We shoud
therefore Pay this Attention; when even 
Stimuli are Present, the Astringents
We Employ are Various, some of which
we apply to the part as the calces of Metals;
and some to the Stomach; As Astringent
Vegetable Substances, this Astringent
Juice Acts Strongly and Permanently,
Allum also Acts Strongly and Universally
[illegible] Astringents sometimes encrease
the Inflamation Considerably and of 
Consequence the Secretion, We must

Observe that all these different
Astringents are Applied in different
Cures, but We shall Leave these till
We Come to treat of the particular
Diseases in wch. they may be Useful 
We shall now Consider the Treatment
of Inflamations wch. Come to Suppuration,
sometimes We rather Choose
they shou'd Suppurate as when they Arise
in Fevers, and are in the external Part
of the Body, for it is better to Let the 
Inflamation goe on, than the [illegible] of
a return of the fever, and if in the small
Glands to Prevent these Indurations,
It also frequently happens that we
cannot Avoid it, for the Time of Suppuration
taking Place is very Various,
In Infants it happens Quicker than
in Adults, in the former it will
sometimes take Place in 24 Hours,
in the latter if a Phlegomonous

Inflamation Arises and goes on wth.
Violence, the Suppuration seldom begins
till the Fourth Day, in some not till the 
10th. 12th. or even a much longer Time
as in an Inflamation of the Lymphatic
Glands, Evacuation may Retard Suppuration
Considerably, when the Inflamation 
is Considerable, especially if it be
in the Internal Parts of the Body; the 
begining of Suppuration is often Indicated
by Fits of Coldness or Chilliness comming
on at irregular Intervals, and in certain
in their duration, when also Suppuration
takes Place in the Inflamation, sometimes
Contract itself so that it is not so much
Diffused, the Pain too, generally begins
to Decrease, again if the least Quantity
of Pus be form'd We cannot Put a stop
to it, We are therefore under a Necessity
of Letting it goe on, where it is doubtful
whether Suppuration to begun or not 
if it is likely to prove Dangerous

We shoud always Endeavour to Resolve
it, but if there is no Hazard of that 
kind, we shou'd Endeavour to Encourage
the Suppuration, for the Remedies We 
Employ to Prevent it, also make it 
goe on ill, if it takes Place our [illegible]
Endeavour shou'd be to make good
Pus form as soon as Possible, when 
an Inflamation Runs to a great 
Height, they often Germinate in 
gangrene and Mortification sometime also
there will be a greater Degree of 
Suppuration than is Necessary, in
that the Part will be extremly [illegible] 
the Inflamation then shou'd be kept 
up, but in a Moderate Degree, if
if it be Violent We may Diminish
it by moderate Bleeding and Purging
by the Application of Emolliant fomentations
and Poultices, and of
such Sedatives as have no Astringency

this however must not be in so great a 
Degree, as to Endeavour to take away the 
Inflamation, Emollient Fomentations and the 
Poultices, and are also Useful in Suppuration,
as they forward it Considerably
If an Inflamation be too Slight it shoud
be encreased, by the Application of a 
Stimuli; We must observe that in 
general it is better to Let the Inflamation
goe on too slowly, than encrease 
it too fast, We shou'd Wish to make
Suppuration take Place as fast as We 
can wth. Safety, for the ease of the Patient,
sometimes an Inflamation will not
Come to Suppuration, without the Use
of the Stimulants, but if We Push it on
too fast We produce a much larger 
Abscess, and sometimes Endanger the Life
of the Patient, We have Said there are
two Classes of Stimulants, therefore Employ'd 
to encrease an Inflamation, one that
Acts on the Surface, the other in [Resu??]
of a Part, there are also too kinds of 

Universal Stimulants, one that acts Quickly,
the other that are not so Quick in their Action
and these We generally Employ Internally-                             

Lecture 19th.
We Come now to Point out to you the 
Substances We Employ, to encrease Inflamation
so as to forward Suppuration, We 
must however first Observe that in
Strong Habits when there is little Irritability
Suppuration takes Place Quicker and more
Perfect; then to have the Habit is Weak and
Irritable, the Cort. Peruv. as it Strenghtens
the System and Prevents Irritability,
is a very Powerfull Remedy in Promoting
Suppuration, and also makes the Pus
Perfect, and to Confine it in the Part
is that it has been Employ'd wth. the 
greatest Advantage, if we Want a Speedy
Effect, an Ounce in 24. Hours shoud
be given, or as much as the Stomach
will Bear, such Stimulants as have a 
Disposition to Produce Hardness and
Strength together wth. some Degree of

Quickness of the Pulses, are proper as 
the [illegible] and [???mious] Substances
of Vegetables; Mercury is a Stimulant
of the same Kind, and Us'd for the 
same Purpose, but We doe not frequently
Employ these, they are not very Powerfull
and We rather Choose to Trust to the
Bark, this is a Class of Stimulants that
tend to encrease the Inflamation of a Part 
without Affecting the System, these if
taken a great Quantity Affect the Brain,
and are hence Call'd Poisons; they are
the Belladonum, Nicotiana, Cicutae, &c.
They are sometimes Useful in very tedious
Inflamations, as for the Lymphatic
glands; for they will bring it forwards
when We cannot by any other Means,
We apply Stimulants to the Part also,
there are principally of two kinds (viz)
such Farinaceous seeds as Contain
some Essential Oils as Farina Line and

Fanugri. &c. when Suppuration is taking
Place it is Useful in any Cases to Employ
Applications of this Kind, for whether
it be that they keep the Part Warm or whether
they Posses a Retaining Power Suppuration
gos on better for them, We sometimes 
Apply Resinous Substances to Stimulate
the Part and forward Suppuration, these
however are seldom necessary and sometimes
they are hurtful, as they produce a longer
Suppuration than otherways wou'd have
happened; when an Abscess is [n??m?d] it
is a Question whether an opening shou'd
be immediately be Made as to Let
out the Pus, it sometimes happens that the
Matter is Seated deep and in such a Part,
that we cannot Let it out, and when Suppuration
has taken Place there is not one
Parcel of Matter form'd but several smaller
on's by Degrees these join together, so as to 
form one Mass, if they have form'd before the
Opening of the Abscess, the Suppuration will

be of tempor Contrivance, and therefore
Surgeons Prefer N Leaving it to Nature in
general when we wou'd make an opening
the [Atuep??t] in many Cases Subsist
for a Considerable time; it is apt to be
in two States, the sides of it are perfectly
free from Inflamation, or only a small
Phlegomonous one of the surrounding Parts,
in this Case there is very little Pain,
the Internal Surface of the stone, may
be Affected wth. Symptoms of Irritation dies
wth, Erysepellatous Inflamation, have there
is great Pain, the discharge thin Watery
and Stimulating, it becomes an Abscess
of the System, and Produces general 
Restlessness, and uneasiness of the 
Body, frequency and hardness of the 
Pulse, the Pus thrown into Cavities
and produces fresh Inflamation and
in this Case it often happens that it is 
thrown upon the Lungs and Proves Fatal

here we endeavour to take off this Irritability
by the Use of the Bark; indeed it shoud be
Employ'd in all large Abscess, where it is 
out Contraindicated, other Substances which 
tend to Produce Phlegmonous Inflamation,
and good Pus, and much have been Us'd
as Wine and Spices and the like, it has 
been a Question whether the Hectic Fever
Arising from Absorption was Produc'd by
the Stimulus, or the Matter; but the Pus
in Urine and other Symptoms evidently
Show it is Pus, Absorb'd; if an Abscess
is deep but so that we can get at the 
Matter, or if it has a Chance of making
Sinus's that is Destroying or [Re???ing]
between the Muscles, or if it be very
large it is better to Evacuate the Matter
even before a Perfect Suppuration has taken
Place, for it is best to Dispart off such Parts
as are not sufficiently Destroy'd than 
the Risque of an Hectic Fever, from Absorption
when we make an Opening it should be
such a one as will Evacuate the whole

or greater Part of the Skin covering 
the Pus, it shou'd also be made in 
a Depending Part of the Abscess, it is 
a Question whether in very large Abscesses
it is Preferable to Evacuate the Pus at
once or by Degrees, as Evacuation tries 
to Produce Weakness but seldom so 
great as to Prove Fatal, it may however 
Weaken the Abscess itself, and Prevent the 
the Surrounding Phlegmonous Inflamation going 
forward hence some have thought it
better to make a small opening, but 
the Continuation of the Matter in the 
Abscess will be Attended wth. disagreable 
Consequences, on the whole then it is better
to make a large Opening, and Evacuate
the Matter at once; there are Many things
that take Place in an Abscess, first a thin
Matter Oozes out, and the Ulcer neither 
Spreads not Diminishes, Secondly an
Erysepallatous Inflamation may Arise,
a thin Matter is also Discharg'd the surface
is also Converted into Pus, and is Brown 

off in this Case, the Ulcer spreads [illegible]
there may be a Phlegomonous Inflamation not
Attended wth. any great Pain, for their is 
first form'd a Quantity of Pus without
Stimulating, and little Granulations Arise,
this Requires the Application of no Remedy
nothing more then a Defence from the Air,
by something Soft first of there is no
Inflamation at all; if the System in general
be Weak, we shou'd Endeavour to strengthen
it by Bark, and Stimulate it by Wine
and Spices, and Resinous Substances,
We make Use of Mercury for this Purpose,
We may also Apply Stimulants to the
Part, there may be Scarification on the 
Surface, Applying Resinous Substances,
or if the System in general be Strong, and 
if the Inflamation be Contained in a 
Membrane or Cyst, then destroying the 
Part, by Lunar Caustic, and Applying
a Superficial Dressing, a Suppuration
will take Place in Eresepellatous Inflamation,
There are two Ways of taking them
off, the first by Diminishing the Irritability,

of the Part, the Second by Stimulating
Remedies, to Produce a Phlegmonous Inflamation
its Room, if the Ulcer be a [illegible]
the most Powerful Means is
by taking off the Inflamation by diminishing
the Irritability of the Part, this Bark
will Perform most Powerfully and 
Effectually and also three or four
Days before the Abscess is Opened it
shou'd be Us'd as it will Cause a good
Suppuration in all these Cases we
may give it in a much less Quantity 
in the whole by giving it in large
Doses at the beginning; if the Ulcer be
not recent, then the Employing of
Stimulants will Produce the Effect;
Mercury We Use internally, and externally
such Resinnous Substances together wth.
Preparations of Mercury, as Sand to Produce
good Suppuration and Granulation; It
may happen in Erysapelletous Inflamation,
on the Surface of the Ulcer that

the Disease is not owing to an Affection of
the System, but of the Part, in this Care Remedies
Applied to the System are of much less the 
than there Applied to the Part, have the 
best Method is to Destroy the Substance of the 
Part, so as to Come to the Second Parts below,
and bring a Suppuration from the bottom
of the Ulcer; It sometimes happens that 
the Suppuration is Prevented by particular
Matter, as Venereal and Cancerous &c.
If it is Topical the Application of a Caustic
will unite wth. the Matter as well as Destroy
the Surface of the Ulcer, and so bring on
Suppuration, if the Matter has got into 
the System, We must Use such Substances
as Chemically Combine wth. it.

Lecture 20th.
It sometimes happens that the Granulation
Flesh Rises too fast, it is then of a Loose
Texture appears above the Surface of 
the Skin, and cannot be Cover'd over wth.
a Scarf Skin; when the Fonyans Flesh
Arises in an Ulcer, we are first to 
Check its growth by astringents so as
to Resent it Rising above the Surface of the 
Ulcer, the Astringents that have been
Cheifly Employ'd for this Purpose
are the Caleas of Metals, and more 
especialy Vitriol Caruli; the same
may Effect'd in some Degree by 
Pressure or Bandage, but it if shoud
have Arisan for a great quantity so as
to [illegible] greatly the Height of the 
Strain it is better to Cut it off, or applying
a Caustic; sometimes there is such 
a Disposition to form this although
We Endeavour to Prevent it by a 

Danger on Caustic they are Attended
wth. no Effect in this Case it is better to
Destroy the whole of the Granulating Flesh
and this is to be done by the first Cutting
off as much as we Can, and then Applying
a Caustic, or there Caleas of the Metals,
that give a disposition to good Suppuration
and Granulation, in the next Place we
are to Suppose, that the Ulcer is already
filled wth. granulating Flesh, we are
then to Endeavour to form a Scar of
Skin to Cover it, this generally happens
Naturally, it is however prevented principally 
by a Quantity of Putrid Matter
Adhering as being Applied to the
Edges of the Ulcer, hence we must keep 
an Ulcer very Clean, it is also disturbed
by frequent Opening, it shoud not 
therefore be Open'd oftener than is
Necessary, to Prevent the Putrefaction
of the Matter, as once in 24 Hours;
in some Cases 48 Hours; sometimes

the Edges become thick and hard, this
We Call than Callous, have the fresh skin
grows up wth. difficulty, We are therefore
to get rid of these by Cutting or Burning
them, the first method is generally the
best, supposing an Ulcer is feeling
tolerably well, yet we can forward it
greatly, by Applying gentle Astringents
as Lapis Calaminaris, this particularly
forwards the spreading of the Skin,
Oce [illegible] also as, is [illegible], when an
Ulcer is near being Heal'd, it sometimes
Circularly and will not spread entirely
over this to be Remedied by the [R??isea]
we shall now suppose then a gangrene
has taken Place, in this Case the
Putrefaction generally Arises, so last
that we have but little Chance of restoring
the Life, we are therefore to get rid of it
as fast as We Can, that the Sound Part
may begin to granulate and be 
remov'd, supposing a Part Dead and 
the Rest of the Body in Perfect

Health, and that it has no other Effect on the 
Surface of the Living Part, endeavouring
to get rid of the Dead, then a Phlegmonous
Inflamation wou'd Arise, and a Fluid
Issue which woud Serve to Separate 
the two Parts, when a gangrene takes
Place in an Inflamation it immediately
Produces an Effect on the Surrounding
Parts, to wit an Erysepallatous Inflamation,
and in the System in general
Symptoms of Irritation, when these
take Place we endeavour to Occasion
a Phlegmonous Inflamation round the
Part so that an Exfoliation may take
Place, and a Common Ulcer be Left; this
is to be Accomplished by two means
first by the Application of Stimuli as 
sepurates Parts; and Secondly by 
Preventing it from having Effect or the 
System in general, when a Gangrene
Arises the best thing that can happen
in a Phlegmonous Inflamation, No
Treatment of a gangrene [cross out] external simple 

only that the Remedies from the
Particular Habit of the Patient are
not always sufficiently Efficacious,
the Remedies We Employ to unite
Phlegmonous Inflamation as stimulants
Applied to the System in general as 
Wine Spices &c. to the Part Scarification
Essential Oils, Balsams that has
Resins Dissolv'd in them; but none
of these are so helpfull as Cart 
Power, various has been the Opinions
concerning the Action of this Remedy,
some has Suppos'd that it acted
as a Stimulant, but we have several
more spices more Stimulating than
the Carten, some have said that it
acted as an Antiputrescant this
Opinion for several Reasons [illegible]
Admitts of a Sarious Consideration
in all Cases it Diminishes the 
Irritability of the System and this 
Prevents Stimuli from acting upon it

Now if We cou'd make a gangren'd Part have [illegible]
no Effect on the Secondary one, we should always
have a Phlegmonous Inflamation take Place
the Part do's this more Powerfully, than any 
other Remedy, it shou'd be us'd in as great
a Quantity as the Stomach will Bear; some
other Medicines have been Us'd as the Cortane
Preparations of Iron Vitriol &c. when the Slough
is Exfoliated, it is to be treated as a Common
Ulcer; Inflamatory Stimulants may be Us'd
at the same time wth. the Bark, We Come
Now to the Management of the Schirrous
and Cancer if a small gland be Affected,
it is better to Let is Suppurate if a large
one we shou'd Endeavour to Avoid it, We
shall now suppose the Schirous is 
Produc'd, if it be small and Continue in
the same State or Situation it is better
to Leave it to itself, as it will often Continue
for many Years without encreasing or
[illegible]. Ot it be large and encreasing 
We are to get rid of it, as fast as Possible
if samll by a Caustic, if large by the 

Knife first and then the Caustic, we
Choose to Employ Caustics because the 
Living Power endeavours to Defend the 
Part, till a Portion of the Matter is absorb'd
so that they have a greater Disposition
to Destroy the Dead Parts, than the
Living on's, if a Cancer be Produc'd, there
is generally little good to be done, the
Cantee, Belladonum, Arsenicum &c.
have now and then Succeded in 
Producing good Pus, the Pain may
sometimes be Relax'd by Destroying
the Sensibility of the Part by Preparations
of Lead, &c. but Cancers generally Prove 
fatal after a length of time---

Lecture 21th.
We have Describ'd an Inflamation as being 
a Disease of a Part of the Body only whereas
Fever is an Affection of the whole System
This Disease has been differently Defin'd
and indeed Practitioners have act
hitherto fined a Definition, some Call
all Affections of the System [?aces]; others
all those where there is frequency of the 
Pulse, some a pain have extended it to 
Inflamation, but We must Observe that
it has been Systematick Writers, who
have Call'd all Affections of the System
Fever; all Authors that have Wrote from 
Practise as Hippocrates amongst the
Ancients; Sydenham amongst the Moderns
have Confin'd the Word Fever to one
Disease, in order to Classes it is Necessary
to have some Appearances that is always
Present in the Disease, and has been
Call'd the Pathognomic System; This 
no Superficial Practitioners that this
can be Useful [illegible] in Fevers the whole

System is Affected, neither is this 
Affection equal, it is sometimes greater
in one Part than in another, this will
Constantly make a Variety in the Appearances
of the Disease, externally; not that no one
Symptom shall be always Constant in it,
frequently when a Patient is Affected
wth. a fever he tis Hotter, but this is not
a Constant appearance for he is sometimes
Colder, sometimes he feels Colder when
he is realy Hotter, and whether We
Consider heat wth. Regard to the Patient
himself, as by the Thermometer, We
shall evidently find he is sometimes
Hotter, sometimes Colder, if then the
Disease may Arise to such a Height
as to Prove Fatal, without an encreased
Heat; this cannot be a Pathognomic
System, the Pulse is generally more
frequent, but sometimes it is Slower through
the whole fever, as Languor Weakness
Costiveness &c. and as Fever may

Subsist without Heat, and frequency of 
the Pulse so may they without Fever, We
shoud find that some Fevers Subsided
without them and some of them without
Fever, so that no Symptom is always
Constant and for this Reason, the Fever
is an Affection of the whole System, and
sometimes one Part, sometimes another
is not Affected, in order then to Define
Fever We must give a Description of the 
whole Disease in the first Place we must
Observe that a fever in general is a Complaint
Disease, if it be a simple one it never
lasts above 48 Hours, but fresh and pert
Attacks in some Cases take Place, so as
to Prolong the Disease Considerably so that
the Fever is a Compound of a Number
of small Fevers following one Another and
mining; In Order to Understand the 
Disease we must Consider one Paroxysm
as simple and Perfect, the better to 
Understand those that are Minded;
One simple Paroxysm of Fever Consists

of the Attack of the Disease a Natural
Cure Arising, and an Appearance taking
Place on its going off. We then it Consists
of three Stages, first the Attack improbably
Called the Cold fit; secondly the Hot Fit,
and Thirdly the Crisis; the Attack
Consists of two Parts, a depression of
Strength in many Parts of the Body,
and a Contraction of the small Vessels,
wth. an Accumulation of Fluids in the 
large on's; the Symptoms wch. Indicate
a Depression of Strength and Languor;
Weariness, Weakness, &c. If the Paroxysm
be a Violent one they take Place first and
in a greater Degree. Sometimes there is 
no other Appearances at all but so great
a Depression of Strength both of Body
and Mind, that the Patient Dies; As in 
the Plague the Sensibility of the Organs
of Sensation is sometimes Diminished,
the eyes doe not Perform their Office
so well, and the Skin becomes sometimes

Insensible, this takes Place only in very
Violent Attacks, when the Living Powers Act
Weakly, a less Degree of Heat Arises hence
there is a Coldness and Weakness we dont
Know, but so it is when the Stimulus Power
is Diminished, there is always a Coldness
and trembling together with Pain at the
Back, at the same time there is a Sense
of Insects Creeping over the Skin wch.
is Call'd by the Latins Neuipelatio
having no English term to Europe it
the Vessels of the Extremities in particular
and indeed all over the Body Contain a less
Quantity of Blood; so that the Parts become
Pale; the skin has its colour partly from 
the Sebacious Matter wch. is yellow when 
therefore there is less of the Blood, the Skin
becomes more a Dim Colour; the Tongue
becomes Dry and Covered wth. a Mucus
the Kidneys Contract so that the Urine
do's not Contain the separating mucilage
but remains transparent, and when the

Attack is Violent, the Quantity Diminishes
the Secretion for the Intermits is less
the Peristaltic Motion being Distended
so that the costiveness is Produc'd, if there
be any Penetrating wound, in any 
of the Muscles, the Ulcer becomes Dry
so that the Vessels of the Muscles Contracts
and in this Contractions sometimes
Affect so large an Artery as that
of the Arm, so that the Pulse becomes
small, in Consequence also of this
Contraction there is often Pain in
different Parts of the Body, as the
forehead and sometimes extending
all over the external Parts of the 
Head from some Cause; probably from a
Contraction of the Vessels of the 
Brain, there is a Delirium; It may
also be a Symptom of the Quantity 
of the Living Power but this we shall

Explain more fully here after; the Eye
is the Common the Criterion of the State
of the Brain, so that from them we shall
be Enabled to judge of the different
Species of Delirium, if the small Vessels
Contract, the large about the Heart must
be Distended from the greater Accumulation
of the Blood in them, Accordingly We find
[illegible] Oppression and Swelling about 
the Praecordia a greater Quantity of Blood
Laying about the Heart Stimulates it
to more frequent Contractions, hence
frequency of the Pulse, Quick and 
Laborious Respiration and Cough
wch. attend all difficulties of Breathing,
there is also Flatulancy and from an 
Affection of the Stomach rigor and
[illegible], this is sometimes so great
that Sickness and Vomiting take Place
it will admit of a Doubt whether

this arises in Consequence of an
Affection of the Stomach, and the
fulness of the Vessels about the
Praecordia but most probably of the
former, There are the Appearances that
take Place in the Attack of the 
Disease; and there it is that Constitute
the Disease, if [illegible] one of those Symptoms
are Present, there is no fever so
that this Attack is the Disease it self
the other Parts of the Paroxysm
bringing Consequences of the Disease
the Blood in this state is not Alter'd
but the Action of the Swing Powers,
indeed as the Disease advances it
sometimes Inflam'd and sometimes is
Verging towards Putrefaction-

Lecture 22d.
The Appearances of Fever before Enumerated
may be few and only particular Parts
Affected, the remaining Part of the 
Paroxysm in this Case not [?ueading]
We dont Call the Disease Fever, this is 
an Affection that Causes an Alteration
in the whole System, so as to Produce
a Hot Fit and we must observe that
the whole Disease depends on these
Alterations, and is always more or less
Violent according to the Degree and
Number of these Appearances, the
Causes of Inflamation We have been
Able to Point out to you; Now Fever 
Arises sometimes from Causes that
are known, and frequently from [?nton] [illegible];
they are also very Uncertain in
their operation, so that if the same
Causes be Applied to a Number of
People, only a few shall be Affected

with the Disease. The Causes we are
Acquainted wth. are first such Passions
of the Mind, as are Attended wch. Annualy,
and there must be suddenly excited
these however are not very Powerfull
amp. And secondly Fever may be
Excited by an Exposure to Cold; as
Sleeping on Damp ground &c.
Midly Putrid Infectious Matter as
Variables Marbillous, Acting upon the
Irritable Parts, will unite Fever, if
We take a Number of People in Health
Shut them up in a House just Built,
so that there is no Contagion, yet 
a Fever will very often be Produc'd; from
the Putrid Vapour Arising from the
hood and Evacuation; A strange Causing
into the same Place shall be Affected
wth. Fever; If a Number of People are
about a Man Affected wth. a Violent Fever
from any Cause, some of them will be
Affected tho the Patient has no Symptom
of Putrescence, so that a Vapour Arising
from a Man in Fever is Capable of Producing

if an Healthy Body, formly a Man
having Eat food that is not Digested but
become Putrid in the Stomach, has
been Affected wth. Fever, so that now and
then it may Arise from a Retention of the 
of certain Substances on the Primæ
Viæ; as Indigested food in the Stomach,
Fœcas in the Intestin'e. [???ly] a Number
of Men going into a Climate they have
not been Us'd to, some of them will be
Affected wth. Fever, whether this be a
Cause of itself, as only adds to the
other Power, we cannot Determine
simply half the fevers wth. take Place
Arise from Causes that we cannot
Investigate, when the Passions of the 
Mind Produce Fever, They doe not
immediately, or not at all. When they 
are brought on by Cold, it is generally
Produc'd immediately some times
however it is not, when from a Retention
of Substances in the Primæ Viæ it
Arises while they are there, When

from putrid Vapour it seldom takes Place
immediately, sometimes indeed it do's; the
Action however is by no Means at the 
same Period. Variolous and Morbitlous
Matter are Commonly Eight or Ten
Days before they Produce face. If
Varioulous Matter be Applied to a
Warmd an Inflamation will Arise and
A Pustule is form'd full of Matter
at this time it begins to be Absorb'd
and that on its first Application
to the Heart that Produces the Disease
for the Second has no Effect, for if
a Patient has Caught the natural 
Infection, and is Inoculated, this
gets on the faster and Produces the
small Pox of the Inoculation, the Natural
Infection having no Effect. So if you
Inoculate a Patient for several successive
Days, the first take Place and the
Subsequent on's has no Effect in

encreasing the Disease, in other Cases
when the Disease is not Produc'd, upon the
first Application, some Symptoms are
brought on wch. gradually encrease, so as
to Produce the Remaining Part of the 
Disease, As Putrid and Infectious Vapour
do's not appear to be Accumulated in
any Part of the Body, neither do's it
Appear to have any Effect on the Blood,
in the Course of the Fever it may; but
never on its Attack, some Symptoms give
off without being allowed by a Fever is
the encrease and Diminution depend
on some other Causes; and not on the
Accumulation of the Matter, it is to be
Remark'd that Fever when Produc'd
is Independent of its Cause, in this
it differs from Inflamation, and
Symptoms of Irritation; and hence
it was thought to Depend on an Accumulation
of Matter; It is well known that

when one Motion is Produc'd, it will
Continue without its Original in any 
other Cause, to excite it to a Continuation,
frequently also an Addition of the
Original Cause, will have no Effect 
in encreasing the Fever, after it was
once Produc'd as was Observ'd of the 
Variolous Matter---

Lecture 23d.
We have said some of these Causes
Produc'd Fever immediately, and some
not till after several Days, Now We shou'd
be extremely Cautions of Admitting
those Causes of Diseas'd wth. have
not an Immediate Effect and never
till we have formed a Number of Cases
in wch. these Causes have Produc'd the
Disease; when any Cause do's not produce
Fever till after sometime, there are 
two things happens, and Alteration of
some of the Fluids of the Body; in those
Cases where this is evident, we find
the Change Topical, as in Inoculation,
and that as soon as this gets into the
Blood Vessels, it Produces the Disease,
When Putrid Infectious Vapour is 
Applied to the Body, so as to Produce
Fever it is a Question whether it Acts
on the Fluids of a particular Part

of the Body; making some Change, so
that when they are Absorb'd into the
System they shall Produce the Disease,
or whether it makes a Change in the whole
Mass of Fluids wch. as the Circulating
Fluids, by wch. the Disease is Produc'd
it Appears rather that much Putrid
Vapour immediately brings on, for after
the Application of it, [illegible] febrile
Symptoms Appears, wch. Continue
to encrease, till the Fever is Produc'd
or is there any [illegible] of Putrid
Vapour, Producing an Alteration in a 
particular Part, for Putrid Matter will
not Produce Fever by a circulation, or
if we apply any other the Fluids of a 
Man Affected wth. a Putrid Fever, it
will not in a healthy Person Produce
a fever, it will sometimes Produce
Symptoms of Irritation or Inflamation,
We Observe it was the Distinguishing 
Mark of this Disease; that it Continued

after its Cause was Remov'd, this of great
Consequence in the Treatment of it, and it is
this that has given Me an Idea, that Fever
was an Alteration of the Fluids; However
in many Cases there is no Appearance 
of this, it is the [Re?parly] of the Moving
Parts of the Body, that it sometimes
happens, that if they are Set in 
Action there, will Continue Acting even 
tho the Cause by Remov'd; the next
Thing wth. Regard to the Action of the 
Causes of Fever, is that they are Capable
of Cooperating wth. each other; and of
thus Producing Fever when they wou'd
not Singly, those are no particular
predisposing Causes of fever; they being
in Common wth. other Applications and
hence they act more Certainly on an 
Irritable habit; the Symptoms of the 
first stage of Fever sometimes Destroys
the Patient, the most Violent Fever We
know of is the Plague, but as it do's not

happen in the Country, We are Oblig'd
to trust to the Relations for the Knowledge
of it, wch. I must Observe is very Imperfect
thus for however it extends, that those
who are [illegible] wth. it Complain of 
Languor, and such Symptoms as generally
Attend much Violent Fevers, and have
suddenly Dropt down and expired,
have thus then the Symptoms of the 
first Stage have thus Cut off wth. us
the Symptoms of Intermittent Fevers
take Place wth. more Violence, than any
other and now and then a Patient as
Expir'd in the first Stage; according
to the Description of these Cases, the 
Patient becomes extremely Cold, there
is a vast Languor, great Application
about the Præcordia, Paleness and
these wth. the Tremblings, Continue
encreasing until he seems Cut off by
Weakness it is entirely probable
that several of these People, who 
have been suppos'd to Die of

[illegible]; have Died in Consequence
of the first Attack of Fever, that this
sometimes is the Case, I have Experianc'd,
and when the Disease has not gone on
so fast as no kill the Patient the
Paroxysm has gone on the same as in
the Common Paroxysm of Fever the 
Attack then in these Cases may Destroy
the Patient, if it do's not as indeed
most Commonly happens it is 
Succeeded by Rigor and [illegible]; In 
Intermittents when those take place
it is seldom the Patient is Carried
off there Arise a Heat about the Breast,
wch. Differing shall spreads over the 
whole Body, very unequally tho and
likewise Indiscriminately, the Pulse
becomes Stronger and fuller, but it is
Obstructed, or it is frequent and small
but this Symptom do's not always 
take Place here the Heat is more Regular
we often Meet wth. Heat in Fevers

and is extremely troublesome to the
Patient, yet it is not actually encreased
there is great Pain in the Head, wch.
if it Arises in an from the first Stage
of Fever is more Distension, and frequently
in the Joints, as well as the other Parts
of the Extremities, there is Stupor and
sometimes Delirium; the Paleness that 
takes Place in the first Stage gets off
and some Parts become [illegible] but 
that the Contraction Remains in
some Parts is evident, from the Dusky
Colour of the Skin; when the Attack has
been Violent there is often great and
Universal Soreness, the Secretions are some
of them encreased, the Urine is high
Colour'd but perfectly Transparent; there
are also partial Sweatings of the Head
Breast &c these Evacuations have been
Call'd Symptomatic to Distinguish them 
from those wch. take place in the crisis

they differ in this, in the one Case they are
partial, in the other Universal [P??tectic?]
also sometimes Appear on the Skin
this Part of the Paroxysm on would serve
to Point out to us; that the fulness of the
Precordia and Stomach, occasion'd the
Living Power to be Excited, first about
the Heart, and then in the whole Body,
so that the Blood is Propelled wth. great
Fever, as to take off the Contraction the
Heat then is a Mark of a stronger Action
of the Living Power; and from hence frequency
of the Pulse, and sometimes fullness
and Strength; Propelling the fluids
forwards wth, greater Force; Occasions
greater sanctions in particular parts
of the Body, Soreness is a Symptom
of the Contraction going off; as that is
generally full after Contraction of any 
kind; thus then the Symptoms of the
first Stage goe off; as those of the Second
encrease, and there decreasing give Place to the
Symptoms of the kind stage of Fever wch. is the Crisis

Lecture 24th.
Having Pointed out the Symptoms of the 
Second Stage of Fever, we now Come to the
Morbid Stage to wit the Crisis; We cannot
Observe that it is not the Distension but 
the Relaxation, of Loss of Distention
to Contraction that Produces Crises undoubtedly
however the Hot Fit is the Natural Cure of 
the first Stage, partly from the encreased
Action of the Heart and Arteries, and
partly from some other Causes, wch. We
are not as yet Acquainted wth. at least
the small Vessels through the Body
are actually Relaxed; the Pulse becomes
free, the Skin grows soft, and Moist
and recovers its Natural Colour; the
Tongue wch. was Dry becomes likewise
Soft and Moist, the Costiveness gets
off, and the Urine is secreted in a large
Quantity, in others the Appearances of
Contraction gets off from all Parts of 

the Body, but as Relaxation takes Place
before the Symptoms of the Second Stage
entirely Disappear, it seldom happens
but that some of the Sensations are encreased
thus the Urine, is generally in a large Quantity,
and tho transparent when first discharged
after a little time becomes turbid, and
Opaque at the Depositing a copious
Sediment, and this so generally happens
that it has Led some Practitioners to 
Imagine that a Crisis came or Come on
without it; but this is Contrary to
Experience, sometimes a Copious Sweat,
and sometimes Purging Arises, they are
different from those in the hot, as there
are Symptoms of Relaxation in all 
other Parts of the Body, after the Symptoms
of this last Stage are gone through, the
Disease Leaves the Patient, he being only
Weaken'd from the Exertions wch. have
taken Place in it; A Paroxysm of Fever
may be cut off by an Inflamation 

Hemorrhage has forming some Part of the
Body; when the Symptoms of the first
Stage suddenly, disappear or a so considerably
Diminished, why this then to
happen we dont know; some have Said
that the Matter was now Deposited in a 
particular Part, and had left the System
in general nor do's at all Explain the
difficulty, in the first Place, We can 
hardly Believe that all the Matter
supposing Obstructed in the whole
System should be Confin'd in a particular
Part, besides this often an
Inconsiderable Part of the Body,
as the Pleura wch. is very small and
cannot Contain more perhaps than
ifs. of Blood and the internal Parts
of the Blood Vessels except the
Heart are not Capable of being
Stimulated, and if an Inflamation was
to arise from such a Stimulus; the 

Matter would not be Accumulated, but
Pass on the others Parts of the Body,
in what there are so many difficulties
in Supposition and no Positive Proof;
that we cannot Admit it, it is certain
that Fever do's proceed from Matter, in a
few Instances, as in the Small Pox, but
there is still no Accumulation in the
System; when the Fever go's off the same
Pustules Subsist, them whence there is
a Constant Absorption of Matter, so
that there is always more Matter in
the System then at the time that the
Fever was Produc'd, hence it is evident
that the Fever was not Cured, by passing
the System from the Matter and in many
Fevers there is not the least Reason for
Supposing that there is any Matter at
all in the System especially in Inflamatery
Fevers, in wch. Inflamation and 
Hemorrahage generally Arise, as then
We dont know in what Manner these

Cure Fevers, We Commonly take it for
granted that it do's happen, a Patient
may Die also in the Second or third
Stage of Fever, for Causes wch. We shall
afterwards Explain, now a Paroxysm
of Fever may be gone through in four
Hours, sometimes less, it cannot
last more then 36. Hours, it is most
Commonly ended in 10, 14, or 20. Hours
We can Conceive that a Paroxysm might
last a great deal longer than 36
Hours, but Circumstances take Place
in the System, that Prevents this by a
fresh one Arising, there is a Paroxysm
of Fever that happens to all Men
towards the Evening, this is Carried
off by a Crisis taking Place, in the
Morning; you find in the Evening
that the Vessels are contracted, that
the same [illegible] will not Produce
Sweat, as in the Morning, there is also
frequently thirst, the Powers of the 

Body are Depress'd, and a Degree of
Languor takes Place in Disease's. This
Evening Paroxysm, in many Cases
becoming Apparent, and also in Weak
People, it begins about five from Seven
Commonly and Continues from Hence
to five in the Morning; We might Suppose
to arise from the Fatigue of the Day,
but we find it taking Place at the same
time in People that Work at very different
Hours, so that the time is not Alter'd
by the different Modes of Life, why it
shou'd take Place at all we have not
the least Conception, it has this Effect,
that it the Paroxysm takes Place about
Twelve, it shall goe on, but if it Continues
untill the following Day, at the time
it Produces a fresh Exacerbation, so that
the Paroxysm of Fever can Continue about
thirty Six Hours sometimes; when the
Paroxysm has nearly Subsided, the
Evening Paroxysm is not sufficient 
to Produce a fresh Exacerbation, yet

in this Case it seldom Continues above
48 Hours, a Fever consisting of one
Paroxysm, we Call an Ephemera Simplex
wch. if they were to Continue they wou'd
Prove Fatal, but the Patient is generally
well before the Practitioner is Call'd
so that this Fever has for the most
Part been overlook'd. It sometimes
Comes on by Violent Paroxysm or
Symptoms of the first Stage succeed'd
by a Degree of Delirium, that Patient
afterwards falls into a Considerable
Sweat, by wch. the Disease is Carried
off a Fever that Continues longer
than 36 Hours, is generally Compound
and Consists of several Paroxysms
following one Another, and this they do
in all Ways, sometimes they are
Distinct, that is the Symptoms [illegible]
Period goe off entirely before a Second
Arises, this We Call on Intermittent
Fever, when the Patient is greatly 
Beleiv'd, but the Pulse sometimes

frequent, and several other symptoms
are not Carried off before the Second
Period begins, We Call it a Remittent
Fever, and a Continued Fever have one
Period or Evacuation begins before
the former is Considerably abated,
We shall not Consider the Causes of the 
Recurring of Fevers, or rather Paroxysm
of Fever, We shou'd Empart a Prior
that all fevers wou'd be Ephemera
Simplex, we know no Reason why
a Fever shou'd Return of its own Accord,
We shall therefore next Consider these
Causes that occasions the Acronysms
of Fever to Return

Lecture 25th.
We are now to Come to [?less] the
Causes of Recurring of Fevers, that is of the 
Paroxysms of Fevers, we have said
that when the Causes where Applied
in many Cases they Produc'd only some
Symptoms of the Disease, and that
if these Causes when Remov'd, the
Symptoms when Produc'd wou'd Continue
that these where easily encreased as to
bring on a Hot Fit, wch. is Calld the
Paroxysm, if no Hot Fit arises; We
do not Say the Patient is affected wth.
Fever, now these Symptoms may go
off themselves or be Carried off, by the
Natural Evening Paroxysm, or they 
may encrease as to Produce a Hot Fit,
when a Perfect Paroxysm will take Place;
when the Paroxysm is gone through
and Crisis takes Place, when the

Pulse is Come to its ordinary Pitch, the Heat 
gone off, and there is no longer an encrease
of any Secretion; We find that the Fever is
not entirely Cured; that it has left some
Symptoms behind, as a Slight Pain in the
Back, a foul Tongue, as Paleness or a 
Dustiness of the Skin wth. Languor; but
these Symptoms in the first Stage are
not Sufficient to form a Paroxysm; they
Continue however sometimes going off
themselves; and sometimes encreasing so
as to Produce a Second Paroxysm, this
is often the Case in Intermittent fevers
in the next Place fresh Occasional Causes
may Reproduce the Dis Paroxysm, suppose
an Ephemera Simplex, having gone through
its Natural Progress and a Perfect Crisis,
yet if the Patient be Expos'd to Cold Putrid
Vapour &c. in so slight a Degree that in
Health it wou'd have had no Effect it will be

sufficent to Occasion, the Return of the
Paroxysm, the next Cause of Recurrence
of the Paroxysm of Fever, is the Natural
Evening Paroxysm, has has already been
Explained, it is this that Produces
Exacerbations in Continued Fevers moreover
if there shou'd have been several Paroxysms
of Intermittent or Remittent Fevers
it will Continue from Habit, the last
Cause of the Returning of Fevers, is 
what we shou'd never have Imagin'd
was it not evident, from Actual
Observation (J.E) the Action of the 
Types, in Attending to the Return of 
the Paroxysms, we find that
the greatest Number of the Return
at the End of 48 Hours; why they
shou'd have a Disposition to Return
at this particular time, We dont Know;
some have Suppos'd it was in Consequence
of Fermentation taking up this 
Space; but this and many others

Suppositions of the same kind, are by no
Means Satisfactory, Fevers the next to
this are more Apt to Return at the End
of 24. Hours; and at the next to this
at the End of 72. Hours; It is seldom that
We find 8.[illegible] going longer than this
though now and then a Fever will Reoccur
at the End of 96. Hours, and at all
other Intervals; When a Paroxysm of
Fever Reccurs at the End of 24. Hours, We
Call it a Quotidian because this is a
Paroxysm every Day when at the End
of 48. Hours, We Call it a tertian, because
the 49th. Hour is the beginning of the
Third Day. and so if it Return at the 
End of 72. Hours, We call it a Quartan
and for the same Reason we seldom
Meet wth. a Quartan, [illegible]. It is farther
to be Observ'd of Intermittent Fevers;
that they seldom Continue in the [illegible]
in wch. they Arose; Quotidians are frequently

Converted into tertians, and tertians into
Quartans, in the Spring when People
are Strong Quotidians and tertians generally
take Place, in the Autumn when We
are Exhausted by the Heat of the 
preceding Summer, tertians and Quartans
are more frequent so that in some
Degree, the fever Seems to be Connected
wth. the Strength or Weakness of the
Habit. Thus the Symptoms that 
Indicate a Strong Action of the 
Vessels often happen in Quotidians,
the Symptoms of the stage are Violent
in tertians; and there of Weakness 
are frequently met wth. in Quartans;
sometimes however there different Symptoms
Occur in the Type of Fever; when the
Paroxysm takes Place every Day
and in the Intermediate Days is Weak 
is Calld a double Tertian; in a Quartan

there is often a Strong Fit has Slight on's
and then a Strong one again, and so on;
others altho the Paroxysm take Place
every Day, there are Marks of a tertian
and a Quartan; and this is Calld
a Triple Quartan; It was suppos'd by
the Antients that there be here two Tertians
And that the Patient was Affected wth.
two different Fevers at once; but the Reason
of this Appears from Weakness and 
Irritability, hence this seldom happens,
till the Fever has Continued for some
Time; In Continued Fevers we shou'd
Consider them according to the Exacerbations.
It often happens that when a 
Fever is once Produced, the Paroxysms
will Continue to Recover at some of
these Types, without any Apparent
Cause, the Manner in which they do this
we have already Shewn, the Natural Cure
of one Paroxysm do's not Cure the Disease

for this is Apt to be put a Stop to, in
two Ways, we have already Said that
Fevers frequently Continue either
because after the Crisis some Symptoms
of the first Stage, remain as no Crisis
shall takes Place before the Action
of the Natural Evening Paroxysm or
of the Types.
Intermittents seldom Appear at the 
first in their Proper Types. In Continued
Fevers the Disease go's on because the
Paroxysms doe not Terminate before
the next Evening Paroxysm of Fever
if it shou'd Terminate before this a 
perfect Crisis then happening will
Carry off the Disease; in all Fevers the
severer the Paroxysm in general
the Shorter the Duration of the Disease
and the more perfect the Crises. In
Continued Fevers, those more Violent 
Exacerbations often happen on the 4th.

5th. 7th. 9th. 11th. 13th. 14th. 17th. and 21th. Days
than on any others and are the most Part
shorter, so as to goe off about, 4 or 5. in
the Morning, and the Crisis is more Apt
to Terminate the Disease. A Crisis may
be Fatal as well as Salutary. The
Antients Consider'd it as, [???tamen]
into Morbum and Naturam. If the
Crisis is entirely Perfect the Disease
go's off altogether and, and do's not Fever
or if some small Symptoms be left they
grow less and less, till at last they goe
quite off; A Continued Fever at the 
begining is generally first a Quotidian
than a Tertian, then a Quartan and at
last very irregular, this is sometimes
very easily Observable at others not
but not so frequently in this as in
Warmer Climates, nor indeed do's Crisis
Terminate Fever so frequently, in the
former as in the latter; the more Perfect
We can Observe the Tertian Type, the more
likely there is to be a Crisis, it is to be

Observ'd that when Speak of the begining
of Fever, We mean the first Week in wch.
the Exacerbations take Place every Day,
when of the Middle of the Second Week
or while it Observes the Tertian Type,
and when the End wch. is Commonly
more Severe when it Observes the 
Quartan type or becomes irregular; after
a Fever begins to Observe the Quartan
Type, it generally begins to Diminish,
and gradually Wears itself out; and this
Two both of Continued and of Intermittent
Fevers, the time of the duration of a
Quartan of itself is Commonly, 4. or
5. Months, of a Tertian has or 3 Months
and of a Quotidian about 6. Months,
the first Symptom of the going off of the 
Disease is a Moisture about the Tongue
a Relaxation of the Skin, together wth.
the Kidneys in Consequence of wch. the
Urine often Deposits a Lateritious
Sediment, and the Pulse becomes Regular

in all Cases of Fever, The Crisis are more
Apt to be Imperfect at the begining and more
Subject to Relapses, towards the End, if an
Imperfect Crisis do's happen Relapses
seldom occur. If Seems to have been forgot
by Modern Practitioners, that Fever had
a Termination of their own, this Arises
from their Dissenting from the description
of the Disease; as Laid down by the 
Antients; Now if all Fevers where to goe
through the Course already Describ'd no
one wou'd Die, but there are Causes that
Arise in the Course, wch. frequently are
Productive of Death of the Patient and
these we shall Proceed to Explain-

Lecture 26th.
We now Come to Point out to you the
Sources of Danger in Fevers, A Patient
may in the first Place be Cut off, by
the Fever itself, the Inactivity of the
Living Power, and a Depression of
Strength, may be so great as to be 
Fatal; this happens sometimes in the
Plague, in the beginning of a Paroxysm of
the Paroxysm of an Intermittent Fever,
its also Apt to Arise from the Affection of 
the Dram, wch. takes Place in Consequence
of the Symptoms of the first stage; sometimes
in the Second Stage; the Action of the 
Heart and Arteries is so encreased that
the Patient is Cut off by the generall
Inflamation, or the Effects of the Body
during the Paroxysm may have been so
great as to Produce such a Degree of 
Weakness and Irritability as to Prove
Fatal; We shall primarily Consider
the Symptoms of Danger Arising in

The first Stage, there wch. shew the Disease
to be Violent, are great Languor Weariness
and Weakness, wch. if they Continue long
the Shew the Depression of Strength to be
very great, so that the Symptoms of the
first Stage are more Capable of exciting
a Strong Action of the Heart and Arteries,
The Attack may Come on by a great
Prostration of Strength Attending it,
wch. is very different from Weakness as
in the former Case; the Powers of the
Body are Retarded upon the going 
off of the paroxysm A Man Attack'd
wth. a Fever being Incapable of Muscular
Motion; wch. shews the great Violence
of the Fever; the Skin being Tough Dry
and Unequal, these shewing the great
Contraction of it, if an Ulcer unites
and that becomes Dry; it shews the 
Vessels amongst the Muscles are 
Contracted, it Indicates the Contraction,
not being Confin'd to the Capillary

Vessels; if the Pulse is much Contracted
it Indicates the Contraction not being
Confined to the Capillary Vessels, but
smallness of the Pulse must not be
taken for Contraction; as this may Arise
from Weakness. If it be Quick in the
Hot Fit, and neither full nor Strong
especialy if it Intermit, it shews that
the Heart is greatly Oppress'd, and the 
Depression very Considerable frequency of
the Pulse and Intermission, may also
be Consider'd as a Symptom of Weakness
and Irritability; but more especialy
if they Arise towards the End of Fever.
The tongue and Mouth being Dry shews
that the Vessels of the Mouth are
Contracted; if there is a great Quantity
of Mucus Covering the Tongue, it may 
be owing to the Violent Affection of the 
System, and hence it is all Day at
the same Time Again it may Proceed
from an Affection of the Primæ Viæ, but
here the first is very great and not

Diminished by keeping the Mouth
Moisten'd, the urine being Pale Transparent
and in small Quantities shews the
Vessels in the internal Parts of the
Body are greatly Contracted. If it is 
perfectly Transparent and high Colour'd,
the Fever is pretty Considerable; If Pale
and in Large Quantity, it is a Pergnois
of an Approach of Delirium, from the
violence of the Symptoms. The Nails
Fingers and Feet remaining Cold and
Pale, except it be towards the End of
the Disease are Symptoms of its
Violence, and permanency, so as to 
Admit of Little Relaxation between
each Paroxysm, and the Disease
Accumulates to a great Degree
the Nose being Sharp, Temples and
Eyes hollow, Skin of the Forehead
Contracted; Ears Cold and the Face
Universally Pale, or of a dusty Colour
are Symptoms that Indicate a great 
Contraction about the Head and are

Look'd upon as very Dangerous, these
Appearances may Arise from many
Causes; as from the Violence of the 
Fever itself, from Delirium from Weakness
&c and has been Calld the Facia
Hippocrates, from Hippocrates
The first Observer of it, the Breathings
being Short Quick and Laborious, the
Patient moving the Nostrils principally
the Præcordia being Tense Swelld
and hard; the Anxiety and Restlessness
great, wch. Shews that a great Quantity
of Blood is Accumulated about
the Heart, or the Præcordia, and the
Heart is not Able to Clear itself. these
are the Symptoms that Indicate great
Danger, in the first Stage of Fever
but in the Continued Fevers the Symptoms
wch. are more Dangerous is the Delirium
whether it be a Disease of the Brain
itself, or of the Living Power, throughout
the System; If has not for the most Part
been Distinguished, but Consider'd as
the same; there are however several

Species of Delirium that takes Place in
Fevers, and two if not three Arise from
the first Stage; wch. are totally different
from one Another and Require as different
Treatment; first the Vessels of the Brain
may be Contracted, that a smaller Quantity
of Blood shall Pass through, wch. shall
not be sufficient to keep up its Functions
This Species of Delirium is Attended
wth. these particular symptoms, the 
Vessels of the Eye, wch. are the general
Criterion of the State of the Vessels of the
Brain are Pale Small and Hollow, there
is no Redness and Flushing of the 
Face, but a constant Duskiness and
Paleness. Secondly the Delirium is
Considerably encreased at the Exacerbation
and go's off entirely, or is Considerably
Diminished, when the Fever itself gets
off if the Disease go's through its
Natural Course, it Diminishes at the 
Exacerbations, and at last leaves the
Patient without Stupor, Delirium also
often happens from a Relaxation of

the Vessels of the Brain, and fullness
in Consequence, the Symptoms preceding
to this Species are the Eyes being Red
and Blood Shot, the Cheeks as Red as if
Painted and not Swell'd, the Delirium
itself more Constant and equable, tho
it is a little encreased by the Evening
Exacerbation, and when the Fever go's
off, this is often the last Symptom that 
remains, and that wch. dot goe off it
Leaves a Considerable Stupor behind;
the Vessels Requiring sometime before they
regain their Proper Tone probably there
is a Third Species of Delirium wch. do's not
Arise from an Affection of the Brain
but of the System, the first Symptoms of 
both these Species of Delirium are
Watchfullness, and Restless and unrepeating
Sleep, the Patient Dreaming much and
Waking somewhat Delirious, not knowing
where his, or who is about him, the Imagination

begins to be [illegible], then the Organs of the
Senses are Affected, and there is the Appearance
of Flies before the Eyes; the Patient Picks the
Hairs from the Bed Cloaths, this is a Symptom
of great Danger as his thirst suddenly going
off the Violent Drawing on a Total Insensibility
Conceson; and the Patient is sometimes Cut
off wth. Convulsions; these two Deliriums
are the Symptoms wch. generally Prove
Fatal in Continued Fevers; the Danger of the
first Attack of an Intermittent is not so great;
We shall in the next Place proceed to the
Symptoms wch. Point out the Strong Action of 
the Vessels....

Lecture 27th.
The first Stage of Fever Occasions Symptoms
of Strong Action of the Vessels, by wch. it is
Diminish'd and Carried off, but this
encreased Action of the Heart and Arteries
may be so great as to Prove Fatal; that is
such a Degree of general Inflamation may 
be Excited in Fever as to kill the Patient,
this happens in Continued Fever only, it
cannot take Place in an Intermittent because
it would Convert it into a Continued Fever
we have Said that it is probable that the 
encreased Action of the Heart and Arteries
is the Source of Danger in the Second Stage
yet there is something also that encrease
the Symptoms, so as to prolong the Disease
till a fresh Exacerbation Arises, and it is 
by this Means Converted into a Continued
Fever; On this Account general Inflamation

is not a Dangerous Symptom in Intermittent
Fevers; We might Suppose that Fever and
general Inflamation might Subsist at the 
same time and that the Fever might be
gone through without the general Inflamation
Effecting its Progress. In this Case there
would be a Hot Fit, and a Crisis would take
Place, the small Vessels and Glands
wou'd be Relaxed, and the Inflamation
would goe off, in Consequence of the
extraordinary Secretion, but this do's not
happen but in Continued Fevers, general
Inflamation is Dangerous for the most
Part by Producing an Affection of the 
Brain, or at least Delirium, the Symptoms
that Indicate general Inflamation are
hardness of the Pulse; Now we must Observe
that Authors have made but little Distinction
between a hard and an Obstructed Pulse
but there is this Criterion of difference
the Blood in one Case throws up an
Inflamatory Crust wch. it do's not in the

other; when the Blood is Obstructed it
may be of any Appearance hence there is
certainly a difference between an hard
and an Obstructed Pulse and they Point 
out the Strong Action of the Heart and
Arteries; and the other the Blood not 
getting readily into the small Vessels there
is also a generall fulness and Strength
of the Pulse, the general Inflamation may
be Dangerous when the Arteries only 
are Acting Strongly; As in the Hectic
Fever, the Blood being Propelld wth.
great Force into the small Vessels Occasions
a Redness, its returning more frequently
into the Lungs Produces a Quick and
difficult Respiration its being very distinct
from Putrefaction, Occasions a Whiteness 
together wth. a Dryness of the Tongue in
Affections of the Thorax, and sometimes
of the Stomach it is of a Yellow Colour

the Blood being Propell'd in Considerable
Quantities into the Vessels of the Head a
Distensil Pain is felt in the Internal Parts
of it; sometimes this Kind of Pain is 
felt in the Joints and Extremities, and
from the same Cause the Strong Action
of the Heart and Arteries; the Vessels
of different Parts of the Body are forced
Open, hence Sweatings of the Head and 
Breast, and sometimes of the whole
Body, the Symptoms of Strong Action
are only Dangerous when the Brain Comes
to be Affected, in this as in the former
Case, the Eye generally gives a Criterion
of the State of the Brain, they are Swell'd
red and Blood Shot, a Stupor takes
Place at first, sometimes Continuing 
for two or three Days, at other times
a Delirium Comes on, in wch. many different
Appearances Arise, sometimes it Attacks

suddenly, and is as shortly Fatal, sometimes
the Patient Mutters to himself, and if 
excited will Speak to you, but again will
soon forget himself, this is the most Common
kind of Delirium, Arising from this 
Cause, sometimes there are Violent 
Ravings for a Considerable Time, these
are Distinguished from the others by 
proceeding and Accompanying Symptoms there
is generally a Redness of the Face wth.
Swelling; but this is not so florid as in
the former Case and spreads more universally
over the whole Face, it is by this
principally that it is Distinguished from
all others, and most Commonly before 
the Patient is Destroy'd Connections Come
on, Another Way in wch. the Patient is apt
to be Cut off by the too Strong Action
of the Vessels, and is in Consequence 
of the general Irritability that Arises,

this Causes Restlessness and afterwards
Delirium in this Species, the Mind is more Apt 
to be Agitated than in any other, Ravings are
more Violent, so that the Patient often
Attempts to Destroy himself. The Muscular
Strength is encreased, the Eyes are exceedingly 
Bright and Piercing, and the Motions of 
the Body universally Quick a though this 
kind of Delirium Arises from the 
general Inflamation, yet for the most
Part it go's off before it takes Place, this
Delirium happens but seldom in Fevers,
and most Commonly in Fevers Attended
wth. Rheumatism, general Inflamation is
in any Way mostly Dangerous in the 
first Week of the Disease there is little
Danger afterwards. We Come now to 
the last Sense of Danger in Fevers, to wit
the Symptoms of Weakness and Irritability
that some time take Place, the Powers of
the Body are much Exerted in Fevers

in Consequence of which they are Exhausted 
sometimes to such a Degree as to Prove
Fatal, Weakness Renders Fevers more 
irregular, and this Prevents a Crisis from
taking Place, it generally falls in that
Part of the Body that is Retained, and
this is Carried out to us by the particular
Evacuations, as Partial as Universal
Cold, colliquative Sweatings a Purging
wth. a Dry Skin and Tongue, and a Flow
of Tears wch. is a Symptom of great
Irritability in the System, sometimes 
there is a great Secretion of them wch.
if Pale shews a great Irritation, the
great difference between these and a
True Crisis is that; in this the inflamation
is Universal in that only Partial if
the Pulse Continues Obstructed and
at the same time moisture of the
Tongue Purging and sometimes Sweating

it is a Symptom of great Danger, for as
We have just Observ'd there must be
Symptoms of Universal Relaxation to 
form a Crisis there is a Determination
of Fluids in these Cases to the
Relaxed Parts, so that in Fevers where
such Symptoms take Place Run out
to a great Length, and sometimes the
Disease Diminishes apparently for 4
Days and then encreases for four or
5 Days and so on, the next Symptom we
shall take Notice of is one properly
speaking and Dependant on the 
Weakness but Arising from a Depression
of the Strength, to wch. it is for one and
no other. This is the Putrefaction of the
Fluids, it has lately been Consider'd as a 
Cause of Fever, when the Depression of 
Strength and great Oppression about the
Pracordia, [Sigh???] and Soreness have
been Look'd upon, as Symptoms of Fever

but they are Causes of it in reality; As
the Fever takes Place first, it is evident that 
the Putrefaction wch. follows in an Affect of it.

Lecture 28th.
Sleep is sometimes more perfect and sometimes
not so perfect, it seems that all the Operations
are suspend'd the Heart Acts frequently more
slowly and wth. less force, the Respiration
gos on but in perfect Sleep much more
slowly, there Peristaltic Motion of the 
Intestin's go's on more slowly and likewise
the Secretion but in much less Quantity
the Lymphatics Absorb and Carry their
Fluids through them into the Blood Vessels
Sleep may be imperfect, the Organs of 
the Senses may just Impress the Mind
wth. Ideas, the Operations of the Mind
may go forward as in Dreams but 
not wth. that connection of Ideas wch.
take Place when a Man is awake, the 
Muscles may frequently be first in Action
as a Man may move or toss about from one
side of the Bed to another; the Organs
of the Senses do not Impress the Mind
wth. Ideas yet may so easily be excit'd

that the least Noise shall in ther Awake a
Man, or if not Awak'd excite some Ideas of Sound
but an imperfect one; the System is more
Recounted in proportion to the soundness of 
the Sleep, Sleep may be free or prevent'd
altogether by any Thing wch. excites great
Attention or Uneasiness of the Fluid, and
so likewise uneasiness of the Body or
Pain, the Action of any part of the Body
preternaturally encreas'd as for Example
an encreas'd Action of the Heart and Arteries
in general Inflamation sometimes
there is little or no uneasiness or Pain
Contraction continuing after their Cause
is remov'd; such as happens in Fever will
also prevent Sleep, but then Sleep tending 
to Render it overcomes there the Sleep becomes
profound and the uneasiness of the Body
is diminish'd and any preternatural Contraction
is carried off, in that when once Sleep
takes Place it Tends to render itself
imperfect and still in many Cases
removes the Causes of the Imperfection; In
Mania the Patient do's not Sleep for the 

Space of Twelve Months, in this Disease
and in others there are Instances of no
Sleep having taken Place for a fortnight or
three Weeks tho these Instances are Rare
in Health a Man as been kept Awake for 
Ten Days; now in Mania the Strength is 
not dimininsh'd, there Appears not to 
be that exhausting of the Living Power
the Mind do's not exert itself but as
in a Dream and the Body as Lost 
its Irritability so the same the exertion
do's not take Place as in Health
it often happens in Mania that the 
Body requires Sleep when the Mind
Thinks on any Subject, but the Mind
in Mania do's not Act but as it
where in a Dream, the Organs of the 
Senses are not Impress'd wth. just
Ideas, the Powers of the Body are
not excit'd but as in a Dream so
we may consider as in a State of
Sleep in as far as regards the
exhausting the Living Person [cross out] in
all other Cases it Occasions such 
a Weakness to prove Fatal, but
a Man in a Delirium in a fever is

more capable of Reasoning the want of
Sleep then in a Man awake, it is then
the excertion of the Judgement wch. exhausts
the Power of the Mind and in Delirium its
not Acting more at all but its only [illegible]
and a Patient can bear the want of 
Sleep, indeed the want of Sleep will
Occasion Delirium and Mania, a Man then
no Health requires Sleep to keep up the 
Strength of the Body in perfections
when an Animal is young and the 
Powers of the Body and Facultys of the 
Mind, a Larger Quantity of Sleep is Necessary
and the Sleep is generally more perfect
In old Age the Body is wore out and is 
incapable of being recrut'd and no
Sleep takes Place on that wth. difficulty
if any and continues but for a short 
Time, in the middle age of Life the Quantity 
of Sleep Necessary seems to be about one
Third Part of Twenty four Hours; A Man may 
Sleep no more than Six or four Hours,
but he generally wears out his Body
by this Means, to Recruit the Body
about Eight Hours is necessary, indeed
Active Minds wou'd rather Wear out

the Body than loose so much of their
Time as two Hours additional Sleep; longer
Sleep than Eight Hours may take Place
through Habit but always serves to
Obtund and diminish the Powers of the
Body, the Powers of the Body shou'd
be kept in Action to be perfect and
longer Sleep tends to obtund both the
Powers of the Body and Mind as Sleep
tends to take off any preternatural 
Action but its much more efficacious
in Recruiting the System at the Time
of the Natural Evening Paroxysm of
Fever as it tends to take it off
and render the Crisis more compleat
and if we dont Sleep at that time
the Crisis is not compleat
and by that Means the Body is
Wore out. 

Lecture 28th
Its time the depression of Strength as been
Said to depend on the Putrefaction of the
Fluids and according to the Reasoning
of Practitioners it must be said as
depression taken Place for to according
too those Philosophers the Putrefaction must
be the Cause of the Depression of Strength
the Effect according to those Practitioners
must go before the Cause so the Putrefaction
must be the Cause of the consequence
to be deduc'd from this is to employ
Medicines is to take off the putrefaction
of the Fluids and this you are to do in
the beginning; The Symptoms of the putrefaction
of the Fluids are in the first Place
the Mucus of the Tongue in Fever becoming
of a blackish Colour and when the 
putrefaction Arises to a considerable
Height it then becomes quite Black
and its of a loose Texture on the Tongue
the Fever and this is often rubb'd
off by the Teeth wth. this fever and
sometimes the Roof of the Mouth when

the Putrefaction arises to a considerable
Height; in the next place Fætor of the 
Breath and the Evacuations from the
Intestines becoming Fætid Show that
putrefaction of the Fluids is Arising,
then blackish Spots or marbling of the
Skin and these have generally been
called Patechia, in fevers there is a great
many different Fluids; but there is only
one Species wch. Point out putrefaction
of the Fluids wch. are of a blackish
Red appearing through the Skin the 
breadth of any Juniper; or marbling
Purple or blue Specks as in varies an'd
Marble often is Seen, or where the
putrefaction as Arisen to a great height
it now and then happens that the 
whole Skin becomes of a Purple Colour
and in that Case generally the Patient
is Destroy'd in a short time. The others
we do not denote putrefaction of the 
Fluids are reddish Spots on the Skin
superficially, and commonly came
out about the Fifth a Day and then
go off again, this Eruption is Violent

Fever; the Fever is not at all dimminish'd
by the Eruption coming out, and on its
going off again is not more Violent,
and this do's not Afford us any Indication
of Cure, this affording no one Indication
of Cure or alteration in the Fever is not worth
Attending to, it happens generally where the
Patient is Attack'd wth. Fever wth.; considerable
force, then there is another Eruption from 
Weakness it Arises in irregular Miliary
Eruptions, a Number of little Spots on
the Skin and this merely are [illegible]
and wch. Arises from Sweating taking
Place often in consequence of Stimulating
Medicines being Employ'd and happens
more in Nervous Fevers where there is this
irregularity than in Fevers wch. are either
Inflammatory or Violent, then there is 
another Eruption wch. is at the 
Fon'd and sometimes when its gone off
entirely this Eruption is some what like
very small Worms sometimes of a 
blackish Colour, and sometimes of the 
Colour of the Skin Rising in the Skin and hard

and wch. is not Inflamation, and these happen at
the End of Violent Fevers when the Symptoms
of Putrefaction are gone off, the Petechia
dont Seem to be Alter'd by any Treatment
when putrefaction of the Fluids produce
Petechia there is no manner of Treatment
wch. will produce any good Effect
but that Treatment wch. will Cure the Fever
the little Blisters are occaseon'd often by
keeping the Patient too Hot and giving the 
Patient warm fluids wch. are Stimulating
and often they are not diminished by
any Treatment whatever; Marbling of the 
Skin and fœtid Secretions indicate to us 
putrefaction of the Blood, sometimes the 
Urine is load'd wth. Mucus and is of a
frothy Appearance by the Air being stamp'd
in it, sometimes the Red Particles of 
the Blood are formed in it but this but
seldom the Case, the Urine when this 
happens is of a Chocolate Colour a
dark brown and sometimes this Sediment
is deposit'd, there is probably 
then some Affection of the Kidneys

besides putrefaction wch. as Influence
on the Kidneys so as to produce this
Species of some,  and lastly Arises and
produces the most Fatal Symptoms
wch. Arise in the Disease that is Haemorrhage
as he is Weaken'd and cannot bear the
Loss of Blood, sometimes the Gums become
loose and Spongy and Haemorrhage happens
the most common Haemorrhage wch. happens
is from the Mouth Throat or Nose, this takes
place in consequence of the Putrefaction 
and wch. gives no Relieff at all to the
Fever, the Fever remaining as Violent as
before affording not the least Relieff in 
the Fever but tending to weaken the Patient
the Blood thrown out by any natural Hemorrhage
or Blood when taken away by
any other means hardly Coagulates when
in this state, and the Coagulum is Loose
and easily broke to Peices and the Semon
is Mix'd wth. it, it has now and then 
happen'd that the Blood as become
Fœtid, I myself never I knew or Saw it

but its Relat'd by Authors, and sometimes
Practitioners in warm Climates have
Affirm'd that they have Smelt it Fœtid
and we dont doubt but that sometimes
the putrefaction go's so far as to give
a Fœtor to the Fluids/ now this sometimes
go's as far as to Add to the Weakness
and the depression of Strength wch. Tends
to destroy the Patient, so when the Skin
becomes of a Purple Colour it Destroys
a Patient soon a Delirium comes on and
the Patient is carried off soon in the 
space of Ten or Twelve Hours, and no
such Symptoms come on except 
putrefaction of the Fluids take Place,
the putrefaction depends on the depression 
of strength if Inflammation happens
in the middle of the Fever there the
Symptoms go off and the Inflammation
Blood from an encreas'd Action
of the Heart and Arteries and so its
evident that the putrefaction depends
on the Inaction of the Vessels/ Fevers
wch. happen in Jails and in Camps

and that wch. Arises in the Barracks of
Soldier's Arising from Infection are Apt to
exhibit Symptoms of putrefaction of the Fluids

Lecture 30th.
On Fever's























Fordyce
A course of lectures on the
theory and practice of
physick.




A course of Lectur’s
on the Theory and
Practise of Phisick
Dr. Fordyce
Physician to St.
Thomas’s Hospital




Lecture 1st.
A disease is an alteration of the chemical
properties of the solids or fluids or of the
organization of the body, or of the action of the
moving power, producing an inability or a 
difficulty of performing the whole or any part
of the system; or [illegible] as preternatural 
Evacuation every effect has a cause and in
consequence of which an alteration in the human
Body takes place, the causes of many Diseases
have not yet been investigated as far as there
have been we will endeavour to point them out
to you, in general, it is some eternal and 
preternatural applications to the Body or
mind that produces a disease, for example




Cantharides applied to the skin induces an
inflammation, of the mucus membrane of the
lungs a catarrh it has happen’d that sudden fear
has been followed by a fever, it is not always so
in any of theses instances, the [illegible] not always
produce the Disease it is generally followd by it
now was from out having constant experience 
of their action we are not able to judge of them
wth certainly, external applications have been
said to be its occasional cause, not simply
because the things have been called causes, but
the occasional one is the time properly speaking	
this may act two ways, first immediately
as for example, if you apply cantharides 
to the skin, the cuticle is Raisd, and an
inflammation arises, secondly it may act
immediately the first cause may produce 


a second, whose immediate effect will be the Diseases
for example if you make wound in the skin
and apply some Variolus Matter, there will be
new parity produced, but will from an inflammation
in the wound, and that will be taken to the heart
and in to the circulation, which will produce a general
fever here than the wound is the immediate
cause, and the inflammation the intermediate cause
of the fever, tho not always throwing the cause
of the disease, has given room to some for
supposing that they always acted immediately
for example cold they say constringes the
external pores of the skin, and obstructs the
insensible perspiration, this thrown back into
the circulation, is the cause of an inflammation
now this perspiration is nothing more water, and
when to [illegible] [illegible] not that at all, this Method throes
[illegible] method of reasoning, it is evident that



it is evident that many of the known causes act
immediately and some it must be allowed act
intermediately, yet we should always be suspicious
of the latter, now we admit them but on the
Clearest evidence as in case of the variolous matter
a practitioner ought to be [illegible] wth these
causes, as far as they are thrown, it is by this
means that diseases may often be present'd 
[illegible] a hundred Die of Diseas’s
to one by the sword, where we perfectly master
of the causes of diseases, We should be able
to preserve a great number of lives, We must
observe that one part of the [illegible]
of the operation of causes depends, on the
state of the body to which they are applied
for example Let a Man that is fatigued
with an empty stomach be suddenly exposed 
to cold be shall have a fever whereas a man



in Vigour with a full stomach be exposed to the
same degree of cold, shall receive no injury from
it. Thus then in certain states of the body the
causes of diseases act more powerfully, than in
others, these are called the predisposant causes
of diseases, as they render the body more liable to be
affected by the occasional cause, therefore they are
much to be attended to, as the occasional cause 
tho. they can never produce a Disease of itself 
To remove the predisposant Cause often has 
efficacious as to prevent the application of the 
Cause itself; the Blood is sometimes more apt 
to be affected by any Cause than at another, we
we then say it is more irritable, for example a 
Man of a Sanguine temperament, Living in the 
Country is more apt to be affected wth. an 
inflammatory Disease, but as we cannot [illegible]
cases investigate the alteration, we are therefore 
apt to Reject this knowledge, for example, Let 
a Patient be brought to a man entirely Destitute


of the knowledge of Anatomy, wth a Pleuritic 
Pain in his side without knowing there is any 
such Membrane as the Pleura, he will form some
Hypothesis unwilling to appear ignorant in any 
Thing, he will judge of the Disease by its external
Appearance; from hence Practitioners have Divided
into two classes, the Dogmatics and Empirics 
the first consider the Alteration as the Disease,
the latter the external Appearance as the Disease,
We doe not know from external appearances
what Disease is Present, and We consider the 
external Appearance only, We shall not treat 
the Disease equally, as if We knew the Disease
itself but still We must always Avoid Nanmes
the Causes of Disease are Divid'd in to Proximate 
and Approximate the Proximates that wch
Products the Symptoms are internal Appearance
from which We judge of the Diseases with 

Pleura, the Inflamation of the Pleura is the 
Proximate Cause of pain, why then should we not
always take the external appearances for the 
Disease because they sometimes Prove fallacious for 
Example, and difficulty of Breathing may Arise
from Spasmodic Affection, an Inflamation of the 
Pleura and many other Causes, it is also improper
to Class Disease from their external Appearences 
as from this We shall be led to Join Diseases,
which have no Connection wth. each other, and then
are Apt to make general Application to the 
same Class so that We shall Practice very Injudiciously,
by making general tho of the same 
Application.----

Lecture 2d.
On the Diseas's of the Human 
Body----
We have already Defin'd a Disease to be an Alteration
of the Action of one or more of the Moving
Powers of the Body, Producing an Irrability
or Diminition of Performing its Functions
properly, Suppose a Persons knowledge of all 
the Parts of the Body; We ought not always
of an Alteration from external appearances,
it cannot be Denied, but it will be better to 
[illegible], the Alteration as the Disease, [??es]
there are many Material Parts, the Lungs
for Instance where the we doe not know 
material functions and many of the things

of equal importance, wth. which We are [illegible]
We cannot tell wth. perish on what Alteration has
taken Place, still tho We are not so well Acquanit'd with
those things as might be Wish'd, yet it does not follow that
We shou'd reject the Knowledge We have in our 
Power, if We confine ourselves to the Knowledge of 
Disea's as far as have been Investigated and from
no Hypothesis no Conjucture in this Case. This better
to Consider the Alteration itself as the Disease, than 
the external Appearances; if We Consider the external 
Appearances, We shall be Led to Alleviate some Urgent 
Symptom without endeavouring to Cure the Disease
itself. We shall therefore in the Persecution of this Course
in all Cases where We can Point out the internal 
Alteration that takes Place, Now we don't Call it a 
Disease without it Continues to prevent one or more 
of the functions from being Perform'd properly. Now 
a Disease does not always remain in the same State it
is always Varying. The Disease itself indeed sometimes
Varies this is but seldom for the most Part is [Cont???]
the same Let then us Consider the several different
Progressions of a Disease. I have before said it for

the most Part never Continues in the same state
it may encrease so as to cause the Death of a 
Patient, for Example in an Inflamation of the 
Brain the Presure which takes Place Causes a 
Stupor if the inflamation encreases the Stupor
will also encrease untill it kills the Patient.
Secondly a Disease may terminate in some other 
(for Example) an Inflamation takes Place in the 
Cellular Membrane in any Part after Continuing 
for sometime it is Converted into Pus and forms
an Abcess from the encrease of Inflamation 
which is the Cause of Suppuration, here then 
there is the first Disease going off in Consequence of 
the Second, it also frequently happens that 
a Disease Produces its own Cause for Instance
a Quantity of Venereal Matter Apply to the 
Urethra, thus it Converts into Matter similar to 
itself and Reduces an Irritation and in Consequence 
an encreased Secretion, which washes away the 

Venereal Salts and by this Means Cures the Disease
so in any Inflamation of the Lungs a Copious 
Expectoration is united which Carries off the Disease
now it sometimes happens where no Danger of the Disease
itself Arises, yet what was Intend'd as a Natural 
Cure stills (Example) the spilling Produc'd in a 
Peripneumony may be too Copious. and Continue
[illegible] to Darhoea, the Patient whereas if it had
been in a proper degree it would have Prov'd salutary 
so again in the Rheumatism the encreased Action
of the Heart and Arteries, may be so encreased as
as to be the Death of the Patient, when the Rheumatism
itself would not have kill'd, Thirdly the second
Disease may Prove more fatal, than the Primary
an Inflamation of the Lungs may terminate in a
Abcess on the Part, this will Prove more fatal
than the Pleurisy itself in many Instances.
From thly it often be spasms there a temporary
Weakness takes Place and this in but me. We shall
Call a Depression of Strength, this in some Measure
may be Call'd the Disease itself and it often Proves
Fatal, but the Disease may so much exhaust the

The Strength, that [cross out] shall Destroy
For Example a Patient shall have a fever wch. shall be
Extend'd to much a Degree as to prove Fatal, but futher
the Patient is Reduc'd to the lowest [illegible] of 
Weakness could We then instantly Remove the Fever
the Powers of the Body would almost as Instantly
begin to be Restor'd. It is necessary for a Practitioner
wth. the Cause of a Disease as far as we yet know
yet without knowing the History of a Disease We
shall not be Able to cure it therefore this is 
a Study which Requires the greatest Attention
to know what is likely to happen in [illegible] in the
Progress of a Disease, and the more so as without
this Knowledge We shall be Unaquainted with the 
Natural Cure likely to Arise, and at another time
we shall Pay no Attention to the most Dangerous 
Part of a Disease, it is therefore Requisite that We
shou'd be Masters of a Disease, before We can Apply
a Remedy for Instance in the Small Power
Unaquainted Practitioner would probably Endeavour

for to Put a Stop to the Disease on the 
other Hand if you understand the Disease We
shall know that the Disease will go through 
its Course, and therefore We should not Endeavour
to Put a stop to it, but forward its Progress, no
in a Fever, no in a Fever We [illegible] many Remedies
wth. wou'd put a Stop to its A Skillfull Practitioner
will never make one any but those wth. be
known will assist the Patient to go through
the Disease. Secondly where the Natural Cure do's
not take place, We must Employ Remedies
most likely for to bring on this, for Example if
we have an Inflamation wth. no spilling no envelope
of Expectoration it will probably Prove Fatal
We must therefore Endeavour to Produce this
Natural Cure, by Artificial Means, Yet we must
make Use of Remedies most likely to Produce [???d]
this Effect and thirdly We must Endeavour to Remove
the Extraneous Danger, Suppose a Fever to arise
in a young Man of a Robust Habit and that has 
[illegible] We know that Fevers in general doe not kill

but from the Robust [Natis??] general Inflamation will 
arise as for to Prove fatal; We must therefore Endeavour 
to take off as much as We can of the Inflamation
by Copious Bleeding so that by this Means and other 
Evacuations We shall Enable him to go through the 
Fever the Removing this entraneous Danger is of very 
great Consequence in Acute Diseas's particularly
[??urlkly] the last Method to be Atten'd to in 
the Cure of Diseas's is to Employ a Method of Cure
contrary to the Natural Method of Cure, at least
not all Indicated by it in this Cure We must
make immediate Application of those Medicines
which have been thrown to frame of the Disease than
in an Inflamation of the Pleura if we VS. and 
blister it will tend to Put a stop to the Inflamation
immediately and Suffer it to goe through its Natural
Progress, And this Part of Medicine We shoud
by all means make ourselves Acquainted with 
For Instance We Know Preparations of Antimony
will Cure fevers, that the Bark will Cure an

Intermittent, yet if you are not Acquainted with 
the Nature the Disease, We shall not Understand the 
proper Method of inhibiting them, and by this
Ignorance We shall render the Disease more Obstinate
for tho We know Antimonial preparations Cure
come fevers, yet a Practitioner should not farther 
Resolve to Cure every Fever by the same Method
tho Bark will not Cure all Intermittent fevers
it may be given improperly to be of more Disservice
than Service, for Instance if you give the Bark
in the Paroxysm of an Intermittent instead of Curing
the Disease it will by Degrees Come to be a Continual
here then the Disease is rendered Worse by the 
improper there/ this Remedy it is of some 
Importance in Medicine to Observe that there is
no such thing as an Infallible one.----

Lecture 3.d 
Of the General Doctrine of Inflamation
An Inflamation is a Disease Affecting
one Part only it sometimes happens indeed the general
System is Affect'd in Consequence of the Inflamation
but while the Inflamation is Confin'd to one Part only it 
is a Topical Disease not releasing the System
in general, if you apply your finger enternally
to an Inflam'd Part We shall find an encrease
of the Pulsation of the Arteries, a greater Degree
and some Heat so as to Rise to 110 Degrees of 
Farenheits Thermometer commonly however to 
102.4, or 6. Degrees, the Part becomes of a Red 
hue and then a more Florid Redness takes 
Place at first their is an throbbing to increase
Pain wth is Inconsiderably encreased and become,
a throbbing one and is still encreased from 

the Starting of the Inflam'd Part. There is also a levelling
owing in some Cases [illegible] in all to be a Distension of 
the Vessels and an [illegible] action of the Fluids Inflammation
is the [illegible] Cure/ Contraction, hence the Motion
is sometimes Imped'd, sometimes entirely Destroy'd
according to the sensibility and Irritability
of the Parts, there are the Internal Appearances wch.
take Place, You must next Inquire the Reason 
are Marker of the Alteration, wch. is the Disease
and wch. gives Occasion to there Internal Appearances
the Swelling is the first thing to be taken Notice
of and this, If we open the Imflam'd Part, We shall
find it going to a Part of the Blood thrown
out of the Vessels, this Consists of Coagulable
Lymph and Superfluous Water, sometimes
however there is no Extravasation at all, as in an 
Inflamation of the Eye the swelling is owing to 
the Distension in the small Vessels, We know by
the action of the Heart and Arteries that the 
Blood is thrown into the Capillary Veins a 
Distension it is said may arise three Ways from the 

Relaxation Obstruction and greater Quantity, of 
Fluids thrown into those vessels, first the Heart
and Arteries may Propell the fluids wth. greater
force into the vessels incl wth. [Cere??] [illegible]
will be Pres'd on more, and therefore they will become
Inflam'd and Distended. Secondly these 
small Vessels from their Disposition to Contrast
always Endeavouring to Avoid Inflamation 
If they are Relaxed they will allow Consequence
of that be Distended. Thirdly if you stop the
Passage through may be and Continue to throw
into it is will be Distended, in like manner
the Capillary Vessels will be Distended. Now
Distension from Relaxation in no case gives
Pain for Example the Bladder from being
Relax'd will contain [illegible] of [????e]
and Here shall be no Pain. If it in a Cathartic
State one Ounce wil give Pain. The Distension
that takes Place in an Inflamation is always 
Painful, this therefore is a sufficient Proof that 

The swelling in this Disease dos not arise from
[illegible] of the Vessels; neither dos it in Return 
Place Proceed from an Obstruction of them; If this
was the Case the blood would be Prevented from 
Passing. The Blood passes through the Capillary
Arteries into the Veins, Then into the Cavities and 
from them into the Secretory Ducts. When the 
Veins are Inflam'd, the Parts are always swell'd
if they are Open'd the Blood flows wth. greater
Velocity than in an Healthy State, although the 
swelling be very Considerable, when received into a
Vessel it detract Contract more, as Cool, a [illegible]
[illegible], then if it was taken from one when 
no Inflamation was Present neither is it the 
Colour of Extravasated Blood, it is evident
therefore there is a more Considerable Quantity
of Blood Circulating through an inflam'd part,
then there is a Natural Course for there can be 
no Obstruction. Secondly We find in an 
Inflamation from Obstruction, that the [Euhal??]
Vessels are not Obstructed but every [illegible] [???neass]
the Kidney as in Secretion encreased in and sam
Aart. The secretion of the Kidney is Diminished

as well from an Inflamation of a Gland as from 
an Inflamation of any of the Adjacent Vessels
but we cannot draw any Conclusion from this
gland as it is liable to be affected by every
Adjacent Inflamation. It Appears then that there
is at first no Obduction. And if there was 
it would not Produce a Swelling, there must 
be something more to Occasion it for it is known 
that there is somtimes the Quantity of fluids
that Circulate in the Body than actually do
therefore an Obstruction will not cause a swelling
the Blood is Propell'd forwards by the Heart
and Arteries of this Action is encreased a greater
Quantity/ Fluids will be Propell'd forwards
We must Observe that the Action of the Heart
is Uniform, but that of the Arteries and Veins
is not so, and it is this Variation wch. is the 
Cause/ this Alteration is the System, this is
a more frequent Cohesion, the Blood is actually
Propell'd in a greater Quantity as may be Discoved 
by the more frequent Cohesion and Pulsation

of the Arteries, as also from Principial
Observation, no that it is evident the Swelling arises
from an encreased Circulation or Relaxation [illegible]
the Cause that the Heat Arises we cannot Determine
as We doe not sufficiently know on what the 
Heat of the Body Depends, thus far We know
that when the Action is encreased it becomes
Hotter and upon discontinuing this Action it 
grows Cooler, in exercise of any Mind there is 
an encreased Degree of Heat, that the swelling 
do's not Arise from an Obstruction will be evident
If you take some Blood from an Inflam'd Part
it will Appear of a Blou'd Redness, whereas Blood
that as Stagnated will be off a deeper Colour
the pain wch. Arises in an Inflamation is owing
to the Vessels of the Part being Distended beyond
the proper Tone------

Lecture 4th
On Inflamation
We have already Shewn you that the Distension
of the Vessels Arises from a greater Quantity of 
Blood being thrown into them, and that the 
pulse is no other than the difference betwixt 
the Contraction and Dilation of the Arteries,
that Pain is Capable of being Produced in 
any Part of the Body by Distension, as if
the Stomach is over Distend'd by Food or Air
thrown into it, then Pain is Reduc'd, and also
if the Bladder is Distended Pain is Produced
and if the Ligaments are Distend'd Pain
Arises, and a fluid Discharg'd; but all 
Distension does not Produce Pain; For Example
a tumour may Arise under the Skin, as in 
the [illegible] and Prove Painful, the 
Stomach may be Distend'd to a certain Degree
without Pain, so also may the Bladder; thus

We find that Distension in certain Circumstances,
only is Capable of Producing Pain,
the Part must Endeavour to avoid Distension;
and if at this time Distending Cause 
Arises then Pain takes Place; for Example
the Stomach shall have a Disposition to 
Contrast; if at this Time a Quantity of Food or
Air is thrown into it, Pain will be Produc'd
in like Manner if the Bladder has a Disposition
to Contract, Pain will Arise if two Ounces of urine
be Contained in it; tho at other Times it will 
Contain Ten or Twelve Ounces without Pain; it is 
the Contraction wch. gives Pain, when the Blood
is Propell'd into the Capillary Vessels was 
the Distend them beyond their Disposition to 
Contract, We will call it a Distension beyond 
the Tone, and this we say Produces Pain in 
an Inflamation, but in order to excite
Inflamation it is Necessary, that the Circulation
shou'd be Encreased, and that to much
a Degree as to Distend the small vessels beyond

their Tone, if you put your Hand into Warm
Water the Circulation will be encreased and the 
Vessels be Distended, but no Inflamation will
Arise; because the Vessels are not Distended
beyond their tone; Now this Disposition is always
Altering for Instance, the Stomach or Bladder
sometimes have a Disposition to Contract
and then will Receive but a small Quantity 
whereas at another Time they will receive a much
Larger Quantity is like Manner may the 
Blood Vessels themselves be Distended. The Warm
Water Relaxes the small Vessels, they 
will then Receive an encreased Circulation
without Inflamation; some have Consider'd
the Secondary as the Primary Part of Inflamation;
that it is not is evident, because the 
small Vessels are greatly Distended beyond
their Natural Size, there wou'd be Pain, from
their Disposition to Contract, this is not an 
Inflamatory Pain but a Rheumatic one, for 
[illegible] Inflamation a Distension takes Place first

and if a Part is already Distended to as great 
a Degree as it will Allow an encreased Distension
will Cause Pain, wch. Pain Arises from and Inflamation,
in an Inflamation We meet wth. one Symptom
wch. Distinguishes it into two Species; if a 
Vessel of a Considerable Size is Affected the 
Pain will be a throbbing one, and will be more encreased
at the Relaxation, than at the Contraction
of the Arteries. But if a Membrane be 
Inflamed the small Vessels or Arteries only 
be affected, wch. have great Strength in Membranes,
and in wch. the Heart has less Influence
there; the Pain will be the same when the 
Heart is acting as not, so that the Pain will 
be Constant and equal, We must lastly Observe
that Pain is not Absolutely Necessary for 
an Inflamation; the small Vessels must be 
Distended beyond than Some and in most Inflamation
they stimulate and Cause harm it 
now and then happens that the Distension is

no small, as the Vessels only will be stimulated,
why Muscular Fibres are Contracted and
Rendered Incapable of Motion, We doe not as yet
Understand, but supposing Relaxation and 
Obstruction to be the Proximate Cause of Inflamation,
We are equaly it or less to throw out what 
Manner they act, As we are not yet acquainted
wth. the Course of Muscular Motion and flexibility
of the thin fibres, We can only beg then 
that there Alterations are in Consequence are
in Consequence of an encreased Circulation
in the next Place We are to Consider the Cause
of Inflamation, and there are most apparent
then in most of the Diseas's. An Inflamation 
is Reduced by an application to the 
Body, wch. tend to excite Motion these we
Call Internal Stimuli, meaning to take it in 
an Extensive Sense, and not [C???iethem]
to the far face of the Body, but to take every

extreme Part also, Now Ive divide these [???a]
into Restomical as Bruising or Cutting and 
Chemical there wch. Hand to Destroy the Part
Mechanically, and there wch. doe it from particular
Properties they Perhaps as the Destroying the 
Coagulum &c. Some have happen'd that Mechanical
stimuli but Acted in Consequence of that 
Pointed Spiculae running into the Rest; but We
can Demonstrate that the small Particles of 
Caustic Vegetable Alkali will not penetrate the 
Coats of any Vessel, no more than sharp instrument
of an Inch in Fig will Penatrate the Skin
when Impall'd by its own Weight, but Sub [?a??e]
wch. have no Mechanical or Chemical Action,
I say such substances Stimulate frequently, As
per Example if a Deep of Infusion of Cantharides
and one of Infusion of Common Flies, We know 
they both have the same Mechanical Properties
yet they have very different Effects. For the 
Cantharides will Combine wth. the Mucilaginous
Part of the Blood and Inflame; the Common fibres
will [crossed out] Effect at all; this then furnishes a Mind
Class of stimuli wch. We call Medical----

Lecture 5th
The Application of these Stimuli is in general very 
Obvious, some of them however Require a particular
Explanation, first the Distension of a Part whether
it be of the external or Internal Part of the Body,
whether in a Blood Vessel Muscle Nerve or 
Ligament, is Capable of Stimulating and Producing 
Inflamation, this is the only Cause 
that is universal and Capable of Outing on all 
the Parts of the Body is found [???e] per
the Distension of Blood vessel, as of 
a Membrane will [illegible]
Produce Inflamation, for Instance if [alma??]
of Water be thrown into a joint it will have
no Effect as a stimulant, yet the Disturbance
from it will Produce inflamation on the 
Ligament, We see that a Distension is 
Capable of veins Produced in every Part of 
the Body, success of the Bones in wch. it 
comes unless they are in a Diseas'd State

but all Distermind of not Stimulate any Part of 
the Body may be Distended without Pain it is 
the Resistence to the Distending Course that Produces
the Stimulus, Now there are the Powers wch. are apt
to remind the Distending Causes; first the Cohesion 
of the Partion of the Parts w/wch. the latids consist
and wch. We Call Electricity, this Power when the 
Distension is above a certain Degree tends to bring
the Parts nearer to each other, and restore them to their 
former State; this Power is nearly equal at all
times; the Second Power is Capable of Resisting
Distension; the Comparble Power of the Letids
wth. Depends on the Life, and is Inherent in all Parts
of the Body. The Bones however seems to posses
but little of this Power, this is greater than the 
Contractile Power and Varies Considerably,
so that the same stimulus will at one time Stimulate
when at another time not according to 
its Resistance, if the Distension is Slow and 
gradual it will get the better of both of these
Resistances without Stimulating; for Example

a tumour may grow gradualy, under the skin
and Distend it to a greater Degree, Now if the same 
Distension had attempted to have been made suddenly,
the skin wou'd Burst; it also unites the 
Contraction which Depends upon Life, so as
that Resists more strongly, no stimulus Arises
Distension then from both these Causes is Capable/
Stimulating so as to Produce Inflamation
for happening at Present a great Part of the 
Blood Contained and Circulating in the exterior
Parts of the Body, and if it be suddenly Exposed
to a great Degree of Cold, this Power will be 
encreased, so as to Produce Inflamation;
Division is also a stimulus, but it must be
Observed that in Order to Stimulate it must
be on a Irritable Part, that is Divided. Some 
Parts of the Body are Capable of Distension
only, others may be affected by it; for Example
a Piece of the Knife or any Sharp Instrument

has passed through the Stomach, during which 
it has [??anind] much Inflamation, it has then Passed
the Muscules and Produ'd none, then during the 
skin it has Produc'd Inflamation; if a Part not
Irritable be Divided, their will be no Inflamation,
and if a Part be Divided as in a Wound, some Part
of wch. is Imitable and some not then an Inflamation
will Arise in the Irritable Part, and extend 
to the other, if the Patient be strong, but not if he [illegible]
it has been said that an Acrimony of the Fluid
will frequently Produce Inflamation, Now it must be
Observ'd that no Stimulus will affect the Blood
Vessels but Distension, except the Heart, and this
accordingly more Irritable then any of the Blood
Vessels, and hence it is that Poisons Prove Fatal,
when they Come to the Heart, when they have not
affected the Blood Vessels in their Passage through 
them, Acrimony which for the most Part seems
Stimulus) if the Blood as Water is Incapable of 
Producing Inflamation in the Blood Vessels [Nem??]
but supposing a Stimulating Matter Contain'd them 

in Consequence of being thrown out from them
on an Irritable Part, and Inflamation will be Produc'd
A Solution of Neutro Salts when Contained in
the Blood Vessels may be sufficiently Concentrated
so as to Produce Inflamation especially
if the Natural Mucus be Remov'd from the 
Membrane, as in the Urinary Passages Intestines
&c. for Example in an Inflamation of the 
Lachrymal Duct the [M??Jeans] are more [P???fully]
Secreted, wch. Carries off the Natural Mucus
of the Part; they Stimulate so as to Produce
Inflamation, thus it happens in a latent
Dysentrey &c there then Fluids Stimulate,
it is the Natural Salt of the Blood Containes
in them wth. the [Ca??s] it, ferments also and 
in Capable of increasing the Quantity so able 
Stimulate the System in generaly as the Variolous
Matter, the Venereal Matter &c but it is the 
Neutral Salts for most Part that Stimulate

there then are the only Stimuli, it is necessary
for us to take Notice off. however in some Cases it is
very difficult to suppose a Stimulus, sometimes
also a fever arises in course of which an Inflamation 
takes Place.------

Lecture 6th
We come now to treat of the Predisposant Causes
and We shall first suppose that Inflamation is increased 
Action of the vessels, and therefore
the stronger the System in general, the more
liable it is to have an encreased Action of the 
Vessels encited, so that an Inflamation is more 
Apt to Rise in a Man of a Robust Habit
of Body, and that Living in a more Cold
Atmosphere, than one of a Weak Habit of Body
Living in a Warm Moist Atmosphere, and 
it often happens in the Spring than in the 
Autumn from the Cold of the Recceding 
Winter having encreased the Contractile Powers
of the Body as Solids, Living in a Pure
Atmosphere gives strength to the System,
therefore [cross out] Live in the Country are 
Subject to Inflamation, then there who Live

in large towns; the Body is in its greatest strength
from fifteen to twenty five during that time a 
Man is more subject to Inflamation, than of any
other time of Life; Men of a Sanguine temperament
have a greater Disposition to Inflamation than those
of a thin Spare Habit; it must be Remark'd that 
there are two species of Inflamation; the first is
Apt to Arise in the substance of Parts; and 
which we call Phlegmonans; the Second that 
wch. Arises in the Surface of a Part, wch. We Call
Erysepellatous; strong Habits are subject to the 
first Species of Inflamation; but in Weak Habits
the irritability is Commonly encreased; and 
the surface is more apt to be Affect'd from 
external application; In Warm Climates and 
in the Autumn from Living in Large towns and 
being Naturally of Irritable Habit Erisapellatous
Inflamation is Apt to Arise, but Strong and 
Weak are more Subject to Inflamatory Disease
than those of a moderate Strength; particular

Parts may also be tender more irritable by
particular applications, in Inflamation of a 
Part is Capable of Producing a Disease of the 
whole System, so that a second Disease is 
liable to be emited by it. We must first observe
that many Practitioners have us'd the term Fever
to Express a Disease in which there was a more 
frequent contraction of the Heart and Arteries;
And we must at the same Observe that it has
been made tho of differently by others; As 
by Sydenham and Hippocrates and most 
of the Ancients, and but Modern Practitioners
it is improperly us'd to signify all Disease
in wch. the frequency of the Heart is encreased
for by this Means We shall include several
Diseas's, that are properly Call'd fevers, when
the frequency of the Heart is not encreased,
and Employ the term in this sense, We shall
from a particular class of Disea's totaly
Different from one another; fever in its proper

[A??plation] is a Disease Arising Independant of 
any other, and also when Reduc'd is Independant
of its Cause, for it is not true) Physiology) that if the 
Cause be Remov'd the Vessels will Cease, We doe
not then Call the Effects Arising in the system
from Inflamation Fevers, for they frequently Depend
upon their Causes, so that if they be Removed
the Effects will Cease, they have also been called
Symptomatic fevers a Hoffman Calls it a 
Planitic Fever &c And we have said that the 
Affections Arising in the System from Inflamation
are two the one We call general Inflamation
the other symptoms of Irritation. Phlegmonary
Inflamations are Apt to be attend'd wth. The 
former, and the Erysapallatous one wth. the 
latter, but neither of these Diseas's are peculiar
to Inflamation, they may both arise from topical
Applications, the symptoms most common
in general Inflammations are Hardness of the 
Pulse, it is said to be Hard, when it feels like
a Musical Chord high Strung at a vitiating, it is also

Strong full and frequent, but none of these are
Necessary, for general Inflamation may subject
without neither as in an Inflamation of the 
Inter limb, the Pulse is small and frequent, neither
is it Necessary it should be frequent, for if the 
Inflamation be of an external Part, it is full
and hard, but not frequent. However from 70
Beats in a Minute, which is the Natural
Pulsation it Amounts to 110. It happens more
frequently also that it is more frequent at
Night then in the Morning, but in general 
Inflamation is healthy. Cinthart, the [??dass]
of the Pulse Discovers the Action is to be Cuting
Strongly, and this is the most Material Part
of it, this encreased action is attended wth.
an Alteration of the Blood, it becomes 
more Fluid. Some but those have suppos'd
this Alteration to be the Cause of the Disease,
others again have suppos'd it to be thicker, and
more Apt to Coagulate, this than they have [sa??]
to.

be the Cause, but the Blood in an Inflamation
is evidently thinner if taken from the Arm
it continues longer [illegible], so that the red Globules
fall to the bottom, the Coagulable Lymph Coagulates
afterwards more strongly; and adheres to the 
Red Part, was to some [C???] on the [??ss]
but in order to judge of this a large orifice shoud
be made in a large Vein, and receiv'd in a 
glass as nearly Spherical as Possible; the 
Coagulable Lymph in an Inflamation is something
Render'd as this, as to pass through the [illegible]
and be Extravasated, all the small vessels through
the system being Distended, and a [??nienal]
Restlessness takes Place, and being also 
fill'd wth. Blood a general redness and Heat,
and there is also a Degree and whiteness
of the tongue owing to attempt of its Secretion; In most
Affections the Mucus is encreased, here it is
generally Diminished; We are not sufficiently 
Acquainted wth. the Causes of this Appearance 
The Variation of this is a/Consequence in general

Inflamation it is more white, sometimes in an
Inflamation arising from the thorax, there is 
two yellow streaks along it; thirst do's not 
always arise from a Dryness of the Mouth
but the Reason of this as not as yet been sufficently
[illegible] for. the Redness are on a 
different state in different Inflamations,
if it Arises from a Cause that do's not give
great Pain; the mine is forbid and upon
Standing Deposiyes a [???ious] Sediment
but if there is great Pain, the Vessels of the 
[th??ies] Contract, and the urine appears
Clear sometimes a small Quantity of Mucus
Matter is Suspended in it, in form of a Cloud,
when an Inflamation Proves fatal, it is 
from an Affection of the Brain, first it may 
happen from such a Quantity of Blood
into the Brain as to Compress it, which
will cause a stupor on which the Ey's
Appears Red Inquire and Dim and a Delirium

takes Place on which the Patient Mutters
something to himself if she & he is terrible
but his Memory is entirely [illegible]. The Second
Method in which general Inflamation appears
to Destroy during its Violence, is by Producing
Wakefulness from a start of Rest he becomes
Delirious, this at first takes Place towards
Morning, if he sleeps an hour or two it then 
go's off for the whole Day, returning every Night 
in an encreased Degree, here the Eyes are Bright
the Patient is Quick in all his Motions, sinks
gradually untill at last Ravings are very Violent
till at Last he his Destroy'd, this however is 
not properly an affection of the Dream.
The Delirium some times remains after the Disease
itself is Removed, and then a Confirmed Mania is after
Produc'd------

Lecture 7.th
Inflammation greatly Depend upon this 
Cause, but not totaly Suppose an Inflamation of 
the Pleura shall arise, and in Consequence of this
the Pulse will be hard full and pregnant and 
other Symptoms of general Inflamation shall be
Present, by the application of a Blister to the side
We can sometimes Cure the Pain and other 
Symptoms and the Disease gos off; In this 
Case We have Employ'd nothing to Remove
the general Inflamation, We have only Atten'd
to the topical one, so far its Confirmation is not
Dependant on its Cause, but this is not always
the Case, in the first Place it is apt to become
Habitual, far after a Continuance of [M???ax] per
Foundage, if you carry of the Pleurisy by 
Topical Remedies, yet the symptoms if 
general Inflamation will still goe on. If the  
Patient be strong the general Inflamation will 

be great, and after Continuing for several Days
it becomes Habitual, in this Case Disease after
gos off without any Remedy, if Enhart not upon
the contact strong action of the Heart and Arteries
their Powers become Exhausted, their action consequently 
less, and the Inflamations subsides, but 
this is not always happen, for the Heart returns such
proper action the Arteris doe not, this in the 
first Disease Produced by Topical [crossed out] Application
or Inflamation Produ'd by it, we call symptoms
of Irritation, the Disease has more Commonly been
call'd never the general Inflamation yet it is 
Essentially different, or even more so, it is also 
a Disease which requires our Attention greatly 
and is to be Distinguished, both from general Inflamation
when and all other affections of the system,
it is entirely Dependant on its Cause, it continues
as long as the Irritation continues, and when
it Subsides this subsides also, there are certain
Parts of the Body which We call Irritable as 
the Internal Canal Bladder Diaphragm, Womb
when lately Impregnated. &c when Affect'd they [Rod??e]

Symptoms of Irritation, for Example the 
Mucus membrane of the Lungs is liable to be
Irritated, As the Mucus Membrane of the 
Intestines, but if it is Inflamed, the same Symptoms
doe not Arise if the Imbalance of the 
Intestin's was Affect'd, We doe not Calle a Part
Irritable because they are Subject to be 
Irritated by external Causes, but because 
when Affect'd they are Apt to produce great
Irritation in the System in general, the 
first symptom of this Disease is Depression
of Strength Arising from no Cause, We expect
for Example when a [illegible] through 
the Stomach, it happens often that there is
no pain or great loss of Blood, yet the 
Patient shall be almost immediately Incapable
of Supporting himself, and the action
of the whole system being greatly Diminished
until he Dies, have then learns to be no

great reason for the Loss of strength, but 
much it is, this is not a weakness but a Depression
of Strength, for the cause being Remov'd the 
Strength begins immediately to be restor'd if the 
Depression Arises from any Irritation that can
be Remov'd it is only then the symptom of a 
Disease at the time the Strength is Depressed
the functions are all almost Disordered the Heart
Outs more frequently, it almost always Contracting
the Pulse then becomes small Quick and frequent 
the Stomach is also Disordered, there is Sickness
Flatulency Vomiting want of appetite, the tongue
as in other affections is alter'd in its appearance
sometimes however it has no Mucus and appears
white, and sometimes it has more than in a Natural
State, the vessels of the Redmias are also Contracted
so that the Mucilaginous Part of the Urine is not 
secreted, and it appears Clear, there is Mineral 
Restlessness and sometimes Delium is 
a symptom, by generally the Patient remains
Perfectly sensible till he Dies, the symptoms 
are also Reduc'd by other causes than Inflamation

by gangrene Mortification, Spasmodic Contractions
of the Intermit's and the like, What is 
particularly to be Remark'd in this Decrease is
that it is so totaly Dependant on its Cause,
and this makes it Essentially Necessary to 
Distinguish it from a fever; for Example
in a gangrene and Mortification shall take
Place, and when these Symptoms Arise they 
have been heated as a Fever whereas no
Attention ought to be Paid; but to the 
gangrene and Mortification, a [illegible] of 
it other Inflamations may sometimes happen
in this Case the Attention should be Directed to the 
general Inflamation, for Example in an Inflamation 
of the Intestin's, there is Depression
of Strength fainting and other symptoms
of Irritation, but the Pulse is hard therefore
general Inflamation is Present, have too 
doe not Employ stimulants, to support 
the strength, but make the use of Evacuations

which will generally Remove all the other
symptoms, Now Inflamation or particular
Affections of Parts, as of the system in general, We 
now Come to the Progress of Inflamation, if 
a stimulus be applied to a Part of the Body
an Inflamation takes Place in that Part, and 
it happens sometimes upon Removal of the 
Stimulus that the Inflamation will Cease, We 
will next Consider of this Continuation, when the 
Action of the Heart is encreased, the fluids are 
Propell'd wth. greater forces, so cuts as to Distend
the small vessels beyond their Tone; this Promotes
a more frequent Action of the Arteri's, so that they
Continue a Natural Cause Acting and reacting
on each other, but the Matter of the greatest Importance
is that there two Causes shoul'd be just an Equilibrium,
if they are not an Inflamation will be always
encreasing or Diminishing, for if the Distension is
more than Equal the Inflamation will encrease, this 
Action is seldom an Equilibria and accordingly
We find an Inflamation continues longer in the 

same State, it is always either encreasing
or Diminishing, so that if We can once make
it begin to Decrease it will continue to doe so 
and Cure itself. That We must observe that 
there is a difference between the Inflamation of 
a Part or substance of a Part; and that of 
an Irritable one, in the first it is the Distension
which keeps up the Inflamation, but in the 
other, the surface is apt to be Affected by
externall Applications, the Stimulus Acts 
differently from being applied to an Irritable
Part, and by this the Action of the Arteris
is kept up once equaly, hence the Erysepellatous
Inflamation are also apt to encrease
of they are less no than Phlegomanous upon

Lecture 8.th
It has been suppos'd by some Practitioners that 
the Degree of Inflamation Depend'd on a Quantity 
of Matter Obstructing the Inflam'd Part, wch.
if Resolv'd wont'd [illegible] off. but We have made
it Appear that there is a greater Circulation through
the Part, therefore this opinion must be 
Erroneous; the first [illegible] upon Inflamation
is Resolution, by wch. is meant nothing more than
the going off of the Disease; simple Resolution
is when the Removal of the Cause of an Inflamation,
the Effect Ceases of itself; but a Cause
may Arise wch. may be sufficiant to keep up
the Inflamation, after the Original Cause is 
Remov'd, during the Progress an evacuation
may Arise, this always Weakens the System
and may therefore, Terminate the Inflamation
If a part be Preternaturally Distend'd wth. a 
Johu'd making an opening, so as to Evacuate is

may Put a Stop to the Disease; but if this
Evacuation be made suddenly and a large
Quantity such a weakness takes Place as Proves
fatal to the Patient has been Experienced in the 
Ascites; An Evacuation in taking Place Naturally
in an inflamation, will weaken the Action of the 
Arteri's and carry off the Inflamation. This 
Natural Cure happens often in the Mucus glands
than in any other Part; the glands of the skin
Secrete but a small Quantity at anytime so
that the Secretion cannot be sufficiently encreased
to Carry off an Inflamation; the sensation 
of many of the glands of the [illegible] may;
as those of the Kidnies Mouth, Nostrils, that [illegible] 
secretion from any adjacent Gland will
sometimes Remove an Inflamation; tho there
be no Communication between the two Parts;
and their Effect is much more considerable 
than that from a Part at a greater Distance
secondly it is not Necessary the Secretion
shou'd be so great, as to Weaken the whole Body

only the Part affect'd and where it is from a 
gland there is considerable variation. The appearances
of the Evacuating Matter; that which is 
first Evacuated Consists of Water, Containing
the Salts of the Blood; this carries off the 
Natural Mucus of the Part, as it contains no salts
and then it may stimulate, so as to bring on an 
Inflamation, or encrease it when Excited. Then
Watery fluids Stimulate more than Mucilaginous;
in an Inflamation of the Nostrils, there is 
first a secretion of a thin Watery Mucus; wch.
Stimulates and encreases the Inflamation; but
if the Mucus be Continued to be secreted from 
the Inflam'd Part, it soon becomes Viscid; and 
then is lessens the Inflamation, and if it was
great it Puts on a Yellow Appearance, it has 
been said to be Concerted; but it is the Mucus
undergoes these Changes, and not a Reparation
and Evacuation of Matter, as it has been supposed
to be, because the first Evacuation wch. is by much
the greatest do's not carry off the Inflamation,
this Change happens Universally [illegible]

Mucus glands is Affect'd, as for Example
As for Example if the salival glands are
Inflam'd; there is Considerable encrease of 
sensation, wch. Reserve its Natural Appearance
but is apt to Smell, and where the Inflamation
begins to cease, the encreased secretion dos the 
same, till they are both carried off. At this time
also an Hemorrhage may happen, an encreased
Action of the Heart and Arteris, fever open the 
Exhalants; and if the Inflamation be in a 
Part wch. Opens externally, the Disease often
carried off from the Hemorrhage which is 
Produc'd. It happens also that an Evacuation
Arising from Accident will carry off an Inflamation;
for Example if a Woman shou'd be 
Afflicted wth. a Pleurisy and during that 
should Menstruate, the inflamation will be 
Carried off without the Application of any 
Remedy whatever; A small Evacuation 
We must Observe will cure an Inflamation 
when a long as artificial one will not.

The most Natural Cure of an Inflamation
is by fever; but we shall only say at Present that 
a fever coming on has sometimes Cured the Disease
The most Natural Cure is by metastasis when an
Inflamation arises in another Part and Carries off
the Primary one, an Inflamtion, an Inflamation 
Occupies but a small Part of the Body, and it 
seldom happens that two Considerable [?n?s?ubrin??]
at the same time in the Body, where therefore
a second Arises, the first generally Subsides
from this Arts We are not, sufficently, Acquainted
wth. neither do's the Supposition of the 
translation of Matter forward on Account for
the sustains, we only , know that an Alteration
in the Action of Vessels will Produce an Inflamation,
this Cure by the sustains is not Confin'd
to a Natural Inflamation, for an Artificial one
will Produce the same Effect, for Instance a 
Blister applied to the Neighbouring Parts
will take off an Inflamation, when a Part is 
Inflam'd and there is no distinct Surprior,

A Quantity of Coagulable Lymph is
thrown out; wch. glues them together; as in 
and Inflamation of the Pleura it is by this Means
They Adhere to the Lungs; if it be [cross out] large
Surfaces We Call this an adhension; but 
among the Muscular Fibres, and all
other Parts of the Body, where there is
a Quantity of Coagulable Lymph, the Parts
are Naturally Soft and Play one upon 
another, Now this Coagulable Lymph
glueing them together, renders them still 
liquid &c. and this We call Callenity----

Lecture 9th
It happens that an Inflamation may Continue
for sometime, but this is Caused by a Contained
Application of New Causes, for an Inflamation
initial/never Continues long in the same 
Situation, if it did We should Empart that 
the Vessels would, Burst, so that the 
Arteri's would arise at such a Pitatio/Distension
that they could encrease no farther, and 
the Inflamation woul'd be at a stand, but neither
of these happens, for when it Arrives at a Certain
Height it Terminates in a fresh Disease, The 
first of there is Suppuration; which We shall
now Endeavour to Explain; after an Inflamation
there is Matter form'd which we Call
pus, different from all the other fluids of the 
Body not form'd in it Naturally, but only in 
Case of Disease. It is Perform'd by some Chemical
Change for it cannot be filled'd from the

Blood Vessels as it is not Contain as in
Pain; New Pus is form'd in two Cases,
sometimes in a Cavity and sometimes on 
a Surface; We never find it in the Blood
Vessels; Let us first consider the Formation
of Pus in a Cavity inside to this there must
be an Extravasation for suppuration never
happens but from Extravasation, as in 
Inflamation of some of the Membranes, where 
the Extravasation is there the Pus is 
Form'd, as in an Inflamation of the 
Pleura if it is in the Cellular Membrane
there it is that Pus is form'd; if in the 
Cavity of the Lungs it is form'd there, when 
the Matter is first Extravasated it is not 
Pus, but sometimes Coagulable Lymph 
and sometimes serum and Superfluous
Water and not Commonly the Red Part
of the Blood, an Extravasation is not always
Converted into Pus, As in Bruises in the 
Rheumatism Coagulable Lymph is Extravasated

and no Pus form'd, it is then necessary to 
Produce Pus that there shou'd be an Inflamation,
and not only more Inflamation, but it must be in
Proportion to the Extravasated matter otherwise
it will not be form'd. in an Inflamation of the 
Pleura the Cavity in which the fluids Extravasated 
is large the Pleura itself is only a small
Part of the Body, and the Inflamation 
and in general is sufficient to form Pus, but
when it happens in the Cellular Membrane
above the Pleura, the Inflamation Bears a 
Considerable Proportion to the Extravasation 
and Pus is generally Form'd; the Inflamation
then Furnishes the Circumstances for that fermentation,
wch. is to Convert the Extravasated
Fluid into Pus, it has been Contended that Pus
was from'd in a different Way from this that 
the Exhalant Vessels where so Altered as to 
Separate Pus from the Blood, but this is 
entirely Hypothasis, for We actually see a 
Fluid Contained in the Cavity wch. is Insepable

of Absorption, and instead of this We Recently
find Pus, that the Exhalants doe not become
Secretory Organs to denote Pus, is Prov'd by 
this Experiment, in an Ulcer that forms
good Pus, if you Clear it Perfectly and
Observe it wth. the Microscope, the Fluid as it 
Passes from the Vessels You will find it a
Clear transparent fluid, then lay some [t????], 
the Ulcer so that the Matter is contained there,
and you will find it will become Pus; so 
that it is evident in every Case that Pus
is form'd from an Extravasated fluid and 
not from any Power that Exhalants Acquire
of becoming Secretory Organs Where Pus 
is form'd the Extravasated fluid. The Solids also 
Ferment and are Converted into Pus, it is
pretty certain however the Mundane is first 
Converted it is worth attending to; why 
the Life of the Solids do's not Depend them 
against this fermentation as well as any other;

sometimes indeed they are Depended by their
Life, sometimes Partly and sometimes not at 
all; When Pus is form'd it is not necessary that 
the Inflamation shou'd continue any longer
for it will keep up the fermentation, and 
occasion the fermentation of a fresh Quantity of 
Matter; Now the Cellular Membrane is universally,
Diffend'd through the Solid Parts of 
the Body; the Cells of it Communicate wth. one 
Another, We must consider then how it happens
that Pus do's not Diffuse itself through the Cells
as Water do's in Adematous Patients, why a 
Quantity of Coagulable Lymph is thrown out, 
which glues the Surfaces of the Cells together;
so as to render them Impervious to one Another
and the Pus forming in the Middle of the 
Inflamation, first it is Prevented from Diffusing
itself, sometimes a kind of a Membrane is 
form'd round it; and the Pus is Contained in 
a Cyst, but this do's not happen in Common; 
tho the Pus cannot Pass through yet it acts

so Strongly that it makes itself an Opening
on the external Parts, it is remarkable however
that the Pus do's not act alone in all Parts
of the Body for in some it makes its way
Directly, and in others indirectly to the external 
surface, hence less Mischeiff happens in 
many Suppurations; then we should Enpact,
now it may happen that the Cellular Membrane
has on it its Cells glued together in 
this (are Pus will Diffuse in [illegible]to a very great
Degree, sometimes also the Matter do's not 
Destroy towards the Surface of the Skin; but 
Destroys other Parts and Commits great 
Devastation this happens but seldom but 
when form'd Destroys the tumor as well as
the internall surface, so that we have 
instead of an Inflam'd Part a Cavity inside

Lecture 10.th
We have said the Cavity Produc'd in Inflamation
is Call'd an Abcess, after Pus is Evacuated it [illegible]
We Call it an Ulcer no that instead of Inflam'd
Part We have a Cavity, that Part wch.
was Inflam'd being entirely Destroy'd, but there
is a Power in an Animal of Regenerating those
Parts wch. are [illegible] in some this Power go to
to a great Length; if you Cut them in two each
Part will Produce that which was Sort, so that
We shall have two Animals instead of one;
but this happens to few Animals, as the 
Polypus &c in Complicated Animals who 
have a great Organization, even in these
Considerable Parts may often be Regenerated,
The whole taile of a Lizard in which there are
Bones; Blood Vessels nerves and Muscles 
may all be Regenerated and if Cut down the 
Middle there will be two tails; this same Power

of Regeneration exists in a certain Degree in 
Men; but less, in quadropeds in general 
and in other Animals, however Considerable
Parts of the Body have been Regenerated when 
an Extremity has been Cut off entirely it
cannot be Regenerated [ab??] if [illegible]
be left of each Extremity it will be [lege???]
as a large piece of Bone if Taken away will 
be Regenerated how the [??or??s] by which 
Parts are Regenerated in Man, if there be
a Cavity their Arise first an Inflamation
of the Surrounding Parts, this is not a Violent 
one; there is also a redness and some Degree
of Heat and Swelling, how every Considerable
Pain from the bottom of this Ulcer, every where
there arises Little granules of fluid Substance
This We Call granulating Flesh, and these
continue to rise up until the Cavity is fill'd
where it is Covered by a fresh Skin, is that 

after an Ulcer there Arises the Parts that 
where Destroy'd, sometimes in a Part and sometimes
in the whole, however tho by this Measure of Suppuration 
the granule bring Flesh is converted
into small parts that where [??ony'd]; yet the 
Motion will not be Perfectly Restor'd still 
We consider the Patient to be in Healthy; We
may in some Degree Call Suppuration a partial
Cure, it sometimes happens that no 
Inflamation Arises than Pus is form'd in this
Care a [la??ens] Matter goes out in a large Quantity
as an Inflamation the surface of the Ulcer
may Arise, and then it is converted into [illegible],
then the Ulcer spreads, the surrounding Parts
being Destroy'd if any Membrane [???ing]
the Surface of any Cavity wch. opens externally
shou'd be Inflam'd; there is a Quantity of Fluid
thrown out on the Surface of that Membrane,
As the Skin thus seperates the Scar of Skin from
the true, and is sometimes converted into Pus

Pus in an Inflamation of the Mucous
Membrane of the [Ha??] the Secretion
increased which often Rule on the 
Appearance of Air, in the [??mes] in the 
Skin is the Scar of Skin break a Fluid is afterwards 
Secret'd, which is sometimes Converted into 
Pus, this is not always the Case it happens that
when it is form'd it Destroys the Parts below,
and has been Said to Erode, Pus will not Erode
any sooner than Water but it acts as fermant
and Converts it into Matter similar to itself
the next fermentation in Inflamation is in 
Gangrene and Mortification as in the Death
as Puts of action of the Inflam'd Part, These
two terms have been taken Indiscriminately
some have Call'd a slight Degree Gangrene and 
a greater Mortification, if there is any difference 
we shou'd Remind as the gangrene as the 
Death of a Part and Mortification the Putrefaction

of it; now an inflam'd part is apt
to Die in two Ways, first from a [illegible] Ligature
and the Veins &c. in an Inflamation of the Cellular
Membrane under the Skin, the Distension may 
be so great as to Produce gangrene and Mortification.
Secondly the Inflamation of Irritable
Parts, and Extremity is apt to terminate in 
gangrene and Mortification as an Inflamation
of the Skin, and not only such Parts were 
liable to external stimulus but such also as
have Call'd irritable in consequence of the great
Effect they Produce on the whole System, as in the 
Diaphragm &c. when irritability and [illegible]
Combine then the gangrene and Mortification generaly 
takes Place how We can easily conceive
the reason why a Part shou'd Die when an 
Inflamation Arises so as to Distend it; but 
why a very Irritable Part should Die in Consequence
of being Inflam'd We doe not as yet know,
We might indeed suppose the Nervous [???lla]
are Destroy'd; when an Inflam'd Part Dies

The Arteries can no longer Act, Strongly, the
Swelling therefore subsides the Part becomes
Pale from a less Quantity of Blood being Contained
in the Capillary Vessels, the Pain also gets off
how its to be Observ'd that a Part which is indeed
And Attach'd to the Body. Pulse is sooner
than it was [?rem?ou'd]; for Example if you 
Cut off a finger and Place it in firmely right Degree
of the Thermometer wch. is the Natural Heat
of the Human Body; and another was to Die
that was Attack'd in the Body, the Suppuration
in this woul'd come in before the other, and
it do's this in Consequence of the Hope the 
Appearance of the [illegible] exactly the same, small
Blisters Arises Round the Part, it becomes
of a Darker Colour and at last almost Black
it is heated and looses its firmness the 
Surrounding Parts afterwards becomes putrid
and Dead, when any Part of the Body dies
there is a Process Arises which Separates

one Part from Another; and this We generally
Call an Euptiation, Suppose a [illegible] of Muscle
to Die, a Fibre defient Die in its whole Length a 
Part remains sound, there is then a Part where
the Dead and the sound Part form'd together, in 
this Arises a treament wch. Converts it into, a 
fluid so that a separation takes between the 
two Parts, this we have some Reason to Expect,
in the Purulent Inflamation, but We have no
Certainty of it in a Phlegmonous Inflamation
takes Place Round the Sound Part, and in 
Consequence of this, the Fluid is mostly Converted
into Pus, the Dead Part is thrown out and 
and an Ulcer is left behind, its not that the 
gangrened Part is Destroy'd, its Edges by 
Putrefaction becoming Perfect, but the Ends of 
the Sound Parts are Converted into a Fluid,
by which they are Separated, No gangrene 
and Mortification always Produc'd one Ulcer
it woul'd be a better termination than Suppuration
As it would take Place soon and Produce
an Ulcer easier of Cure, When We kill a Part

by Caustic Alkali, the Part is separated and 
an ulcer easy of Cure is left behind, but 
a Part wch. is artificially [illegible] and one that
takes Place Naturally has by no Means
the same Effect for when the Gangrene and 
Mortification is Natural it is very apt
to Produce an Erysapellatous Inflamation 
of the Surrounding Parts, so that most
Commonly they spread very Considerably 

Lecture 11th
When a Part is ganegrened and Mortified it 
is evident that a Quantity of Putred Matter
is Absorb'd and Carried into the System, when
this has happen'd it has been Call'd a Putrid
Fever it is however only a Symptom of Irritation
As great Depression of the Strength smallness
and frequency of the Pulse, and indeed an Irrability
of all the Functions of the Body; the Brain
is sometimes Affect'd and sometimes not 
and the Patient grows gradualy and Sensibly
Weaken till he, Dies; We might Suppose it was 
owing to an Absorption, and this may indeed
in some Part Contribute, but it is the Action
of the Dead Part on the Living in general. This 
to be Depend'd upon in Absorption the Symptom
wou'd be in Proportion to the Quality of the Dead Part
but this we find is not the Case, for Example
a gangrene of the whole Leg shall not kill in as

many Days, when a Man Dies it is not in
Consequence of the Functions of a Part being 
Destroy'd but in Consequence of the Irritability
of the Part, the whole Intestinal Canal is 
very Irritable therefore a gangrene of any 
Part of this is more apt to Prove Fatal
they certainly Symptoms of Irritation,
and not Fevers, as of the the of the Bark
Species &c, We can bring on a [Enp?ia?ia???]
a Phlegmenous Inflamation and the Patients
Restor'd, if they where Symptoms a Fever
it would still continue. The last [illegible]
is in Schirrous and Cancer; properly speaking
it is not a termination it is a Disease apt
to be left after Inflamation in general. A 
Schirrous as I have first said is a hard
Tumour of a Part left after Inflamation,
so in Callous also but there broad is for
Essentially from one Another a Schirrous
may be Converted into a Cancer and in this 
Consists the Essential difference between the

Two hard Tumours left after Inflamation
a Schirrous can only Remain in a gland and
is evidently owing to an Accumulation of Matter
in the Substance of the gland, which is generally
Solid and Hard, some have been apt to Call hard
Bodies Schirrous but they are not, because
they cannot terminate in Cancer; A Schirrous 
frequently remains in the same state, and 
may Continue through the Life of the Patient,
but it more frequently encreases, and after 
a certain Time it enter a Degree of Inflamation
in wch. the Circulation being encreased, an 
Extravasation follows, which Forms Matter,
This ferments and Forms more, it is then absor'd
by the Lymphatics and Thrown into the System,
that it is a particular Matter is evident, because
when it has been Applied to any Wound it has
Produc'd a Cancer the most Part it do's not
in certain as Variolenus Matter in Venereal;
but that it do's not Act is Indisputable and 
encreases till at the last it makes an Opening thro

the skin and Forms an Ulcer extremely
difficult of Cure; Ulcers of difficult Cure have
all been Call'd Caries, We mean those only 
in which a particular Matters in form'd an is
where it is Absorb'd and Carried in to the System
System, this difficulty of Cure Proceeding 
from this Absorption, for if you cut the part off
wch. is Ulcerated it will Heal, but it will 
again Break out in some other Part of the 
Body wch. shows the Matter has got into the 
System, so as to be Able to Produce Ulcers
of the same kind in other Parts of the Body,
Now the Stimulus Occasions Pains the 
Ulcer is very Faetid and the Evacuation
Weakens the Patient, and the Constant 
Application of the Stimulus wears him 
out, till symptoms of Weakness comming 
on, he tis Cut off by a certain and Painful
Death, Schirrus Glands without a Nervous 
Inflamation, it is to be [??maty] of [illegible]

a long Time [illegible] in this Case it generally
encreases till about the Age of 40 or 50 in
Woman about the Cessation of their Menstruation
having thus endeavour'd to [illegible] to you 
the different Methods of Termination, in simple
Resolution, this Occasions the Inflamation
to Subside and be Carried off therefore We
generally Aim at it on the Treatment of the 
Disease, the [illegible] suppuration wch. if it takes
Place is follow'd by the Restoration of the Part,
but if the gangrene and Mortification Comes on
We must Endeavour to make an Exfoliation
take Place or if no Mortification Comes on, if
it be Possible We must Endeavour to Restore
the Dead Part to Life, and if a Schirrous
takes Place We must Endeavor togethe'd of
as Prevent Immediating in a Cancer, the 
Cure then in the first Place, is the Application
of such Remedis as Dispose it to Resolve,
Secondly such as are proper to bring Suppuration
and for the Management of the Ulcer [illegible]





is Form'd. Thirdly the Management of gangrene
and Mortification, in most cases simple
Resolution is best, but not Universally
there are some Cases, where it is better to
Let the Disease go on to suppuration for 
Example a Fever shall Arise and afterwards
an Inflamation, if this happens in an external
Part of the Body it is better to Let it goe
on to Suppuration, as it will Prevent a 
Return of the Fever when endeavour to 
terminate it by simple Resolution to 
shoul'd very probably Cause a Return of the 
Fever, Consequently it is better to run the 
Risque of an external Inflamation, then 
such a Disease as a Fever, in the Course
of wch. is an external one shou'd happen its
better to Let this goe on to Suppuration,
by which the Primary one will be Cured,
if We dont it will be very Apt to Return 
there being generally some few Symptoms

of the former left, and if a small gangrene
shou'd be in the Inflam'd Part, and that an 
Indolent one, it is better to let much come on to 
Suppuration it is be large it is be [illegible]
unless the whole Gangrene Suppurate there is
Danger of a Schirrous comming on in that
Part in wch. the suppuration did not place,
We are then sometimes to Endeavour [sim??]
to Resolve the Inflamation, sometimes to make 
it Suppurate, there is one great Point to be
Consider'd in the Cure of Inflamation, We 
have shown that it is an encreased Action of 
the Arteris of a Part Distending the small
Vessels beyond their tone, and whatever has 
been the Opinion of particular Practitioners
it has been almost Universally allow'd that 
the principal Part of [???ation] was the 
[S???i] Propelling the Fluids with a greater
Velocity, this therefore is to be Attend'd so that 
in any Case the strong Action of the Arteries which
is the Material Part of an Inflamation may
be united by a Cure applied, a Man can
be so Weak, but this Cause may be answer'd and

and you Cure the Inflamation if this 
Cause be left, A New Inflamation will Arise
the first and great End then is to Remove
the Original, and any other Cause that may
Arise in the Remedy of the Inflamation-

Lecture 12th
We have Shewn you that it is sometimes better
to make an Inflamation subside simply in 
Order for this We shou'd endeavour first to 
Remove the Cause which Produc'd the Disease,
or now Occasion it to Continue, it is time We can
sometimes Cure an Inflamation, tho the 
Original Cause Remains, and that must be
Afterwards sufficiant to Reproduce it, but the Cause
of Inflamation being in general capable
of Acting in Weak as well an in Strong
[illegible] its often an Inflamation is Cured as 
well as before it more frequently happens
that it takes Place again, unless the Cause 
be Removed, an Inflamation is seldom
Stational, you will find that many of the 
most Powerfull Remedies we Employ doe 
not Cure the Disease at once, they only make

it Diminish and it then gets off itself now
if the Cause be Less it will encrease by little
and little till the Disease is Reproduc'd
it is therefore of Importance to Remove the 
Cause, which first Produc'd the Inflamation, or 
any Stimulus that may Now keep it up
the Means of Removing the Cause/many
Inflamations is very Obvious, but We must 
Observe to you wth. regard to the Removal
of such Causes, that are so Obvious that 
if it shou'd Require some Violence to Remove it
so as at Present to encrease the Inflamation
yet We should always doe it, per example
in a Fracture of the Bone, a Splinter [illegible]
Stimulate and Distend the surrounding
Part, it will be better to Remove it, tho some 
Violence be Us'd, again there are some Causes
which frequently Produce and keep it up,
an Inflamation that are by no Means
Obvious, and therefore Require particular

Explanations, the first of these Causes, which
shall be taken Notice of is that which has been
Commonly Call'd Acrimony of the Fluids, We
have said there is no such Acrimony as would
Produce an Inflamation by Affecting the 
Insides of the Vessels, so that they only Acted
on the Irritable Membrane and accordingly 
whenever stimulating Fluids, are Contained
in the Body We find them always Acting 
on Surfaces, the Stimulating Fluids may
be Universally Prevented from Acting 
an Irritable Surfaces, if We can Prevent their
Touching but they are of them of the Watery
Fluids as Solution of the Neutro Salts of the 
Blood, Variolous Merbillous as Cancerous
Matter, if We rub a Quantity of [??l] over the
Membrane We shall Prevent any Watery
Stimulus from Affecting of it and if We 
[Ca??] the surface of one with any Viscous
Watery Fluid, it will be sometime be pre the 
Irritating Fluid will [illegible] itself wth. this

Mucilaginous one, and We know that the 
Stimulating Matter do's not Act so Strongly
when Dispos'd in a Viscid Fluid, thus [??r] the
Covering a Membrane wth. Vegetable Mucilage
will in a great Measure Prevent the 
Stimulus from Acting, for Example suppose
the tears run down the Cheek in a large
Quantity they will Excoriate and Raise
a Degree; of Inflamation if we rub a 
Quantity of Oil over the Part, We shall
Prevent the Stimulus from Acting and 
Cure the Inflamation in Order that an
Evapor'd Oil shou'd be Applied w th
Lungs it must be taken into the Stomach
Absorbe'd and Carried there by the Circulation
which shoul'd hardly Imagine possible that 
it shou'd be Carried in such a Proportion as to
Produce any Effect, but We actually find if We 
Show in a Quantity of Evapor'd Oil into 
the Stomach it do's Diminish the Action

of the Stimulating Matter, some other Manner
of Action has been sought for (namely that the 
Evapor'd Oils had a Power of sheathing or [Pl???]
the Particles of the Stimuli but it is Prov'd that 
they have no such Power, for the Stimuli are 
simply the Neutral Salts of the Blood, as wth.
they have no Power, so that [illegible] 
must Act by Depending the Irritable Parts
from their Stimulating Matter, Consequently
Comming into Contact wth. them; some have
suppos'd the Oil given internally slips down
the Trachea, but this it certainly do's not
for it woul'd then Stimulate more bendes Oil
Thrown into the System in a Solid from Produces
the Effect, however Let the Manner of Acting
be what it will, Evapor'd oil and Vegetable
Mucilages have a Power of Defending Irritable
Parts from Stimuli; when they are Us'd they 
shou'd not Contain a Quantity of Stimuli; for 
sometimes they Contain a Quantity of Essential
Oil, Linseed Oil Contains this, therefore it is

not proper in this (are to be Employ'd; Evapor'd
Oils are frequently known by Heat, when they 
Acquire a Degree of Empyreumatic, such is 
improper for the Vegetable Mucilages if 
kept too long are apt to [??sy], There are 
then improper to be Employ'd; when Evapor'd
Oils are made use of internally, the Heat of 
the Body Renders them Fluid, so that it 
Matters not; whether they are in a Fluid
or Solid Form; when externally Applied
they shou'd be Fluid in just the Heat of 
the Body, if they are too thin they will
Run off it too thick they will not [Rene??]
Oils of this Consistence have been Contrived
which we Call ointments, the Vegetable
Mucilage We Employ, is simply so are 
equaly Useful, but they cannot be us'd
externally because the Watery part will
Apt to Evaporate, and have the others Dos
upon the skin, then it will stimulate of 
itself; there are the Remedi's We Employ

to Cover the Surface of a Membrane as for 
to Prevent the Stimulating Matter from touching 
it; the Second Means of Preventing a Stimulating
Fluid from Acting on the Surface of Membranes
is by Destroying such Fluids. In Practical
Authors We find [illegible] deal about the 
Destroying the Acrimony of the Fluids, yet
there are but few Cases in wch. We can; if 
the Inflamation happens externally; We 
may by the Application of Caustic or Vegetable 
Alkali But when the Stimuli has 
got into the System; We only know of one 
Instance in which it can be Destroy'd, wch
is the Venereal Matter by Mercury, and its
Preparations; how it Acts We are at a Loss
to Account for; It must be Observ'd that the 
most Common Stimuli are the Nutro Salts
of the Blood these We cannot Destroy, nor
[??acuate], consequently We cannot Destroy
the Stimulating Matter; the Next Method
of taking of the Stimulating Matter, that is 
the Action of Stimulating Fluids and

other Stimuli also, is one that has not been 
sufficiently Considered, the Nutro Salts
of Fluids Applied to a Mucus Membrane in
any Part of the Body; after the Natural
Mucus is Washed off, will Stimulate and 
Inflame, but when applied to the Surface
of the Pleura or Peritoneum wch. are not 
Cover'd wth. Mucus, they do not Stimulate
at all, for Example; if by Purging the Mucus
be Wash'd off from the Inner Surface of the 
Colon or Rectum, the Stimulating fluid will 
Produce an Inflamation, but the Nutro Salts
wch. are Constantly thrown out in the Pleura
and Peritoneum doe not Stimulate throughout
these are not so apt to be Inflam'd; We
find then that the Mucus Membranes are 
not Irritable supposing We cou'd take 
off, this Disposition, they might than 
be Applied without Producing any Stimulus

The Disposition of a Part to be Stimulat'd
Depends on Life; if We cou'd then Vary the 
Life, tho the same stimulus was applied
it would not be capable of Producing an Inflamation,
We have Remedis that will render 
a Part less Irritable and Prevent much 
Fluids from Stimulating and Producing 
Inflamation, for Instance in an Inflamation
of the Skin from Heat, A Blister Arises and 
wch. Breaks, there then oozes out a Fluid containing
the Nutro Salts of the Blood, this Stimulates
and Occasions the Inflamation to Spread, Now
if you Exhibit the Center Reno tho of itself
rather tends to Produce Inflamation, it will 
alter the Power of the Life, so as to Render the Part
less Irritable. Thus when a stimulating Fluid
is Acting on a Vessel, We can by the application
of particular Remedis diminish or in some
Cases entirely take off the Inflamation in Irritable
Habits, then We can cure an Inflamation by the 
Exhibition of the Bark, tho it has a tendency 
to Inflamation-

Lecture 13th
The next Cause which Requires our particular
Attention is the Distension of the internal small
Vessels, the Quantity of Blood Circulating
in different Parts of the Body is very various
at one time somtimes the Quantity circulating
as at another, but there is a kind of general
Disposition in the Blood to Circulate in 
a large Quantity, in the Vessels of the Extremities
as in the Internal Parts as in the Thoracic
and Abdominal Viscera, so that when the 
Circulation is Diminished in one of these 
internal Parts, as in the external Parts
it generally is in the whole, so also it is wth.
the internal Parts, there is a kind of Balance
between the Internal and external Circulating
for it happens not Uncommonly that
a Contraction of the external Vessels, [gua???]
a greater Quantity of Blood being thrown 
in some of the Internal Parts, for [E??d??]

of a Man Unaccustomed to such a Practise
spend Walk Bare foot on the Cold Stoes it 
will frequently happen that a Pain will Arise
in the Abdomen, and where an Inflamation
Arises in an Internal Part of the Body, the
Stimulus Occasioned by it will encrease the 
Circulation by this Means the Vessels are
Distended and the Inflamation kept up, Now
by encreasing the Circulation in the external 
Vessels We Diminish that on the Internal
one's Consequently take off the Distension and 
Cure the Disease, the Manner of Restoring the
the Circulation to the external Part comes now 
to be Explained, first then there are certain Substances
wch. [cross out] to Relax the small vessels
through the whole system, that there are Remedis
which Produce this Effect is sufficiently evident
the Question is whether much [illegible] do's
actually take Place, Now there are certain
Remedis if Applied to the Stomach often 
[Occassion] [crossout] encrease of all the Secretions

through the Body, this Effect has,
Produce in three Ways, either by encreasing 
the Action of the Vessels themselves as the 
Secreting Vessels of the glands, or by Returning
the glands themselves, Thus if We Apply
Ipecach or Tartar Emetic to the Stomach
it shall happen in many Cares that 
tho the Skin was Dry before, it shall become
Moist as also the Tongue there shall 
likewise [illegible] something from the 
Intestin's, We Say it happens in many
Cases for no Medicine is certain not always
in its Effects, not if the encreased Secretion 
Arise from a general Stimulus, the Circulation
also wou'd be encreased; It is true sometimes
on the first Application of themselves the 
Stomach they Disorder it but encreased the 
general Action of the Vessels; Now if the
Secretory Organs for it We employ
Emetic Tartar to any Gland, it is so for

from encreasing the Secretion that it
diminishes and Acts as a Sedative, it is 
evident then that they have a Disposition
to Relax the Vessels, but this May doe more
in the external than in the Internal Vessels
Now the Medicines of this Kind We are
at Present Acquainted with, are all the 
Neutral Salts Squills, Ipacac, Rad Senica,
Preparations of Antimony and Water Rendered
Cold, is as to be nearly at the Freezing
Point, the Power of the Neutro Salts in 
Producing Relaxation is not very Considerable
the Powers of the others is much more Considerable,
When We want them to Act more 
Powerfully We must use Prepar'd Antimony
or Ipecac in this Country, in Warm Climates
are Italy Cold Water is made use off Squills
have been Employ'd only in Slow Inflamation
of the thorax, it is to be Observ'd that when [th???]

Considerable Inflamation if We Relax the
Vessels of the Skin a Profuse Sweat takes
Place, the Bed Cloaths get Wet, and if 
the Patient is Covered Close regulates
and Inflamd, if Expos'd to Cold the 
Distension and Topical Inflamation is 
much encreased, hence We are Prevented
from trying them Constantly in general
Inflamation; In these Cases We must
Confine [illegible] to make [illegible]
as Nitre and the Neutral Salts; when 
a Man is Cover'd with his ordinary
Cloathing, some Parts of the Body are 
apt to be expos'd to the Cold, and the 
Circulation is frequent by Changing
But when equally Cover'd in Bed
an equal and constant warmth is
Applied to all the Parts of the Body
and such Changes take Place therefore

in Internal Inflamations the Patient
shou'd be Confin'd to Bed, the Pratice
has Varied Considerably in the Treatment
of this Disease, owing to its not being sufficiently
Consider'd. It is evident We ought
to Confine the Patient to his Bed in an
Internal Inflamation of any Consequence
but at the same time is improper to See 
him wth. Cloaths so as to Occasion a great
Degree of Heat, for much a Constant Inflamation
or Application would Stimulate the 
whole System and encrease the Disease
treatment Means of bringing the Circulation
to the external Parts of the Body; is Warm
Water, it is not necessary to apply it
to the whole Body; The Heat only on upper
Extremities as in some Cases the Trunk 
of the Body, Warm Water of Relaxing
and Stimulating so as to encrease
the external Circulation; and has

a Power of encreasing it also; but at
not relaxing the Vessels like Warm 
Water. If this be applied to the lower
Extremities it will encrease the Circulation
in the whole System. It is to be
Remark'd that after a Part has been 
sometime immersed in Warm Water,
both the internal and external Circulation
is encreased, so that is Continued
for more than fifteen Minutes there
Appears Symptoms of an Universal
encrease of the Circulation, therefore it
shou'd not be Applied for too long
a Time in the next Place it is more 
proper to encrease the Circulation in the 
external Parts, In Inflamations of the 
Abdominal than of the thoracic Viscera;
another Method of encreasing the external
Circulation is by the the of Stimulants
there where frequently Us'd by the 

Ancients, in Employing these Remedies
We are to Consider at the same time that
they tend to Diminish the Internal they
Stimulate and encrease the general Circulation.
This Method then is now look'd
upon as improper, sometimes indeed
it may Succeed; One Stimulant yet
remains in Practise (viz) Vol. Alkali
of which we shall speak hereafter.
The Cause which Constantly tends to 
the Keeping up of all Inflamations
in the Distension of the small Vessels
beyond their Tone; there are two Ways
of Removing the Stimulus; arising
from the Distension, one by Removing
the Distension itself. The other by taking
off the Counteraction or Disposition
the Contraction of the small Vessels
or Capillaries, by the Application 
then of Relaxing Medicines to the 
Inflam'd Part, diminish the 
Disposition of the small Vessels to 
Contraction no more the stimulus 
Cure the Inflamation; by Applying

Warm Water to the Part Affected, We
are frequently Able to take of the 
Inflamation, it is to be Observ'd that
the Vapour is more Powerfully
Relaxing than the Water itself, therefore
instead of Immersing the Inflam'd 
Part in Warm Water, We apply some 
such a Substance as Cloth, Membranes
wth. the Water, and Repeated as after 
as it grows Cold; the Application
of it in this Manner We Call Formation,
we also Use it wth. Farinaceous
Substances and when Applied in 
this Manner We Call it a Poultice
sometimes We throw it on the Body
in the form of Vapour, but this is not 
to be done in Inflamation as We cannot
sufficiently Cool it before it Comes
to the Inflam'd Part; the Application
in Poultice and Fermentation are 
therefore the best and this We shall
Proceed to Explain

Lecture 14th.
We have Said that by the Application
of Warm Water we cou'd take off the 
Stimulus in an Inflamation, and that 
the Steam Arising from it as more
Powerfully Relaxing; and that therefore
We Chose to Immerse some Substance
in Water, and Apply it to the Part, We 
Come Now to make some further Observations
on the Application of Water to 
Relax the Vessels so as to take off the 
Inflamation, We must first Observe
that the Relaxation do's not Depend
on the Elasticity of the Part, it may 
happen that the external Part of the 
Skin in an Inflamation may be Dry
in this Case the Application of Warm
Water is not Confined to the Skin for 
Example if there is a stone Contained
in the Urethra, the contraction is in 
Consequence of it, suffering the Urine to 
Pass wth. difficulty, by Placing the 

Patient in Warm Water the Ureters will be
Relax'd so that the Urine will Pass more 
freely, in this Case it is evident it cannot
be Moistening the Part, there are many 
more Instances wch. We cou'd Point
out to you, where Warm Water do's
not Out in Consequence of Moistening 
the Part; this the Contractile Power
of the Vessels Depending upon Life
that We [al??arencess] when the Skin
is much Distended and Dry hence
the Fomentations and Poultices are 
Serviceable not only in Inflamations
not only of the external but of the 
Internal Parts of the Body also and
as the Balancing Power is [illegible]
on the Tone of the Vessels, it is not Necessary
the Water shou'd Penetrate to the 
Part to Produce its Effects, in the 
next Place it is to be Observ'd that the
Water shou'd be of a proper Temperature
if it be too Hot it will Act as a Stimulus

and encrease the Inflamation, it 
shou'd be made a little Hotter than the 
Inflam'd Part, and tho it may be Necessary
to Apply Cold Water to an Inflam'd
Part it has quite the Reverse Effect, We 
must Observe that in the Application of Cloth
Moistened in Warm Water, then is this 
difference that Cloth of a firm texture, is
soon Heated and soon Cold, and a Centrano
Cloth of a Loose Texture in therefore better
for the Purpose a Course Flannel
We also sometimes employ both Fomentations
and Poultices at the same time
and not Singly for this Reason, that 
Fomentations are more Powerfull as a greater
Quantity of Water is Applied in this for yet
if we Continue Constantly to Foment
a Part, We shall Wash off the Natural
Mucus and Cause an Inflamation 
on the Skin; We therefore only apply
them twice or thrice in Twenty four hours
and afterwards the Poultice and whenever

We the either, We shou'd Add some 
Mucilaginous Substances to Prevent
the Mucus from being Wash'd off
the last Observation we shall make 
is that the Application of Warm Water
encreases the Irritability of the Part
therefore in an Inflamation of the 
Skin; as in the Erysepellatous Inflamation
Warm Water will doe Mischeiff And 
Oil is held to Prevent the other
Applications from growing Dry; We 
Come next to Shew the Remedies to be 
Employ'd immediately to take off
the Inflamation; Now the most Powerfull
Means of the Weakening that We 
Know of is by Evacuation either by 
Opening a Blood Vessel, as encreasing 
the Secretion from and of the Glands
for Example the Opening an Abcess
suddenly if it be large; will often
Weaken the Patient so much as to Occasion
faintings, this happens also

in Taking Water from the Abdomen,
Thus Opening a Cavity that Contains a 
Fluid in Solid Weakens Considerably
it is wth. this Intent that We Employ
it and other Methods of Evacuation
and there We make in four several Ways
first when We want to make an 
Evacuation from any Part of the 
Body indiscriminately We open a 
Vein and this generally in the Arm
if it is easily got at; We must Observe
it there be a Topical Disease and the 
Rest of the System be Affect'd in the 
same Manner, but not in so great a 
Degree, then the Application of a Remedy
that shall Affect the System, will 
Carry off the Topical Disease; if the 
System be not Affect'd it will have
no Effect, if then the Os tenias of a Part
are Aching in the System are acting
strongly Evacuation will generally 
take off the Strong Action hence We

Cure an [illegible] woman than any 
small Inflamation of the Skin by VS
His useful there person general Inflamation
when the Pulse is full hard and strong
and frequent as also when the Habit
is strong, tho the Pulse be not full and 
Strong &c; in some Inflamation Bleeding 
is of no Use, tho the Inflamation be
Violent, for Example when the System
in general is Weak, as in a Woman after
Child Bearing, in these Cases it is often
Detrimental for where it is only the 
Arteries of a Part, which are Acting 
Strongly, and not of the System in 
general; Secondly the more suddenly
We take away the Blood, the greater
Temporary and less Permanent We
Produce; thus then it We make an opening
into a large Vessel and let the Blood
run out very fast, an Animal Die
much sooner, than if it was to follow
gradually it will therefore Produce a 

greater Degree of Weakness, than if 
taken away slowly and at different Times;
If therefore We Wish to Produce a great and 
sudden Weakness, We ought to Choose a 
large Vessel, and make a large Orifice and
also take a great Quantity at once; We 
may Bleed with Safety until the Patient
Faints; in every Strong, and when there
is a great Inflamation, We may take away
℥xxx. of Blood at one time but generally
℥xxx. is the Largest Quantity and this is 
frequently Requir'd in the Country, in some
Cases it may be necessary to be only
℥6 or even ℥iv. of the Inflamations that
happens in Large Towns, from ℥8 to ℥6.
is generally the Quantity Require'd it is 
to be Observ'd that sometimes open 
V.S. the Inflamation immediately Ceases
but this is not always the Care; nor has
it bear sufficiently Attend'd to, that the 
V.S only makes the Inflamation begin
to Diminish, We have said that an

Inflamation seldom Continues in the same
State; if by V.S we diminish the Action
of the Heart and Arteries this will begin
to make the Distension to begin to 
Diminish so that it will Continue so
to doe till the Inflamation Ceases, here
after Evacuation, shou'd Avoid every Thing
that may Stimulate so as to make the 
Inflamation to begin to encrease, for it
will then Continue to encrease as much or 
more than at the first. A Want of 
Attention to this as often Destroy'd the
Effects of V.S. We have said that 
Bleeding is of no use, We must also 
Observe that it is [???full] if no 
general Inflamation Arises, for it
encreases the Irritability, as well as
the Inflamation, thus in Pure Inflamations
of the Skin, Catarrhs Erysepallalous
Sore throat, and Autumnal Dysentery 
it is of no use, in mined Inflamations
that is of the Substances, as well as

Surfaces of Parts; Bleeding is Usefull
as it will Remove in general both that of the 
Substance and Surface also; this Evacuation
of Employ'd properly is the most
Powerfull Remedy of any in Inflamation

Lecture 15th.
The only large Evacuation We can make
from a Gland quickly enough to Cure an
Inflamation is Purging it differs from that
of Bleeding in this Circumstance if you
Open a large Vein so as to take away a 
Considerable Quantity of Blood, the 
Evacuation is justly Uniform from the 
whole System, but in Purging We Employ
a Stimulus to the Intestin's which not only
Produces a large Evacuation, but also Causes
a quicker Circulation through them, hence
in Considerable Effects of Purging, We must
not only Consider the general Weakness, but
the Partial Evacuation Arising from Purging 
is more useful in external than in 
Internal Inflamations, as it Empties
them more, We shall find that making 
an Evacuation from the Gland affect'd
is very Powerfull in Carrying off Inflamation,
hence it is useful in Inflamations

of the Intestin's in that of the thoracic Duct
it is sometimes thus full, for it Occasions
a greater Quantity of Blood to be thrown 
out on the Part, which stimulates it the 
more, but in all Inflamations it faeculent
Matters are Contained in the Prima Via
it is always Usefull; Purgatives may 
be Divid'd into three Classes; First those
that Produce their Effect by encreasing 
the Perilistaltic Motion. And Secondly
those that encrease the Secretion from them 
in Consequence of Stimulating them;
the first species Evacuate the Intestines
only Producing very little Effect from the 
Blood Vessels. The Second doe produce
an Effect from them, so that they are the 
most Usefull in Inflamations, Purgatives
may again be Divided into three classes;
first when We Exhibit the Neutral Salts
as Purges, there is Considerable Evacuation
from the Intestine's without any Alteration
of the Pulse, but it you give Jalap

Scammony and not like Reamous Purges
at the same time they Produce their Effect,
the Pulse becomes Quick and the System
in general becomes more Heat'd, hence 
the first Class are the most Usefull in 
Inflamations, the other Observations We 
made on V.S. applicable to Purging 
except that Purging is more proper in 
external Inflamations; thus it is Usefull
in Phlegmonous on's; No Erysepellatous
Inflamations this Evacuation as well
as V.S. is hurtfull; and for the same
Reason We come in the next Place to 
Consider the Effects of Topical Evacuation;
and first the opening of a Blood Vessel
in or near the Part Affect'd, after the 
Knowledge of the Circulation of the 
Blood, it was thought Topical Bleeding 
woul'd be of no Use; it being of no Consequence 
from what Part the Blood was

taken; and it is evident that if We
Want'd Blood that was improper for 
Circulation, We could only Evacuate the 
Blood that was Distributed to every Part
of the Body; but Let us Consider how 
far We can Empty the Blood Vessels
of an Inflamed Part; if We open an 
Artery of an Inflam'd Part, it will Prevent
the Blood from flowing into it; if We 
Apply Leeches to give the Blood apear
Opening to Pass out than if it was to goe
to the Heart and therefore We Evacuate the 
Vessels of the Part more; This Evacuation
may be made either wth. or without a System
the latter is generally the best, We 
must Observe from Experience that in 
whatever of these Ways, it is made from 
the Part Affected; it will doe more 
Service, than Evacuation from a distant
Parts; when We open a Vein of an Inflam'd
Part, it is not always Necessary We should
Apply a Ligature for the Vessels being

Distended, upon making an Opening
a large Quantity of Blood will flow out,
as the Blood is Passing wth. greater
Velocity to the Heart, and is in some
Degree Obstructed, if the Orifice be made
on the Side of the Vessels the Blood will 
flow the fear, Topical Bleeding is 
certainly a very Powerfull Remedy
in Carrying off of an Inflamation; Cupping
wth. Scarification is sometimes Us'd; but 
We cannot make this Application to the 
Inflam'd Part; nor is it absolutely Necessary
the Evacuation shou'd be made from the 
Vessels of the Part; provid'd it be made
near it, this good Effect will be Produc'd
even though the Vessels of the Part have 
very little or no Connection; as Bleeding 
in the Breast in an Inflamation of the 
Pleura will have more good Effect than 
Bleeding in the Arm, it is seldom that We 
can open a Vessel in the Inflam'd Part of 

a sufficient Size, for a Plentifull
Evacuation, We therefore in this Case employ
Bleeding from the System in general, Topical
Bleeding is usefull in Phlegmonous
Inflamation only; in Erysapellatous 
Inflamation it is often Hurtfull, for it
encreases the Irritability of the Part, so 
as to doe more Mischef than good,
hence Eryspallatous Inflamation of the 
Throat, Gonorrhea &c it is of no Advantage,
it is to be Observ'd that where is a Mixture
of the Inflamation, Topical Evacuation
is generally more Powerfull in Carrying 
off the Plegmonous Inflamation, than
Bleeding from the System in general

Lecture 16 th.
The Weakness or Strength of a Part and 
its Acting is being at Best, are encreasing 
different from one Another for a Part 
however Strong may be at Rest, and 
somehow Weak may exert itself, the 
bringing a Part to Rest, and the 
Weakening of it are different Effects
Application wch. bring Parts to Rest
without Weakening We Call a Sedative
Weakness is always more or less a 
Disease, it Prevents the Functions of the 
Body from being Perform'd so Perfectly
as they woul'd be, it We cou'd bring a Part 
to Rest without Weakening it. We should
Cure the Inflamation better, Consequently
We ought to Prefer the Application 
of Sedative as to the Antiphlogistic
Remedies, in all Cases they are not

sufficient to Carry off the Inflamation 
in some they are, it is therefore worth while
to Employ them as far as We can
Sedatives may be Applied to the Stomach
so as to Act on the System in general, or 
to the Part Affected, or near it, so as to 
Act more immediately on the Diseased
Part. When the System in general is Affected
as well as a particular Part; Sedatives
Applied to the System may be of Use;
Now the Sedatives that We Apply to the 
Stomach are [A??d?], the Action of these is
small, and not to be Depend'd upon; when 
there is only the Hardness of the Pulse and 
Fever turning out into general Inflamation
As in the Hectic Fever, and if Contained 
for sometime are of Use; Infusion of the 
Tea of Sarsaparilla &c, are of Use unless
the Fever runs out for a Considerable 
Length, they may be had wth. advantage
they are of no Use on Topical Inflamation 
The next Sedative We shall take Notice of 

in Warm Water which being Drank in a 
moderate Quantity, exerts a Sedative Power
it has however been Employed in Inflamations
to Produce different Effects, there has
also been Considerable Variation in its
Use,the Antients forbid it entirely, for 
three of the first Days, and allow'd it
afterwards very Moderately; while in Modern
Practise has much has been pushed down
as the Patient cou'd Swallow, it the Drink
in Acute Inflamations, As the Pleurisy 
has been given only Warm, and not a Drop
of Cold Water has been Exhibited, supposing
it wou'd prove fatal to the Patient, it was
Necessary a Man shou'd have a Natural
Appetite, for Meat and Drink, in order
for his Support; and I believe that We 
may in general trust to the Natural
Appetite as to Drink, there not Appearing 
to have been any Advantage gaind by 
forbidding Drink, [illegible] Superfluous Water,

do's not seem to Distend the Vessels in 
any Degree as little hence is Required to throw 
it out of the System it is therefore not worth
while to make the Patient Uneasy for Want
of it, as that will encrease the general
Inflamation; On the Contrary a great 
Quantity will be Detrimental as it may
in some Degree Distend the Vessels, and 
perhaps make the Inflamation to begin 
again to encrease; the Warm Water thrown
down even supposing the Distension
Depend'd in the Viscidity of the Fluids
would be of no use; as there is always
a sufficient Quantity of Superfluous Water
in the Blood Vessels; in the Second Place
if an Obstruction Arose in Consequence
of the Viscidity of the Fluids Contained
in the Vessels, the Warm Water wou'd not get 
at it to Produce any Effect, as the Circulation 
wou'd be Stop'd in a Part it is then 
certainly the best to Leave it to the 

Patient, taking Care that the Fluids
are entirely Watery, for all that Contain
Alcohol tend to encrease the Inflamation
by their Stimulus, it is a Question 
whether the Water shou'd be Us'd Warm
or Cold, the followers of Boarhaves
Doctrine, have Suppos'd that Cold
Water would Condense the Fluids, but 
it do's not at all Appear Sensibly to encrease 
the Viscidity of the Fluids, neither Can
it act on the Blood so as to Cool
it, for the Body has a Power Preventing
it from being Cool'd, hence there is no 
Disadvantage in Employing Fluids that 
are Cold, on the other Hand Cold Water
acts as a Relexant, but as We have 
more Powerfull Relaxants, We need not 
make this Use of it, the Patients Drink 
may be given either Warm or Cold; Not
has been Employ'd in Inflamations and

Considered has a very Powerfull Sedative;
but I Believe it is of very little Use if any,
for nobody in the first Place nor even its
warmest [Ada?rate] have Employ'd it alone,
neither has it been Employ'd in any particular
Dose, there is one Reason for Employing
this, or some other Neutral Salts in Acute
Inflamations as it may be given in 
the beginning of the Disease, when it is 
not proper to give any more Efficacious 
Medicine, besides the Practitioner is always
Obliged to give something in Order to 
Amuse the Patient, upon the whole We 
can doe little good in Inflamations
by Sedatives Applied to the System
in general, but Applied to the Part they 
are frequently so Powerfull as to Carry
off the Inflamation of themselves. Here 
are two kinds of Sedatives, More the have 
any Considerable Astringency, and 
those wch. has very little or none;
the Sedatives which have but little

Astringencey are [illegible] of the Plants wth.
[illegible] flowers, as Nerbum [Ab??th]
Matricania &c; some Roots also as the 
Preyenia Alba and Beets also as the 
Aryenia Alba and Poppies, as those now 
Employ'd in fomentations and Poultices
it has been suppos'd that it was the
Warm Water, that Produc'd the Effect, so
that they have reject'd every other Ingredient.
But this Opinion is extremely Erroneous
for the Application of these Substances
has been Attend'd wth very Considerable 
Effect, when Warm Water has been
Produc'd from or at least a vary Considerable
one, in external Phlegmonous Inflamations
Reppias or Opium or Decotion
of Wormwood, or some other of these
Plants of this Class; Applied in the 
form of Fomentation, and afterwards the 
Plants Beat down, so that the hardness 
is taken off; and then Applied as a 

Poultice, and are more Efficacious than
Farinaceous Substances Moistened wth. Water
but especialy Opium, so that by these means
We shall be Able to Carry off an Inflamation,
when a Simple Fomentation, or Poultice
would not; Matricaria and other Antispasmodic 
Plants, are not so Usefull in Inflamations
Lying immediately under the Skin, as in 
those that Lye deeper, as in an Inflamation
of the Womb, We shall at Present only observe
that Sedatives of small Degree of 
Astringency are not so Serviceable in 
Erysepallatous Inflamations as those 
of a greater. 

Lecture 17th.
We Come now to Consider the Action of 
Astringent Sedatives in the Cure of 
Inflamation, there where Commonly
Employ'd by the Antients and were
Call'd Repallants, they Consider'd
Inflamation as a Relaxation of the Part
and Consequently an Accumulation of 
Blood in it, Astringents they thought
therefore the most proper Applications
to Occasion the Blood to be thrown out,
but when it was suppos'd that Inflamation 
Depended an Obstruction, every 
thing that encreases the Contraction
was Hurtfull and accordingly thrown
aside in Doctrine, tho not entirely in 
Practise, We however find that they are 
frequently sufficiently Powerfull for
Carrying of an Inflamation, those who

Suppose their Action as Repellents, suppose
also a Quantity of Morbid Matter, if
therefore the Vessels they urge to Made to 
Contract, so as to throw it into the Circulation
it would Produce seem Dangerous
Disease, and on this Account they where
Rejected, they have however been always
kept in Practise, and are now more
frequently Us'd, than they where sometime
ago there are certain Cases in which
We wou'd not Wish to Cure an Inflamation
by any Topical Application at all 
first when it is a Critical one; Secondly 
if the Inflamation has been Habitual
for if We Cure such a one by any Topical
Application we shall have frequently
some Violent Disease, Attack the Internal
Parts of the Body; kindly in Phlegmonous
Inflamations Lying immediately under the 
Skin, for if you tye a Ligature over if 
gangrene and Mortification will ensue

so if You [ce??dus] the Skin evey Sense
the like will be the Consequence, to show we 
have Seen them Applied wth. Success
in these Cases, but as the Suppuration
of such Inflamation is seldom of any 
great Consequence, they ought not to be
Us'd, in all other Phlegmonous Inflamations
there is Danger of Contracting 
the Skin, so as to Press it against
the Inflam'd Part, as they likewise 
Diminish the Irritability they are 
Serviceable in Erysepallatous Inflamation
the Sedatives of this Kind We Employ
at first Vegetable Astringents as
Inter. Rosar. rub. Nurb. Agsiman. Red
Termantillec &c, when We Employ these
as Sedatives and Emollients it is 
better to Apply them Cold than Hot,
Acids Applied externally are Powerfull
Sedatives in Phlegmonous Inflamations [illegible]

Lying immediately under the Skin,
and where it is Affected also; Acids are 
not Employ'd in Consequence of their
Stimulating in Inflamations, that are 
deeper Seated, they have been Employ'd
wth. Success, they are not to be Us'd in 
Erysepallatous Inflamations, Alcohol may 
be Us'd in most Cases especially in 
Erysepallatous Inflamations it is better
however to Dilute it wth. an equal Quantity
of Water or it may be farther Dilut'd and
Produce Considerable Effect Farina Matter
is also an Astringent Sedative, it differs
however from the Farina of some Seeds 
having more Astringency than that of others
as Oatmeal Indian Wheat &c. Oatmeal 
has been Us'd in Erysepallatous Inflamation 
but [illegible] wth. Advantage 
they are however Employ'd in external
Inflamations wth. Considerable Effect, the 
last Class of Astringent Sedatives

Possess this Power in a great Degree
they are the Salts and Calxes of some
Metals; and Allum, there are too
Powerfull to be Employ'd in most
Cases, sometimes however they may 
be Us'd wth. good Effect, but as We
shall hereafter have Occasion to 
Shew you the particular Cases in 
which they are Applicable; We shall
now Proceed to Consider the next
means of Carrying off an Inflamation
which is by Raising another in a 
different Part of the Body, for two
Inflamations doe not Subsist well 
together; We have Said that we dont 
Understand in what Manner one
Inflamation Cures Another, but it dos
whether the Second be a Natural or 
an Artificial one, We doe indeed
Produce a New Disease, but it is of no 
Consequence, it may be necessary
to take Notice of some Opinions

that have been held, wth. regard to the 
Method of Cure, if in the first Place it is made
in the Inflam'd Part, that will occasion
a greater Circulation in it, if act a Distance
it was suppos'd that it Diverted the Flow
of the Humours from the Part originally
Inflam'd tho there may be something in 
this Opinion, yet We know it is not 
Actualy so, for the nearer the Second
Inflamation is to the first, the more certainly 
it will Carry it off, it was agreeable to 
this Opinion the farther it was off the 
better it would be, We most Commonly
Employ Cantharides to Procure this 
Inflamation there are two supposed [illegible]
in Cantharides first, in the
first there is a Disposition in it as to 
Raise a Blister, it has been Suppos'd
that the Flow of Mucous from this Cured
the Inflamation, but they cannot Produce
this Effect in this Manner, as We can
Expect little Advantage to Arise from 

this small Discharge, it is certainly,
not from this, for if you Raise
an Inflamation when no Discharge
is Produc'd, the Effect will be the 
same. Secondly the Particles of the 
Flies have been Suppos'd to be Sharp
and [??ide] the Obstructing Matter, This 
opinion it is to be observed to [??wire]
one, Reputation, nor dos the Juice
of Cantharides when Absorb'd into the 
Body Act as a Sedative, for [illegible]
Not from Applied to the Skin will
Produce the same Effect, so that the 
Action of Cantharides is no other
than the Power of simply Raising 
an Inflamation; there are two classes
of stimulants the first tends to [illegible]
an Inflamation of the Skin, the Second
of the Cellular Membrane, the first 
Produce no Suppuration, the Second 
doe, in this Case we would not Wish

to excite a Suppuration Cantharides
Tehadyorania, and Lilliaceas/Limmous,
Volatile and picad alkalis and Acids
are all Apt to excite an Inflamation
of the Skin only on this Account we
Employ them in Preprance to [illegible]
Substances; as they excite Suppuration
two of these are generally Us'd Volatile
Alkali and Cartharides, the first 
is a Powerful Antispasmodic and 
to be Employ'd when We Want but
a small Degree of Inflamation, and when
a great one is Requir'd We Use Cantharides
not from any Power they Posses of Carrying
the Disease, but because they Raise
an Inflamation, that is never difficult
to Cure, the Inflamation Cured by this
Means in generally external [illegible], We 
must observe that in Case there is a 
great Degree of general Inflamation 
as if there be hardness fullness and
Strength of the Pulse, We run some
Risque of encreasing it in these Cases

it is better to Use Evacuation by [?ate?ing]
and Purging first, and those
Employ these Stimulants.

Lecture 18th.
We Come now to Point out to you the
Manner of making a Topical Evacuation
by encreasing the Secretion from the Gland;
When a Gland is Inflam'd, the encreased
Action of the Arteries Propells a larger
Quantity of Fluids through that Gland, and
Occasions a greater Secretion, this is the 
Case in every Gland except the dryness
when the Substance of a Part where those
are Glands that is Inflam'd then also
there is generally, but not Constantly 
a Secretion from the Glands, sometimes
when a Part near a Gland is affected
wth. an Inflamation, there is an encreased
Secretion, but not so frequently as in 
the former Instance; It is farther to be
Observed that in the too Cast Cares
the Matter Secreted is not Alter'd; It is
thick the Mucus Part frequently

retaining its Consistence when the 
Membrane itself is not Inflam'd when 
the Secretion is more Copious it is 
thinner and Contains the Neutral Salts
of the Blood, when a Part near a 
Gland is Affected wth. Inflamation
and very little or no Secretion ensues
We employ stimulants to encrease
or Produce it, how far they can be
Applied so as to be Effectual We
must Leave to be Explain'd when We 
Come to the Treatment of Inflamation 
Requiring this particular Method of 
Cure, when the Secretion is at the first
Copious and Watery, the Salts Contain'd
frequently Stimulate the Surface of 
the Membrane along which it Flows so 
as to encrease even Cause an Inflamation 
of the Part, as it happens in 
Catarrhs, in Order to Avoid this We
must Defend the Part, by expressed Oil

and Vegetable Mucilages; It frequently
happens that after an Inflamation is
Considerably Diminished the Secretion
Continues and is sometimes more Copious,
when this is the Case it keeps up in some 
Degree the Inflamation, and Prevents
the Natural mucus from being Applied
to the Part, hence We must Apply
Remedies to Put a Stop to it; this is 
sometimes a Matter of difficulty, when
this encreased Secretion is in Consequence
of Weakness and a Relaxation of the 
Glands, We must endeavour to Strengthen
them, Now by Strengthening the System
in general, We doe not frequently Strengthen
any particular Gland, as it is only 
a Topical Weakness, and is therefore
the more difficult to Cure, when this
Proceeds from Relaxation, We may
Apply Astringents, these however
frequently fail of their Effects, for they

only Act for a time, Leaving their Part
after their Action often more Relax'd
them before; as is Inflamed in the
of Opium; except these Astringents
produce some Effect, they will 
I say frequently fail, sometimes
the Inflamation is kept up also so
that they Act as a Natural Cause,
in this Case if We put a Stop to the 
Evacuation for a few Days the Inflamation
will begin to Decrease so that 
they will both goe off gradually
together by Putting a Stop to the 
Evacuation or rather the Secretion for 
a Length of Time We Can take off the 
Weakness of a Part, tho the Remedies
may actualy Tend to Relax the Part 
afterwards; unless Astringents Produce
some such Effects as there, They 
seldom Produce a Permanent and

good Effect, it sometimes happens
that the Secretion Continues in Consequence
of Habit, here Astringents Put a Permanent
Stop to it, in general they must not
be Us'd till We have Remov'd the Stimulus
that was the Cause of the Evacuation
sometimes indeed the Application of 
Astringents Destroys the Stimulating Matter
but is always doubtfull, when this is not
the Case, the Inflamation most Commonly
Returns wth. greater Violence; We shoud
therefore Pay this Attention; when even 
Stimuli are Present, the Astringents
We Employ are Various, some of which
we apply to the part as the calces of Metals;
and some to the Stomach; As Astringent
Vegetable Substances, this Astringent
Juice Acts Strongly and Permanently,
Allum also Acts Strongly and Universally
[illegible] Astringents sometimes encrease
the Inflamation Considerably and of 
Consequence the Secretion, We must

Observe that all these different
Astringents are Applied in different
Cures, but We shall Leave these till
We Come to treat of the particular
Diseases in wch. they may be Useful 
We shall now Consider the Treatment
of Inflamations wch. Come to Suppuration,
sometimes We rather Choose
they shou'd Suppurate as when they Arise
in Fevers, and are in the external Part
of the Body, for it is better to Let the 
Inflamation goe on, than the [illegible] of
a return of the fever, and if in the small
Glands to Prevent these Indurations,
It also frequently happens that we
cannot Avoid it, for the Time of Suppuration
taking Place is very Various,
In Infants it happens Quicker than
in Adults, in the former it will
sometimes take Place in 24 Hours,
in the latter if a Phlegomonous

Inflamation Arises and goes on wth.
Violence, the Suppuration seldom begins
till the Fourth Day, in some not till the 
10th. 12th. or even a much longer Time
as in an Inflamation of the Lymphatic
Glands, Evacuation may Retard Suppuration
Considerably, when the Inflamation 
is Considerable, especially if it be
in the Internal Parts of the Body; the 
begining of Suppuration is often Indicated
by Fits of Coldness or Chilliness comming
on at irregular Intervals, and in certain
in their duration, when also Suppuration
takes Place in the Inflamation, sometimes
Contract itself so that it is not so much
Diffused, the Pain too, generally begins
to Decrease, again if the least Quantity
of Pus be form'd We cannot Put a stop
to it, We are therefore under a Necessity
of Letting it goe on, where it is doubtful
whether Suppuration to begun or not 
if it is likely to prove Dangerous

We shoud always Endeavour to Resolve
it, but if there is no Hazard of that 
kind, we shou'd Endeavour to Encourage
the Suppuration, for the Remedies We 
Employ to Prevent it, also make it 
goe on ill, if it takes Place our [illegible]
Endeavour shou'd be to make good
Pus form as soon as Possible, when 
an Inflamation Runs to a great 
Height, they often Germinate in 
gangrene and Mortification sometime also
there will be a greater Degree of 
Suppuration than is Necessary, in
that the Part will be extremly [illegible] 
the Inflamation then shou'd be kept 
up, but in a Moderate Degree, if
if it be Violent We may Diminish
it by moderate Bleeding and Purging
by the Application of Emolliant fomentations
and Poultices, and of
such Sedatives as have no Astringency

this however must not be in so great a 
Degree, as to Endeavour to take away the 
Inflamation, Emollient Fomentations and the 
Poultices, and are also Useful in Suppuration,
as they forward it Considerably
If an Inflamation be too Slight it shoud
be encreased, by the Application of a 
Stimuli; We must observe that in 
general it is better to Let the Inflamation
goe on too slowly, than encrease 
it too fast, We shou'd Wish to make
Suppuration take Place as fast as We 
can wth. Safety, for the ease of the Patient,
sometimes an Inflamation will not
Come to Suppuration, without the Use
of the Stimulants, but if We Push it on
too fast We produce a much larger 
Abscess, and sometimes Endanger the Life
of the Patient, We have Said there are
two Classes of Stimulants, therefore Employ'd 
to encrease an Inflamation, one that
Acts on the Surface, the other in [Resu??]
of a Part, there are also too kinds of 

Universal Stimulants, one that acts Quickly,
the other that are not so Quick in their Action
and these We generally Employ Internally-                             

Lecture 19th.
We Come now to Point out to you the 
Substances We Employ, to encrease Inflamation
so as to forward Suppuration, We 
must however first Observe that in
Strong Habits when there is little Irritability
Suppuration takes Place Quicker and more
Perfect; then to have the Habit is Weak and
Irritable, the Cort. Peruv. as it Strenghtens
the System and Prevents Irritability,
is a very Powerfull Remedy in Promoting
Suppuration, and also makes the Pus
Perfect, and to Confine it in the Part
is that it has been Employ'd wth. the 
greatest Advantage, if we Want a Speedy
Effect, an Ounce in 24. Hours shoud
be given, or as much as the Stomach
will Bear, such Stimulants as have a 
Disposition to Produce Hardness and
Strength together wth. some Degree of

Quickness of the Pulses, are proper as 
the [illegible] and [???mious] Substances
of Vegetables; Mercury is a Stimulant
of the same Kind, and Us'd for the 
same Purpose, but We doe not frequently
Employ these, they are not very Powerfull
and We rather Choose to Trust to the
Bark, this is a Class of Stimulants that
tend to encrease the Inflamation of a Part 
without Affecting the System, these if
taken a great Quantity Affect the Brain,
and are hence Call'd Poisons; they are
the Belladonum, Nicotiana, Cicutae, &c.
They are sometimes Useful in very tedious
Inflamations, as for the Lymphatic
glands; for they will bring it forwards
when We cannot by any other Means,
We apply Stimulants to the Part also,
there are principally of two kinds (viz)
such Farinaceous seeds as Contain
some Essential Oils as Farina Line and

Fanugri. &c. when Suppuration is taking
Place it is Useful in any Cases to Employ
Applications of this Kind, for whether
it be that they keep the Part Warm or whether
they Posses a Retaining Power Suppuration
gos on better for them, We sometimes 
Apply Resinous Substances to Stimulate
the Part and forward Suppuration, these
however are seldom necessary and sometimes
they are hurtful, as they produce a longer
Suppuration than otherways wou'd have
happened; when an Abscess is [n??m?d] it
is a Question whether an opening shou'd
be immediately be Made as to Let
out the Pus, it sometimes happens that the
Matter is Seated deep and in such a Part,
that we cannot Let it out, and when Suppuration
has taken Place there is not one
Parcel of Matter form'd but several smaller
on's by Degrees these join together, so as to 
form one Mass, if they have form'd before the
Opening of the Abscess, the Suppuration will

be of tempor Contrivance, and therefore
Surgeons Prefer N Leaving it to Nature in
general when we wou'd make an opening
the [Atuep??t] in many Cases Subsist
for a Considerable time; it is apt to be
in two States, the sides of it are perfectly
free from Inflamation, or only a small
Phlegomonous one of the surrounding Parts,
in this Case there is very little Pain,
the Internal Surface of the stone, may
be Affected wth. Symptoms of Irritation dies
wth, Erysepellatous Inflamation, have there
is great Pain, the discharge thin Watery
and Stimulating, it becomes an Abscess
of the System, and Produces general 
Restlessness, and uneasiness of the 
Body, frequency and hardness of the 
Pulse, the Pus thrown into Cavities
and produces fresh Inflamation and
in this Case it often happens that it is 
thrown upon the Lungs and Proves Fatal

here we endeavour to take off this Irritability
by the Use of the Bark; indeed it shoud be
Employ'd in all large Abscess, where it is 
out Contraindicated, other Substances which 
tend to Produce Phlegmonous Inflamation,
and good Pus, and much have been Us'd
as Wine and Spices and the like, it has 
been a Question whether the Hectic Fever
Arising from Absorption was Produc'd by
the Stimulus, or the Matter; but the Pus
in Urine and other Symptoms evidently
Show it is Pus, Absorb'd; if an Abscess
is deep but so that we can get at the 
Matter, or if it has a Chance of making
Sinus's that is Destroying or [Re???ing]
between the Muscles, or if it be very
large it is better to Evacuate the Matter
even before a Perfect Suppuration has taken
Place, for it is best to Dispart off such Parts
as are not sufficiently Destroy'd than 
the Risque of an Hectic Fever, from Absorption
when we make an Opening it should be
such a one as will Evacuate the whole

or greater Part of the Skin covering 
the Pus, it shou'd also be made in 
a Depending Part of the Abscess, it is 
a Question whether in very large Abscesses
it is Preferable to Evacuate the Pus at
once or by Degrees, as Evacuation tries 
to Produce Weakness but seldom so 
great as to Prove Fatal, it may however 
Weaken the Abscess itself, and Prevent the 
the Surrounding Phlegmonous Inflamation going 
forward hence some have thought it
better to make a small opening, but 
the Continuation of the Matter in the 
Abscess will be Attended wth. disagreable 
Consequences, on the whole then it is better
to make a large Opening, and Evacuate
the Matter at once; there are Many things
that take Place in an Abscess, first a thin
Matter Oozes out, and the Ulcer neither 
Spreads not Diminishes, Secondly an
Erysepallatous Inflamation may Arise,
a thin Matter is also Discharg'd the surface
is also Converted into Pus, and is Brown 

off in this Case, the Ulcer spreads [illegible]
there may be a Phlegomonous Inflamation not
Attended wth. any great Pain, for their is 
first form'd a Quantity of Pus without
Stimulating, and little Granulations Arise,
this Requires the Application of no Remedy
nothing more then a Defence from the Air,
by something Soft first of there is no
Inflamation at all; if the System in general
be Weak, we shou'd Endeavour to strengthen
it by Bark, and Stimulate it by Wine
and Spices, and Resinous Substances,
We make Use of Mercury for this Purpose,
We may also Apply Stimulants to the
Part, there may be Scarification on the 
Surface, Applying Resinous Substances,
or if the System in general be Strong, and 
if the Inflamation be Contained in a 
Membrane or Cyst, then destroying the 
Part, by Lunar Caustic, and Applying
a Superficial Dressing, a Suppuration
will take Place in Eresepellatous Inflamation,
There are two Ways of taking them
off, the first by Diminishing the Irritability,

of the Part, the Second by Stimulating
Remedies, to Produce a Phlegmonous Inflamation
its Room, if the Ulcer be a [illegible]
the most Powerful Means is
by taking off the Inflamation by diminishing
the Irritability of the Part, this Bark
will Perform most Powerfully and 
Effectually and also three or four
Days before the Abscess is Opened it
shou'd be Us'd as it will Cause a good
Suppuration in all these Cases we
may give it in a much less Quantity 
in the whole by giving it in large
Doses at the beginning; if the Ulcer be
not recent, then the Employing of
Stimulants will Produce the Effect;
Mercury We Use internally, and externally
such Resinnous Substances together wth.
Preparations of Mercury, as Sand to Produce
good Suppuration and Granulation; It
may happen in Erysapelletous Inflamation,
on the Surface of the Ulcer that

the Disease is not owing to an Affection of
the System, but of the Part, in this Care Remedies
Applied to the System are of much less the 
than there Applied to the Part, have the 
best Method is to Destroy the Substance of the 
Part, so as to Come to the Second Parts below,
and bring a Suppuration from the bottom
of the Ulcer; It sometimes happens that 
the Suppuration is Prevented by particular
Matter, as Venereal and Cancerous &c.
If it is Topical the Application of a Caustic
will unite wth. the Matter as well as Destroy
the Surface of the Ulcer, and so bring on
Suppuration, if the Matter has got into 
the System, We must Use such Substances
as Chemically Combine wth. it.

Lecture 20th.
It sometimes happens that the Granulation
Flesh Rises too fast, it is then of a Loose
Texture appears above the Surface of 
the Skin, and cannot be Cover'd over wth.
a Scarf Skin; when the Fonyans Flesh
Arises in an Ulcer, we are first to 
Check its growth by astringents so as
to Resent it Rising above the Surface of the 
Ulcer, the Astringents that have been
Cheifly Employ'd for this Purpose
are the Caleas of Metals, and more 
especialy Vitriol Caruli; the same
may Effect'd in some Degree by 
Pressure or Bandage, but it if shoud
have Arisan for a great quantity so as
to [illegible] greatly the Height of the 
Strain it is better to Cut it off, or applying
a Caustic; sometimes there is such 
a Disposition to form this although
We Endeavour to Prevent it by a 

Danger on Caustic they are Attended
wth. no Effect in this Case it is better to
Destroy the whole of the Granulating Flesh
and this is to be done by the first Cutting
off as much as we Can, and then Applying
a Caustic, or there Caleas of the Metals,
that give a disposition to good Suppuration
and Granulation, in the next Place we
are to Suppose, that the Ulcer is already
filled wth. granulating Flesh, we are
then to Endeavour to form a Scar of
Skin to Cover it, this generally happens
Naturally, it is however prevented principally 
by a Quantity of Putrid Matter
Adhering as being Applied to the
Edges of the Ulcer, hence we must keep 
an Ulcer very Clean, it is also disturbed
by frequent Opening, it shoud not 
therefore be Open'd oftener than is
Necessary, to Prevent the Putrefaction
of the Matter, as once in 24 Hours;
in some Cases 48 Hours; sometimes

the Edges become thick and hard, this
We Call than Callous, have the fresh skin
grows up wth. difficulty, We are therefore
to get rid of these by Cutting or Burning
them, the first method is generally the
best, supposing an Ulcer is feeling
tolerably well, yet we can forward it
greatly, by Applying gentle Astringents
as Lapis Calaminaris, this particularly
forwards the spreading of the Skin,
Oce [illegible] also as, is [illegible], when an
Ulcer is near being Heal'd, it sometimes
Circularly and will not spread entirely
over this to be Remedied by the [R??isea]
we shall now suppose then a gangrene
has taken Place, in this Case the
Putrefaction generally Arises, so last
that we have but little Chance of restoring
the Life, we are therefore to get rid of it
as fast as We Can, that the Sound Part
may begin to granulate and be 
remov'd, supposing a Part Dead and 
the Rest of the Body in Perfect

Health, and that it has no other Effect on the 
Surface of the Living Part, endeavouring
to get rid of the Dead, then a Phlegmonous
Inflamation wou'd Arise, and a Fluid
Issue which woud Serve to Separate 
the two Parts, when a gangrene takes
Place in an Inflamation it immediately
Produces an Effect on the Surrounding
Parts, to wit an Erysepallatous Inflamation,
and in the System in general
Symptoms of Irritation, when these
take Place we endeavour to Occasion
a Phlegmonous Inflamation round the
Part so that an Exfoliation may take
Place, and a Common Ulcer be Left; this
is to be Accomplished by two means
first by the Application of Stimuli as 
sepurates Parts; and Secondly by 
Preventing it from having Effect or the 
System in general, when a Gangrene
Arises the best thing that can happen
in a Phlegmonous Inflamation, No
Treatment of a gangrene [cross out] external simple 

only that the Remedies from the
Particular Habit of the Patient are
not always sufficiently Efficacious,
the Remedies We Employ to unite
Phlegmonous Inflamation as stimulants
Applied to the System in general as 
Wine Spices &c. to the Part Scarification
Essential Oils, Balsams that has
Resins Dissolv'd in them; but none
of these are so helpfull as Cart 
Power, various has been the Opinions
concerning the Action of this Remedy,
some has Suppos'd that it acted
as a Stimulant, but we have several
more spices more Stimulating than
the Carten, some have said that it
acted as an Antiputrescant this
Opinion for several Reasons [illegible]
Admitts of a Sarious Consideration
in all Cases it Diminishes the 
Irritability of the System and this 
Prevents Stimuli from acting upon it

Now if We cou'd make a gangren'd Part have [illegible]
no Effect on the Secondary one, we should always
have a Phlegmonous Inflamation take Place
the Part do's this more Powerfully, than any 
other Remedy, it shou'd be us'd in as great
a Quantity as the Stomach will Bear; some
other Medicines have been Us'd as the Cortane
Preparations of Iron Vitriol &c. when the Slough
is Exfoliated, it is to be treated as a Common
Ulcer; Inflamatory Stimulants may be Us'd
at the same time wth. the Bark, We Come
Now to the Management of the Schirrous
and Cancer if a small gland be Affected,
it is better to Let is Suppurate if a large
one we shou'd Endeavour to Avoid it, We
shall now suppose the Schirous is 
Produc'd, if it be small and Continue in
the same State or Situation it is better
to Leave it to itself, as it will often Continue
for many Years without encreasing or
[illegible]. Ot it be large and encreasing 
We are to get rid of it, as fast as Possible
if samll by a Caustic, if large by the 

Knife first and then the Caustic, we
Choose to Employ Caustics because the 
Living Power endeavours to Defend the 
Part, till a Portion of the Matter is absorb'd
so that they have a greater Disposition
to Destroy the Dead Parts, than the
Living on's, if a Cancer be Produc'd, there
is generally little good to be done, the
Cantee, Belladonum, Arsenicum &c.
have now and then Succeded in 
Producing good Pus, the Pain may
sometimes be Relax'd by Destroying
the Sensibility of the Part by Preparations
of Lead, &c. but Cancers generally Prove 
fatal after a length of time---

Lecture 21th.
We have Describ'd an Inflamation as being 
a Disease of a Part of the Body only whereas
Fever is an Affection of the whole System
This Disease has been differently Defin'd
and indeed Practitioners have act
hitherto fined a Definition, some Call
all Affections of the System [?aces]; others
all those where there is frequency of the 
Pulse, some a pain have extended it to 
Inflamation, but We must Observe that
it has been Systematick Writers, who
have Call'd all Affections of the System
Fever; all Authors that have Wrote from 
Practise as Hippocrates amongst the
Ancients; Sydenham amongst the Moderns
have Confin'd the Word Fever to one
Disease, in order to Classes it is Necessary
to have some Appearances that is always
Present in the Disease, and has been
Call'd the Pathognomic System; This 
no Superficial Practitioners that this
can be Useful [illegible] in Fevers the whole

System is Affected, neither is this 
Affection equal, it is sometimes greater
in one Part than in another, this will
Constantly make a Variety in the Appearances
of the Disease, externally; not that no one
Symptom shall be always Constant in it,
frequently when a Patient is Affected
wth. a fever he tis Hotter, but this is not
a Constant appearance for he is sometimes
Colder, sometimes he feels Colder when
he is realy Hotter, and whether We
Consider heat wth. Regard to the Patient
himself, as by the Thermometer, We
shall evidently find he is sometimes
Hotter, sometimes Colder, if then the
Disease may Arise to such a Height
as to Prove Fatal, without an encreased
Heat; this cannot be a Pathognomic
System, the Pulse is generally more
frequent, but sometimes it is Slower through
the whole fever, as Languor Weakness
Costiveness &c. and as Fever may

Subsist without Heat, and frequency of 
the Pulse so may they without Fever, We
shoud find that some Fevers Subsided
without them and some of them without
Fever, so that no Symptom is always
Constant and for this Reason, the Fever
is an Affection of the whole System, and
sometimes one Part, sometimes another
is not Affected, in order then to Define
Fever We must give a Description of the 
whole Disease in the first Place we must
Observe that a fever in general is a Complaint
Disease, if it be a simple one it never
lasts above 48 Hours, but fresh and pert
Attacks in some Cases take Place, so as
to Prolong the Disease Considerably so that
the Fever is a Compound of a Number
of small Fevers following one Another and
mining; In Order to Understand the 
Disease we must Consider one Paroxysm
as simple and Perfect, the better to 
Understand those that are Minded;
One simple Paroxysm of Fever Consists

of the Attack of the Disease a Natural
Cure Arising, and an Appearance taking
Place on its going off. We then it Consists
of three Stages, first the Attack improbably
Called the Cold fit; secondly the Hot Fit,
and Thirdly the Crisis; the Attack
Consists of two Parts, a depression of
Strength in many Parts of the Body,
and a Contraction of the small Vessels,
wth. an Accumulation of Fluids in the 
large on's; the Symptoms wch. Indicate
a Depression of Strength and Languor;
Weariness, Weakness, &c. If the Paroxysm
be a Violent one they take Place first and
in a greater Degree. Sometimes there is 
no other Appearances at all but so great
a Depression of Strength both of Body
and Mind, that the Patient Dies; As in 
the Plague the Sensibility of the Organs
of Sensation is sometimes Diminished,
the eyes doe not Perform their Office
so well, and the Skin becomes sometimes

Insensible, this takes Place only in very
Violent Attacks, when the Living Powers Act
Weakly, a less Degree of Heat Arises hence
there is a Coldness and Weakness we dont
Know, but so it is when the Stimulus Power
is Diminished, there is always a Coldness
and trembling together with Pain at the
Back, at the same time there is a Sense
of Insects Creeping over the Skin wch.
is Call'd by the Latins Neuipelatio
having no English term to Europe it
the Vessels of the Extremities in particular
and indeed all over the Body Contain a less
Quantity of Blood; so that the Parts become
Pale; the skin has its colour partly from 
the Sebacious Matter wch. is yellow when 
therefore there is less of the Blood, the Skin
becomes more a Dim Colour; the Tongue
becomes Dry and Covered wth. a Mucus
the Kidneys Contract so that the Urine
do's not Contain the separating mucilage
but remains transparent, and when the

Attack is Violent, the Quantity Diminishes
the Secretion for the Intermits is less
the Peristaltic Motion being Distended
so that the costiveness is Produc'd, if there
be any Penetrating wound, in any 
of the Muscles, the Ulcer becomes Dry
so that the Vessels of the Muscles Contracts
and in this Contractions sometimes
Affect so large an Artery as that
of the Arm, so that the Pulse becomes
small, in Consequence also of this
Contraction there is often Pain in
different Parts of the Body, as the
forehead and sometimes extending
all over the external Parts of the 
Head from some Cause; probably from a
Contraction of the Vessels of the 
Brain, there is a Delirium; It may
also be a Symptom of the Quantity 
of the Living Power but this we shall

Explain more fully here after; the Eye
is the Common the Criterion of the State
of the Brain, so that from them we shall
be Enabled to judge of the different
Species of Delirium, if the small Vessels
Contract, the large about the Heart must
be Distended from the greater Accumulation
of the Blood in them, Accordingly We find
[illegible] Oppression and Swelling about 
the Praecordia a greater Quantity of Blood
Laying about the Heart Stimulates it
to more frequent Contractions, hence
frequency of the Pulse, Quick and 
Laborious Respiration and Cough
wch. attend all difficulties of Breathing,
there is also Flatulancy and from an 
Affection of the Stomach rigor and
[illegible], this is sometimes so great
that Sickness and Vomiting take Place
it will admit of a Doubt whether

this arises in Consequence of an
Affection of the Stomach, and the
fulness of the Vessels about the
Praecordia but most probably of the
former, There are the Appearances that
take Place in the Attack of the 
Disease; and there it is that Constitute
the Disease, if [illegible] one of those Symptoms
are Present, there is no fever so
that this Attack is the Disease it self
the other Parts of the Paroxysm
bringing Consequences of the Disease
the Blood in this state is not Alter'd
but the Action of the Swing Powers,
indeed as the Disease advances it
sometimes Inflam'd and sometimes is
Verging towards Putrefaction-

Lecture 22d.
The Appearances of Fever before Enumerated
may be few and only particular Parts
Affected, the remaining Part of the 
Paroxysm in this Case not [?ueading]
We dont Call the Disease Fever, this is 
an Affection that Causes an Alteration
in the whole System, so as to Produce
a Hot Fit and we must observe that
the whole Disease depends on these
Alterations, and is always more or less
Violent according to the Degree and
Number of these Appearances, the
Causes of Inflamation We have been
Able to Point out to you; Now Fever 
Arises sometimes from Causes that
are known, and frequently from [?nton] [illegible];
they are also very Uncertain in
their operation, so that if the same
Causes be Applied to a Number of
People, only a few shall be Affected

with the Disease. The Causes we are
Acquainted wth. are first such Passions
of the Mind, as are Attended wch. Annualy,
and there must be suddenly excited
these however are not very Powerfull
amp. And secondly Fever may be
Excited by an Exposure to Cold; as
Sleeping on Damp ground &c.
Midly Putrid Infectious Matter as
Variables Marbillous, Acting upon the
Irritable Parts, will unite Fever, if
We take a Number of People in Health
Shut them up in a House just Built,
so that there is no Contagion, yet 
a Fever will very often be Produc'd; from
the Putrid Vapour Arising from the
hood and Evacuation; A strange Causing
into the same Place shall be Affected
wth. Fever; If a Number of People are
about a Man Affected wth. a Violent Fever
from any Cause, some of them will be
Affected tho the Patient has no Symptom
of Putrescence, so that a Vapour Arising
from a Man in Fever is Capable of Producing

if an Healthy Body, formly a Man
having Eat food that is not Digested but
become Putrid in the Stomach, has
been Affected wth. Fever, so that now and
then it may Arise from a Retention of the 
of certain Substances on the Primæ
Viæ; as Indigested food in the Stomach,
Fœcas in the Intestin'e. [???ly] a Number
of Men going into a Climate they have
not been Us'd to, some of them will be
Affected wth. Fever, whether this be a
Cause of itself, as only adds to the
other Power, we cannot Determine
simply half the fevers wth. take Place
Arise from Causes that we cannot
Investigate, when the Passions of the 
Mind Produce Fever, They doe not
immediately, or not at all. When they 
are brought on by Cold, it is generally
Produc'd immediately some times
however it is not, when from a Retention
of Substances in the Primæ Viæ it
Arises while they are there, When

from putrid Vapour it seldom takes Place
immediately, sometimes indeed it do's; the
Action however is by no Means at the 
same Period. Variolous and Morbitlous
Matter are Commonly Eight or Ten
Days before they Produce face. If
Varioulous Matter be Applied to a
Warmd an Inflamation will Arise and
A Pustule is form'd full of Matter
at this time it begins to be Absorb'd
and that on its first Application
to the Heart that Produces the Disease
for the Second has no Effect, for if
a Patient has Caught the natural 
Infection, and is Inoculated, this
gets on the faster and Produces the
small Pox of the Inoculation, the Natural
Infection having no Effect. So if you
Inoculate a Patient for several successive
Days, the first take Place and the
Subsequent on's has no Effect in

encreasing the Disease, in other Cases
when the Disease is not Produc'd, upon the
first Application, some Symptoms are
brought on wch. gradually encrease, so as
to Produce the Remaining Part of the 
Disease, As Putrid and Infectious Vapour
do's not appear to be Accumulated in
any Part of the Body, neither do's it
Appear to have any Effect on the Blood,
in the Course of the Fever it may; but
never on its Attack, some Symptoms give
off without being allowed by a Fever is
the encrease and Diminution depend
on some other Causes; and not on the
Accumulation of the Matter, it is to be
Remark'd that Fever when Produc'd
is Independent of its Cause, in this
it differs from Inflamation, and
Symptoms of Irritation; and hence
it was thought to Depend on an Accumulation
of Matter; It is well known that

when one Motion is Produc'd, it will
Continue without its Original in any 
other Cause, to excite it to a Continuation,
frequently also an Addition of the
Original Cause, will have no Effect 
in encreasing the Fever, after it was
once Produc'd as was Observ'd of the 
Variolous Matter---

Lecture 23d.
We have said some of these Causes
Produc'd Fever immediately, and some
not till after several Days, Now We shou'd
be extremely Cautions of Admitting
those Causes of Diseas'd wth. have
not an Immediate Effect and never
till we have formed a Number of Cases
in wch. these Causes have Produc'd the
Disease; when any Cause do's not produce
Fever till after sometime, there are 
two things happens, and Alteration of
some of the Fluids of the Body; in those
Cases where this is evident, we find
the Change Topical, as in Inoculation,
and that as soon as this gets into the
Blood Vessels, it Produces the Disease,
When Putrid Infectious Vapour is 
Applied to the Body, so as to Produce
Fever it is a Question whether it Acts
on the Fluids of a particular Part

of the Body; making some Change, so
that when they are Absorb'd into the
System they shall Produce the Disease,
or whether it makes a Change in the whole
Mass of Fluids wch. as the Circulating
Fluids, by wch. the Disease is Produc'd
it Appears rather that much Putrid
Vapour immediately brings on, for after
the Application of it, [illegible] febrile
Symptoms Appears, wch. Continue
to encrease, till the Fever is Produc'd
or is there any [illegible] of Putrid
Vapour, Producing an Alteration in a 
particular Part, for Putrid Matter will
not Produce Fever by a circulation, or
if we apply any other the Fluids of a 
Man Affected wth. a Putrid Fever, it
will not in a healthy Person Produce
a fever, it will sometimes Produce
Symptoms of Irritation or Inflamation,
We Observe it was the Distinguishing 
Mark of this Disease; that it Continued

after its Cause was Remov'd, this of great
Consequence in the Treatment of it, and it is
this that has given Me an Idea, that Fever
was an Alteration of the Fluids; However
in many Cases there is no Appearance 
of this, it is the [Re?parly] of the Moving
Parts of the Body, that it sometimes
happens, that if they are Set in 
Action there, will Continue Acting even 
tho the Cause by Remov'd; the next
Thing wth. Regard to the Action of the 
Causes of Fever, is that they are Capable
of Cooperating wth. each other; and of
thus Producing Fever when they wou'd
not Singly, those are no particular
predisposing Causes of fever; they being
in Common wth. other Applications and
hence they act more Certainly on an 
Irritable habit; the Symptoms of the 
first stage of Fever sometimes Destroys
the Patient, the most Violent Fever We
know of is the Plague, but as it do's not

happen in the Country, We are Oblig'd
to trust to the Relations for the Knowledge
of it, wch. I must Observe is very Imperfect
thus for however it extends, that those
who are [illegible] wth. it Complain of 
Languor, and such Symptoms as generally
Attend much Violent Fevers, and have
suddenly Dropt down and expired,
have thus then the Symptoms of the 
first Stage have thus Cut off wth. us
the Symptoms of Intermittent Fevers
take Place wth. more Violence, than any
other and now and then a Patient as
Expir'd in the first Stage; according
to the Description of these Cases, the 
Patient becomes extremely Cold, there
is a vast Languor, great Application
about the Præcordia, Paleness and
these wth. the Tremblings, Continue
encreasing until he seems Cut off by
Weakness it is entirely probable
that several of these People, who 
have been suppos'd to Die of

[illegible]; have Died in Consequence
of the first Attack of Fever, that this
sometimes is the Case, I have Experianc'd,
and when the Disease has not gone on
so fast as no kill the Patient the
Paroxysm has gone on the same as in
the Common Paroxysm of Fever the 
Attack then in these Cases may Destroy
the Patient, if it do's not as indeed
most Commonly happens it is 
Succeeded by Rigor and [illegible]; In 
Intermittents when those take place
it is seldom the Patient is Carried
off there Arise a Heat about the Breast,
wch. Differing shall spreads over the 
whole Body, very unequally tho and
likewise Indiscriminately, the Pulse
becomes Stronger and fuller, but it is
Obstructed, or it is frequent and small
but this Symptom do's not always 
take Place here the Heat is more Regular
we often Meet wth. Heat in Fevers

and is extremely troublesome to the
Patient, yet it is not actually encreased
there is great Pain in the Head, wch.
if it Arises in an from the first Stage
of Fever is more Distension, and frequently
in the Joints, as well as the other Parts
of the Extremities, there is Stupor and
sometimes Delirium; the Paleness that 
takes Place in the first Stage gets off
and some Parts become [illegible] but 
that the Contraction Remains in
some Parts is evident, from the Dusky
Colour of the Skin; when the Attack has
been Violent there is often great and
Universal Soreness, the Secretions are some
of them encreased, the Urine is high
Colour'd but perfectly Transparent; there
are also partial Sweatings of the Head
Breast &c these Evacuations have been
Call'd Symptomatic to Distinguish them 
from those wch. take place in the crisis

they differ in this, in the one Case they are
partial, in the other Universal [P??tectic?]
also sometimes Appear on the Skin
this Part of the Paroxysm on would serve
to Point out to us; that the fulness of the
Precordia and Stomach, occasion'd the
Living Power to be Excited, first about
the Heart, and then in the whole Body,
so that the Blood is Propelled wth. great
Fever, as to take off the Contraction the
Heat then is a Mark of a stronger Action
of the Living Power; and from hence frequency
of the Pulse, and sometimes fullness
and Strength; Propelling the fluids
forwards wth, greater Force; Occasions
greater sanctions in particular parts
of the Body, Soreness is a Symptom
of the Contraction going off; as that is
generally full after Contraction of any 
kind; thus then the Symptoms of the
first Stage goe off; as those of the Second
encrease, and there decreasing give Place to the
Symptoms of the kind stage of Fever wch. is the Crisis

Lecture 24th.
Having Pointed out the Symptoms of the 
Second Stage of Fever, we now Come to the
Morbid Stage to wit the Crisis; We cannot
Observe that it is not the Distension but 
the Relaxation, of Loss of Distention
to Contraction that Produces Crises undoubtedly
however the Hot Fit is the Natural Cure of 
the first Stage, partly from the encreased
Action of the Heart and Arteries, and
partly from some other Causes, wch. We
are not as yet Acquainted wth. at least
the small Vessels through the Body
are actually Relaxed; the Pulse becomes
free, the Skin grows soft, and Moist
and recovers its Natural Colour; the
Tongue wch. was Dry becomes likewise
Soft and Moist, the Costiveness gets
off, and the Urine is secreted in a large
Quantity, in others the Appearances of
Contraction gets off from all Parts of 

the Body, but as Relaxation takes Place
before the Symptoms of the Second Stage
entirely Disappear, it seldom happens
but that some of the Sensations are encreased
thus the Urine, is generally in a large Quantity,
and tho transparent when first discharged
after a little time becomes turbid, and
Opaque at the Depositing a copious
Sediment, and this so generally happens
that it has Led some Practitioners to 
Imagine that a Crisis came or Come on
without it; but this is Contrary to
Experience, sometimes a Copious Sweat,
and sometimes Purging Arises, they are
different from those in the hot, as there
are Symptoms of Relaxation in all 
other Parts of the Body, after the Symptoms
of this last Stage are gone through, the
Disease Leaves the Patient, he being only
Weaken'd from the Exertions wch. have
taken Place in it; A Paroxysm of Fever
may be cut off by an Inflamation 

Hemorrhage has forming some Part of the
Body; when the Symptoms of the first
Stage suddenly, disappear or a so considerably
Diminished, why this then to
happen we dont know; some have Said
that the Matter was now Deposited in a 
particular Part, and had left the System
in general nor do's at all Explain the
difficulty, in the first Place, We can 
hardly Believe that all the Matter
supposing Obstructed in the whole
System should be Confin'd in a particular
Part, besides this often an
Inconsiderable Part of the Body,
as the Pleura wch. is very small and
cannot Contain more perhaps than
ifs. of Blood and the internal Parts
of the Blood Vessels except the
Heart are not Capable of being
Stimulated, and if an Inflamation was
to arise from such a Stimulus; the 

Matter would not be Accumulated, but
Pass on the others Parts of the Body,
in what there are so many difficulties
in Supposition and no Positive Proof;
that we cannot Admit it, it is certain
that Fever do's proceed from Matter, in a
few Instances, as in the Small Pox, but
there is still no Accumulation in the
System; when the Fever go's off the same
Pustules Subsist, them whence there is
a Constant Absorption of Matter, so
that there is always more Matter in
the System then at the time that the
Fever was Produc'd, hence it is evident
that the Fever was not Cured, by passing
the System from the Matter and in many
Fevers there is not the least Reason for
Supposing that there is any Matter at
all in the System especially in Inflamatery
Fevers, in wch. Inflamation and 
Hemorrahage generally Arise, as then
We dont know in what Manner these

Cure Fevers, We Commonly take it for
granted that it do's happen, a Patient
may Die also in the Second or third
Stage of Fever, for Causes wch. We shall
afterwards Explain, now a Paroxysm
of Fever may be gone through in four
Hours, sometimes less, it cannot
last more then 36. Hours, it is most
Commonly ended in 10, 14, or 20. Hours
We can Conceive that a Paroxysm might
last a great deal longer than 36
Hours, but Circumstances take Place
in the System, that Prevents this by a
fresh one Arising, there is a Paroxysm
of Fever that happens to all Men
towards the Evening, this is Carried
off by a Crisis taking Place, in the
Morning; you find in the Evening
that the Vessels are contracted, that
the same [illegible] will not Produce
Sweat, as in the Morning, there is also
frequently thirst, the Powers of the 

Body are Depress'd, and a Degree of
Languor takes Place in Disease's. This
Evening Paroxysm, in many Cases
becoming Apparent, and also in Weak
People, it begins about five from Seven
Commonly and Continues from Hence
to five in the Morning; We might Suppose
to arise from the Fatigue of the Day,
but we find it taking Place at the same
time in People that Work at very different
Hours, so that the time is not Alter'd
by the different Modes of Life, why it
shou'd take Place at all we have not
the least Conception, it has this Effect,
that it the Paroxysm takes Place about
Twelve, it shall goe on, but if it Continues
untill the following Day, at the time
it Produces a fresh Exacerbation, so that
the Paroxysm of Fever can Continue about
thirty Six Hours sometimes; when the
Paroxysm has nearly Subsided, the
Evening Paroxysm is not sufficient 
to Produce a fresh Exacerbation, yet

in this Case it seldom Continues above
48 Hours, a Fever consisting of one
Paroxysm, we Call an Ephemera Simplex
wch. if they were to Continue they wou'd
Prove Fatal, but the Patient is generally
well before the Practitioner is Call'd
so that this Fever has for the most
Part been overlook'd. It sometimes
Comes on by Violent Paroxysm or
Symptoms of the first Stage succeed'd
by a Degree of Delirium, that Patient
afterwards falls into a Considerable
Sweat, by wch. the Disease is Carried
off a Fever that Continues longer
than 36 Hours, is generally Compound
and Consists of several Paroxysms
following one Another, and this they do
in all Ways, sometimes they are
Distinct, that is the Symptoms [illegible]
Period goe off entirely before a Second
Arises, this We Call on Intermittent
Fever, when the Patient is greatly 
Beleiv'd, but the Pulse sometimes

frequent, and several other symptoms
are not Carried off before the Second
Period begins, We Call it a Remittent
Fever, and a Continued Fever have one
Period or Evacuation begins before
the former is Considerably abated,
We shall not Consider the Causes of the 
Recurring of Fevers, or rather Paroxysm
of Fever, We shou'd Empart a Prior
that all fevers wou'd be Ephemera
Simplex, we know no Reason why
a Fever shou'd Return of its own Accord,
We shall therefore next Consider these
Causes that occasions the Acronysms
of Fever to Return

Lecture 25th.
We are now to Come to [?less] the
Causes of Recurring of Fevers, that is of the 
Paroxysms of Fevers, we have said
that when the Causes where Applied
in many Cases they Produc'd only some
Symptoms of the Disease, and that
if these Causes when Remov'd, the
Symptoms when Produc'd wou'd Continue
that these where easily encreased as to
bring on a Hot Fit, wch. is Calld the
Paroxysm, if no Hot Fit arises; We
do not Say the Patient is affected wth.
Fever, now these Symptoms may go
off themselves or be Carried off, by the
Natural Evening Paroxysm, or they 
may encrease as to Produce a Hot Fit,
when a Perfect Paroxysm will take Place;
when the Paroxysm is gone through
and Crisis takes Place, when the

Pulse is Come to its ordinary Pitch, the Heat 
gone off, and there is no longer an encrease
of any Secretion; We find that the Fever is
not entirely Cured; that it has left some
Symptoms behind, as a Slight Pain in the
Back, a foul Tongue, as Paleness or a 
Dustiness of the Skin wth. Languor; but
these Symptoms in the first Stage are
not Sufficient to form a Paroxysm; they
Continue however sometimes going off
themselves; and sometimes encreasing so
as to Produce a Second Paroxysm, this
is often the Case in Intermittent fevers
in the next Place fresh Occasional Causes
may Reproduce the Dis Paroxysm, suppose
an Ephemera Simplex, having gone through
its Natural Progress and a Perfect Crisis,
yet if the Patient be Expos'd to Cold Putrid
Vapour &c. in so slight a Degree that in
Health it wou'd have had no Effect it will be

sufficent to Occasion, the Return of the
Paroxysm, the next Cause of Recurrence
of the Paroxysm of Fever, is the Natural
Evening Paroxysm, has has already been
Explained, it is this that Produces
Exacerbations in Continued Fevers moreover
if there shou'd have been several Paroxysms
of Intermittent or Remittent Fevers
it will Continue from Habit, the last
Cause of the Returning of Fevers, is 
what we shou'd never have Imagin'd
was it not evident, from Actual
Observation (J.E) the Action of the 
Types, in Attending to the Return of 
the Paroxysms, we find that
the greatest Number of the Return
at the End of 48 Hours; why they
shou'd have a Disposition to Return
at this particular time, We dont Know;
some have Suppos'd it was in Consequence
of Fermentation taking up this 
Space; but this and many others

Suppositions of the same kind, are by no
Means Satisfactory, Fevers the next to
this are more Apt to Return at the End
of 24. Hours; and at the next to this
at the End of 72. Hours; It is seldom that
We find 8.[illegible] going longer than this
though now and then a Fever will Reoccur
at the End of 96. Hours, and at all
other Intervals; When a Paroxysm of
Fever Reccurs at the End of 24. Hours, We
Call it a Quotidian because this is a
Paroxysm every Day when at the End
of 48. Hours, We Call it a tertian, because
the 49th. Hour is the beginning of the
Third Day. and so if it Return at the 
End of 72. Hours, We call it a Quartan
and for the same Reason we seldom
Meet wth. a Quartan, [illegible]. It is farther
to be Observ'd of Intermittent Fevers;
that they seldom Continue in the [illegible]
in wch. they Arose; Quotidians are frequently

Converted into tertians, and tertians into
Quartans, in the Spring when People
are Strong Quotidians and tertians generally
take Place, in the Autumn when We
are Exhausted by the Heat of the 
preceding Summer, tertians and Quartans
are more frequent so that in some
Degree, the fever Seems to be Connected
wth. the Strength or Weakness of the
Habit. Thus the Symptoms that 
Indicate a Strong Action of the 
Vessels often happen in Quotidians,
the Symptoms of the stage are Violent
in tertians; and there of Weakness 
are frequently met wth. in Quartans;
sometimes however there different Symptoms
Occur in the Type of Fever; when the
Paroxysm takes Place every Day
and in the Intermediate Days is Weak 
is Calld a double Tertian; in a Quartan

there is often a Strong Fit has Slight on's
and then a Strong one again, and so on;
others altho the Paroxysm take Place
every Day, there are Marks of a tertian
and a Quartan; and this is Calld
a Triple Quartan; It was suppos'd by
the Antients that there be here two Tertians
And that the Patient was Affected wth.
two different Fevers at once; but the Reason
of this Appears from Weakness and 
Irritability, hence this seldom happens,
till the Fever has Continued for some
Time; In Continued Fevers we shou'd
Consider them according to the Exacerbations.
It often happens that when a 
Fever is once Produced, the Paroxysms
will Continue to Recover at some of
these Types, without any Apparent
Cause, the Manner in which they do this
we have already Shewn, the Natural Cure
of one Paroxysm do's not Cure the Disease

for this is Apt to be put a Stop to, in
two Ways, we have already Said that
Fevers frequently Continue either
because after the Crisis some Symptoms
of the first Stage, remain as no Crisis
shall takes Place before the Action
of the Natural Evening Paroxysm or
of the Types.
Intermittents seldom Appear at the 
first in their Proper Types. In Continued
Fevers the Disease go's on because the
Paroxysms doe not Terminate before
the next Evening Paroxysm of Fever
if it shou'd Terminate before this a 
perfect Crisis then happening will
Carry off the Disease; in all Fevers the
severer the Paroxysm in general
the Shorter the Duration of the Disease
and the more perfect the Crises. In
Continued Fevers, those more Violent 
Exacerbations often happen on the 4th.

5th. 7th. 9th. 11th. 13th. 14th. 17th. and 21th. Days
than on any others and are the most Part
shorter, so as to goe off about, 4 or 5. in
the Morning, and the Crisis is more Apt
to Terminate the Disease. A Crisis may
be Fatal as well as Salutary. The
Antients Consider'd it as, [???tamen]
into Morbum and Naturam. If the
Crisis is entirely Perfect the Disease
go's off altogether and, and do's not Fever
or if some small Symptoms be left they
grow less and less, till at last they goe
quite off; A Continued Fever at the 
begining is generally first a Quotidian
than a Tertian, then a Quartan and at
last very irregular, this is sometimes
very easily Observable at others not
but not so frequently in this as in
Warmer Climates, nor indeed do's Crisis
Terminate Fever so frequently, in the
former as in the latter; the more Perfect
We can Observe the Tertian Type, the more
likely there is to be a Crisis, it is to be

Observ'd that when Speak of the begining
of Fever, We mean the first Week in wch.
the Exacerbations take Place every Day,
when of the Middle of the Second Week
or while it Observes the Tertian Type,
and when the End wch. is Commonly
more Severe when it Observes the 
Quartan type or becomes irregular; after
a Fever begins to Observe the Quartan
Type, it generally begins to Diminish,
and gradually Wears itself out; and this
Two both of Continued and of Intermittent
Fevers, the time of the duration of a
Quartan of itself is Commonly, 4. or
5. Months, of a Tertian has or 3 Months
and of a Quotidian about 6. Months,
the first Symptom of the going off of the 
Disease is a Moisture about the Tongue
a Relaxation of the Skin, together wth.
the Kidneys in Consequence of wch. the
Urine often Deposits a Lateritious
Sediment, and the Pulse becomes Regular

in all Cases of Fever, The Crisis are more
Apt to be Imperfect at the begining and more
Subject to Relapses, towards the End, if an
Imperfect Crisis do's happen Relapses
seldom occur. If Seems to have been forgot
by Modern Practitioners, that Fever had
a Termination of their own, this Arises
from their Dissenting from the description
of the Disease; as Laid down by the 
Antients; Now if all Fevers where to goe
through the Course already Describ'd no
one wou'd Die, but there are Causes that
Arise in the Course, wch. frequently are
Productive of Death of the Patient and
these we shall Proceed to Explain-

Lecture 26th.
We now Come to Point out to you the
Sources of Danger in Fevers, A Patient
may in the first Place be Cut off, by
the Fever itself, the Inactivity of the
Living Power, and a Depression of
Strength, may be so great as to be 
Fatal; this happens sometimes in the
Plague, in the beginning of a Paroxysm of
the Paroxysm of an Intermittent Fever,
its also Apt to Arise from the Affection of 
the Dram, wch. takes Place in Consequence
of the Symptoms of the first stage; sometimes
in the Second Stage; the Action of the 
Heart and Arteries is so encreased that
the Patient is Cut off by the generall
Inflamation, or the Effects of the Body
during the Paroxysm may have been so
great as to Produce such a Degree of 
Weakness and Irritability as to Prove
Fatal; We shall primarily Consider
the Symptoms of Danger Arising in

The first Stage, there wch. shew the Disease
to be Violent, are great Languor Weariness
and Weakness, wch. if they Continue long
the Shew the Depression of Strength to be
very great, so that the Symptoms of the
first Stage are more Capable of exciting
a Strong Action of the Heart and Arteries,
The Attack may Come on by a great
Prostration of Strength Attending it,
wch. is very different from Weakness as
in the former Case; the Powers of the
Body are Retarded upon the going 
off of the paroxysm A Man Attack'd
wth. a Fever being Incapable of Muscular
Motion; wch. shews the great Violence
of the Fever; the Skin being Tough Dry
and Unequal, these shewing the great
Contraction of it, if an Ulcer unites
and that becomes Dry; it shews the 
Vessels amongst the Muscles are 
Contracted, it Indicates the Contraction,
not being Confin'd to the Capillary

Vessels; if the Pulse is much Contracted
it Indicates the Contraction not being
Confined to the Capillary Vessels, but
smallness of the Pulse must not be
taken for Contraction; as this may Arise
from Weakness. If it be Quick in the
Hot Fit, and neither full nor Strong
especialy if it Intermit, it shews that
the Heart is greatly Oppress'd, and the 
Depression very Considerable frequency of
the Pulse and Intermission, may also
be Consider'd as a Symptom of Weakness
and Irritability; but more especialy
if they Arise towards the End of Fever.
The tongue and Mouth being Dry shews
that the Vessels of the Mouth are
Contracted; if there is a great Quantity
of Mucus Covering the Tongue, it may 
be owing to the Violent Affection of the 
System, and hence it is all Day at
the same Time Again it may Proceed
from an Affection of the Primæ Viæ, but
here the first is very great and not

Diminished by keeping the Mouth
Moisten'd, the urine being Pale Transparent
and in small Quantities shews the
Vessels in the internal Parts of the
Body are greatly Contracted. If it is 
perfectly Transparent and high Colour'd,
the Fever is pretty Considerable; If Pale
and in Large Quantity, it is a Pergnois
of an Approach of Delirium, from the
violence of the Symptoms. The Nails
Fingers and Feet remaining Cold and
Pale, except it be towards the End of
the Disease are Symptoms of its
Violence, and permanency, so as to 
Admit of Little Relaxation between
each Paroxysm, and the Disease
Accumulates to a great Degree
the Nose being Sharp, Temples and
Eyes hollow, Skin of the Forehead
Contracted; Ears Cold and the Face
Universally Pale, or of a dusty Colour
are Symptoms that Indicate a great 
Contraction about the Head and are

Look'd upon as very Dangerous, these
Appearances may Arise from many
Causes; as from the Violence of the 
Fever itself, from Delirium from Weakness
&c and has been Calld the Facia
Hippocrates, from Hippocrates
The first Observer of it, the Breathings
being Short Quick and Laborious, the
Patient moving the Nostrils principally
the Præcordia being Tense Swelld
and hard; the Anxiety and Restlessness
great, wch. Shews that a great Quantity
of Blood is Accumulated about
the Heart, or the Præcordia, and the
Heart is not Able to Clear itself. these
are the Symptoms that Indicate great
Danger, in the first Stage of Fever
but in the Continued Fevers the Symptoms
wch. are more Dangerous is the Delirium
whether it be a Disease of the Brain
itself, or of the Living Power, throughout
the System; If has not for the most Part
been Distinguished, but Consider'd as
the same; there are however several

Species of Delirium that takes Place in
Fevers, and two if not three Arise from
the first Stage; wch. are totally different
from one Another and Require as different
Treatment; first the Vessels of the Brain
may be Contracted, that a smaller Quantity
of Blood shall Pass through, wch. shall
not be sufficient to keep up its Functions
This Species of Delirium is Attended
wth. these particular symptoms, the 
Vessels of the Eye, wch. are the general
Criterion of the State of the Vessels of the
Brain are Pale Small and Hollow, there
is no Redness and Flushing of the 
Face, but a constant Duskiness and
Paleness. Secondly the Delirium is
Considerably encreased at the Exacerbation
and go's off entirely, or is Considerably
Diminished, when the Fever itself gets
off if the Disease go's through its
Natural Course, it Diminishes at the 
Exacerbations, and at last leaves the
Patient without Stupor, Delirium also
often happens from a Relaxation of

the Vessels of the Brain, and fullness
in Consequence, the Symptoms preceding
to this Species are the Eyes being Red
and Blood Shot, the Cheeks as Red as if
Painted and not Swell'd, the Delirium
itself more Constant and equable, tho
it is a little encreased by the Evening
Exacerbation, and when the Fever go's
off, this is often the last Symptom that 
remains, and that wch. dot goe off it
Leaves a Considerable Stupor behind;
the Vessels Requiring sometime before they
regain their Proper Tone probably there
is a Third Species of Delirium wch. do's not
Arise from an Affection of the Brain
but of the System, the first Symptoms of 
both these Species of Delirium are
Watchfullness, and Restless and unrepeating
Sleep, the Patient Dreaming much and
Waking somewhat Delirious, not knowing
where his, or who is about him, the Imagination

begins to be [illegible], then the Organs of the
Senses are Affected, and there is the Appearance
of Flies before the Eyes; the Patient Picks the
Hairs from the Bed Cloaths, this is a Symptom
of great Danger as his thirst suddenly going
off the Violent Drawing on a Total Insensibility
Conceson; and the Patient is sometimes Cut
off wth. Convulsions; these two Deliriums
are the Symptoms wch. generally Prove
Fatal in Continued Fevers; the Danger of the
first Attack of an Intermittent is not so great;
We shall in the next Place proceed to the
Symptoms wch. Point out the Strong Action of 
the Vessels....

Lecture 27th.
The first Stage of Fever Occasions Symptoms
of Strong Action of the Vessels, by wch. it is
Diminish'd and Carried off, but this
encreased Action of the Heart and Arteries
may be so great as to Prove Fatal; that is
such a Degree of general Inflamation may 
be Excited in Fever as to kill the Patient,
this happens in Continued Fever only, it
cannot take Place in an Intermittent because
it would Convert it into a Continued Fever
we have Said that it is probable that the 
encreased Action of the Heart and Arteries
is the Source of Danger in the Second Stage
yet there is something also that encrease
the Symptoms, so as to prolong the Disease
till a fresh Exacerbation Arises, and it is 
by this Means Converted into a Continued
Fever; On this Account general Inflamation

is not a Dangerous Symptom in Intermittent
Fevers; We might Suppose that Fever and
general Inflamation might Subsist at the 
same time and that the Fever might be
gone through without the general Inflamation
Effecting its Progress. In this Case there
would be a Hot Fit, and a Crisis would take
Place, the small Vessels and Glands
wou'd be Relaxed, and the Inflamation
would goe off, in Consequence of the
extraordinary Secretion, but this do's not
happen but in Continued Fevers, general
Inflamation is Dangerous for the most
Part by Producing an Affection of the 
Brain, or at least Delirium, the Symptoms
that Indicate general Inflamation are
hardness of the Pulse; Now we must Observe
that Authors have made but little Distinction
between a hard and an Obstructed Pulse
but there is this Criterion of difference
the Blood in one Case throws up an
Inflamatory Crust wch. it do's not in the

other; when the Blood is Obstructed it
may be of any Appearance hence there is
certainly a difference between an hard
and an Obstructed Pulse and they Point 
out the Strong Action of the Heart and
Arteries; and the other the Blood not 
getting readily into the small Vessels there
is also a generall fulness and Strength
of the Pulse, the general Inflamation may
be Dangerous when the Arteries only 
are Acting Strongly; As in the Hectic
Fever, the Blood being Propelld wth.
great Force into the small Vessels Occasions
a Redness, its returning more frequently
into the Lungs Produces a Quick and
difficult Respiration its being very distinct
from Putrefaction, Occasions a Whiteness 
together wth. a Dryness of the Tongue in
Affections of the Thorax, and sometimes
of the Stomach it is of a Yellow Colour

the Blood being Propell'd in Considerable
Quantities into the Vessels of the Head a
Distensil Pain is felt in the Internal Parts
of it; sometimes this Kind of Pain is 
felt in the Joints and Extremities, and
from the same Cause the Strong Action
of the Heart and Arteries; the Vessels
of different Parts of the Body are forced
Open, hence Sweatings of the Head and 
Breast, and sometimes of the whole
Body, the Symptoms of Strong Action
are only Dangerous when the Brain Comes
to be Affected, in this as in the former
Case, the Eye generally gives a Criterion
of the State of the Brain, they are Swell'd
red and Blood Shot, a Stupor takes
Place at first, sometimes Continuing 
for two or three Days, at other times
a Delirium Comes on, in wch. many different
Appearances Arise, sometimes it Attacks

suddenly, and is as shortly Fatal, sometimes
the Patient Mutters to himself, and if 
excited will Speak to you, but again will
soon forget himself, this is the most Common
kind of Delirium, Arising from this 
Cause, sometimes there are Violent 
Ravings for a Considerable Time, these
are Distinguished from the others by 
proceeding and Accompanying Symptoms there
is generally a Redness of the Face wth.
Swelling; but this is not so florid as in
the former Case and spreads more universally
over the whole Face, it is by this
principally that it is Distinguished from
all others, and most Commonly before 
the Patient is Destroy'd Connections Come
on, Another Way in wch. the Patient is apt
to be Cut off by the too Strong Action
of the Vessels, and is in Consequence 
of the general Irritability that Arises,

this Causes Restlessness and afterwards
Delirium in this Species, the Mind is more Apt 
to be Agitated than in any other, Ravings are
more Violent, so that the Patient often
Attempts to Destroy himself. The Muscular
Strength is encreased, the Eyes are exceedingly 
Bright and Piercing, and the Motions of 
the Body universally Quick a though this 
kind of Delirium Arises from the 
general Inflamation, yet for the most
Part it go's off before it takes Place, this
Delirium happens but seldom in Fevers,
and most Commonly in Fevers Attended
wth. Rheumatism, general Inflamation is
in any Way mostly Dangerous in the 
first Week of the Disease there is little
Danger afterwards. We Come now to 
the last Sense of Danger in Fevers, to wit
the Symptoms of Weakness and Irritability
that some time take Place, the Powers of
the Body are much Exerted in Fevers

in Consequence of which they are Exhausted 
sometimes to such a Degree as to Prove
Fatal, Weakness Renders Fevers more 
irregular, and this Prevents a Crisis from
taking Place, it generally falls in that
Part of the Body that is Retained, and
this is Carried out to us by the particular
Evacuations, as Partial as Universal
Cold, colliquative Sweatings a Purging
wth. a Dry Skin and Tongue, and a Flow
of Tears wch. is a Symptom of great
Irritability in the System, sometimes 
there is a great Secretion of them wch.
if Pale shews a great Irritation, the
great difference between these and a
True Crisis is that; in this the inflamation
is Universal in that only Partial if
the Pulse Continues Obstructed and
at the same time moisture of the
Tongue Purging and sometimes Sweating

it is a Symptom of great Danger, for as
We have just Observ'd there must be
Symptoms of Universal Relaxation to 
form a Crisis there is a Determination
of Fluids in these Cases to the
Relaxed Parts, so that in Fevers where
such Symptoms take Place Run out
to a great Length, and sometimes the
Disease Diminishes apparently for 4
Days and then encreases for four or
5 Days and so on, the next Symptom we
shall take Notice of is one properly
speaking and Dependant on the 
Weakness but Arising from a Depression
of the Strength, to wch. it is for one and
no other. This is the Putrefaction of the
Fluids, it has lately been Consider'd as a 
Cause of Fever, when the Depression of 
Strength and great Oppression about the
Pracordia, [Sigh???] and Soreness have
been Look'd upon, as Symptoms of Fever

but they are Causes of it in reality; As
the Fever takes Place first, it is evident that 
the Putrefaction wch. follows in an Affect of it.

Lecture 28th.
Sleep is sometimes more perfect and sometimes
not so perfect, it seems that all the Operations
are suspend'd the Heart Acts frequently more
slowly and wth. less force, the Respiration
gos on but in perfect Sleep much more
slowly, there Peristaltic Motion of the 
Intestin's go's on more slowly and likewise
the Secretion but in much less Quantity
the Lymphatics Absorb and Carry their
Fluids through them into the Blood Vessels
Sleep may be imperfect, the Organs of 
the Senses may just Impress the Mind
wth. Ideas, the Operations of the Mind
may go forward as in Dreams but 
not wth. that connection of Ideas wch.
take Place when a Man is awake, the 
Muscles may frequently be first in Action
as a Man may move or toss about from one
side of the Bed to another; the Organs
of the Senses do not Impress the Mind
wth. Ideas yet may so easily be excit'd

that the least Noise shall in ther Awake a
Man, or if not Awak'd excite some Ideas of Sound
but an imperfect one; the System is more
Recounted in proportion to the soundness of 
the Sleep, Sleep may be free or prevent'd
altogether by any Thing wch. excites great
Attention or Uneasiness of the Fluid, and
so likewise uneasiness of the Body or
Pain, the Action of any part of the Body
preternaturally encreas'd as for Example
an encreas'd Action of the Heart and Arteries
in general Inflamation sometimes
there is little or no uneasiness or Pain
Contraction continuing after their Cause
is remov'd; such as happens in Fever will
also prevent Sleep, but then Sleep tending 
to Render it overcomes there the Sleep becomes
profound and the uneasiness of the Body
is diminish'd and any preternatural Contraction
is carried off, in that when once Sleep
takes Place it Tends to render itself
imperfect and still in many Cases
removes the Causes of the Imperfection; In
Mania the Patient do's not Sleep for the 

Space of Twelve Months, in this Disease
and in others there are Instances of no
Sleep having taken Place for a fortnight or
three Weeks tho these Instances are Rare
in Health a Man as been kept Awake for 
Ten Days; now in Mania the Strength is 
not dimininsh'd, there Appears not to 
be that exhausting of the Living Power
the Mind do's not exert itself but as
in a Dream and the Body as Lost 
its Irritability so the same the exertion
do's not take Place as in Health
it often happens in Mania that the 
Body requires Sleep when the Mind
Thinks on any Subject, but the Mind
in Mania do's not Act but as it
where in a Dream, the Organs of the 
Senses are not Impress'd wth. just
Ideas, the Powers of the Body are
not excit'd but as in a Dream so
we may consider as in a State of
Sleep in as far as regards the
exhausting the Living Person [cross out] in
all other Cases it Occasions such 
a Weakness to prove Fatal, but
a Man in a Delirium in a fever is

more capable of Reasoning the want of
Sleep then in a Man awake, it is then
the excertion of the Judgement wch. exhausts
the Power of the Mind and in Delirium its
not Acting more at all but its only [illegible]
and a Patient can bear the want of 
Sleep, indeed the want of Sleep will
Occasion Delirium and Mania, a Man then
no Health requires Sleep to keep up the 
Strength of the Body in perfections
when an Animal is young and the 
Powers of the Body and Facultys of the 
Mind, a Larger Quantity of Sleep is Necessary
and the Sleep is generally more perfect
In old Age the Body is wore out and is 
incapable of being recrut'd and no
Sleep takes Place on that wth. difficulty
if any and continues but for a short 
Time, in the middle age of Life the Quantity 
of Sleep Necessary seems to be about one
Third Part of Twenty four Hours; A Man may 
Sleep no more than Six or four Hours,
but he generally wears out his Body
by this Means, to Recruit the Body
about Eight Hours is necessary, indeed
Active Minds wou'd rather Wear out

the Body than loose so much of their
Time as two Hours additional Sleep; longer
Sleep than Eight Hours may take Place
through Habit but always serves to
Obtund and diminish the Powers of the
Body, the Powers of the Body shou'd
be kept in Action to be perfect and
longer Sleep tends to obtund both the
Powers of the Body and Mind as Sleep
tends to take off any preternatural 
Action but its much more efficacious
in Recruiting the System at the Time
of the Natural Evening Paroxysm of
Fever as it tends to take it off
and render the Crisis more compleat
and if we dont Sleep at that time
the Crisis is not compleat
and by that Means the Body is
Wore out. 

Lecture 28th
Its time the depression of Strength as been
Said to depend on the Putrefaction of the
Fluids and according to the Reasoning
of Practitioners it must be said as
depression taken Place for to according
too those Philosophers the Putrefaction must
be the Cause of the Depression of Strength
the Effect according to those Practitioners
must go before the Cause so the Putrefaction
must be the Cause of the consequence
to be deduc'd from this is to employ
Medicines is to take off the putrefaction
of the Fluids and this you are to do in
the beginning; The Symptoms of the putrefaction
of the Fluids are in the first Place
the Mucus of the Tongue in Fever becoming
of a blackish Colour and when the 
putrefaction Arises to a considerable
Height it then becomes quite Black
and its of a loose Texture on the Tongue
the Fever and this is often rubb'd
off by the Teeth wth. this fever and
sometimes the Roof of the Mouth when

the Putrefaction arises to a considerable
Height; in the next place Fætor of the 
Breath and the Evacuations from the
Intestines becoming Fætid Show that
putrefaction of the Fluids is Arising,
then blackish Spots or marbling of the
Skin and these have generally been
called Patechia, in fevers there is a great
many different Fluids; but there is only
one Species wch. Point out putrefaction
of the Fluids wch. are of a blackish
Red appearing through the Skin the 
breadth of any Juniper; or marbling
Purple or blue Specks as in varies an'd
Marble often is Seen, or where the
putrefaction as Arisen to a great height
it now and then happens that the 
whole Skin becomes of a Purple Colour
and in that Case generally the Patient
is Destroy'd in a short time. The others
we do not denote putrefaction of the 
Fluids are reddish Spots on the Skin
superficially, and commonly came
out about the Fifth a Day and then
go off again, this Eruption is Violent

Fever; the Fever is not at all dimminish'd
by the Eruption coming out, and on its
going off again is not more Violent,
and this do's not Afford us any Indication
of Cure, this affording no one Indication
of Cure or alteration in the Fever is not worth
Attending to, it happens generally where the
Patient is Attack'd wth. Fever wth.; considerable
force, then there is another Eruption from 
Weakness it Arises in irregular Miliary
Eruptions, a Number of little Spots on
the Skin and this merely are [illegible]
and wch. Arises from Sweating taking
Place often in consequence of Stimulating
Medicines being Employ'd and happens
more in Nervous Fevers where there is this
irregularity than in Fevers wch. are either
Inflammatory or Violent, then there is 
another Eruption wch. is at the 
Fon'd and sometimes when its gone off
entirely this Eruption is some what like
very small Worms sometimes of a 
blackish Colour, and sometimes of the 
Colour of the Skin Rising in the Skin and hard

and wch. is not Inflamation, and these happen at
the End of Violent Fevers when the Symptoms
of Putrefaction are gone off, the Petechia
dont Seem to be Alter'd by any Treatment
when putrefaction of the Fluids produce
Petechia there is no manner of Treatment
wch. will produce any good Effect
but that Treatment wch. will Cure the Fever
the little Blisters are occaseon'd often by
keeping the Patient too Hot and giving the 
Patient warm fluids wch. are Stimulating
and often they are not diminished by
any Treatment whatever; Marbling of the 
Skin and fœtid Secretions indicate to us 
putrefaction of the Blood, sometimes the 
Urine is load'd wth. Mucus and is of a
frothy Appearance by the Air being stamp'd
in it, sometimes the Red Particles of 
the Blood are formed in it but this but
seldom the Case, the Urine when this 
happens is of a Chocolate Colour a
dark brown and sometimes this Sediment
is deposit'd, there is probably 
then some Affection of the Kidneys

besides putrefaction wch. as Influence
on the Kidneys so as to produce this
Species of some,  and lastly Arises and
produces the most Fatal Symptoms
wch. Arise in the Disease that is Haemorrhage
as he is Weaken'd and cannot bear the
Loss of Blood, sometimes the Gums become
loose and Spongy and Haemorrhage happens
the most common Haemorrhage wch. happens
is from the Mouth Throat or Nose, this takes
place in consequence of the Putrefaction 
and wch. gives no Relieff at all to the
Fever, the Fever remaining as Violent as
before affording not the least Relieff in 
the Fever but tending to weaken the Patient
the Blood thrown out by any natural Hemorrhage
or Blood when taken away by
any other means hardly Coagulates when
in this state, and the Coagulum is Loose
and easily broke to Peices and the Semon
is Mix'd wth. it, it has now and then 
happen'd that the Blood as become
Fœtid, I myself never I knew or Saw it

but its Relat'd by Authors, and sometimes
Practitioners in warm Climates have
Affirm'd that they have Smelt it Fœtid
and we dont doubt but that sometimes
the putrefaction go's so far as to give
a Fœtor to the Fluids/ now this sometimes
go's as far as to Add to the Weakness
and the depression of Strength wch. Tends
to destroy the Patient, so when the Skin
becomes of a Purple Colour it Destroys
a Patient soon a Delirium comes on and
the Patient is carried off soon in the 
space of Ten or Twelve Hours, and no
such Symptoms come on except 
putrefaction of the Fluids take Place,
the putrefaction depends on the depression 
of strength if Inflammation happens
in the middle of the Fever there the
Symptoms go off and the Inflammation
Blood from an encreas'd Action
of the Heart and Arteries and so its
evident that the putrefaction depends
on the Inaction of the Vessels/ Fevers
wch. happen in Jails and in Camps

and that wch. Arises in the Barracks of
Soldier's Arising from Infection are Apt to
exhibit Symptoms of putrefaction of the Fluids

Lecture 30th.
On Fever's