Bi^$Pit iSS^S ^ij&5-- I1 1r i f Iff v Mr ;: t» | ■- . r '*«\ - /•frfctt'.i !"/■' '."■:•■ i-t\ s. yy. X .}£\ DOMESTIC MEDICINE; OR, A TREATISE ON THE PREVENTION AND CURE OF DISEASES, BT BEGIMEN AND SIMPLE MEDICINES: WITH AN APPENDIX, COSTAIMTG A DISPENSATORY FOR THE USE OF PRIVATE PRACTITIONERS. By WILLIAM BUCHAN, M.D. FELLOW Off THE EOYAIr COLLEGB OI1 PHYSICIANS, ETJIKBUBGH. A NEW AND ENLARGED EDITION. CONTAINING NEW TREATISEsloN SE|-BAtalNG, MINEPvAL WATERS, VACCINE INOCffLATIUJMlHET, 4c- &0t HALIFAX LIFAX: , _ , , « / ND SOWppjl / J \J*S MI1M*EB A |—» . .... JL^_ 18G3. s/ Mease-Is Btruj Worm's ■Intestinal Worms. DOMESTIC MEDICINE; or, A TREATISE ON THE PREVENTION AND CURE OF DISEASES, BT BEGIMEN AND SIMPLE MEDICINES: wna AN APPENDIX, CONTAINIG A DISPENSATORY FOR THE USE OF PRIVATE PRACTITIONERS. By WILLIAM BUCHAN, M.D. *** __, FELLOW OF THE KOTAL COLLEGE OF PHYSICIANS, EDINBURGH. A NEW AND ENLARGED EDITION N SB'I-BAttHlNG, MIN ATKIK^IMET, Ac. &lc CONTAINING NEW TREATISES ON SEl-BAfcHlNG, MINERAL WATERS, I VACCINE 1NOCWLATIOJMIMET, Ac. &c HALIF iiiiuie a LIFAX: iii /i7 ND SOWpilj / 0 \m& 18C3. V W2 891 Ed \U5 TO SIE JOSEPH BANKS, BAET. PRESIDENT OF THE ROYAL SOCIETY. Sir, The Domestic Medicine having been honoured, on its first appearance, with the patronage of your learned and worthy predecessor, the late Sir John Pringle, I beg leave, in a more improved state, to dedicate it to you, as a small but sincere testimony of that veneration and esteem with which I have long beheld the man who, born to ease and affluence, had resolution to encounter the dangers of unknown seas and distant climes, in pursuit of useful science; and whose constant object has been to render that science subservient to the happiness and civilization of society. I have the honour to be, with great respect, Sir, Your most obedient Servant, W. BUCHAN. London, 10th Nov. 1782. CONTENTS. PART I. OP TIB GENERAL CAUSES OF DISEASES. CHAP I. FAG1 Of Children................................................................ l — Diseased Parents....................................................... 5 — Clothing of Children .................................................... fi — Food of-ditto ......................................................... 10 — Exercise of ditto ........................................................ •4 — Bad effects of unwholesome air upon ditto.............................. 20 — Nurses ............................................................... ■'" CHAP. II. Of the Laborious, &c....................................................... 25 -----Sedentary .......................................................... aa -----Studious............................................................ 38 CHAP. IIL Of Aliment................................................................ 42 CHAP. IV. Of Air................................................................... 51 CHAP. V. Of Exercise .............................................................. CHAP. VL Of Sleep ................................ ................................. *' — Clothing................................................................ CHAP. VIL ____............. 64 Of Intemperance fUi CONTENTS. CHAP. VIII. PICA Of Cleanliness ........................................................... aj CHAP. IX. Oflnfection ............................................................. ?3 CHAP. X. Of the Passions............................................................ «' — Anger................................................................ ib- — Fear................................................................. ib- -Grief .................................................................. "" — Love ................................................................. 8-2 — Religious Melancholy.................................................. it>. CHAP. XL Of the common evacuations................................................ 84 — Stool,................................................................. ib, — Urine.................................................................. 8.5 — Perspiration.......................................................... 1)7 — being affected by changes in the atmosphere ............................ ib. — Wet Clothes............................................................ 8J — Wet Feet.............................................................. ib. — Night Air............................................................. ib. — Damp Beds ........................................................... U) — Damp Houses......................................................... gu — Sudden transitions from heat to cold...................................... ib. PART II. or DISEASES. CHAP. XII. Of the knowledge and cure of diseases .................................... 94 CHAP. XIII. Fevers in general.................................................... 07 CHAP. XIV. 0f intermitting fevers or ajjues................................. ,,,<« CONTENTS. ix CHAP. XV. TAGR Of an acute continual fover ................................................ I09 CHAP. XVI. Of the Plenrisy .......................................................... 113 -----Bastard ditto..................................................... 117 ——— Paraphrenias ...................................................... 118 CHAP. XVII. Inflammations of the lungs ................................................ 118 CHAP. XVIII. Of Consumptions.......................................................... 120 CHAP. XIX. Of the slow or nervous fever .............................................. 130 CHAP. XX. Malignant, putrid, or spotted fever .......................................135 CHAP. XXL Miliary Fever ............................................................ 141 CHAP. XXII. Remitting Fever............................................................ 145 CHAP. XXIIL The Small-pox............................................................ 147 Inoculation...........................................................--- 15(j CHAP. XXIV. The Measles............................................................. iGi Scarlet Fever ............................................................ 1,;7 Bilious Fever.............................................................. ll,J CHAP. XXV. Of the Erysipelas, or St. Anthony's Sre.................................. 170 CHAP. XXVI. Of the Phrcnitis, or Inflammation of the Brain ..........................173 K cc^Trvrrg. CHAP. XXVII. PA Gil Of the Ophthalmia, or Inflammation of the Eyes........................... 177 CHAP. XXVIII. The Qainsey, or Inflammation of the Throat................................ 181 Malignant ditto .......................................................... 185 CHAP. XXIX. Colds and Coughs.......................................................... 180 A common Cough ........................................................ 191 Hooping Cough .......................................................... 194 CHAP. XXX. Inflammation of the Stomach .............................................. 197 -------- Intestines ...................... ................... 19.) OftheColio ............................................................ 201 Inflammation of the Kidneys .............................................!>0a -------------------Bladder ............................................ 2117 •---------Liver................................................2Ud CHAP. XXXI Of the Cholera Morbus and other excessive discharges from the stomach and bowels............................................................211 — A Diarrhoea, or looseness.............................................212 — Vomiting .............................................................. 215 CHAP. XXXIL Of the Diabetes, and other Disorders of the Kidneys and Bladder............217 ------Suppression of Urine ................................................ 219 -----Gravel and Stone............................................... t> 5j20 CHAP. XXXIII. Involuntary discharges of blood ................................ 004 Bleeding at the nose ............................ ooi- Bleeding and blind Piles ....................................-# " 0.2H Spitting of Blood.................................. " 1^, Vomiting of ditto .................................. " ...... Bloody urine .......................... ------Flux..................... ............................... *''* .............•..........................................2SJ C'selio Passion.............. ...................................................... i\»y CHAP. XXXIV. Of the head-ache .................. CONTENTS. T.\ r.vGK ---Tooth-acho..........................................................243 ---Ear-ache..............................................................245 Pain of the Stomach, &c..................................................... 246 CHAP. XXXV. OfWorms ............................................................... 249 CHAP. XXXVI. Of the Jaundico............................................................ s53 CHAP. XXXVII. Of the Dropsy.........................................................V S-'5 CHAP. XXXVIII. Of theGout............................................................... 2^9 ----Kheumatisiu....................................................... CHAP. XXXIX. Of the Scurvy ............................................................ f™ ---- Scrofula .......................................................... ____Itch ..............................................................m CHAP. XL. .... °76 Of the Asthma ................................................... CHAP. XLI. ................ 272 Of the Apoplexy .......................................... CHAP. XLII. .......................281 Of Costiveness .................................... 2g3 — Want of appetite.............. ......................................... — Heartburn................................... CHAP. XLIII. „. .........................285 Of Nervou3 Diseases .............................. 28g — Melancholy .......................•.........................""'^ ][ 2i)3 — thePalsy ........................................*........... " 2<)4 — theEpUepsy, or Falling Sickness.....................................•• ^ — the Hieeup ................................. 297 — Cramp of the stomach................................ ...... — the Night-Mare ............................................... Jtll C0NTE.VT3. PiOU — Swoonings...........................................•................. 2(1fl — Flatulencies, or wind.................................................... 3°" — Low-spirits ............................................................ 3"" — Hysteric Affections......................................................30:i — Hypochondriac Affections ..............................................30u CHAP. XLIV. Disorders of the senses ....................................................S03 -------------Eye........................................................ ;b" A gutta Serena............................................................310 A Cataract................................................................ ib. Short Sightedness.......................................................... 811 Seeing only at too great a distance ........................................ ib- Squinting.................................................................. iu Spots or Specks .........................•................................ ib. Blood-shot eye............................................................ ib* Watery or Weeping eye .................................................. ib. Of the Ear................................................................312 —-— Tasteand Smell.......................... ........................... 313 ------Touch............................................................... 313 CHAP. XLV. Of a Schirrus and Cancer.................................................. 316 CHAP. XLVI. Of Poisons.................................................... #> 3.™ — Mineral .Poisons............................................. _ 301 — Vegetable ditto ................................................. ^ go., Bites of Poisonous animals.......•............................... «.,.j Bite of a Mad-dog........................................... :u -----the Viper ................................................... ......338 -----Poisonous insects .....................#................ 3.,, ■ the Rattle-snake......................................... o™ CHAP. XLVIL Of the Venereal disease — Virule — Gleets — the Sv — Buboes >••••.....•........................ ........ 331 — Virulent Gonorrhaea ................................ " „.,. the Swelled Testicle .:................................'_' '.............. " WO 141 344 — Chancres ........................... — a Confirmed Lues or pux..................... — General Observations .................... .............•......317 CHAP. XLVIII. Diseases of women .......... ........................................'.... 351 CONTENTS. . X.H FACE Of the menstrual discharge..................................................352 Pregnancy "..........................'...................................3^7 Ciiild-birth................................................................ S59 Barrenness................................................................334 CHAP. XLIX. Diseases of Children ......................................................305 Of the Meconium.........................................................3 >7 Of the Aphthrea or Thrush................................................ ib. — Acidities ..............................................................363 — Galling and Excoriation...... -..........................................309 — Stoppage of the nose...........................•........................370 — Vomiting .............................................................. '° — a Looseness ............................................................ 371 — Eruptions ..............................................•».............. 3/2 — the Croup.............................................................. 374 — Teething................................................................ 375 — the Rickets ...........................................................377 — Convulsions ............................................................379 — Water in the head.....................................................380 CHAP. L. Of Surgery................................................................ 381 Bleeding ..................................................................382 Inflammations & Absceses..................................................384 Wounds ................................................................. 385 Burns .................................................................... 3S8 Bruises.................. ................................................. 389 Ulcers....................................................................391 CHAP LI. Of Dislocations.....................................;......................393 Dislocation of the Jaw...................................................... ib. . ______.-----Neck ....................................................394 ______. Ribs .................................................... ib. _____.________Shoulder.................................................. 395 _____________Eltjow.................................................... 39G .____,________Wrist and Fingers ....................................... ib _____________.Thigh.................................................... ib| .______._______Knees, Ancles, and Toes..—.............................. ib CHAP. LI. Of Broken Bones, &c....................................................... 397 — Strains ................................................................ 3y9 — Ruptures .............................................................. 400 CHAP. LIII. Of Casualties..............................................................4(n — Substances stopped between the Mouth and the Stomach ................403 — Drowned Persons ..................................................... *uti srir CONTENTS. PAcifl — Noxious Vapours................ .......................................4J0 Effects of extreme Cold....................................................iU ----------------Heat.................................................... 413 CHAP. LIV. Of Fainting Fits, and other cases which require immediate assistance ........413 — Intoxication............................................................4':i — Suffocation and Strangling................................................418 — Persons who Expire In Convulsion Fits ...............................4-J CHAP. LV. Of Cold Bathing, with Remarks on the Cases in which the Warm Bath is more advisable........................................................422 , CHAP. LVI. Of Mineral Waters ........................................................4-3 CHAP. LVII. Of the Cow-Pox..........................................................4C1 CHAP. LVIII. Of Diet................................................ ...................rJC7 CONTENTS OF THE APPENDIX. PAGE Introduction ....................449 List of Simples .................453 General Catalogue of Medicines .. 455 MEDICAL PEEPABATIONS. Balsams..........................4C1 Boluses.......................... ib. Cataplasms and Sinapisms........462 Clysters..........................463 Collyria, or Eye-waters ..........464 Confections ...................... 465 Conserves and Preserves.......... ib. Decoctions ......................486 Draughts ........................467 Electuaries ...................... 468 Emulsions.......................469 Extracts ........................470 Fomentations.................... ib. A Glossary ........................... Index ........................ Gargles........................, Infusions ....................... Juleps ........................ Mixtures ...................... Ointments, Liniments, Cerates ... Pills ......................... Plasters........................, Poultices ...................... Powders ...................... Syrups ........................ Tinctures, Elixirs, &c............ Vinegars ...................... Waters by Infusion, &c......... Simple distilled Waters .......! Wheys......................... Wines......................... 473 474 ■b. 47e 478 480 ib- 482 ib- 485 4JS 438 ib. ib. 4C0 4J3 PREFACE. When I first signified my intention of publishing the following sheets, I was told by my friends it would draw on me the resentment of the whole Faculty. As I never could entertain such an unfavourable idea, I was resolved to make the experiment, which indeed came out pretty much as might have been expected. Many whose learning and liberality of sentiments do honour to medicine, received the book in a manner which at once showed their indulgence, and the falsity of the opinion thai every Physician wishes to conceal his art; while the more selfish and narrow-minded, generally the most numerous in every profession, have not failed to persecute both the book and its Author. The reception, however, which this work has met with from the public, merits my most grateful acknowledgments. As the best way of expressing these, I have en- deavoured to render it more generally useful, by enlarging the prophylaxis, or that part which treats of preventing diseases; and by adding many articles which had been entirely omitted in the former impression. It is needless to enumerate these additions: I shall only say. that 1 hope they will be found real improvements. The observations relative to Nursing and the Management of Children were chiefly suggested by an extensive practice among infants, in a large branch of the Foundling Hospital, where I had an opportunity, not only of treating the diseases incident to childhood, but likewise of trying different plans of nursing, and observing their effects. Whenever I had it in my power to place the children under the care of proper nurses, to instruct these nurses in their duty, and to be satisfied that they performed it, very few of them died: but when, from distance of place, and other unavoidable circumstances, the children were left to the sole care of mercenary nurses, withoutany person to instruct or superintend them, scarce any of them lived. This was so apparent, as with me to amount to a proof of the following melan- choly fact: Thut almost one half of the human species perish in infancy, by im- proper management or neglect. This reflection has made me often wish to be the happy instrument of alleviating the miseries of those suffering innocents, or of rescuing them from an untimely grave. No one, who has not had an opportunity of observing them, can imagine what absurd and ridiculous practises still prevail in the nursing and management of infants, and what numbers of lives are by that means lost to society. As these practices are chiefly owing to ignorance, it is to be hoped, that when nurses are better informed, their conduct will be more proper. The application of medicine to the various occupations of life has been in general the result of observation. An extensive practice for several years, in one of the largest manufacturing towns in England, afforded me sufficient opportunities of observing the injuries which those useful people sustain from their particular employments, and likewise of trying various methods of obviating such injuries. The success which attended these trials was sufficient to encourage this attempt, which I hope will be of use to those who are under the necessity of earning their bread by such emp.uj. men's as are unfavourable to health. XVI PREFACE. I do not mean to intimidate men, far less to insinuate that even those arts, the prac- tice of which is attended with some degree of danger, should not be carried on ; but to guard the less cautious and unwary against those dangers which they have it in their power to avoid, and which they often through mere ignorance incur. As every occupation in life disposes those who follow it to some particular disease mora than to others, it is certainly of importance to know these, in order that people may be upon their guard against them. It is always better to be warned of the approach of an enemy, than to be surprised by him, especially when there is a possibility of avoid- ing the danger. The observations concerning Diet, Air, Exercise, &c. are of a more general nature, and have not escaped the attention of physicians in any age. They are subjects of too great importance, however, to be passed over in an attempt of this kind, and can never be sufficiently recommended. The man who pays a proper atention to these will seldom need a physician; and he who does not will seldom enjoy health, let him employ as many physicians as he pleases. Though we have endeavoured to point out the cause of diseases, and to put people upon their guard against them, yet it must be acknowledged that they are often cf such a nature as to admit of being removed only by the diligence and activity of the public magistrate. We are sorry, indeed, to observe that the power of the magis- trate is seldom exerted in this country for the preservation of health. The import- ance of a medical police is either not understood, or little regarded. Many things highly injurious to the public health are daily practised with impunity, while others, absolutely necessary for its preservation, are entirely neglected. Some of the public means of preserving health are mentioned in the general pro- phylaxis, as the inspection of provisions, widening the streets of great towns, keeping ttiem clean, supplying the inhabitants with wholesome water, &c.; but they are passed over in a very cursory manner. A proper attention to these would have swelled this volume to too large a size; I have therefore reserved them for the subject of a future publication. In the treatment of diseases, I have been peculiarly attentive to, regimen. The generality of people lay too much stress upon Medicine, and trust too little to their own endeavours. It is always in the power of the patient, or of those about him, to do as much towards his recovery, as can be effected by the physician. By not attending to this, the designs of Medicine are often frustrated ; and the patient, by pursuing a wrong plan of regimen, not only defeats the Doctor's endeavours, but renders them dangerous. I have often known patients killed by an error in reregimen when they were using very proper medicines. It will be said, the physician orders the regimen when he prescribes a medicine. I wish it were so both for the honour of the Faculty and the safety of their patients; but physicians as well as other peo- ple are too little attentive to this matter. Though many reckon it doubtful wheth?r physic is more beneficial or hurt- ful to mankind, yet all allow the neceessity and importance of a proper regimen in diseases. Indeed the very appetites of the sick prove its propriety. No man in his senses ever imagined that a person in a fever, for example, could eat, drink or conduct himself in the same manner as one in perfect health. This 'part of medicine, therefore, is evidently founded on Nature, and is every way consistent with reason and common sense. Had men been more attentive to it, and less solicitous in hunting after secret remedies, Medicine had never become' an object of ridicule. Tins seems to have been the first idea of Medicine. The ancient physicians acted chiefly in the capacity of nurses. They weut very little beyond aliment inthej PREFACE. Xvil proscriptions; and even this they generally administered themselves, attending the sick for that purpose through the whole course of the diesase. which gave them an opportunity, not only of marking the changes of the disease with great accuracy, but likewise of observing the effects of their applications, and adapting them to the symptoms. The learned Dr. Arbuthnot asserts, that by a proper attention to those things which are almost within the reach of every body, more good and less mischief will be done in acute diseases, than by medicines improperly administered; and that great cures may be effected in chronical distempers, by a proper regimen of tho diet only. So entirely do the Doctor's sentiments and mine agree, that I would tidviso every person, ignorant of physic, to confine his practice solely to diet, and t io other parts of regimen; by which means he may often do much good, and can seldom do any hurt. This soems also to have been the opinion of the ingenious Dr. Huxam, who ob- serves, that we often seek from art what all-bountiful Nature most readily, and ns effectually offers us, had we diligence and sagacity enough to observe and mako use of them ; that the dietetic part of Medicine is not so much studied as it ought to be; and that though less pompous, yet it is the most natural method of curing diseases. To render the book more generally useful, however, as well as more acceptable to the intelligent part of mankind, I have, in most diseases, besides regimen, recoin. mended some of the most simple and approved forms of medicine, and added such cautions and directions as seemed necessary for their safe administration. It would no doubt have been more acceptable 4o many, had it abounded with pompous pre- scriptions, and promised great cures in consequence of their use; but this was not my plan; I think the administration of medicines always doubtful, and often dangerous, and would much rather teach men how to avoid the necessity of using them, than how they should be used. Several medicines, and those of considerable efficacy, may be administered with great freedom and safety. Physicians generally trifle a long time with medicines be- fore they learn their proper use. Many peasants at present know better how to use Borne of the most important articles in the materia medica, than physicians did a century ago; and, doubtless, the same observation will hold with regard to others some time hence. Wherever I was convinced that medicine might be used with safety, or where the cure depended chiefly upon it, I have taken care to recommend it; but where it was either highly dangerous, or not very necessary, it is omitted. I have not troubled the reader with a useless parade of quotations from different authors, but have in general adopted their observations where my own were either defective, or totally wanting. Those to whom I am most obliged are, Ramazini, Arbuthnot, and Tissot; the last of which in his Avis ait Peuple, comes the nearest to my views of any author I have seen. Had the Doctor's plan been as complete as the execution is masterly, we should have had no occasion for any new treatise of this kind so soon; but by confining himself to the acute diseases, he has, in my opi- nion, omitted the most useful part of his subject. People in acute diseases, may sometimes be their own physicians; but in the chronic, the cure must ever depend chiefly upon the patient's own endeavours. The Doctor has {also passed over the Prophylaxis, or preventive part of the medicine, very slightly, though it is certainly of the greatest importance in such a work. He had no doubt his reasons for so doing, and I am so far from finding a fault with him, that I think his performance docs great honour both to his head and to his heart. Several other foreign physicians of eminence have written on nearly the sam« b tlan with Tissot, as the Baron Van Swieton, physician to their Imperial Majesty, M. Rosen, first physician of the kingdom of Sweden, &c.; but these gentlemen'3 productions have never come to my hand. I cannot help wishing, however, tliat Eome of our distinguished countrymen would follow their example. There still re- mains much to be done on this subject, and it does not appear to me how any n:;in could better employ his time or talents, than in eradicating hurtful prejudices, and diffusing useful knowledge among the people. I know some of the Faculty disapprove of every attempt of this nature, imagining that it must totally destroy their influence. But this notion appears to me as nbsurd as it is illiberal. People in distress will always apply for relief to m*n of superior abilities, when they have it in their power; and they will do this with far greater confidence and readiness, when they believe that medicine is a national science, than when they take it to be only a matter of mere conjecture. Though I have endeavoured to render this Treatise plain and useful, yet I found it impossible to avoid some terms of art; but those are in general either explained, or are such as most people understand. In short, I have endeavoured to con- form my style to the capacities of mankind in general; and, if my readers do not flatter either themselves or me, with some degree of success. On a medical subject, this is not so easy a matter as some may imagine. To make a show of learning is easier than to write plain sense, especially in a science which has been kept at such a distance from common observation. It would, however, be no difficult matter to prove, that every thing valuable in the practical part of Medicine is within the reach of common abilities. It would be ungenerous not to express my warmest acknowledgments to those gen- tlemen who have endeavoured to extend the usefulness of this performance, by translating it into the language of their respective countries. Most of them have not only given elegant translations of the book, but have also enriched it with many useful observations; by which it is rendered more complete, and better adapted to the climate and constitution of their countrymen. To the learned Dr. Duplanil of Paris, physician to the Count d'Artois, I lie under particular obligations ; as this gentleman iias not only enlarged my treatise, but, by his very ingenious aud useful notes, lias rendered it so popular on the Continent, as to occasion its being translated into all the languages of modern Europe. I have only to add, that the book has not more exceeded my expectations in its success, than in the effect it has produced. Some of the most pernicious practices, with regard to the treatment of the sick have already given place to a more rational conduct; and many of the most hurtful prejudices, which seemed to be quite in- surmonntable, have in a great measure yielded to better information. Of this a stronger instance cannot be given than inoculation of the small-pox. Few mothers some years ago, would submit to have their children inoculated even by the hand of a physician ; yet nothing is more certain, than that of late many of them have per- formed this operation with their own hands ; and as their success has been equal to that of the most dignified inoculators, there is little reason to doubt that the practice will become general. Whenever this shall be the case, more Uves will be laved by inoculation alone, than are at present by all the endeavours of the Faculty. INTRODUCTION. The improvements in Medicine, since the revival of learning, have by no means kppl price with those of other arts. The reason is obvious. Medicine has been studied by few, except those who intended to live by it as a trade. Such, either from a mis- taken zeal for the honour of Medicine, or to raise their own importance, have en- deavoured to disguise and conceal the art. Medical authors have generally written in a foreign language; and those who were unequal to this task, have even valued themselves upon couching, at least, their prescriptions in terms and characters unin- telligible to the rest of mankind. The contentions of the ciergy, which happened soon after the restoration of learn- ing, engaged the attention of mankind, and paved the way for that freedom of thought and inquiry, which has since prevailed in most parts of Europe with regard to religious matters. Every man took a side in those bloody disputes; and every gentleman, that he might distinguish himself on one side or other, was instructed in Divinity. This taught people to think and reason for themselves in matters of religion, and at last totally destroyed that complete and absolute dominion which the clergy had obtained over the minds of men. The study of Law has likewise, in most civilized nations, been justly deemed a necessary part of the education of a gentleman. Every gentleman ought certainly to know at least the laws of his own country; and if he were also acquainted with those of others, it might be more than barely an ornament to him. The different branches of Philosophy have also of late been very universally studied by all who pretended to a liberal education. The advantages of this are manifest. It frees the mind from prejudice and superstition; fits it for the investigation of truth; induces habits of reasoning and judging properly; opens an inexhaustible source of entertainment; paves the way to the improvement of arts and agriculture ; and qualifies men for acting with propriety in the most important stations of life. Natural History is likewise become an object of general attention ; and it well de^erves to be so. It leads to discoveries of the greatest importance. Indeed agricul- ture, the most useful of all arts, is only a branch of Natural History, and can never a.rive at a high degree of improvement where the study of that science is neglected. Medicine, however, has not, as far as I know, in any conntry, been reckoned a necessary part of the education of a gentleman. But surely no sufficient reason can ho assigned for this omission. No science lays open a more extensive field of useful knowledge, or affords a more ample entertainment to an inquisitive mind. Anatomy, Botany, Chemistry, and the Materia lleUica, are all branches of Natural History, and are fraught with such amusement and utility, that the man who entirely neg- lects them has but a sorry claim either to taste or learning. If a gentleman has a turn for observation, says an excellent and sensible writer,* surely the Natural History of his own species is a more interesting subject, and presents a more ample field fo( Hie exertion of genius, than the natural history of spiders and cockle-shells. * Observat ons on the Duties and Offices of a Physician. SS INTRODUCTION. We do not mean that every man should become a physician. This would be nv attempt as ridiculous as it is impossible. AU we plead for is, that men of sense aiu: learning should be so far acquainted with the general principles of Medicine, as to he in a condition to derive from it some of those advantages with which it is fraught; and at the same time to guard themselves against the destructive influences of Igno- rance, Superstition, and Quackery. As matters stand at present, it is easier to cheat a man out of his life than of a Bhilling, and almost impossible either to detect or punish the offender. Notwith- standing this, people still shut their eyes, and take every thing upon trust that is administered by any Pretender to Medicine, without daring to ask him a reason for any part of his conduct. Implicit faith, everywhere else the object of ridicule, is still held sacred here. Many of the Faculty are no doubt worthy of the confidence that can be reposed in them; but as this can never be the character of every indivi- dual in any profession, it would certainly be for the safety, as well as the honour of mankind, to have some check upon the conduct of those to whom they intrust so valuable a treasure as health. The veil of mystery, which still hangs over Medicine, renders it not only a con- jectural, but even a suspicious art. This has been long ago removed from the other sciences, which induces many to believe that Medicine is a mere trick, and that it will not bear a fair and candid examination. Medicine, however, needs only to be better known, in order to secure the general esteem of mankind. Its precepts are such as every wise man would choose to observe, and it forbids nothing but what is incompatible with true happiness. Disguising medicine not only retards its improvement as a science, but exposes the profession to ridicule, and is injurious to the true interests of society. An art founded on observation never can arrive at any high degree of improvement while it is coufined to a few who make a trade of it. The united observations of all the ingenious and sensible part of mankind, would do more in a few years towards the improvement of Medicine, than those of the Faculty alone in a great many. Any man can tell when a medicine gives him ease as well as a physician; and if he only knows the name and dose of the medicine, and the name of the disease, it is sufficient to perpetuate the fact. Yet the man who adds one single fact to the stock of med:caj observations, does more real service to the ait than he who writes a volume in tupportof some favourable hypothesis. Very few of the valuable discoveries in Medicine have been made by physicians. They have in general either been the effect of chance or of necessity, and have b^en usually opposed by the Faculty, till every one else was convinced of their Im- portance. An implicit faith in the opinion of teachers, an attachment to systems and established forms, and the dread of reflections, will always operate upon those who follow Medicine a3 a trade. Few improvements are to be expected from a man who might ruin his character and family by even the smallest deviation from an old estab- lished rule. If men of letters, says the author of the performance quoted above, were to claim their right of inquiry into a matter that so nearly concerns them, the good effects on Medicine would soon appear. Such'men would have no" separate interest from that of the art. They would detect and expose assuming Ignorance under the mask of Gravity and Importance, and would be the judges and patrons of modest merit. Not having their understanding perverted in their youth by false theories, unawe.l by authority, and unbiassed by interest, they would canvass with freedom the mo-1 universally received principles in Medicine, and expose the uncertainty of many ol •in)=e doctrii.e= of which a physician dares not so much as aeem to doubt. ■ INTRODUCTION. ZXl No argument, continues he, can be brought against laying open Medicine, which does not apply with equal, if not greater force, to religion ; yet experience has shown, that since the laity have asserted their right of inquiry into these subjects, Theology, considered as a science, has been improved, the interests of real religion have been promoted, and the clergy have become a more learned and more useful, and a more respectable body of men, than they ever were in the days of their greatest power aud splendour. Had other medical writers been as honest as this gentleman, the art had been upon a very different footing at this day. Most of them extol the merit of those men who brought Philosophy out of the schools, and subjected it to the rules of common sense. But they never consider that Medicine, at present, is in nearly the same situation us Philosophy was at that time, and that it might be as much improved by being treated in the same manner. Indeed no science can either be rendered rational or useful, without being submitted to the common sense and reason of man- kind. These alone stamp a value upon science ; and what will not bear the test of these ought to be rejected. I know it will be said, that diffusing medical knowledge among the people might induce them to tamper with Medicine, and to trust to their own skill instead of calling a physician. The reverse of this, however, is true. Persons who have most knowledge in these matters, are commonly most ready both to ask and to follow advice, when it is necessary. The ignorant are always most apt to tamper with medicine, and have the least confidence in physicians. Instances of this are daily to be met with among the ignorant peasants, who, while they absolutely refuse to taka a medicine which has been prescribed by a physician, will swallow with greediness any thing that is recommended to them by their credulous neighbours. Where men will act even without knowledge, it is certainly more rational to afford them all the light we can, than to leave them entirely in the dark. It may be also alleged, that laying Medicine more open to mankind would lessen their faith in it. This would indeed be the case with regard to some; but it would have a quite contrary effect upon others. I know many people who have the utmost dread and horror of every thing prescribed by a physician, but who will nevertheless very readily take a medicine which they know, and whose qualities they are in some measure acquainted with. Hence it is evident, that the dread arises from the doctor, not from the drug. Nothing ever can or will inspire mankind with an absolute confidence in physicians, but an open, frank, and undisguised behaviour. While the least shadow of mystery remains in the conduct of the Fa- culty, doubts, jealousies, and suspicions, will arise in the minds of men. No doubt cases will sometimes occur where a prudent physician may find it expe- dient to disguise a medicine. The whims and humours of men must be regarded by those who mean to do them a service; but this can never affect the general argu- ment in favour of candour and openness. A man might as well allege, because there are knaves and fools in the world, that he ought to take every one he meets for such, and to treat him accordingly. A sensible physician will always know where disguise is necessary, but it ought never to appear on the face of his general conduct. The appearance of mystery in the conduct of physicians not only renders their art suspicious, but lays the foundations of Quackery which is the disgrace of medicine. Xo two characters are more different than that of the honest physician and the uuack; yet they have generally been very much confounded. The line between tiiera is not sufficiently apparent; at least it is too fine for the general eye. Few persons are able to distinguish sufficiently between the condect of that man who a poorer sort, and could do no hurt to the rich as most women who make good nuravs are able to suckle two children in succession up.iu the Suaiu uiuk. OF CHILDREN. tending the nursery ? This is at once the most delightful and important office ; yet the most trivial or insipid amusements are often preferred to it! A strong proof both of the bad tastt> and wrong education of modern females. It is indee d to be regretted that more care is not bestowed in teach- ing the proper management of children to those whom nature has de- signed for mothers. This, instead of being made the principal, is seldom considered as any part of female education. Is it any wonder, when females so educated come to be mothers, that they should be quite ignor- ant of the duties belonging to that character ? However strange it may appear, it is certainly true that many mothers, and those of fashion too, are as ignorant when they have brought a child into the world, of what is to.be done for it, as the infant itself. Indeed the most ignorant of the sex are generally reckoned most knowing in the business of nursing. Hence sensible people become the dupes of ignorance and superstition ; and the nursing of children, instead of being conducted by reason, is the result of whim and caprice.* Were the time that is generally spent by females in the acquisition of trifling accomplishments, employed in learning how to bring up* their children,—how to dress them so as not to hurt, cramp, or confine their motions; how to feed them with wholesome and nourishing food; how to exercise their tender bodies, so as best to promote their growth and strength ; were these made the objects of female instruction, mankind would derive the greatest advantages from it. But while the education of females implies little more than what relates to dress and public show, we have nothing to expect from them but ignorance even in the most important concerns. Did mothers reflect on their own importance, and lay it to heart, they would embrace every opportunity of informing themselves of the duties which they owe to their infant offspring. It is their province, not only to form the body, but also to give the mind its early bias. They have it very much in their power to make them healthy or valetudinary, useful in life or the pest of society. But the mother is not the only person concerned in the management of children. The father has an equal interest in their welfare, and ought to assist in every thing that respects either the improvement of the body or mind. * Tacitus the celebrated Roman historian, complains greatly of the degeneracy of ♦ Tacitus, ineceieu ^^ of tnelf off3pring. He says MltRrfaormeri^stheTr^test women in Rome used to account it their chief 1 * ' 1« ulZ"the house ana attend their children ; but that now the young infant glory to ^'y^thegoie cart 0f some poor Grecian wench, or other menial ser- ^tC°Te afe afr^id!°vheTeverluxury and effeminacy prevail, there will be too much grouud for this couii>Uiufc 4 OP CHILDREN'. It is a pity that men should be so inattentive to this matter. Theif negligence is one reason why females know so little of it. Women will ever be desirous to excel in such accomplishments as recommend them to the other sex. But men generally keep at such a distance from even the smallest acquaintance with the affairs of the nursery, that many would reckon it an affront, were they supposed to know any thing of them. Not so, however, w ith the kennel or the stables ; a gentleman of the first rank is not ashamed to give directions concerning the manage- ment of his dogs or horses, yet would blush were he surprised perform- ing the same office for that being who derived its existence from himself who is the heir of his fortunes, and the future hope of his country. Nor have physicians themselves been sufficiently attentive to the management of children : this has been generally considered as the sole province of old women, while men of the first character in physic have refused to visit infants even when sick. Such conduct in the faculty has not only caused this branch of medicine to be neglected, buj has also encouraged the other sex to assume an absolute title to pre. scribe for children in the most dangerous diseases. Tiie consequence is, that a physician is seldom called till the good women have exhausted all their skill, when his attendance can only serve to divide the blame and appease the disconsolate parents. Nurses should do all in their power to prevent diseases; but, when a child is taken ill, some person of skill ought immediately to be con- sulted. The diseases of children are generally acute, and the least delay is dangerous Were physicians more attentive to the diseases of infants, they would not only be better qualified to treat them properly when sick, but like- wise to give useful directions for their management when well. The diseases of children are by no means so difficult to be undersloo 1 as many imagine. It is true, children cannot tell their complaints : but the causes of them may be pretty certainly discovered by observing the symptoms, and putting proper questions to the nurses. Besides, the diseases of infants being less complicated, are easier cured than those of adults.* It is really astonishing that so little attention should in general be paid to the preservation of infants. What labour and expense are daily bestowed to prop an old tottering carcase for a few years, while thou- sands of those who might be useful in life perish without bein* regarded i Mankind are too apt to value things according to their present, noi OP CHILDREN. 5 their future usefulness. Though this is of all others the most erroneous method of estimation, yet upon no other principle is it possible to ac- count for the general indifference with respect to the death of infants. OF DISEASED PARENTS. One great source of the diseases of children is the unhealthiness of pa rents. It would be as reasonable to expect a rich ci'op from a bar- ren soil, as that strong and healthy children should be born of parents whose constitutions have been worn out with intemperance and disease. An ingenious writer* observes, that on the constitution of mothers depends originally that of their offspring. No one who believes this, will be surprised, on a view of the female world, to find diseases and death si frequent among children. A delicate female, brought up within doors, an utter stranger to exercise an'd open air, wholives on tea and other slops, may bring a child into the world, but it will hardly be fit to live. The first blast of disease will nip the tender plant in the bud : or, should it struggle through a few years' existence, its feeble frame, shaken with convulsions from every trivial cause, will be unable to per- form the common functions of life, and prove a burden to society. If, to the delicacy of mothers, we add the irregular lives of fathers, we shall see further cause to believe that children are often hurt by the constitution of their parents. A sickly frame may be originally induced by hardships or intemperance, but chiefly by the latter. It is impossible that a course of vice shall not spoil the best constitution : and, did the evil terminate here, it would be a just punishment for the folly of the sufferer ; but when once a disease is contracted and rivet- ted in the habit, it is entailed on posterity. What a dreadful inherit- ance is the gout, the scurvy, or the king's-evil, to transmit to our off- spiring ! how happy had it been for the heir of many a great estate, had he been born a beggar, rather than to inherit his father's fortunes at the expense of inheriting his diseases ! A person labouring under any incurable malady ought not to marry. He thereby not only shortens his own life, but transmits misery to others; but when both parties are deeply tainted with the scrofula, the scurvy, or the like, the effects must be still worse. If such have any issue they must be miserable indeed. Want of attention to these things, in forming connexions for life, has rooted out more families than plague, faminej or the sword ; and, as long as these connexions are formed from mer- cenary views, the evil will be continued/)- In our matrimonial contracts, it is amazing so little regard is had * Rousseau. t The Lacedemonians condemned their King Archidamus for having married a weak, puny woman ; because, said they, instead of propagating a race of heroes, vou will till the throne with a pro0yuy of changelings. 6 of cniLDR^X. to the health and form of the object. Our sportsmen know that the generous courser cannot be bred out of the foundered jade, nor the sagacious spaniel out of the snarling cur. This is settled upon immu- table laws. The man who marries a woman of a sickly constitution, and descended of unhealthy parents, whatever his views may be, cannot be said to act a prudent part. A diseased woman may prove fertile : should this be the case, the family must become an infirmary; what prospect of happiness the father of such a family has, we shall leave any one to judge.* Such children as have the misfortune to be born of diseased parents, will require to be nursed with greater care than others. This is the only way to make amends for Jlie defects of constitution : and it will often go a great length. A healthy nurse, wholesome air, and suffi- cient exercise, will do wonders. But, when these are neglected, little is to be expected from any other quarter. The defects of constitution cannot be supplied by medicine. Those who inherit any family disease ought to be very circumspect in their manner of living. They should consider well the nature of such disease, and guard against it by a proper regimen. It is certaii^ that family diseases have often, by proper care, been kept off for one generation ; and there is reason to believe, that, by persisting in the same course, such diseases might at length be wholly eradicated. This is a subject very little regarded, though of the greatest importance Family constitutions are as capable of improvement as family estates and the libertine who impairs the one does greater injury to his posterity than the prodigal who squanders the other. OF THE CLOTHING OF CHILDREN. The clothing of an infant is so simple a matter that it is surprising how any person should err in it; yet many children lose their lives, and others are deformed by inattention to this article. Nature knows of no use of clothes to an infant but to keep it warm. All that is necessary for this purpose is to wrap it in a soft, loose cover- ing. Were a mother left to the dictates of nature alone, she would certainly pursue this course. But the business of dressing an infant has long been out of the hands of mothers, and has at last become a secret which noue but adepts pretend to understand. From the most early ages it has been thought necessary that a woman in labour should have some person to attend her. This in time became * The Jews by their laws, were. In certain cases, forbid to have any manner of commerce with the diseased; and indeed to this all wise legislators ought to have a special regard. In some countries, diseased persons have actually been forbid to marry. This is an evil of a complicated kind, a natural deformity, and poUtioal mischief; and therefore requires a public consideration. puuuwm or children. 7 a business ; and, as in all < thers, those who were employed in it strove to outdo one another in the different branches of their profession. The dressing of a child came of course to be considered as the midwife's province ; who no doubt imagined the more dexterity she could show in this article the more her skill would be admired. Her attempts are t-econdcd by the vanity of parents, who, too often desirous of making a show of the infant as soon it is born, are ambitious to have as much finery heaped upon it as possible. Thus it came to be thought as ne- cessary for a midwife to excel in bracing and dressing an infant a3 for a surgeon to be expert in applying bandages to a broken limb ; and the poor child, as soon as it came into the world, had as many rollers and wrappers applied to its body as if every bone had been fractured in the birth ; while these were often so tight as not only to gall and wound its tender frame, but even to obstruct the motion of the heart, lungs, and other organs necessary for life. In most parts of Britain the practice of rolling children with so many bandages is now, in some measure, laid aside ; but it would still be a ilfficult task to persuade the generality of mankind that the shape of an infant does not entirely depend on the care of the midwife. So far, however, are all her endeavours to mend the shape from being success- ful, that they constantly operate the contrary way, and mankind become deformed in proportion to the means used to prevent it. How little deformity of body is to be found among uncivilized nations ? So lhtle indeed that it is vulgarly believed they put all their deformed children to death. The truth is, they hardly know such a thing as a deformed child. Neither should we, if we followed their example. Savage nations never think of manacling their children. They allow them full use of every organ, carry them abroad in the open air, wash their bodies daily in cold water, &c. By this management their children become so strong and hardy, that by the time our puny infants get out of the nurse's arms, theirs are able to shift for themselves.* Among brute animals, no art is necessary to procure a fine shape. Though many of them are extremely delicate when they come into the world, yet we never find them grow crooked for want of swaddling bands. Is nature less generous to the human kind ? No : but we take the business out of nature's hand. Not only the analogy of other animals, but the very feelings of infants tell us, they ought to be kept eac>y and free from pressure. They cannot indeed tell their complaints, but they can show signs of pain ; and this * A friend of mine, who was several years on the coast of Africa, tells me, that the natives neither put any clothes upon their children, nor apply to their bodies bandages of any kind, but lay them on a pnlkt, and suffer them to tumble about at pleasure; yet they are all straight, mid seldom have any disease. 8 OF CHILDREN. they never fail to do by crying when hurt by their clothes. No sooner are they freed from their bracings than they seem pleased and happy : yet, strange infatuation ! the moment they hold their peace, they are again committed to their chains. If we consider the body of an infant as a bundle of soft pipes, re- plenished with fluids in continual motion, the danger of pressure will appear in the strongest light. Nature, in order to make way for the growth of children, has formed their bodies soft and flexible ; and, Jest they should receive any injury from pressure in the womb, has sur- rounded the fcctue everywhere with fluids. This shows the cai'e which nature takes to prevent all unequal pressure on the bodies of infants, and to defend them against every thing that might in the least cramp or confine their motions. Even the bones of an infant are so soft and cartilaginous that they readily yield to the slightest pressure, and easily assume a bad shape, which can never after be remedied. Hence it is that so many people appear with high shoulders, crooked spines, and flat breasts, who were as well proportioned at their births as others, but had the misfortune to be squeezed out of shape by the application of stays and bandages. Pressure, by obstructing the circulation, likewise prevents the equal distribution of nourishment to the different parts of the body, by which means the growth becomes unequal. One part grows too large, while another remains too small ; and thus in time the whole frame becomes disproportioned and misshapen. To this we must aud, when a child is cramped in its clothes it naturally shrinks from the part that is hurt . and, by putting its body into unnatural postures, it becomes deformed by habit. Deformity of body may indeed proceed from weakness or disease • but, in general, it is the effect of improper clothing. Nine-tenths at least of the deformuy among mankind must be imputed to this cause. A deformed body is not only cisagreeable to the eye, but by a bad figure both the animal and vital functions must be impeded, and of course health impaired. Hence few people remarkably misshapen are strong or healthy. The new motions which commence at the birth, as the circulation of the whole mass of blood through the lungs, respiration, the peristaltic motion, &c. afford another strong argument for keeping the bodv of an infant free from all pressure. These organs, not having been" accus- tomed to move, are easily stopped ; but, when this happens, death must ensue. Hardly any method could be devised more effectually t > stop these motions, than bracing tho body too tight with roller ,* and partJot^i^^S^trol^S ffi iu 7 "Sf "^ J" «"* round the child's body a* soon as it is born. S h' w ai*1,ed t:Sluly OF CHILDREN. 9 bandages. Were these to be applied in the same manner to the boily »f au adult for an equal length of time, they would hardly fail to hurt the digestion and make him sick. How much more hurtful they must prove to the tender bodies of infants, we shall leave any one to judge. Whoever considers these things will not be surprised that so many children die of convulsions soon alter the birth. These fits are generally attributed to some inward cause ; but in fact they oftener proceed from our own imprudent conduct. I have known a child seized with con- vulsion fits soon after the midwife had done swaddling it, who, upon taking off the rollers and bandages, was immediately relieved, and never ha ! the disease afterwards. Numerous examples of this might be given, were they necessary. It would be safer to fasten the clothes of an infant with strings* than pins, as they often gall and irritate their tender skins, and occasion disorders. Pins have been found sticking about half an inch into the body of a child, after it had died of convulsion fits, which in all pro- bability proceeded from that cause. Children are not only hurt by the tightness of their clothes, but also by the quantity. Every child has some degree of fever after the birth ; and if it be loaded with too many clothes, the fever must be increased- But this is not all ; the child is generally laid in bed with the mother, who is often likewise feverish : to which we may add the heat of the bed-chamber, the wines and other heating things, too frequently given to children immediately after the birth. When all these are combined, which does not seldom happen, they must increase the fever to such a degree as will endanger the life of the infant. The danger of keeping infants too hot will further appear, if we con- sider that, after they have been some time in the situation mentioned above, they are often sent iuto the country to be nursed in a cold house. Is it any wonder if a child, from such a transition, catches a mortal cold, or contracts some other fatal disease ! When an infant is kept too hot, its lungs, not being sufficiently expanded, are apt to remain weak and flaccid for life ; hence proceed coughs, consumptions, and other diseases of the breast. It would answer little purpose to specify the particular species of d ress proper for an infant. These will always vary in different countries, according to custom and the humour of parents. The great rule to bo observed is, That a child have no more clothes than are necessary to keep it warm, and that they be quite easy for its body. Stays are the very bane of infants. A volume would not suffice to point out all the bad effects of tnis ridiculous piece of dress both on chi' ■ dicu and adults. The madness in favour of stays seems, however, V> 10 OF CHTT.DP.TIN. be somewhat abated ; and it is to be hoped the world will, in time, become wise enough to know that the human shape does not solely depend upon whalebone and bend leather.* I shall only add, with respect to the clothes of children, that they ought to be kept thoroughly clean. Children perspire more than adults J and if their clothes be not frequently changed, they become very hurtful- Dirty clothes not only gall and fret the tender skins of infants, but likewise occasion ill-smells; and, what is worse, tend to produce vermin and cutaneous diseases. Cleanliness is not only agreeable to the eye, but tends greatly to pre- serve the health of children. It promotes the perspiration, and, by that means, frees the body from the superfluous humours, which, if retainedj could not fail to occasion diseases. No mother or nurse can have any excuse for allowing a child to be dirty. Poverty may oblige her to give it coarse clothes ; but if she does not keep them clean, it must be her own fault. OF THE FOOD OF CHILORRN. Nature not only points out the food proper for an infant, but actually prepares it. This, however, is not sufficient to prevent some who think themselves wiser than nature, from attempting to bring up their chil- dren without her provision. Nothing can show the disposition which mankind have to depart from nature, more than their endeavouring to bring up children without the breast. The mother's milk, or that of a healthy nurse, is unquestionaby the best food for an infant. Neither art nor nature can afford a proper substitute for it. Children may seem to thrive for a few mouths without the breast; but when teething, the small-pox, and other diseases incident to children, come on, they generally perish. A child, soon after the birth, shows an inclination to suck ; and there is no reason why it should not be gratified. It is true, the mother's milk does not always come immediately after the birth ; but this is the way to bring it: besides, the first milk that the child can squeeze out of the breast answers the purpose of cleansing better than all the drugs in the apothecary's shop, and at the same time prevents inflammations of the breast, fevers, and other diseases incident to mothers. It is strange how people came to think that the first thing given to a child should be drugs. This is beginning with medicine betimes, and ™!»oSt,?/l,D?de.,0f bxend leather are worn fey aU the women of lower station in many ?n w„ th • ^h^T1 am SOrry t0 """"stand that there are still mothers made, ou"h to lace the.r daughters very tight in order to improve their shape. As reason^ wou d be totally lost upon such people, I shall beg leave just to ask them why tl ere are ten deformed women for one man ? And likewise to recommend toTheXusai a short moral precept, which forbids us to deform the human body. P *" OF "HII.DREN. 11 no wonder if they generally end with it. It sometimes happens, Indeed, that a child does not discharge the meconium so soon as could be wished : this has induced physicians, in such cases, to give something of an opening nature to cleanse the first passages. Midwives have improved upon this hint, and never fail to give syrups, oils, &c. whether they be necessary or not. Cramming an infant with such indigestible stuff as soon as it is born, can hardly fail to make it sick, and is more likely to occasion diseases than to prevent them. Children are seldom long after the birth without having passage both by stool and urine ; though these evacuations may be wanting for some time without any danger. But if children must have something before they be allowed the breast, let it be a little thin water-pap, to which may be added an equal quantity of new milk ; or rather water alone, with the addition of a little moist sugar. If this be given without any wine or spiceries, it will neither heat the blood, load the stomach, nor occasion gripes. Upon the first sight of an infant, almost every person is struck with the idea of its being weak, feeble, and wanting support. This naturally suggests the need of cordials. Accordingly wines are universally mixed with the first food of children. Nothing can be more fallacious than this way of reasoning, or more hurtful to infants than the conduct founded upon it. Children require very little food for some time after the birth; and what they receive should be thin, weak, light, and of a cooling quality. A very small quantity of wine is sufficient to heat and inflame the blood of an infant ; but every person conversant in these matters must know, that most of the diseases of infants proceed from the heat of their humours. If the mother or nurse has enough of milk, the child will need little or no other food before the third or fourth month. It will then be pro- per to give it, once or twice a-day, a little of some food that is easy of digestion, as water-pap, milk-pottage, weak broth with bread in, and such like. This will ease the mother, will accustom the child by degrees to take food, and will render the weaning both less difficult and less dangerous. All great and sudden transitians are to be avoided in nursing. For this purpose, the food of children ought not only to be simple, but to resemble, as nearly as possible, the properties of milk. Indeed, milk itself should make a principal part of their food, not only before they are weaned, but for some time after. N#xt to milk, we would recommend good light bread. Bread may be "iven to a child as soon as it shows an inclination to chew ; and lt may at all times be allowed as much plain bread as it will eat. The very chewing of bread will promote the cutting of the teeth, and the discharge of "saliva, while, by mixing with the nurse's milk in the sto- 12 of childrt;^. mach, it will afford an excellent nourishment. Children discover an early inclination to chew whatever is put into their hands. Parents observe the inclination, but generally mistake the object. Instead of giving the child something which may at once exercise its gums and afford it nourishment, they commonly put into its hand a piece of hard metal or impenetrable coral. A crust of bread is the best gum-stick. It not only answers the purpose better than any thing else, but has the additional properties of nourishing the child and carrying the saliva down into the stomach, which is too valuable a liquor to be lost. Bread, besides being used dry, may be many ways prepared into food for children. One of the best methods is to boil it in water, afterwards pouring the water off, and mixing with the bread a proper quantity of new milk unboiled. Milk is both more wholesome and nourishing this way than boiled, and is less apt to occasion costiveness. For a child farther advanced, bread may be mixed in veal or chicken-broth, made into puddings, or the like. Bread is a proper food for children at ail times, provided it be plain, made of wholesome grain, and well fer- mented ; but when enriched with fruits, sugar, or such tilings, it be- comes very unwholesome. It is soon enough to allow children animal food when they have goj teeth to eat it. They should never taste it till after they are weaned, and even then they ought to use it spariugly. Indeed, when children live wholly on vegetable food, it is apt to sour on their stomachs ; but on the other hand, too much flesh heats the body, and occasions fevers and other inflammatory diseases. This plainly points out a due mix- ture of animal and vegetable food as most proper for children. Few things prove more hurtful to infants than the common method of sweetening their food. It entices them to take more than they ought to do, which makes them grow fat and bloated. It is pretty certain if the food of children were quite plain, that they would never t.'ike more than enough. Their excesses are entirely owing to nurses. If a child be gorged witk food at all hours, and enticed to take it, by making ;t sweet and agreeable to the palate, is it any wouder that such a child should in time be induced to crave more food than it ought to have I Children may be hurt by too little as well as by too much food. After a child is weaned, it ought to be fed four or five times a day ; but should never be accustomed to eat in the night: neither should it have to» much at a time. Children thrive best with small quantities of*food frequently given. This neither overloads the stomach nor hurts the digestion, and is certainly most agreeable to nature. Writers on nursing have inveighed with such vehemence against OF CHTLDREV. 13 giving children too much food, that many parents by endeavouring to shun that error, have run into the opposite extreme, and ruined the constitutions of their children. But the error of pinching children in their food is more hurtful than the other extreme. Nature has many ways of relieving herself when overcharged ; but a child who is pinched with hunger, will never become a strong or a healthy man. That errors are frequently committed on both s'.des we are ready to acknowledge ; but where one child is hurt by the quantity of its food, ten suffer from the quality. This is the principal evil, and claims our strictest attention. Many people imagine that the food which they themselves love can- not be bad for their children : but this notion is very absurd. In the more advanced periods of life we often acquire an inclination for food, which when children, we could not endure. Besides, there are many things that by habit, may a^ree very well with the stomach of a grown person, which would be hurtful to a child : as high-seasoned, salted, and smoke-dried provisions, &e. It would also be improper to feed children with fat meat, strong broths, rich soups, or tho like. . All strong liquors are hurtful to children. Some parents teach their children to guzzle ale, and other fermented liquors, at every meal. Such a practice cannot fail to do mischief. These children seldom escape the violence of the small-pox, measles, hooping-cough, or some inflam- matory disorder. Milk, water, butter-milk, or whey, is the most proper for children to drink. If they have any thing stronger, it may be fine small beer, or a little wine mixed with water. The stomachs of children can digest well enough without the assistance of warm stimulants : besides being naturally hot, they are easily hurt by any thing of a heat- ing quality. Few things are more hurtful to children than unripe fruits. They weaken the powers of digestion, and sour and relax the stomach, by which means it becomes a proper nest for insects. Children, indeed show a great inclination for fruit, and, I am apt to believe, that if good ripe fruit were allowed them in proper quantity, it would have no bad effects. We never find a natural inclination wrong, if properly regu- lated. Fruits are generally of a cooling nature, and correct the heat and acrimony of the humours. This is what most children require ; only care should be taken lest they exceed. Indeed the best way to prevent children going to excess in the use of fruit, or eating that which is bad, is to allow them a proper quantity of what is good.* * Children are alwnys sickly in the fruit season, which may be thus accounted for. Two thirds of 'he fruit which comes to market in this country is really unripe ; and children not being in a condition to judge for themselves, eat whatever they can lnv their hands upon, which often proves little better than poison to their tender bowels Servants, and others who have the care of children, should be strictly for- bidden'to give them any fruit without the knowledge of their parents. 14 OK CHILDREN. Roots which contain a crude viscid juice should be sparingly givon to children. They fill the body with gross humours, and tend to produce eruptive diseases. This caution is peculiarly necessary for the poor : glad to obtain, at a small price, what will fill the bellies of their children, they stuff them two or three times a day with crude vegetables Children had better eat a smaller quantity of food which yields a whole- some nourishment, than be crammed with what their digestive powers are unable to assimilate. Butter ought likewise to be sparingly given to children. It both relaxes the stomach, and produces gross humours. Indeed most things that are fat or oily have this effect. Butter when salted becomes still more hurtful. Instead of butter so liberally given to children in most parts of Britain, we would recommend honey. Children who eat honey a-/e seldom troubled with worms : they are also less subject tocutaneoua diseases, as itch, scabbed heads, &c. Many people err in thinking that the diet of children ought to be altogether moist. When children live entirely on slops, it relaxes their solids, renders them weak, and disposes them to the rickets, scrofula, and, other glandular disorders. Relaxation is one of the most general cause of the diseases of children. Every thing, therefore, which tends to un. brace their solids, ought to be carefully avoided. We would not be understood by these observations, as confinin" children to any particular kind of food. Their diet may be frequently varied, provided always sufficient regard be had to siruplic.ry. OF THE EXERCISE OF CHILDREN. Of all the causes which conspire to render the life of man short and miserable, none has greater influence than the want of proper exer- cise. Healthy parents, wholesome food, and proper clothing, will avail 1'ttle where exercise is neglected. Sufficient exercise will make up for several defects in nursing; but nothing can supply the want of it. It is absolutely necessary to the health, the growth, and the streno-th of children. The desire of exercise is coeval with life itself. Were this principle attended to, many diseases might be prevented. But, while indolence and sedentary employments prevent two-thirds of mankind from either taking sufficient exercise themselves, or giving it to their children what have we to expect but diseases and deformity among their offspring ? The rickets, so destructive to children, never appeared in Britain till manufactures began to flourish, and people, attracted by the love of gain, left the country to follow sedentary employments in great towns. OF CHILDREN. 13 It is amongst these people that this disease chiefly prevails, and not only deforms, but kills many of their offspring. The conduct of other young animals shows the propriety of giving e\ercise to children. Every other animal makes use of its organs of motion as soon as it can, and many of them, even when under no neces- sity of moving in quest of food, cannot be restrained without force. This is evidently the case with the calf, the lamb, and most other young animals. If these creatures were not permitted to frisk about and take exercise, they would soon die or become diseased. The same inclina- tion appears very early in the human species ; but as they are not able to take exercise themselves, it is the business of their parents and nurses to assist them. Children may be exercised various ways. The best method, while they are light, is to carry them about in the nurse's arms.* This gives the nurse an opportunity of talking to the child, and of pointing out every thing that may please and delight its fancy. Besides, it is much safer than swinging an infant in a machine, or leaving it to the care of such as are not fit to take care of themselves. Nothing can be more iibsurd than to set one child to keep another ; this conduct has prowed fatal to many infants, and has rendered others miserable for life. When children begin to walk, the safest and best method of leading them about is by the hands. The common way of swinging them about in leading-strings fixed to their backs, has several bad consequences. It makes them throw their bodies forward, and press with their whole weight upon their stomach and breast ; by this means the stomach is obstructed, the breast flattened, and the bowels compressed; which must hurt the digestion, and occasion consumptions of the lungs, and other diseases. It is a common notion, that, if children are set upon their feet too Boon, their legs will become crooked. There is reason to believe that the very reverse of this is true. Every member acquises strength in proportion as it is exercised. The limbs of children are weak indeed, but their bodies are proportionably light; and had they skill to direct themselves, they would soon be able to support their own weight. Who ever heard of any other animal that became crooked by using its legs too soon ? Indeed, if a child is not permitted to make use of its legs till a considerable time after its birth, and be then set upon them with its whole weight at once, there may be some danger : but this proceeds * The nurse ought to be careful to keep the child in a proper position; as deformity Is often the consequence of inattention to this circumstance. Its situation oujht also to be frequently changed. I have known a child's legs bent all on one sida, by the nurse carrying it constantly on o.ie arm. 16 OF CKILDREV. entirely from the child's not having been accustomed to use its leg5) from the beginning. Mothers of the poorer sort think they are great gainers by making their children lie or sit while they themselves work. In this they are greatly mistaken. By neglecting to give their children exercise they are obliged to keep them a long time before they can do any thing for themselves, and to spend more on medicine than would have paid for proper care. To take care of their children, is the most useful business in which even the poor can be employed: but, alas! it is not always in their power. Poverty often obliges them to neglect their off-spring in order t'> procure the necessaries of life. When this is the case, it becomes the interest as well as the duty of the public to assist them. Ten thousand times more benefit would accrue to the state, by enabling the poor to bring up their own children, than from all the hospitals* that ever can be erected for that purpose. Whoever considers the structure of the human body will soon be convinced of the necessity of exercise for the health of children. The body is composed of an infinite number of tubes, whose fluids cannot be pushed on without the action and pressure of the muscles. But, if the fluids remain inactive, obstructions must happen, and the humours will of course be vitiated ; which cannot fail to occasion diseases. Nature has furnished both the vessels which carry the blood and lymph with numerous valves, in order that the action of every muscle might push forward their contents ; but, without action, this admirable contrivance can have no effect. This part of the animal economy proves to a demonstration the necessity of exercise for the preservation of health. Arguments to show the importance of exercise might be drawn from every part of the animal economy ; without exercise, the circulation of the blood cannot be properly carried on, nor the different secretions duly performed ; without exercise, the fluids cannot be properly pre- pared, nor the solids rendered strong or firm. The action of the heart, the motion of the lungs, and all the vital functions, are greatly assisted by exercise. But to point out the manner in which these effects are produced would lead us farther into the economy of the human body than most of those for whom this treatise is intended would be able to follow. We shall therefore only add, that, when exercise is neglected, * If it were made the interest of the poor to keep their childsen alive we shou'i lose veryfew of them. A small premium given annually to eaeh poor family, for every child they have alive at the year's end. would save more Infant lives than if he »hole revenue of the crown were expended on hospitals for this purpose. This would make the poor esteem fertility a blessing; whereas manv of them think it till greatest curse that can befal them; and in place of wishing their children to live wh^tir/uTe:610' ^ *° '^ °f UatUKtl a^Cti0n' that the> Me ^XC OF CHILDRE"*. 17 noueof the animal fu:ict'ons can be duly performed ; and, when this is the case, the whole constitution must go to wreck. A good constitution ought certainly to be our first object in the management of children. It lays a foundation for their being useful and happy in life : and whoever neglects it, not only fails in his duty to his offspring, but to society. One very common error of parents, by which they hurt the constitutions of t;ie!r children, is the sending them too young to school. This is often done solely to prevent trouble. When the child is at school, he needs no keeper. Thus the schoolmaster is made the nurse ; and the poor child is fixed to a scat seven or eight hours a-day, which time ought to be spent in exercise and diversion. Sitting so long cannot fail to produce the worst effects upon the body ; nor is the mini le.-s injured. Early application weakens the faculties, and often fixes in the mud an aversion to books, which continues for life.* But suppose this were the way to make children scholars, it certainly ought not to be done at the expense of their constitutions. Our ances- tors', who seldom went to school very young, were not less learned than we. But we imgaine the boy's education will be quite marred, unless he be carried to school in his nurse's arms. No wonder if such hot- bed plants seldom become either scholars or men 1 Not only the confinement of children in public schools, but their number, often proves hurtful. Children are much injured by being kept in crowds within doors ; their breathing nofonly renders the place unwholesome,-but if anyone of them happen to be diseased the rest catch the infection. A single child has been often known to com- municate the bloody flux, the hooping-cough, the itch, or other dis- eases, to almost every individual in a numerous school. But if fashion must prevail, and infants are to be sent to school, we would recommend it to teachers, as they value the interests of society, not to confine them too long at a time, but allow them to run about ai,l play at such active diversions as may promote their growth and strengthen their constitutions. Were boys, instead of being whipped for stealing an hour to run, ride, swim, or the like, encouraged to em- ploy a proper part of their time in these manly and useful exercises, it would have many excellent effects. It would be of great service to boys, if, at a proper age, tney were taught the military exercise. This would increase their strength, inspire a 1 f^iu- the dutv of narents to instruct their children at least till they * It is «ndTOh^"}to take MmrSre of themselves. This would tend much to mSt VJio oarentoI tenderness and filial affection, of the want of which there couhnu the tus of parens fiances. Though few fathers have time to l^n.ctSchud^n.yefn^t mothers have; and 8un*v they cannot be better enip.uyed. C 18 OF CHILDREN. them with courage, and when their country called for their assistance, would enable them to act in her defence, without being obliged to un- dergo a tedious and troublesome course of instructions, at a time when they are less fit to learn new motions, gestures, &c* An effeminate education will infallibly spoil the best natural consti- tution : and if boys are brought up in a more delicate manner than even girls ought to be, they will never be men. Nor is the common education of girls less hurtful to the constitution tli in that of boys. Miss is set down to her frame before she can put on her own clothes ; and is taught to believe, that to excel at the needle is the only thing that can entitle her to general esteem. It is unnecessary here to insist upon the dangerous consequences of obliging girls to sit too much. They are pretty well known, and are too often felt at a certain time of life. But supposing this critical period to be got over, greater dangers still await them when they come to be mothers. Women who have been early accustomed to a sedentary life generally run great hazard in child-bed ; while those who have been used to romp about, and take sufficient exercise, are seldom in any danger. One hardly meets with a girl who can at the same time boast of early performances by the needle, and a good constitution. Close and early confinement generally occasions indigestions, headaches, pale complexions, pain of the stomach, loss of appetite, coughs, consumptions of the lungs, and deformity of body. The last of these indeed is not to be wondered at, considering the awkward postures in which girls sit at many kinds of needle-work, and the delicate flexible state of their bodies in the early periods of life. Would mothers, instead of having their daughters instructed in many trifling accomplishments, employ them in plain work and housewifery, and allow them sufficient exercise in the open air, they would both make them more healthy mothers and more useful members of society. I am no enemy to genteel accomplishments, but would have them only considered as secondary, and always disregarded when they impair health. Many people imagine it a great advantage for children to be early taught to earn their bread. This opinion is certainly right, provided they were so employed as not to hurt their health or growth ; but, when these suffer, society, instead of being benefited, is a real loser by their labour. There are few employments, except sedentary ones, by which children can earn a livelihood ; and if they be set to these too soon, it * I am happy to find that the masters of academies now begin to put in practice this advice. Each nf them ought to keep a drill-sergeant for teaching the boys the military exercise Thin, beside* "intribucing to their health and vigour of body, would have many oilier happy effects OF CHILDREN. 19 ruins their constitution. Thus, by gaining a few years from childhood, we generally lose twice as many in the latter period of life, and even render the person less useful while he does live. In order to be satisfied of the truth of this observation, we need only to look into the great manufacturing towns, where we shall find a puny degenerate race of people, weak and sickly all their lives, seldom exceeding the middle period of life ; or if they do, being unfit for busi- ness, they become a burden to society. Thus arts and manufactures, though they may increase the riches of a country, are by no means favourable to the health of its inhabitants. Good policy would there- fore require, that such people as labour during life should not be set too early to work. Every person conversant with the breed of horsesj or other working animals, knows, that if they be set to hard labour too soon, they will never turn out to advantage. This is equally true with respect to the human species. There are, nevertheless, various ways of employing young people, without hurting their health. The easier parts of gardening, husbandry, or any business carried on without doors, are most proper. These are employments which most young people are fond of, and some parts of them may be always adapted to their age, taste, and strength* Such parents, however, as are under the necessity of employing their children within doors, ought to allow them sufficient time for active diversions without. This would both encourage them to do more work and prevent their constitutions from being hurt. Some imagine, that exercise within doors is sufficient ; but they are greatly mistaken. One hour spent in running, or any other exercise without doors, is worth ten within. 'When children cannot go abroad they may indeed be exercised at home. The best method of doing this, is to make them run about in a long room, or dance. This last kind of exercise, if not carried to excess, is of excellent service to young people. It cheers the spirits, promotes perspiration, strengthens the limbs, clc- I knew an eminent physician who used to say, that he made his children dance instead of giving them physic. It were well if more people fol- lowed his example. The cold bath may be considered as an aid to exercise. By it the body is braced and strengthened, the circulation and secretions pro- moted and were it conducted with prudence, many diseases, as rickets, scrofula, &c. might thereby be prevented. The ancients, who took every method to render children hardy and robust, were no strangers to the t i. c. Wn told that in China, where the police is the best in the world, all the * l nave ue* . jn the e.^ier ))lirts 0f gardening and husbandry; as weediug, :arni:gsIonJ,uthelund,aiid,uchl..e. 29 OF CHILDREN. nse of the cold bath ; and, if we may credit report, the practice of iffis mersing children daily in cold water must have been very common among our ancestors. The greatest objection to the use of the cold bath arises from the superstitious prejudices of nurses. These are often so strong that it is impossible to bring them to make a proper use of it. I have known some of them who would not dry a child's skin after bathing it, lest it should destroy the effect of the water. Others will even put clothes dipt in the water upon the child, and either put it to bed, or suffer it to go about in that condition. Some believe that the whole virtue of the water depends upon its being dedicated to a particular saint ; while others place their confidence in a certain number of dips, as threej seven, nine, or the like ; and the world could not persuade them, if these do not succeed, to try it a little longer. Thus, by the whims of nurses, children lose the benefit of the cold bath, and the hopes of the physician from that medicine are often frustrated. We ought not, however, entirely to set aside the cold bath, because some nurses make a wrong use of it. Every child, when in health, should at least have its extremities daily washed in cold water. This is a partial use of the cold bath, and it is better than none. In winter this may suffice : but in the warm season, if a child be relaxed, or seem to have a tendency to the rickets or scrofula, its whole body ought to be frequently immersed in cold water. Care, however, must be taken not to do this when the body is hot, or the stomach full. The child should be dipped only once at a time, should be taken out immediately, and have its skin well rubbed with a dry cloth. THE HAD EFFECTS OF UNWHOLESOME AIR UPON CHILDREN. Few things prove more destructive to children than confined or un- wholesome air. This is one reason why so few of those infants, who are put into hospitals, or parish-workhouses, live. These places are generally crowded with old, sickly, and infirm people ; by which means the air is rendered so extremely pernicious that it becomes a poison to infants. Want of wholesome air is likewise destructive to many of the children born in great towns. There the poorer sort of inhabitants live in low dirty, confined houses, to which the fresh air has scarcely any access' Though grown people, who are hardy and robust, may live in such situations, yet they generally prove fatal to their offspring, few of whom arrive at maturity, and those who do are weak and deformed As Mich people are not in a condition to carry their children abroad 'nto OF CHILDREN. 21 the open air, we must lay our account with losing the greater part of them. But the rich have not this excuse. It is their business to see that their children be daily carried abroad, and that they be kept in the o; en air a sufficient time. This will always succeed better if the mother goes along with them. Servants are often negligent in these matters, and allow a child to sit or lie on the damp ground, instead of leading or carrying it about. The mother surely needs air as well as her chil- dren ; and how can she be better employed than attending them ? A very bad custom prevails, of making children sleep in small apart- ments, or crowding two or three beds into one chamber. Instead of this, the nursery ought always to be the largest and best aired room in the house. When children are confined in small apartments, the air not only becomes unwholesome, but the heat relaxes their solids, ren- ders them delicate, and disposes them to colds and many other disorders. Nor is the custom of wrapping them up too close in cradles less per- nicious. One would think that nurses were afraid lest children should suffer by breathing free air, as many of them actually cover the child's face while asleep, and others wrap a covering over the whole cradle, by which means the child is forced to breathe the same air over and over all the time it sleeps. Cradles indeed are on many accounts hurt- ful to children, and it would be better if the use of them were totally laid aside.* A child is generally laid to sleep with all its clothes on ; and if a number of others are heaped above them, it must be overheated ; by which means it cannot fail to catch cold on being taken out of the cradle, and exposed to the open air, with only its usual clothing, which is too frequently the case. Children who are kept within doors all day, and sleep all night in warm close apartments, may with great propriety, be compared to plants nursed in a hot-house, instead of the open air. Though such plants may by this means be kept alive for some time, they will never arrive at that degree of strength, vigour, and magnitude, which they would have acquired in the open air, nor would they be able to bear it after- wards should they be exposed to it. . Children brought up in the country, who have been accustomed to * It is amazing how children escape suffocation, considering the manner in which they are often rolled up in flannels, &c. I lately attended an infant, whom I found muffled up over head and ears in many folds of flannel, though it was in the midd e nf Tune I beeKed for a little free air to the poor babe; but though this indulgence «'is Granted during my stay, I found it always on my return in the same situation. rwth as might be expected, soon freed the infant from all its miseries; but it was «nrinmv Dower to free the minds of its parents from those prejudices which piovtd f»t J to their child —1 was very lately called to see an infant which was said to be expiring in convulsion tits. I desired the mother to strip tha child, and wrap it iu a .oose covering, it had no more convulsion tits. 22 OF CTlfLnREN. open air, should not be too early sent to great towns where it is con« fined and unwholesome. This is frequently done with a view to forward their education, but proves very hurtful to their health. All schools and seminaries of learning ought, if possible, to be so situated as to have fresh, dry, wholesome air, and should never be too much crowded. Without entering into a detail of the particular advantages of whole- some air to children, or of the bad consequences which proceed from the want of it, I shall only observe, that of several thousands of children which have been under my care, I do not remember one instance of a single child who continued healthy in a close confined situation; but have often known the most obstinate diseases cured by removing them from such a situation to an open free air. OF NURSES. It is not here intended to lay down rules for the choice of nurses This would be wasting time. Common sense will direct every one to choose a woman who is healthy, and has plenty of milk.* If she be at the same time cleanly, careful, and good natured, she can hardly fail to make a proper nurse. After all, however, the only certain proof of a good nurse is a healthy child upon her breast. But, as the mis- conduct of nurses oft proves fatal to children, it will be of importance to point out a few of their most baneful errors, in order to rouse the attention of parents, and to make them look more strictly into the conduct of those to whom they commit the care of their infant offspring Though it admits of some exceptions, yet we may lay it down as a general rule, That every woman who nurses for hire should be carefully looked after, otherwise she will not do her duty. For this reason parents ought always to have their children nursed under their own eye, if pos- sible ; and where this cannot be done, they should be extremely cir- cumspect in the choice of those persons to whom they intrust them- It is a folly to imagine that any woman who abandons her own child to suckle another for the sake of gain, should feel all the affections of a parent towards her nursling ; yet so necessary are these affections in a nurse, that but for them the race would soon be extinct. One of the most common faults of those who nurse for hire, is dosin* children with stupefactives, or such things as lull them asleep. An indolent nurse who does not give her child sufficient exercise in the open air to make it sleep, and does not choose to be disturbed by it in the mght, will seldom fail to procure for it a dose of laudanum, diaco- >:^:z£?£?z ix0\°^\x-h^ieive an iufant * •—" OF CHILDREN. 23 dium, saffron, or what answers the same purpose, a dose of spiiics <>r o:her strong liquors. These, though they be certain poison to infants, are every day administered by many who bear the character of very good nurses.* A nurse who has not milk enough, is apt to imagine that this defect may be supplied by giving the child wines, cordial-waters, or other strong liquors. This is an egregious mistake. The only thing that has a iy chance to supply the place of the nurse's milk, must be somewhat nearly of the same quality, as cow's milk, ass's milk, or beef tea, with a little bread. It can never be done by the help of strong liquors. These, instead of nourishing an infant, never fail to produce the con- trary effect. Children are often hurt by their nurses suffering them to cry long and vehemently. This strains their bodies, and frequently occasions rup- tures, inflammations of the throat, lungs, &c. A child never continues to cry long without some cause, which might always be discovered by proper attention ; and the nurse who can hear an infant cry till it has almost spent itself, without endeavouring to please it, must be cruel indeed, and is unworthy to be intrusted with the care of a human creature. Nurses who deal much in medicine are always to be suspected. They trust to it, and neglect their duly. I never knew a good nurse who bad her Godfrey's cordial, Daily's elixir, Dalby's carminative, &c. at hand. Such generally imagine that a dose of medicine will make up for all defects in food, air, exercise, and cleanliness. By errors of th's kind, I will venture to say that one-half the children who die annually in London lose their lives. Allowing children to continue long wet, is another very pernicious custom of indolent nurses. This is not only disagreeable, but it galls and frets the infant, and, by relaxing the solids, occasions scrofulas, rickets, and other diseases. A dirty nurse is always to be suspected. Nature often attempts to free the bodies of children from bad hu- mours, by throwing them upon the skin ; by this means fevers and other diseases are prevented. Nurses are apt to mistake such critical eruptions for an itch, or some other infectious disorder. Accordingly they take every method to drive them in. In this way many children Io6e their lives ; and no wonder, as nature is opposed in the very me- thod she takes to relieve them. It ought to be a rule, which every nurse should observe, never to stop any eruption without proper advice, or being well assured that it is not of a critical nature. At any rate, it is never to bo done without previous evacuations. * If a mo:her on visiting her child at nurse finds it always asleep, I would advice bar to remove it immediately; otherwise it will soon sleep its lust. 24 OF CHTT.nREN. Loose stools is another method by which nature often prevents or carries off the diseases of infants. If these proceed too far, no doubt they ought to be checked : but this is never to be done without tho greatest caution. Nurses, upon the first appearance of loose stools, frequently fly to the use of astringents or such things as bind the body. Hence inflammatory fevers, and other fatal diseases, are occasioned. A dose of rhubarb, a gentle vomit, or some other evacuations, should always precede the use of astringent medicines. One of the greatest faults of nurses is, concealing the diseases oi children from their parents. This they are extremely ready to do especially when the disease is the effect of their own negligence^ Many instances might be given of persons who have been rendered lame for life by a fall from their nurse's arin-i, which she, through fear, concealed till the misfortune was past cure. Every parent who intrusts a nurse with the care of a child, ought to give her the strictest charge not to conceal the most trifling disorder or misfortune that may befal it. We can see no reason why a nurse who conceals any misfortune which happens to a child under her care, till it loses its life or limbs should not be punished. A few examples of this would save the lives of many infants; but as there is little reason to expect that it ever will be the case, we would earnestly recommend it to all parents to look carefully after their children, and not to trust so valuable a treasure entirely in the hands of an hireling. No person ought to imagine these things unworthy of his attention. On the proper management of children depend not only their health and usefulness in life, but likewise the safety and prosperity of the state to which they belong. Effeminacy ever will prove the ruin of any state where it prevails ; and, when its foundations are laid in in- fancy, it can never afterwards be wholly eradicated. Parents who love their offspring, and wish well to their country, ought, therefore, in the management of their children, to avoid every thing that may have ;» tendency to make them weak or effeminate, and to take every method in their power to render their constitutions strong and hardy. ----------By arts like these Laconia nurs'd of old her hardy sons ; And Rome's unconquer'd legions urg'd their way, Unhurt, thro every toil in every clime.—Armstrong. Few things tend more to the destruction of children than drenching them with drugs. That medicine may be sometimes necessary for chil- dren, I do not deny ; but that it hurts them ten times for once it does iheinjrood, I will venture to assert. A London mother, the mo.neiu her child seems to ail anything, runs immediately to the apothecary, OF TUB LABORIOUS, ETC- 25 who throws in his powders, pills, and potions, till the poor infant ia poisoned ; when the child might have been restored to perfect health by a change of diet, air, exercise, clothing, or some very easy and simple regulation. But misguided fondness is not satisfied with drugging children frcm the apothecary's shop, many of them are Jed from the same quarter. A starch from the West Indies called flour of arrow-root, is the food of those parents who can afford to pay for it. I lately offended a mother very much by saying, it was not half so good as oatmeal, though more than ten times the price. Of this, however, she had sufficient proof by a child in her arms, who had been fed on that root, and though a year and a half old, could scarcely put a foot to the ground, while her neighbour's child only nine months old, but nursed in the north country manner, could, by a hold of the one finger, run all over the house. I have taken notice of the powder, to show the influence of fashion even in the feeding of an infant. I wish it were the only instance I could give of the fatal effects of the same cause. Ten thousand infants in this island,, before they are out of the nurse's arms, sip tea twice a-day ; which, to be sure, is the true way to propagate heroes 1 CHAP. II. OF THE LABORIOUS, THE SEDENTARY, AND THE STUDIOUS. That men are exposed to particular diseases from the occupations which they follow, is a fact well known ; but to remedy this evil is a matter of some difficulty. Most people are under the necessity of following those employments to which they have been bred, whether they be°favourable to health or not. For this reason, instead of in- veighing, in a general way, as some authors have done, against these occupations which are hurtful to health, we shall endeavour to point out the circumstances in each of them from which the danger chiefly arises, and to propose the most rational methods of preventing it. Chvinists, founders, forgers, glass-makers, and several other artists, are hurt by the unwholesome air which they are obliged to breathe. This air is not only loaded with the noxious exhalations arising from metals and minerals, but is so charged with phlogiston as to be rendered unlit for expanding the lun-o sufficiently, and answerhg the ocher 25 OF THE T.AT11HTO"*. Tnfi SEDENTART, important purposes of respiration. Hence proceed asthmas, cougns, and consumption of the lungs, so incident to persons who follow these employments. To prevent such consequences as far as possible, the places where these occupations are carried on, ought to be constructed in such a manner as to discharge the smoke and other exhalations, and admit a free current of fresh air. Such artists ought never to continue long at work, and when they give over, they should suffer themselves to cool gradually, and put on their clothes before they go into the open air. They ought never to drink large quantities of cold, weak, or watery liquors while their bodies are hot, nor to indulge in raw fruits, salads, or any thing that is cold on the stomach.* Miners, and all who work under ground, are likewise hurt by un- wholesome air. The air, by its stagnation in deep mines, not only loses its proper spring and other qualities necessary for respiration, but is often loaded with such noxious exhalations as to become a most deadly poison. The two kinds of air which prove most destructive to miners, are what they call the fire damp and the choke damp. In both cases the air becomes a poison by its being loaded with phlogiston. The danger from the former may be obviated by making it explode before it accu- mulates in too great quantities ; and the latter may be generally carried off by promoting a free circulation of air in the mine. Miners are not only hurt by uuwholesome air, but likewise by the particles of metal which adhere to their skin, clothes, &c. These are absorbed or taken up into the body, and occasion palsies, vertigoes, and other nervous affections, which often prove fatal. Fallopius observes, that those who work in mines of mercury seldom live above three or four years. Lead, and several other metals, are likewise very per- nicious to the health. Miners ought never to go to work fasting, nor to continue too Ion* at work. Their food ought to be nourishing, and their liquor generous : nothing more certainly hurts them than living too low. They should by all means avoid costiveness. This may either be done by chewinc a little rhubarb, or taking a sufficient quantity of salad oil. Oil not only opens the body, but sheathes and defends the intestines from the ill effects of the metals. All who work in mines or metals ought to wash carefully, and to change their clothes as soon as they give over working Nothing would tend more to preserve the health of such people than a strict, and almost religious, regard to cleanliness. *When persons heated with labour, have drunk cold liquor, they ought to con. Unue at work for some time afier. ° and the iTcmors. 27 Plumbers, painters, gilders, smelters, makers of white lead, ami many others who work in metals, are liable to the same diseases as miners ; and ought to observe the same directions for avoiding them. Tallow chandlers, boilers of oil, and all who work in putrid animal substances, are likewise liable to suffer from the unwholesome smells or effluvia of these bodies. They ought to pay the same regard to cleanliness as miners ; and when they are affected with nausea, sick- ness or indigestion, we would advise them to take a vomit or a gentle purge. Such substances ought always to be manufactured as soon as possible. When long kept they not only become unwholesome to those who manufacture them, but likewise to people who live in the neigh. bourhood. It would greatly exceed the limits of this part of our subject to specify the diseases peculiar to persons of every occupation ; we shall therefore consider mankind under the general classes of Laborious, Sedentary, and Studious. THE LABORIOUS. Though those who follow laborious employments are in general the most healthy of mankind, yet the nature of their occupations, and the places where they are carried on, expose them more particularly to some diseases. Husbandmen, for example, are exposed to all the vicissitudes of the weather, which, in this country, are often very great and sudden, and occasion colds, coughs, quinsies, rheumatisms, fevers, and other acute disorders. They are likewise forced to work hard, and often carry burthens above their strength, which, by overstraining the vessels, oc- casion asthmas, ruptures, pleurisies, &c. Those who labour without doors are often afflicted with intermitting fevers or agues, occasioned by the frequent vicissitudes of heat and cold, poor living, bad water, sitting or lying on the damp ground, evening dews, night air, &c. to which they are frequently exposed. Such as bear heavy burdens, as porters, labourers, &c. are obligedto draw in the air with much greater force, and also to keep their lungs distended with more violence than is necessary for common respira- tion : by this means the tender vessels of the lungs are overstretched, and often burst, insomuch that a spitting of blood or fever ensues. Hippocrates mentions an instance to this purpose, of a man, who, upon a wa^er, carried an ass ; but was soon after seized with a fever, a vomiting of blood, and a rupture. Carrying heavy burdens is generally the effect of mere laziness^ which prompts people to do at once what should be done at twice. 23 OF THE LABORIOUS, TUB SEDENTARY, Sometimes it proceeds from vanity or emulation Hence it is, that the . strongest men are most commonly hurt by heavy burdens, hard labour, or feats of activity. It is rare to find one who boasts of his strength, without a rupture, a spitting of blood, or some disease, which he reaps as the fruit of his folly. One would imagine the daily instances we have of the fatal effects of carrying great weights, running, wrestling, aud the like, would be sufficient to prevent such practices. There are indeed some employments which necessarily require a great exertion of strength ; as porters, blacksmiths, carpenters, &c. None ought to follow these but men of strong body ; and they should never exert their strength to the utmost, nor work too long. When the muscles are violently strained, frequent rest is necessary, in order that they may recover their tone: without this the strength and consti- tution will soon be worn out, and a premature old age be induced. The erysipelas, or St. Anthony's fire, is a disease very incident to the laborious. It is occasioned by whatever gives a sudden check to the perspiration, as drinking cold water when the body is warm, wet feet, keeping on wet clothes, sitting or lying on the damp ground, &c. It is impossible for those who labour without doors always to guard against these inconveniences ; but it is known from experience, that their ill consequences might often be prevented by proper care. The illiac passion, the colic, and other complaints of the bowels, are often occasioned by the same causes as the erysipelas ; but they may likewise proceed from flatulent and indigestible food. Labourers gen- erally eat unfermented bread, made of peas, beans, rye, and other windy ingredients. They also devour great quantities of unripe fruit, baked, stewed, or raw, with various kinds of roots and herbs, upon which they drink sour milk, stale small beer, or the like. Such a mix- ture cannot fail to fill the bowels with wind, and occasion diseases of those parts. Inflammations, whitloes, and other diseases of the extremities, are likewise common to those who labour without doors. These diseases are often attributed to venom, or some kind of poison ; but they gener- ally proceed either from sudden heat after cold, or the contrary. When labourers, milk-maids, &c. come from the field, cold or wet, they run to the fire, and often plunge their hands into warm water ; by which means the blood and other humours in those parts are suddenly expanded, and, the.vessels not yielding so quickly, a strangulation happens, and au inflammation or a mortification ensues. When such persons come home cold, they ought to keep at a distance from he fire for some time, to wash their hands in cold water, and to tub them well w.th a dry cloth. It sometimes happens, that peopie AND TIlF STUDIOUS. 29 are so benumbed with cold, as to be quite deprived of the use of their limbs. In this case the only remedy is to rub the parts affected with snow, or where it cannot be had, with cold water. If they be held near the fire, or plunged into warm water a mortification will generally ensue. Labourers in the hot season are apt to lie down and sleep in the sun. This practice is so dangerous that they often awake in a burning fever. These ardent fevers which prove so fatal about the end of summer and beginning of autumn, are frequently occasioned by this means. When labourers leave off work, which they ought always to do during the heat of the day, they should go home, or at least get under some cover, where they may repose themselves in safety. Many people follow their employments in the fields from morning till night, without eating anything. This cannot fail to hurt their health. How ever homely their fare may be, they ought to have it at regular times ; and the harder they work, the more frequently they should eat. If the humours be not more frequently replenished with fresh nourishment, they soon become putrid, and produce fevers of the very worst kind. Many peasants are extremely careless with respect to what they eat or drink, and often, through mere indolence, use unwholesome food, when they might, for the same expense, have that which is wholesome. In some parts of Britain, the peasants are too careless even to take the trouble of dressing their own victuals. Such people would live upon one meal a-day in indolence, rather than labour, though it was to procure them the greatest affluence. Fevers of a very bad kind are often occasioned among labourers, by poor living. When the body is not sufficiently nourished, the hu- mours become vitiated, and the solids weak ; from whence the most fatal consequences ensue. Poor living is likewise productive of many of those cutaneous diseases so frequent among the lower class of people. It is remarkable, that cattle when pinched in their food, are generally affected with diseases of the skin, which seldom fail to disappear when they are put upon a good pasture. This shows how much a good state of the humours depends upon a sufficient quantity of proper nourishment. Poverty not only occasions, but aggravates, many of the diseases of the laborious. Few of them have much foresight; and if they had, it is seldom in their power to save any thing. They are glad to make a shift to live from day to day ; and when any disease overtakes them, they are miserable indeed. Here the godlike virtue of charity ought always to exert itself. To relieve the industrious poor in distress, is Mirelv the most exalted act of religion and humanity. They alone who are witnesses of these scenes of calamity, can form a notion of what 30 OF THE LABORIOUS, THE SEDENTART, numbers perish in diseases for want of proper assistance, and even for want of the necessaries of life. Labourers are often hurt by a foolish emulation which prompts them to vie with one another, till they overheat themselves to such a degree a^s to occasion a fever, or even to drop down dead. Such as wantonly throw away their lives in this mauuer, deserve to be looked upon in no better light than self-murderers. The office of a soldier in time of war, may be ranked among the laborious employments. Soldiers suffer many hardships from the inclemency of seasons, long marches, bad provisions, hunger, watching, unwholesome climates, bad water, &c. These occasion fevers, fluxes, rheumatisms, and other fatal diseases, which generally do greater execution than the sword, especially when campaigns are continued too late in the season. A few weeks of cold rainy weather will often prove more fatal than an engagement. Those who have the command of armies, should take care that their soldiers be well clothed and well fed. They ought also to finish their campaigns in due season, and to provide their men with dry and well aired winter quarters. These rules, taking care at the same time to keep the sick at a proper distance from those in health, would tend greatly to preserve the lives of the soldiery.* Sailors may also be numbered among the laborious. They undergo great hardships from change of climate, the violence of the weather, hard labour, bad provisions, &c. Sailors are of so great importance both to the trade and the safety of this kingdom, that too much pains can never be bestowed in pointing out the means of preserving their lives. One great source of the diseases of sea-faring people is excess. When they get on shore, after having been long at sea, without regard to the climate, or their own constitutions, they plunge headlong into all man- ner of riot, and often persist till a fever puts an end to their lives. Tims intemperance, and not the climate, is often the cause why so many of our brave sailors die on foreign coasts. Such people ought not to * It is indeed to he regretted, that soldiers suffer not less from indolence and in- temperance in time of peace, than from hardships in time of war. If men are idle they will be vicious It would therefore be of great importance, could a scheme be formed for rendering the military, in times of peace, both more healthy and more useful. These desirable objects might, in our opinion, be obtained, by employing them for some hours every day, and advancing their pay accordingly By this means, idleness, the mother of vice, might be prevented, the price of labour lowered public works, as harbours, canals, turnpike roads, &c might be made without hurt- ing manufactures, and soldiers might be enabled to marry and bring up children. A scheme of this kind might easily be conducted so as not to depress the martial Bpirit, provided the men were only to work four or five hours every day, and always to work without doors: no soldier should be suffered to work too long, or to follow f.aL^teunftr^r.f^- Aadenta,ry ^P^^ts render men weak and effeml- uate, quite unfit for the hardships of war: whereas working for a few hours every th^r^ngthTd ZSr"tllem '° 'he w"th-' braC8 ll'eir ""«. a»J ~ AND THE STUDIOUS. 31 live too low ; but they will find moderation the best defence against fevers and many other maladies. Sailors, when on duty, cannot avoid sometimes getting wet. When this happens they should change their clothes as soon as they are relieved, and take every method to restore the perspiration. They should not in this case, make too free with spirits or other strong liquors, but should rather drink them diluted with warm water, and go immediately to bed, where a sound sleep and a gentle sweat will set all to r ghts. But the health of sailors suffers most from unwholesome food. The constant use of salted provisions inflames their humours, and occa- sions the scurvy, and other obstinate maladies. It is no easy matter to prevent this disease in long voyages ; yet we cannot help thinking that much might be done towards effecting so desirable an end, were due pains bestowed for that purpose. For example, various roots, greens, and fruits, might be kept a long time at sea, as onions, pota- toes, cabbages, lemons, oranges, tamarinds, apples, &c. When fruits c ninot be kept, the juices of them, either fresh or fermented, may. With these all the drink, and even the food, of the ship's company ought to be acidulated in long voyages. Stale bread and beer likewise contribute to vitiate the humours. Flour will keep for a long time onboard, of which fresh bread might frequently be made. Malt too might be kept, and infused with boiling water at any time. This liquor, when drank even in form of wort,is very whole. some, and is found to be an antidote against the scurvy. Small wines and cider might likewise be plentifully laid in; and should they turn sour, they would still be useful as vinegar. Vinegar is a great antidote against diseases, and should be used by all travellers, especially at sea. It may be either mixed with the water they drink, or taken in their food. Such animals as can be kept alive, ought likewise to be carried on board, as hens, ducks, pigs, &c. Fresh broths made of portable soup, and puddings made of peas or other vegetables, ought to be used plentifully. Many other things will readily occur to people conversant in these matters, which would tend to preserve the health of that brave and useful set of men.* We have reason to believe, if due attention were paid to the diet, air, Joining, and above all things to the cleanliness of sea-faring people, * Our countryman, the celebrated Captain Cook, has shown how far, by proper careaud attention, the diseases formerly so fatal to seamen may be prevented. In a vovuKe of three years and eighteen days, during which he was exposed to every a \ojage 01 hub , ___ p latitude, of onehundied and eighteen procure ... allow his people .umcient time lor ust. 32 OF Till! LABORIOUS, THE SEDENTARY, they would be the most healthy set of men in the world; but wlien these are neglected, the very reverse will happen. The best medical antidote that we can recommend to sailors or sol. diers, on foreign coasts, especially where dampness prevails, js the Peruvian bark. This will often prevent fevers, and other fatal diseases. About a dram of it may be chewed every day ; or if this should prove disagreeable, an ounce of bark, with half an ounce of orange peel, and twondramsof snake-root coarsely powdered, may be infused for two or three days in an English quart of brandy, and half a wine glass of it taken twice or thrice a day, when the stomach is empty. This has been found to be an excellent antidote against fluxes, putrid, intermit- ting, and other fevers, in unhealthy climates. It is not material in what form this medicine is taken. It may either be infused in water, wine, or spirits, as recommended above, or made into an electuary with syrup of lemons, oranges, or the like. THE SEDENTARY. Though nothing can be more contrary to the nature of man than a sedentary life, yet this class comprehends by far the the greater part of the species. Almost the whole female world, and in manufacturing countries, the major part of the males, may be reckoned sedentary.* Agriculture, the first and most healthful of all employments, is no.v followed by few who are able to carry on any other business. But those who imagine that the culture of the earth is not sufficient to employ all its inhabitants, are greatly mistaken. An ancient Roman, we are told, could maintain his family from the produce of one acre of ground. So might a modern Briton, if he would be contented to live like a Roman. This shows what an immense increase of inha- bitants Britain might admit of, aud all of whom might live by the cul- ture of the ground. Agriculture is the great source of domestic riches. When it is neglected, whatever wealth may be imported from abroad, poverty and misery will abound at home. Such is, and ever will be, the fluctuating state of trade and manufactures, that thousands of people may be in full employment to-day, and beggary to-moi row. This can never hap- pen to those who cultivate the ground. They can eat the fruit of their labour, and can always by industry obtain, at least, the necessaries of life- * The appellation of sedentary has generally been given only to the studious • we can see no reason, however, for restricting it to them alone. Many artilicers may with as much propriety, be denominated sedentary as the studious, with this parti' culm disadvantage, that they are often obliged to sit in very awkward postures winch the studious need not do, nnless tlay please. AND THE STUDIOUS. 33 Though sedentary employments are necessary, yet there seems to be no reason why any person should be confined for life to these alone. Were such employments intermixed with the more active and labo- rious, they would never do hurt. It is constant confinement that ruins the health. A man may not be hurt by sitting five or six hours a-day ; but if he is obliged to sit ten or twelve, he will soon become diseased. But it is not want of exercise alone which hurts sedentary people . they likewise suffer from the confined air which they breathe. It is very common to see ten or a dozen tailors,* or stay makers, for exam- ple, crowded into one small apartment, where there is hardly room forone person to breathe freely. In this situation they generally conti- nue for many hours at a time, often with the addition of several candles, which tend likewise to waste the air, and render it less fit for respira- tion. Air that is breathed repeatedly becomes unfit for expanding the lungs. This is one cause of the phthisical coughs and other complaints of the breast, so incident to sedentary artificers. Even the perspiration from a great number of persons pent up toge- ther, renders the air unwholesome. The danger from this quarter will be greatly increased, if any one of them happen to have bad lungs, or to be otherwise diseased. Those who sit near him, being forced to breathe the same air, can hardly fail to be infected. It would be a rare thing, however, to find a dozen of sedentary people all in good health. The danger of crowding thein together must therefore be evident to every one. Many of those who follow sedentary employments are constantly in a bending posture, as shoemakers, tailors, cutlers, &c. Such a situation is extremely hurtful. A bending posture obstructs all the vital motions, and of course must destroy the health. Accordingly we find such artificers generally complaining of indigestions, flatulencies, headaches, pains of the breast, &c. The aliment in sedentary people instead of being pushed forward by an erect posture, and the actions of the muscles, is in a manner con- fined in the bowels. Hence indigestions, costiveness, wind, and other hypochondriacal affections, the constant companions of the sedentary. Indeed none of the excretions can be duly performed where exercise is wanting ; and when the matter which ought to be discharged in this vav, is retained too long in the body, it must have bad effects, as it is a -am taken up into the mass of humours. * A person of observation in that line of life told me, that most tailors die of con- sumptions • which he attributed chiefly to the unfavourable postures in which they kit and the unwholesomeness of those places where their business is carried on. If more attention were not paid to profit thun to the preservation of human lives, this eul wuiit ne tasilv remedied ; but while m:i»ters only mind their own inlcicot, uo- U.uj w.il ho done"for the sit.-.y of their ;m.i.us. V 34 OF THE LABORIOUS, THE SEDENTARY, A bending posture is likewise hurtful to the lungs. When this organ is compressed, the air cannot have free access into all its parts so as to expand them properly. Hence tubercles, adhesions, &c. are formed which often end in consumptions. Besides the proper action of the lungs being absolutely necessary for making good blood, when that organ fails, the humours soon become universally depraved, and the whole constitution goes to wreck. Being of a soft texture, and in con- tinual action, their functions are easily obstructed by pressure. The sedentary are not only hurt by pressure on the bowels, but also on the inferior extremities, which obstructs the circulation in these parts, and renders them weak and feeble. Thus tailors, shoemakers, &c. frequently lose the use of their legs altogether ; besides, the blood and humours are, by stagnation, vitiated, and the perspiration is ob- structed ; whence proceed the scab, ulcerous sores, foul blotches, and other cutaneous diseases, so commrn among sedentary artificers. A bad figure of body is a very common consequence of close appli- cation to sedentary employments. The spine, for example, being continually bent, puts on a crooked shape, and generally remains so ever after. But a bad figure of body has already been observed to be hurtful to health, as the vital functions are thereby impeded. A sedentary life seldom fails to occasion an universal relaxation of the solids. This is the great source from whence most of the diseases of sedentary people flow. The scrofula, consumption, hysterics, and nervous diseases, now so common, were very little known in this country before sedentary artificers became so numerous; and they are very little known still among such of our people as follow active employments without doors, though in our great towns at least two-thirds of the in- habitants are afflicted with them. It is very difficult to remedy those evils, because many who have been accustomed to a sedentary life, liko rickety children, lose all inclination for exercise : we shall, however, throw out a few hints with respect to the most likely means for preserving the health of this useful set of people, which some of them, we hope, will be wise enough to take. It has been already observed, that sedentary artificers are often hurt by their bending posture. They ought, therefore, to stand or sit as erect as the nature of their employments will permit. They should likewise change their posture frequently, and should never sit too lor- at a time, but leave off work, and walk, ride, run, or do any thing thai will promote the vital functions. Sedentary artificers are generally allowed too little time for exev- cise ; yet, short as it is, they seldom employ it properly. A journey- man tador or w,.aveP, for instance, instead of walking abroad fLr AND THE STUDIOUS. exercise and fresh air, at his hours of leisure, choses rather to spend them in a public house, or at playing at some sedentary game, by which he generally loses both his time and his money. The awkward postures in which many sedentary artificers work, seem rather to be the effect of custom than necessity. For example, a table might surely be contrived for ten or a dozen tailors to sit round, with liberty for their legs either to hang down or rest upon a foot-board, as they should chose. A place might likewise be cut out for each person, in such a manner that he might sit as conveniently for working, as in the present mode of sitting cross-legged. All sedentary artificers ought to pay the most religious regard to cleanliness. Both their situation and occupations render this highly necessary. Nothing would contribute more to preserve their health than a strict attention to it; and such of them as neglect it, not only run the hazard of losing health, but of becoming a nuisance to their neighbours. Sedentary people ought to avoid food that is windy or hard of diges- tion, and should pay the strictest regard to sobriety. A person who works hard without doors, will soon wear off a debaucli, but one who sits has by no means an equal chance. Hence it often happens, that sedentary people are seized with fever after hard drinking. When such persons feel their spirits low, instead of running to the tavern for relief, they should ride or walk in the fields. This would remove the complaint more effectually than strong liquor, and would never hurt the constitution. Instead of multiplying rules for preserving the health of the sedentary, we shall recommend to them the following general plan, viz. That every person who follows a sedentary employment should cultivate a piece of ground with his own hands. This he might dig, plant, sow, and weed, at leisure hours, so as to make it both an exercise and amuse- ment, while it produced many of the necessaries of life. After working an hour in a garden a man will return with more keenness to his em- ployment within doors, than if he had been all the while idle. Labouring the ground is every way conducive to health. It not only gives exercise to every part of the body, but the very smell of the earth and fresh herbs revives and cheers the spirits, whilst the per- petual prospect of something coming to maturity delights and entertains the mind. We are so formed as to be always pleased with somewhat in prospect, however distant, or however trivial ; hence the happiness that most men feel in planting, sowing, building, &c. These seem to have been the chief employments of the more early ages ; and, when kings and conquerors cultivated the ground, there is reason to believe that they knew as well wherein true lnppmes consisted as we do. S3 OF THE LABORIOUS, THE SEDENTART, It may seem romantic to recommend gardening to manufacturers in great towns ; but observation proves that the plan is very practicable. In the town of Sheffield, in Yorkshire, where the iron-manufacture is carried on, there is hardly a journeyman cutler who does not possess a piece of ground, which he cultivates as a garden. This practice has many salutary effects. It not only induces these people to take exer- cise without doors, but also to eat many greens, roots, &c. of their own growth which they would never think of purchasing. There can be no reason why manufacturers in any other town in Great Britain should not follow the same plan. It is indeed to be regretted, that, in such a place as London, a plan of this kind is not practicable : yet, even there sedentary artificers may find opportunities of taking air and exercise, if they chuse to embrace them. Mechanics are too much inclined to crowd into great towns. The situation may have some advantages ; but it has likewise many disad- vantages. All mechanics who live in the country have it in their power to cultivate a piece of ground ; which indeed most of them do. This not only gives them exercise, but enables them to live more comfortably. So far at least as my observation extends, mechanics who live in the country are far more happy than those in great towns. They enjoy better health, live in greater affluence, and seldom fail to rear a healthy and numerous offspring. In a word, exercise without doors, in one shape or another, is abso- lutely necessary to health. Those who neglect it, though they may for a while drag out life, can hardly be said to enjoy it. Weak and effe- minate, they languish for a few years, and soon drop into an untimely grave. THE STUDIOUS. Intense thinking is so destructive to health, that few instances can be produced of studious persons who are strong and healthy. Hard study always implies a sedentary life ; and when intense thinking is joined to the want of exercise, the consequence must be bad. We have fre- quently known even a few months of close application to study, ruin an excellent constitution, byinducing a train of nervous complaints which could never be removed. Man is evidently not formed for continual thought more than for perpetual action, and would be as soon worn out by the one as by the other. So great is the power of the mind over the body, that by its influence, the whole vital motions may be accelerated or retarded to almost any degree. Thus cheerfulness and mirth quicken the circulation and pro- AND THE STUDIOUS. 37 mote all the secretions ; whereas sadness aud profound thought never fail to retard them. Hence it would appear that even a degree of thoughtlessness is necessary to health. Indeed the perpetual thinker seldom enjoys either health or spirits ; while the person who can hardly be said to think at all, generally enjoys both. Perpetual thinkers, as they are called, seldom think long. In a few years, they generally become quite stupid, and exhibit a melancholy proof how readily the greatest blessings may be abused. Thinking, like every thing else, when carried to extreme, becomes a vice ; nor can any thing afford a greater proof of wisdom, than for a man frequently and seasonably to unbend his mind. This may generally be done by mixing in cheerful company, active diversions, or the like. Instead of attempting to investigate the nature of that connexion which subsists between the mind and the body, or to inquire into the manner in which they mutually affect each other, we shall only mention those diseases to which the learned are more peculiarly liable, and endeavour to point out the means of avoiding them. Studious persons are very subject to the gout. This painful disease in a great measure proceeds from indigestion, and an obstructed per- spiration. It is impossible that the man who sits from morning till night should either digest his food, or have any of the secretions in due quan- tity. But when that matter which should be thrown off by the skin, is retained in the body, and the humours are not duly prepared, diseases must ensue. The studious are likewise very liable to the stone and gravel. Exercise greatly promotes both the secretion and discharge of urine : consequently a sedentary life must have the contrary effect. Any one may be satis- fied of this by observing, that he passes much more urine by day than by night, and also when he walks or rides, than when he sits. The dis- charge of urine not only prevents the gravel and stone, but many other diseases. The circulation in the liver being slow, obstructions in that organ can hardly fail to be the consequence of inactivity. Hence sedentary people are frequently afflicted with schirrous livers. But the proper secretion and discharge of the bile is so necessary a part of the animal economy, that where these are not duly performed the health must soon be impaired. Jaundice, indigestion, loss of appetite, and a wasting of the whole body, seldom fail to be the consequences of a vitiated state of the liver, or obstructions of the bile. Few diseases prove more fatal to the studious than consumptions of the lungs. It has already been observed, that this organ cannot be duly expauded in those who do not take proper exercise; and where that 33 OF THE LABORIOUS, TIIE SEDENTARY", is the case, obstructions and adhesions will ensue. Not only want of exercise, but the posture in which studious persons generally sit, is very Hurtful to the lungs. Those who read or write much are ready to contract a habit of bending forwards, and often press with their breast upon a table or bench. This posture cannot fail to hurt the lungs. The functions of the heart may likewise by this means be injured. I remember to have seen a man opened, and whose pericardium adhered to the breast-bone in such a manner as to obstruct the motion of the heart, and occasion his death. The only probable cause that could be assigned for this singular symptom was, that the man, whose business was writing, used constantly to sit in a bended posture, with his breast upon the edge of a plain table. No person can enjoy health who does not properly digest his food. But intense thinking and activity never fail to weaken the powers of digestion. Hence the humours become crude and vitiated, the solids weak and relaxed, and the whole constitution goes to ruin. Long and intense thinking often occasions grievous headachs, which bring on vertigoes, apoplexies, palsies, and other fatal disorders. The best way to prevent these is, never to study too long at one time, and keep the body regular, either by proper food, or taking frequently a little of some opening medicine. Those who read or write much are often afflicted with sore eyes. Studying by candle-light is peculiarly "hurtful to the sight. This ought to be practised as seldom as possible. When it is unavoidable, the eyes should be shaded, and the head should not be held too low. When the eyes are weak or painful, they should be bathed every night and morning in cold water, to which a little brandy may be added. It has already been observed, that the excretions are very defective in the studious. The dropsy is often occasioned by the retention of those humours which ought to be carried off in this way. Any person may observe that sitting makes his legs swell, and that this goes off by ex- ercise ; which clearly points out the method of prevention. ^ Fevers, especially of the nervous kind, are often the effect of study. Nothing affects the nerves so much as intense thought. It in a manner unhinges the whole human frame, and not only hurts the vital motions but disorders the mind itself. Hence delirium, melancholy, and even madness, are often the effect of close application to study. In fine, there is no disease which can proceed either from a bad state of the humours, a defect of the usual secretions, or a debility of the nervous system, which may not be induced by intense thinking But the most afflicting of all the diseases which attack the studious uithe hypochondriac. This disease seldom fails to be the companion AND THE STUDIOUS. 39 of deep thought. It may rather be called a complication of maladies than a single one. To what a wretched condition are the best of men often reduced by it 1 Their strength and appetite fail; a perpetual gloom hangs over their minds ; they live in the constant dread of death, and are continually in search of relief from medicine, where, alas 1 it is not to be found. Those who labour under this disorder, though they are often made the subject of ridicule, justly claim our highest sympathy and compassion. Hardly any thing can be more preposterous than for a person to make study his sole business. A mere student is seldom a useful mem- ber of socieiy. He often neglects the most important duties of life, in order to pursue studies of a very trifling nature. Indeed it rarely happens, that any useful invention is the effect of mere, study. The farther men dive into profound researches, they generally deviate the more from common sense, and too often lose sight of it altogether. Profound speculations, instead of making men wiser or better, generally render them absolute sceptics, and overwhelm them with doubt and uncertainty. All that is necessary for man to know, in order to be happy, is easily obtained ; and the rest, like the forbidden fruit, serves only to increase his misery. Studious persons, in order to relieve their minds, must not only dis- continue to read aud write, but engage in some employment or diversion that will so occupy the thought as to make them forget the business of the closet. A solitary ride or walk are so far from relaxing the mind, that they encourage thought. Nothing can divert the mind when it gets into a train of serious thinking, but attention to subjects of a more trivial nature. These prove a kind of play to the mind, and consequently relieve it. Learned men often contract a contempt for what they call trifling company. They are ashamed to be seen with any but philosophers. This, however, is no proof of their being philosophers themselves. No man deserves that name who is ashamed to unbend his mind, by asso- ciating with the cheerfnl and gay. Even the society of children wid relieve the mind, and expel the gloom which application to study is too apt to occasion. As studious people are necessarily much within doors, they should make their choice of a large and well-aired place for study. This would 0>t only prevent the bad effects which attend confined air, but would cheer the spirits, and have a most happy influence both on the body and mind. It is said of Euripides the tragedian, that he used to retire to a dark cave to compose his tradgedies ; and of Demosthenes the Grecian orator, that he chose a place for study where nothing could be heard 40 OT THE LABORIOUS, THE SEDENTARY-, or seen. With all deference to such venerable names, we cannot help condemning their taste. A man may surely think to as good purpose in an elegant apartment as in a cave; and may have as happy conceptions where the all-cheering rays of the sun render the air wholesome, as in places where they never enter. Those who read or write much should be very attentive to their pos- ture. They ought to sit and stand by turns, always keeping as nearly in an erect posture as possible. Those who dictate may do it walking. It has an excellent effect frequently to read or speak aloud. This not only exercises the lungs, but almost the whole body. Hence studious people are greatly benefited by delivering discourses in public. Public speakers, indeed, sometimes hurt themselves by overacting their part: but this is their own fault. The martyr to mere vociferation merits not our sympathy. The morning has, by all medical writers, been reckoned the best time for study. It is so. But it is also the most proper season for exerciser while the stomach is empty, and the spirits are refreshed with sleep. Studious people should therefore sometimes spend the morning in walk- ing, riding, or some manly diversions without doors. This would make them to study with greater alacrity, and would be of more service than twice the time after their spirits are worn out with fatigue. It is not suffieient to take diversion only when we can think no longer. Every studious person should make it a part of his business, and should let nothing interrupt his hours of recreation more than those of study. Music has a very happy effect in relieving the mind when fatigued with study. It would be well if every studious person, were so° far acquainted with that science as to amuse himself, after severe thought, by playing such airs as have a tendency to raise the spirits, and inspire cheerfulness and good humour. It is a reproach to learning that any of her votaries, to relieve th« mind after study, should betake themselves to the use of strong liquors This indeed is a remedy ; but it is a desperate one, and alwavs proves destructive. Would such persons, when their spirits are low, get on horseback, and ride ten or a dozen miles, they would find it a more effectual remedy than any cordial medicine in the apothecary's shop or all the strong liquors in the world. ' The following is n,y plan, and I cannot recommend a better to other*. W hen my mind is fatigued with study, or other serious business, I mo*t my horse, and ride ten or twelve miles into the country, wherTl spend a day and sometimes two, with a cheerful friend : after which I never fa, to return to town with renewed vigour, and to pursue my studies or business with fresh alacrity. * AND THE STUDI0U3. 41 It is n.nch to be regretted, that learned men, while in health, pay so little regard to these things. There is not any thing more common thnn to see a miserable object overrun with nervous diseases, bathing, walk- ing, riding, and in a word, doing every thing for health after it is gone ; yet, if any one had recommended these things to him by way of preven- tion, the advice would, in all probability, have been treated with con- tempt, or at least with neglect. Such is the weakness and folly of mankind, and such the want of foresight, even in those who ought to be wiser than others. With regard to the diet of the studious, we see no reason why they should abstain from any kind of food that is wholesome, provided they use it in moderation. They ought however to be sparing in the use of every thing that is windy, rancid, or hard of digestion. Their suppers should always be light, or taken soon in the evening. Their drink may be water, fine malt liquor, not too strong, good cider, wine and water, or, if troubled with acidities, water mixed with a little brandy, rum, or any other genuine spirit. We shall only observe, with regard to those kinds of exercise which are most proper for the studious, that they should not be too violent, nor ever carried to the degree of excessive fatigue. They ought likewise to be frequently varied, so as to give action to all the different parts of the body ; and should, as often as possible, be taken in the open air. In general, riding on horseback, walking, working in a garden, or plny- ing at some active diversions, are the best. We would likewise recommend the use of the cold bath to the Btudious. It will, in some measure, supply the place of exercise, and should not be neglected by persons of a relaxed habit, especially in the warm season. No person ought either to take violent exercise, or study immediately after a full meal. In the above remarks on the usual diseases of the studious, my chief object was to warn them of the evil consequences of painful and intense thinking. But I should be sorry to damp the ardour of their literary pursuits, which are injurious to health only when continued with incessant toil, at late hours, and without due intervals of rest, refreshment, relaxation and exercise. It is not thought, says the medi- c.il poet, 'tis painful thinking, that corrodes our clay. I deemed it neces- sary to be more explicit on this head, in consequence of having found that my former cautions to men of genius and science had been under- stood in too rigorous a seuse, as discouraging the manly exertions of real talents. 42 CHAP. III. OF ALIMENT. Unwholesome food, and irregularities of diet, occasion many diseases. There is no doubt but the whole constitution of body may be changed by diet alone. The fluids may be thereby attenuated or condensed, rendered mild or acrimonious, coagulated or diluted, to almost any de- gree. Nor are its effects upon the solids less considerable. They may be braced or relaxed, have their sensibility, motions, &c. greatly in- creased or diminished, by different kinds of aliment. A very small attention to these things will be sufficient to show, how much the pre- servation of health depends upon the proper regimen of the diet. Nor is an attention to diet necessary for the preservation of health only : it is likewise of importance in the cure of diseases. Every intention in the cure of many diseases, may be answered by diet alone. Its effects, indeed, are not always so quick as those of medicine, but they are generally more lasting ; besides, it is neither so agreeable to the patieut, nor so dangerous a medicine, and is always more easily obtained. Our intention here is not to inquire minutely into the nature and properties of the various kinds of aliment in use among mankind, nor to' show their effects upon the different constitutions of the human body, but to mark some of the most pernicious errors which people are apt to fall iuto, with respect both to the quantity and quality of their food, and to point out their influence upon health. It is not indeed an easy matter to ascertain the exact quantity of food proper for every age, sex, and constitution; but a scrupulous nicety here is by no means necessary. The best rule is to avoid all extremes. Man- kind were never intended to weigh and measure their food. Nature teaches every creature when it has enough ; and the calls of thirst and hunger are sufficient to inform them when more is necessary. Though moderation is the chief rule with regard to the quantity, yet the quality of food merits a farther consideration. There are many ways by which provisions may be rendered unwholesome. Bad seasons may either prevent the ripening of grain or damage it afterwards. These, indeed, are acts of Providence, and we must submit to them j but surely no punishment can be too severe for those who suffer provi' OF AMMEXT. 43 sions to spoil by hoarding them, on purpose to raise the price, or uho promote their own interest by adulterating the necessaries of life.* Animal as well as vegetable food may be rendered unwholesome by being kept too long. All animal substances have a constant tendency to putrefaction ; and when that has proceeded too far, they not only become offensive to the senses, but hurtful to health. Diseased animals, and such as die of themselves, ought never to be eaten. It is a common practice, however, in some grazing countries, for servants and poor people to eat such animals as die of any disease, or are killed by acci- dent. Poverty indeed may oblige people to do this ; but they had bet- ter eat a small quantity of what is sound and wholesome; it would both afford a better nourishment, and be attended with less danger. The injunction given to the Jews, not to eat any creature which died of itself, seems to have a strict regard to health ; and ought to be ob- served by Christians as well as Jews. Animals never die themselves without some previous disease ; but how a diseased animal should be wholesome food is inconceivable: even those which die by accident must be hurtful, as their blood is mixed with the flesh, and soon turns putrid. Animals which feed grossly, as tame ducks, hogs, &c. are neither so easily digested, nor afford such wholesome nourishment as others. No animal can be wholesome which does not take sufficient exercise. Most of our stall cattle are crammed with gross food, but not allowed exercise nor free air ; by which means they indeed grow fat, but their juices not being properly prepared or assimilated, remain crude, and occasion indigestions, gross humours, and oppression of the spirits, in those who feed upon them. Animals are often rendered unwholesome by being overheated. Ex- cessive heat causes a fever, exalts the animal salts, and mixes the blood so intimately with the flesh, that it cannot be separated. For this reason, butchers should be severely punished who overdrive their cattle. No person would chuse to eat the flesh of an animal which had died in a high fever; yet that is the case with all over- driven cattle ; and the fever is often raised even to a degree of madness. But this is not the only way by which butchers render meat un- wholesome. The abominable custom of filling the cellular membrane of animals with air, in order to make them appear fat, is every day prac- tised. This not only spoils the meat, and renders it unfit for keeping, * The noor Indeed, are generally the first who suffer by unsound provisions; but the lives of the labouring poor are of (treat importance to the state: besides, dista^ci . Atoned bv unwholesome food often prove infectious, by which means they reach L'Ji.le in every station. It is therefore the interest of all to take eaie that no spoiled pi elisions of auj kind be exposed to salo. 44 07 ALIMENT. but is such a dirty trick, that the very idea of it is sufficient to disgust a person of any delicacy at every thing which comes from the shambles. Who can bear the thought of eating meat which has been blown up with air from the lungs of a dirty fellow, perhaps labouring under the very worst of dieases. Butchers have likewise a method of filling the cellular membranes of animals with blood. This makes the meat seem fatter, and likewise weigh more, but is notwithstanding, a very pernicious custom, as it both renders the meat unwholesome and unfit for keeping. I seldom see a piece of meat from the shambles, where the blood is not diffused through the cellular texture. I shall not say that this is always the effect of design ; but I am certain it is not the case with animals that are killed fordomestic use, and properly blooded. Veal seems to be most frequently spoiled in this way. Perhaps that may in some measure be owing to the practice of carrying calves from a great distance to market, by which means their tender flesh is bruised, and many of their vessels burst. No people in the world eat such quantities of salted animal food as the English, which is one reason why they are so generally tainted with the scurvy, and its numerous train of consequences, indigestion, low spirits, hypocondriacism, &c. Animal food was surely designed for man, and, with a proper mixture of vegetables, it will be found the most wholesome ; but to gorge feeef, mutton, pork, fish, and fowl, twice or thrice a-dny is certainly too much. All who value health ought to be contented with making one meal of flesh in the twenty-four hours, and this ought to consist of one kind only. The most obstinate scurvy has often been cured by a vegetable diet; nay, milk alone will frequently do more in that disease than any medi- cine. Hence it is evident, that if vegetables and milk were more used in diet, we should have less scurvy, and likewise fewer putrid and in- flammatory feves. Fresh vegetables, indeed, come to be daily more used in diet; this laudable practice we hope will continue to gain ground. Our aliment ought neither to be too moist nor too dry. Moist aliment relaxes the solids, and renders the body feeble. Thus we see females, who live much on tea, and other watery diet, generally be- come weak and unable to digest solid food : hence proceed hysterics and all their dreadful consequences. On the other hand, food that is too dry, renders the solids in a manner rigid, and the humours viscid, which disposes the body to inflammatory fevers, scurvies, and the like. Much has been said on the ill effects of tea in diet. They are, no doubt, numerous ; but they proceed rather from the imprudent use of it, than from any bad qualities in the tea itself. Tea is now the universal OF ALIMENT. 45 breakfast in this part of the world ; but the morning is surely the most improper time of the day for drinking it. Most delicate persons, who by the bye, are the greatest tea drinkers, cannot eat any thing in the morning. If such persons, after fasting ten or twelve hours, drink four or five cups of gi'een tea without eating almost any bread, it must hurt them. Good tea, taken in moderate quantity, not too strong, nor too hotj nor drank upon an empty stomach, will seldom do harm; but if it be bad, which is often the case, or substituted in the room of solid food, it must have many ill effects. The arts of cookery render many things unwholesome, which are not bo in their own nature. By jumbling together a number of different ingredients in order to make a poignant sauce, or rich soup, the com- position proves almost a poison. All high seasoning, pickles, &c. are only incentives to luxury, and never fail to hurt the stoma gome ^ will atone for excess ; but this, instead of mending the matter, generally" " food^r, I" theSt°mach *»« intestines are over distended we'kantinZlT',^^J"* *"d b-v ^ **»* they become £X1fi££ Wmd> Thus'either glutt0"*or fasti"s d—>° OF ALIMENT. 49 The frequent repetition of aliment is not only necessary for repairing the continual waste of our bodies, but likewise to keep the fluids sound and sweet. Our humours, even in the most healthy state, have a con- stant tendency to putrefaction, which can only be prevented by frequent supplies of fresh nourishment ; when that is wanting too long, the pu- trelaction often proceeds so far as to occasion very dangerous fevers. From hence we may learn the necessity of regular meals. No person can enjoy a good state of health, whose vessels are either frequently overcharged, or the humours long deprived of fresh supplies of chvle. Long fasting is extremely hurtful to young people ; it not only vitiates their humours, but prevents their growth. Nor is it less injurious to the aged. Most persons in the decline of life, are afflicted with wind ; this complaint is not only increased, but even rendered dangerous, and often fatal by long fasting. Old people, when their stomachs are empty, are frequently seized with giddiness, head-achs, and faintness. These complaints may generally be removed by a piece of bread and a glass of wine, or taking any other solid food; which plainly points out the method of preventing them. It is more than probable, that many of the sudden deaths, which happen in the advanced periods of life, are occasioned by fasting too long, as it exhausts the spirits and fills the bowels with wind ; we would therefore advise people in the decline of life, never to allow their stomachs to be too long empty. Many people take nothing but a few cups of tea and a little bread, from nine o'clock at night till two or three next afternoon. Such may be said to fast almost three-fourths of their time. This can hardly fail to ruin the appetite, vitiate the hu-. niours, and fill the bowels with wind ; all which might be prevented by a solid breakfast. It is a very common practice to eat a light breakfast and a heavy supper. This custom ought to be reversed. When people sup late, their supper should be very light; but the breakfast ought always to be solid. If any one eats a light supper, goes soon to bed, and rises betimes in the morning, he will be sure to find an appetite for his breakfast, and he may freely indulge it. The strong and healthy do not indeed suffer so much from fasting as the weak and delicate; but they run great hazard from its opposite, viz. repletion. Many diseases, especially fevers, are the effect of a plethora, or too great fulness of the vessels. Strong people in high health, have generally a great quantity of blood and other humours. When these are suddenly increased by an overcharge of rich and nourishing diet, the vcbsels become too much distended, and obstructions and inflammations B 50 OF ALIMENT. ensue. Hence so many people are seized with inflammatory and erup- tive fevers, apoplexies, &c. after a feast or debauch. All great and sudden changes in diet are dangerous. What the stomach has been long accustomed to digest, though less wholesome, will agree better with it than food of a more salutary nature to which it has not been used. When therefore a change becomes necessary, it ought always to be made gradually ; a sudden transition from a poor and low to a rich and luxurious diet, or the contrary, might so disturb t'.ie functions of the body, as to endanger health, or even to occasion death itself. When we recommend regularity in diet, we would not be under- stood as condemning every small deviation from it. It is next to im- possible for people at all times to avoid some degree of excess, and living too much by rule might make even the smallest deviation dangerous. It may therefore be prudent to vary a little, sometimes taking more, sometimes less, than the usual quantity of meat and drink, provided always that a due regard be paid to moderation. The details which some writers have entered into respecting the sup- posed qualities of every article of food and drink, as well as the proper quantities of each, appear to me just as trifling as the minuteness of the physician who inserted in his prescription how many grains of salt should be eaten with an egg. Every man's experience of what he has found to agree or disagree with him, is a much more unerring guide than whimsical calculations of the difference between the mucilage of a carrot and a parsnip, or between the jelly contained in a leg and a shoulder of mutton. But while I point out the folly of extreme soli- citude in such matters, I am far from advising people to eat and drink without any choice or restraint, whatever falls in their way. This would be inconsistent with the rules I have already laid down. Rational enjoyment of the gifts of nature, is the happy medium between bound- less indulgence and frivolous or unnecessary self-denial. 51 CHAP. IV. OF AIR. Unwholesome air is a very common cause of diseases. Few are aware of the danger arising from it. People generally pay some attention to what they eat or drink, but seldom regard what goes into the lungs, though the latter proves often more suddenly fatal than the former. Air, as well as water, takes up parts of most bodies with which it comes into contact, and is also so replenished with those of a noxious quality, as to occasion immediate death. But such violent effects sel- dom happen, as people are generally on their guard against them. The less perceptible influences of bad air, prove more generally hurtful to mankind ; we shall therefore endeavour to point out some of these, and to show where the danger chiefly arises. Air may become noxious many ways. Whatever greatly alters this degree of heat, cold, moisture, &c. renders it unwholesome ; for ex- ample, that which is too hot dissipates the watery parts of the blood, exalts the bile, and renders the whole humours adust and thick. Hence proceed bilious and inflammatory fevers, cholera-morbus, &c. Very cold air obstructs the perspiration, constringes the solids, and condenses the fluids. It occasions rheumatisms, coughs, and catarrhs, with other diseases of the throat and breast. Air that is too moist de- stroys the elasticity, or spring of the solids, induces phlegmatic or lax constitutions, and disposes the body to agues or intermitting fevers, dropsies, &c. Wherever great numbers of people are crowded into one place, if the air has not a free circulation, it soon becomes unwholesome. Hence it is that delicate persons are so apt to turn sick or faint in crowded churches, assemblies, or any place where the air is injured by breathing, fires, caudles, or tho like. In great cities so many things tend to contaminate the air, that it is uo w onder it proves so fatal to the inhabitants. The air in cities is not only breathed repeatedly over, but is likewise loaded with sulphur, smoke, and other exhalations, besides the vapours continually arising from innumerable putrid substances, as dunghills, slaughter-houses, &c. AH possible care should be taken to keep the streets of large towns open and wide, that the air may have free current through them. They ought likewise to be kept very clean. Nothing tends more to pollute aud contaminate the air of a city than dirty streets. 52 of aiu. It is very common in this country to have churchyards in the middle of populous cities. Whether this be the effect of ancient superstition, or owing to the increase of such towns, is a matter of no consequence. Whatever gave rise to the custom, it is a bad one. It is habit alone which reconciles us to these things : by means of which the most ridiculous, nay, pernicious customs, often become sacred. Certain it is, that thousands of putrid carcases, so near the surface of the earth, in a place where the air is confined, cannot fail to taint it: and that such air, when breathed into the lungs, must occasion diseases.* Burying within churches is a practice still more detestable. The air in churches is seldom good, and the air from putrid carcases must render it still worse. Churches are generally old buildings with arched roofs. They are seldom open above once a-week, are never ventilated by fires, nor open windows, and rarely kept clean. This occasions a damp, musty, unwholesome smell, which one feels upon entering a church, and renders it a very unsafe place for the weak and valetu- dinary. These inconveniences might, in a great measure, be obviated, by prohibiting all persons from burying within churches, by keeping them clean, and permitting a stream of fresh air to pass frequently through them, by opening opposite doors and windows.f Wherever air stagnates long, it becomes unwholesome. Hence the unhappy persons confined in jails, not only contract malignant fevers themselves, but often communicate them to others. Nor are many of the holes, (for we cannot call them houses,) possessed by the poor in great towns, much better than jails. These low dirty habitations are the very lurking places of bad air and contagious diseases. Such as live in them seldom enjoy good health ; and their children commonly die young. In the choice of a house, those who have it in their power ought always to pay the greatest attention to open free air. The various methods which luxury has invented to make houses close and warm, contribute not a little to render them unwholesome. No house can be wholesome unless the air has a free passage through it. For which reason, houses ought daily to be ventilated, by opening opposite windows, and admitting a current of fresh air into every room. Beds, instead of being made up as soon as people rise out of them, ought to be turned down, and exposed to the fresh air from the open windows through the day. This would expel any noxious vapour, and could not fail to promote the health of the inhabitants. * In most eastern countries it was customary to bury the dead at some distance from any town. As this practice obtained among the Jews, the Greeks, and also the Romans, it is strange that the western parts of Europe should not have followed their example in a custom so truly laudable. t One cannot pass through a large church or cathedral, even in summer, without feeling quite chdly. Iii hospitals, jails, ships, &c. where that cannot be conveniently done, ventilators should be used. The method of expelling foul, and introducing fresh air by means of ventilators, is a most salutary in- vention, and is indeed the most useful of all our medical improvements. It is capable of universal application, and is fraught with numerous advantages, both to those in health and sickness. In all places where numbers of people are crowded together, ventilation becomes absolutely necessary. Air which stagnates in mines, wells, cellars, &c. is extremely noxious. That kind of air is to be avoided as the most deadly poison. It often kills almost as quick as lightning. For this reason people should be very cautious in opening cellars that have been long shut, or going down into deep wells or pits, especially if they have been kept close covered.* Many people who have splendid houses, choose to sleep in small apartments. This conduct is very imprudent. A bed-chamber ought always to be well aired ; as it is generally occupied in the night only, when all doors and windows are shut. If a fire be kept in it, the danger from a small room becomes still greater. Numbers have been stifled when asleep by a fire in a small apartment, which is always hurtful. Those who are obliged,* on account of business, to spend the day in small towns, ought, if possible, to sleep in the country. Breathing free a'r in the night will, in some measure, make up for the want of it through the day. This practice would have a greater effect in pre- serving the health of citizens than is commonly imagined. Delicate persons ought, as much as possible, to avoid the air of great towns. It is peculiarly hurtful to the asthmatic and consumptive. Such persons should avoid cities as they would the plague. The hypo- chondriac are likewise much hurt by it. I have often seen persons so much afflicted with this malady while in town, that it seemed impossible for them to live, who, upon being removed to the country, were immediately relieved. The same observation holds with regard to nervous and hysteric women. Many people, indeed, have it not in their power to change their situation in quest of better air. All we can say to such persons is, that they should go as often abroad in the open air as they can, that they should admit fresh air frequently into their houses, and take care to keep them very clean. It was necessary in former times, for safety, to surround cities, colleges, and even sin-le houses with high walls. These, by obstructing the free current of air, never fail to render such places damp and un- * We have dailv accounts of persons who lose their lives by going down into deep JuandXr%es where the air stagnates: all these accidents might be pre- xented by oily letting down a lighted candle before them, and .loppi..; when tucjr perceive it go out; yet thi. precaution, simple as it is, is seldom used. 51 OF AIS. wholesome. As such walls are now, in most parts of the country, he- come useless, they ought to be pulled down, and every method taken to admit a free passage to the air. Proper attention to Air and Clean- liness would tend more to preserve the health of mankind than all the prescriptions of the Faculty. Surrounding houses too closely with plantations or thick woods, likewise tends to render the air unwholesome. Wood not only obstructs the free current of air, but sends forth great quantities of moist exha lations, which render it constantly damp. Wood is very agreeable at a proper distance from a house, but should never be planted too near it; especially in a flat country. Many of the gentlemen's seats in Eng- land are rendered very unwholesome from the great quantity of wood which surrounds them. Houses situated in low marshy countries, or near large lakes of stagnating water are likewise unwholesome. Waters which stagnate, not only render the air damp, but load it with putrid exhalations, which produce the most dangerous and fatal diseases. Those who are obliged to inhabit marshy countries, ought to make choice of the driest situa- tions they can find, to live generously, and to pay the strictest regard to cleanliness. • If fresh air be necessary for those in health, it is still more so for the sick, who often lose their lives for want of it. The notion that sick people must be kept very hot, is so common, that one can hardly enter the chamber where a patient lies, without being ready to faint, by reason of the suffocating smell. How this must affect the sick, any one mny judge. No medicine is so beneficial to the sick as fresh air. It is the most reviving of all cordials, if it be administered with prudence. We are not, however, to throw open doors and windows at random upon the sick. Fresh air is to be let into the chamber gradually, aud, if possible, by opening the windows of some other apartment. The air of a sick person's chamber may be greatly freshened, and the patient much revived, by sprinkling the floor, bed, &c. frequently, with vinegar, juice of lemon, or any other strong vegetable acid. In places where numbers of sick are crowded into the same house, or which is often the case, into the same apartment, the frequent admission of fresh air becomes absolutely necessary. Infirmaries, hos- pitals, &c. are rendered so noxious, for want of proper ventilation, that the sick run more hazard from them than from the disease. This is particularly the case when putrid fevers, dysenteries, and other in- fectious diseases prevail. Physicians, surgeons, and others who attend hospitals, ought, for their own safety, to take care that they be properly ventilated. Such per- or EXLRcisr.. Cj sons as are obliged to spend most of their time amongst the sick, ru:i great hazard of being themselves infected when the air is bad. All hos- pitals, and places of reception for the sick, ought to have an open situ- ation, at some distance from any great town, and such patients as labour under any infectious disease ought never to be suffered to come near the rest.* Great attention has of late years been paid to selecting proper sites in erecting hospitals, as well as to keep them properly ventilated ; b».t the interment of the dead in the middle of crowded towns is not done away. The ancients never interred their dead in temples, churches, or churchyards ; this is evident from the first words of the inscriptions on the old Roman tomb stones, Sitte viator,' stop traveller ;' which shows us that they interred their dead by the sides of public roads, and not in their temples, nor, in the heart of their towns or cities. The late Joseph II. passed a law on this subject, which does him great honour, in which, after strictly prohibiting the interment of dead bodies iu places of public worship, the emperor observes, 'It is horrid that a place of worship, a temple of the Supreme Being, should be converted into a pest-house for living creatures 1 A person who, upon his death- bed, makes it a condition of his will to be buried in a church or chapel, acts like a madman ; Jie ought to set his fellow-creatures a good ex- ample, and not to do all in his power to destroy their constitutions, by exposing them to the effluvia arising from a corpse in a otate of l>uti'L taction.' CHAP. V. OF EXERCISE. Many people look upon the necessity man is under of earning his bread by labour, as a curse. Be this as it may, it is evident from the structure of his body, that exercise is not less necessary than food for the preservation of health : those whom poverty obliges to labour for daily bread, are not only the most healthy, but generally the most happy part of mankind. Industry seldom fails to place them above want, and activity serves them instead of physic. This is peculiarly the case with * A year seldom passes that we do not hear of some hospital physician or surgeon havinglost his life by nn hospital fever caught from his patients. For this thny have themselves alone to blame. Their patients are either in an improper situatiun, or they ore careless with repaid to their own conduct. 53 or l\:rkci-:e. those who live by the culture of the ground. The great increase of inhabitants in infant colonies, and the longevity of such as follow agri- cul'ure everywhere, evidently prove it to be the most healthful, aa well as the most useful employment. The love of activity shows itself very early in man. So strong is this principle, that a healthy youth cannot be restrained from exercise even by the fear of punishment. Our love of motion is surely a strong proof of its utility. Nature implants no disposition in vain. It seems to be a catholic law throughout the whole animal creation that no creature without exercise should enjoy health, or be able to find subsistence. Every creature, except man, takes as much of it as is necessary. He alone, and such animals as are under his direction, deviate from this original law, and they suffer accordingly. Inactivity never fails to induce an universal relaxation of the solids, which disposes the body to innumerable diseases. When the solids are relaxed, neither the digestion nor any of the secretions can be duly performed. In this case the worst consequences must ensue. How can persons who loll all day in easy chairs, and sleep all night on beds of down, fail to be relaxed % Nor do such greatly mend the matter, who never stir abroad but in a coach, sedan, or such like. These elegant pieces of luxury are become so common, that the inhabitants of great towns seem to be in danger of losing the use of their limbs altogether. It is now below any one to walk who can afford to be carried. How ridiculous would it appear to a person unacquanted with modern luxury, to behold the young and healthy swinging along on the shoulders of their fellow creatures : or to see a fat carcase, over-run with diseases occasioned by inactivity, dragged through the street by horses.* Glandular obstructions, now so common, generally proceed from inactivity. These are the most obstinate of maladies. So long as the liver, kidneys, and other glands, duly perform their functions, health is seldom impaired: but when they fail, nothing can restore it. Exercise is almost the only cure we know for glandular obstructions : indeed it does not always succeed as a remedy ; but there is reason to believe that it would seldom fail to prevent these complaints were it used in due time. One thing is certain, that among those who take sufficient exercise, glandular diseases are very little known ; whereas the indolent and inactive are very seldom free from them. Weak nerves are the constant companion of inactivity. Nothing but * It is not necessity, hut fashion, which makes the use of carriages so common. There are many people who have not exercise enough to keep their humours whole- some, who yet dare not venture to make a visit to their next neighbours but in a coa.-h or sedan, lest they should be looked down upon. Strange, that men should he such fools as to b* laughed out of the use of their limbs, or to throw away th ir health, in order to gratify a piece of vanity, or to comply with a ridiculous lasluou! OF EXERCISE. 57 rxercise and open air can brace and strengthen the nerves, or prevent the endless train of diseases which proceed from a relaxed state of these organs. We seldom hear the active or laborious complain of ner- vous diseases ; these are reserved for the sons of ease and affluence. Many have been completely cured of these disorders, by being reduced from a state of opulence, to labour for their daily bread. This plainly points out the sources from whence nervous diseases flow, and the means by which they may be prevented. It is absolutely impossible to enjoy hea"lth where the perspiration is not duly carried on ; but that can never be the case where exercise is neglected. When the matter which ought to be thrown off by per- spiration is retained in the body, it vitiates the humours, and occasions the gout, fevers, rheumatisms, &c. Exercise alone would prevent many of those diseases which cannot be cured, and would remove others, where medicine proves ineffectual. A late author,* in his excellent treatise on health, says, that the weak and valetudinary ought to make exercise a part of their religion. W0 would recommend this, not only to the weak and valetudinary, but to all whose business does not obligethem to take sufficient exercise, as sedentary artificers/)- shopkeepers, studious persons, &c. Such ought to use exercise as regularly as they take food. This might generally be done without any interruption to business or real loss of time. No piece of indolence hurts the health more than the modern custom of lying in bed too long in the morning. This is the general practice in great towns. The inhabitants of cities seldom rise before eight or nine o'clock, but the morning is undoubtedly the best time for exercise, while the stomach is empty and the body refreshed with sleep. Besides, the morning air braces and strengthens the nerves, and, in some mea- sure, answers the purpose of a cold bath. Let any one who has been accustomed to lie in bed till eight or nine o'clock, rise by six or seven, spend a couple of hours in walking, riding, or any active diversion with- out doors, and he will find his spirits cheerful and serene through the d iy, his appetite keen, and his body braced and strengthened. Cus- t solitary occupations ought chiefly to be followed out by women. They bear r ...Hu'ement much better than me... and are fitter for everv kind of business which rt„es not r.quire much strength. It is ridiculous enough to see * lusty Mlow n.ak- I. Tins ne.-dl.-s, or watch wheels, while many of the laborious parts of husbandry are carried on by the other sex. The fact is. we want men for laborious employ- ments- while one half of the other sex are rendered useless for want of ocupat.oiis Xdto their strength, fce. Were girls bred to mechanical employments, we should o.^e such number of ihem pros.itute themselves for bread, nor find such a want nf men for the important purposes of navigation, agriculture &c. An eminent si >. ma" ,ct, rer told me. that he found women answer better for that purpose tlviu u ° "in! lhat he had lat.ly taken a great ninny girls apprentice as silk w,awi'*. I i,,,,'; his example will be followed by many other*. 58 OP E*T'RCUE. torn soon renders early rising agreeable, and nothing contributes more to the preservation of health. The inactive are continually complaining of pains of the stomach, flatulencies, indigestions, &c. These complaints, which pave the way to many others, are not to be removed by medicines. They can only be cured by a vigorous course of exercise, to which indeed they seldom fail to yield. Exercise, if possible, ought always to be taken in the open air. When that cannot be done, various methods may be contrived for exercising the body within doors, as the dumb bell, dancing, fencing, &c. It is not necessary to adhere strictly to any particular kind of exercise. The best way is to take them by turns, and to use that longest which is most suitable to the strength and constitution. Those kinds of exercise which give action to most of the bodily organs, are always to be preferred, as walking, running, riding, digging, rubbing furniture, and such like. It is much to be regretted, that active and manly diversions are now so little practised. Diversions make people take more exercise than they otherwise would do, and are of the greatest service to such as are not under the necessity of labouring for their bread. As active diver- sions lose ground, those of a sedentary kind seem to prevail. Sedentary diversions are of no other use but to consume time. Instead of re- lieving the mind, they often require more thought than either study or business. Every thing that induces people to sit still, unless it bo some necessary employment, ought to be avoided. The diversions which afford the best exercise are, hunting, shooting, playing at cricket, hand-ball, golff,* Ac. These exercise the limbs, promote perspiration, and the other secretions. They likewise strengthen the lungs, and give firmness and agility to the whole body. Such as can, ought to spend two or three hours a-day on horseback ; those who cannot ride should employ the same time in walking. Exercise should never be continued too long. Over fatigue prevents the benefit of exercise, and instead of strengthening the body, tends to weaken it. Every man should lay himself under some sort of necessity to take exercise. Indolence, like other vices, when indulged, gains ground, and at length becomes agreeable. Hence many who are fond of exer- cise in the early part of life, become quite averse to it afterwards. This is the case of most hypochondriac and gouty people, which renders their disease in a great measure incurable. * Go,ff '* a diversion very common in North Britain. It is well calculated for exercising the body and may always be taken in such moderation as neither to over- heat nor fatigue. It has greatly the preference over cricket, tenuis, or any of thou games which cannot be played without violence. ' OF SLEEP AND CLOTIIIXO. M In some countries laws have been made obliging every man, of whr.-.- ever rank, to learn some mechanical employment. Whether such laws were designed for the preservation of health, or the encouragemc -it of manufactures, is a question of no importance. Certain it is, that if gentlemen were frequently to amuse and exercise themselves in this way, it might have many good effects. They would at leist derive as much honour from a few masterly specimens of their own workman* fchip, as from the character of having ruined most of their companions by gaming and drinking. Besides, men of leisure, by applying them- selves to the mechanical arts, might improve them, to the great benefit of society. Indolence not only occasions diseases, and renders men useless to society, but promotes all manner of vice. To say a man is idle, is littles better than to call him vicious. The mind, if not engaged in some use- ful pursuit, is constantly in quest of ideal pleasures, or impressed with the apprehension of some imaginary evil. From these sources proce* d most of the miseries of mankind. Certainly man was never made to bo idle. Inactivity frustrates the very design of his creation : whereas ;.u active life is the best guardian of virtue, and the greatest presena- tive of health. It is indeed evident that the love of motion, as well as the love of food, so observable in every living creature, from the moment of its birth, is wisely designed by nature as the means of its preservation. The indolent man is therefore a rebel to her laws, and will certainly provoke her severest punishment. In vain does he hope for enjoyment in the lap of sloth ; its chilling influence poisons the source of every pleasure, aud not only invites disease, but renders it almost incurable. CHAP. YI. OF SLEEP AND CLOTHING. St.eep, as well as diet, ought to be duly regulated. Too little sleep weakens the nerves, exhausts the spirits, and occasions diseases ; and too much renders the mind dull, the body gross, and disposes to ap- poplevcs, lethargies, and other complaints of a similar nature. A medium ought therefore to be observed ; but this is not easy to fix. Children require more sleep than grown persons, the laborious than t..a idle, and such as eat and drink freely, than those who live abstemiously. CO OF SLEET AND CLOTHIN3. Besides the real quantity of sleep cannot be measured by time, as one person will be more refreshed by five or six hours sleep, than another by eight or ten. Children may always be allowed to take as much sleep as they please ; but for adults, six or seven hours are sufficient, and no one ought to exceed eight. Those who lie in bed more than eight hours may slumber, but they can.hardly be said to sleep; such generally toss and dream away the fore part of the night, sink to rest towards morning, and dose till noon. The best way to make sleep sound and refreshing is to rise betimes. The custom of lying in bed for nine or ten hours, not only makes the sleep less refreshing, but relaxes the solids, and greatly weakens the constitution. Nature points out night as the proper season for sleep. Nothing more certainly destroys the constitution than night watching. It is a great pity that a practice so destructive to health should be so much in fashion. How quickly the want of rest in due season will blast the most bloom- ing complexion, or ruin the best constitution, is evident from the ghastly countenances of those who, as the phrase is, turn day into night, and night into day. To make sleep refreshing, the following things are requisite : First, to take sufficient exercise in the open air ; to avoid strong tea or coffee ; next, to eat a light supper ; and lastly, to lie down with a mind as cheerful and serene as possible. It is certain that too much exercise will prevent sleep, as well as too little. We seldom however hear the active and laborious complain of sleepless nights. It is the indolent and slothful who generally have these complaints. Is it any wonder that a bed of down should not be refreshing to a person who sits all day in an easy chair ? A great part of the pleasure of life consists in alternate rest and motion : but they who neglect the latter can never relish the former. The labourer enjoys more true luxury in plain food and sound sleep, than is to be found in sumptuous tables and downy pillows, where exercise is wanting. That light suppers cause sound sleep is true even to a proverb. Many persons if they exceed the least at that meal, are sure to have uneasy nights ; and, if they fall asleep, the load and oppression on their stomach occasion frightful dreams, broken and disturbed repose, the ni-iit-mare, &c. Were the same persons to go to bed with a light supper, or sit up till that meal was pretty well digested, they would enjoy sound sleep, and rise refreshed and cheerful. There are indeed some people who cannot sleep unless they have eaten some solid food at night ; but this does not imply the necessity of a heavy supper ; lesides, these are generally persons who have accustomed themselves to this method, and who do not take a sufficient degree of exercise. OF SLEEP AND CLOTHING. CI Nothing more certainly disturbs our repose than anxiety. When the mind is not at ea«e, one seldom enjoys sound sleep. This greatest of human blessings flies the wretched, and visits the happy, the cheerful and the gay. This is a sufficient reason why every man should endea- vour to be as easy ill his mind as possible when he goes to rest. Many, by indulging grief and anxious thought, have banished sound sleep so long, that they could never afterwards enjoy it. Sleep, when taken in the fore part of the night, is generally reckoned most refreshing. Whether this be the effect of habit or not, is hard to say ; but as most people are accustomed to go early to bed when young, it may be presumed that sleep at that season, will prove most r freshing to them ever after. Whether the fore part of the night be best for sleep or not, surely the fore part of the day is fittest both for business and amusement. I hardly ever knew an early riser who did not enjoy a good state of health.* Early rising is the natural consequence of going to bed early ; and this habit implies sobriety, good order, and an exemption from many fashionable follies extremely prejudicial to health. The man who ac- customs himself to go to bed at an early hour, can seldom join in the revels of Bacchus, or what are improperly called the amusements of the gay world. His rest is not disturbed by the effects of unseasonable luxury. He knows that temperance, moderate exercise, composure of mind, and external tranquillity, are the best opiates. His slumbers are sound and refreshing. The waste of spirits on the preceding day is fuily repaired. Every muscle, every fibre, every nerve has regained its proper tone. He rises with cheerfulness and vigour to breathe the morning air, and to enter upon the duties of the to day. In short, an attention to this single point of going to bed early, and of rising betimes, will be found to supersede a variety of other precepts, and may Le justly called the golden rule for the attainment of health and long life. OF CLOTHING. The clothing ought to be suited to the climate. Custom has no doubt a very great influence in this article ; but no custom can ever change the nature of things so far as to render the same clothing fit for an inhabitant of Nova Zembla aud the island of Jamaica. It is not indeed necessary to observe an exact proportion between the quantity ' of clothes we wear, and the degree of latiude which we inhabit; but at * Men of every occupation, and in every situation of life, have lived to a good old B-e • nay some have enjoyed this blessing whose plan of living was by no means regular.: but'it consists with observation, that all very old men have been early risers This it the only circumstance attending longevity to which I never knew an exception. C2 OF SLEEP AND CLOTHING. the same time, proper attention ought to be paid to it, as well as to the openness of the country, the frequency and violence of storms, &c. In youth, while the blood is hot and the perspiration free, it is less nece-ssary to cover the body with a great quantity of clothes ; but in the decline of life, when the skin becomes rigid and the humours more cool, the clothing should be increased. Many diseases in the latter period of life proceed from a defect of perspiration ; these may, in some mea- sure, be prevented by a suitable addition to the clothing, or by wearing such as are better calculated for promoting the discharge from the skin, as clothes made of cotton, flannel, &c. The clothing ought likewise to be suited to the season of the year. Clothing may be warm enough for summer which is by no means suffi- cient for winter. The greatest caution, however, is necessary in mak- ing these changes. We ought neither to put off our winter clothes too soon, nor to wear our summer ones too long. In this country, the winter often sets in very early with great rigour, and we have frequently cold weather after the commencement of summer months. It would likewise not be prudent to make the change all at once, but to do it gradually ; and indeed the changes of apparel in this climate ought to be very inconsiderable, especially among those who have passed the meridian of life.* Clothes often become hurtful by their being made subservient to the purposes of pride or vanity. Mankind in all ages seem to have consi. dered clothes in this view; accordingly their fashion and figure have been continually varying, with very little regard either to health, the climate, or conveniency ; a farthingale, for example, may be very necessary in hot southern climates, but surely nothing can be more ridiculous in the cold regions of the north. Even the human shape is often attempted to be mended by dress, and those who know no better believe that mankind would be monsters without its assistance. All attempts of this nature are highly pernicious. The most destructive of them in this country is that of squeezing the stomach and bowels into as narrow a compass as possible, to procure what is falsely called a fine shape.f By this practice, the action of the stomach and bowels, the motion of the heart and lungs, and almost all the vital functions, are obstructed. Hence proceed indigestions, syn- ,v,-t Thattcold» *»«««•• than plagues, is an old observation ; and with recard to ce eCTatr mostho° thf^f!y "Th **"* P6/S°n °f di^"™nt, however, Z per" ceive, that most of the colds which prove so destructive to the inhabitants of Hrit-iin KKSe'm 7tnU"wnCefri?hCha^ingCl0theS- A feW ~ alyfinllar*. or ™L}!*J* ™*dness .seems to have pervaded the mind of mothers In everv arro md ^n^^\^&?Z^ ***. the u^SSL'S OF SLEEP AND CLOTHING. 03 copes, or fainting-fits, coughs, consumptions of the lungs, and other coinplaints so common to females. The feet likewise often suffer by pressure. How a small foot came to be reckoned genteel I will not pretend to say; but certain it is, that this notion has made many persons lame. Almost nine-tenths of mankind are troubled with corns : a disease that is seldom or never occasioned but by strait 6hoes. Corns are not only very troublesome, but by rendering people unable to walk, they may likewise be coiibi- dered as the remote cause of other diseases.* The size and figure of the shoe ought certainly to be adapted to the foot. In children the feet areas well shaped as the hands, and the motion of the toes as free and easy as that of the fingers ; yet few per- sons in the advanced periods of life are able to make any use of their to".-s. They are generally, by narrow shoes, squeezed all of a heap, and often laid over one another in such a manner as to be rendered altoge- ther incapable of motion. Nor is the high heel less hurtful than the narrow toe. A lady may seem taller for walking on her tiptoes, but she will never walk well in this manner. It strains her joints, distorts her limbs, makes her stoop, and utterly destroys all her ease and gracefulness of motion : it is entirely owing to shoes with high heels and narrow toes, that not one female in ten can be said to walk well. In fixing on the clothes, due care should be taken to avoid all tight bandages. Garters, buckles, &c. when drawn too tight, not only pre- vent the free motion and use of the parts about which they are bound, but likewise obstruct the circulation of the blood, which prevents the equal nourishment and growth of these parts, and occasions various diseases. Tight bandages about the neck, as stocks, cravats, necklaces, &c. are extremely dangerous. They obstruct the blood in its course from the brain, by which means head-achs, vertigoes, apoplexies, aud other fatal diseases, are often occasioned.' The perfection of dress is to be easy and clean. Nothing can be more ridiculous, than for any one to make himself a slave to fine clothes. Such a one, and many such there are, would rather remain as fixed as a statue from morning till night, than decompose a single hair or alter the position of a pin. Were we to recommend any particular pattern for * We often see persons, who are rendered quite lame by the nails of their to"s having grown into the flesh ; and frequently hear of mortifications proceeding froui this cause. All these, and many other inconveniences attending the feet, must be iniput d solely to the use of short and tight shoes.—Though we hear frequently of plasters salves, oiutim-nts, &c for eradicating corns, yet they are never known to produce that effect The only rational mode of proceeding is to soften the corn a little bv immersion in warm water, and then to cut it carefully, and to renew this operation every week, till the scarf skin is reduced to its original or nitural thinness, ■Vi.-r which it must be preserved from the irritating pressure of strait shoes, w...lu u..d at hist occasioned the p.na:ul ca:lo-i.y. 64 OF INTEMPERANCE. dress, it would be that which is worn by the people called Quaker* They are always neat, clean, and often elegant, without any thing super. fiuous. What others lay out upon tawdry laces, ruffles, and ribands, they bestow upon superior cleanliness. Finery is only the affectation of dress, and very often covers a great deal of dirt. We shall only add with regard to clothing, that it ought not only to be suited to the climate, the season of the year, and the period of life, but likewise to the temperature and constitution. Robust persons are able to endure either cold or heat better than the delicate ; consequently may be less attentive to their clothing. But the precise quantity of clothes necessary for any person cannot be determined by reasoning, It is entirely a matter of experience, and every man is the best judge for himself what quantity of clothes is necessary to keep him warm.* Of late years a reformation has taken place in female dress, at once beneficial to the health, and honourable to the taste of our fair coun- trywomen. Elegaut simplicity has suceeded to capricious absurdity. The distortion of close stays is abolished, and the body left to its natural shape ; the dangerous and awkward position of the foot, treading on the tiptoe on higli-heeled shoes, has given place to the flat-heel, when the wearer can walk with firmness, ease, and grace. Nature and good sense have returned their dominion. CHAP. VII. OF INTEMPERANCE. A modern authorf observes, that temperance and exercise are the two best physicians in the world. He might have added, that if these were duly regarded, there would be little occasion for auy other. Tem- perance may justly be called the parent of health : yet numbers o^ mankind act as if they thought diseases and death too slow in their progress, and by intemperance and debauch seem as it were to solicit their approach. * The celebrated Boerhaave used to say, that nobody suffered by cold, save fools and beggars; the latter not being able to procure clothes, and the former not having sense to wear them. Be this as it may, I can with the strictest truth declare, that in many cases where the powers of medicine had been tried in vain, I have cured the patient by recommending thick shoes, a flannel waistcoat and drawers, a pair of under stockings, or a flannel petticoat, to be worn during the cold season at least. vv here warmer clothing is wanted, 1 would recommend the fleecy hosiery to be worn next the skin. f ltousseau. OF INTEMPERANCE. 65 The danger of intemperance appears from the very construction of the human body. Health depends on that state of the solids and fluids which fits them for the due performance of the vital functions ; and while these go regularly on, we are s >und and well; but whatever dis- turbs them necessarily impairs health. Intemperance never fails to disorder the whole animal economy ; it hurts the digestion, relaxes the nerves, renders the different secretions irregular, vitiates the hu- mours, aud occasions numberless diseases. The analogy between the nursing.- of plants and animals affords a striking proof of the danger of intetnperauce. Moisture and manure greatly promote vegetation ; yet an over quantity of either will entirely destroy it- The best things become hurtful, nay destructive, when carried to excess. Hence we learn, that the highest degree of human wisdom consists in regulating our appetites and passions so as to avoid all extremes. It is that chiefly which entitles us to the character of rational beings. The slave of appetite will ever be tiie disgrace of human nature. The Author of Nature hath endowed us with various passions, for the propagation of the species, the preservation of the individual, &c. Intemperance is the abuse of these passions ; and moderation consists in a proper regulation of them. Men, not contented with satifying the Bimple calls of nature, create artificial wants, and are perpetually in search after something that may gratify them ; but imaginary wants can never be gratified. Nature is content with little, but luxury knows no bounds. Hence the epicure, the drunkard, the debauchee, seldom stop in their careijr till their money or their constitution fails ; then indeed they generally see their error when too late. It is impossible to lay down fixed rules with regard to diet, on account of the different constitutions of mankind. The most ignorant person, however, certainly knows what is meant by excess ; and it is in the power of every man, if he chooses, to avoid it. The great rule of diet is to study simplicity. Nature delights in the most plain and simple food, and every animal, except man, follows her dictates. Man alone riots at large, and ransacks the whole crea- tion in quest of luxuries, to his own destruction. An elegant writer* of the last age speaks thus of intemperance in diet: ' For my part, when I behold a fashionable table set out in all its magnificence, I fancy that I see gouts and dropsies, fevers and lethargies, with other innumerable distempers, lying in ambuscade among the dishes.' Nor is intemperance in other things less destructive than in diet. How quickly docs the immoderate pursuit of carnal pleasures, or the * Addison. V 00 OF INTEMPERANCE. abuse of intoxicating liquors, ruin the best constitution ! Indeed these vices generally go hand in hand. Hence it is that we so often behold the votaries of Bacchus and Venus, even before they have arrived at the prime of life, worn out with diseases, and hastening with swift pace to an untimely grave. Did men reflect on the painful diseases and premature deaths which are daily occasioned by intemperance, it would be sufficient to make them shrink back with horror from the in. dulgence even of their darling pleasures. Intemperance does not hurt its votaries alone : the innocent too often feel the direful effects of it. How many wretched orphans are to be seen embracing dung hills, whose parents, regardless of the future spend in riot and debauch what might have served to bring up their offspring in a decent manner ! How often do we behold the miserable mother, with her helpless infants, pining in wantj while the cruel father is indulging his insatiable appetites ! Families are not only reduced to misery, but even extirpated by intemperance. Nothing tends so much to prevent propagation, and to shorten the lives of children, as the intemperance of parents. The poor man who labours all day, aud at night lies down contented with his humble fare, cau boast of a numerous offspring, while his pampered lord, sunk in ease and luxury, often languishes without an heir to his ample fortunes. Even states and empires feel the influence of intemperance, and rise or full as it prevails. Instead of mentioning the different kinds of intemperance, and point- ing out their influence upon health, we shall only, by way of example, make a few observations on one particular species of that vice, viz. the abuse of intoxicating liquors. Every act of intoxication puts nature to the expense of a fever, in order to discharge the poisonous draught. When this is repeated almost every day, it is easy to foresee the consequences. That con- stitution must be strong indeed, which is able to hold out under a daily fever ! but fevers occasioned by drinking do not always go off in a day ; they frequently end in an inflammation of the breast, liver, or brain, and produce fatal effects. Though the drunkard should not fall by an acute disease, he seldom escapes those of a chronic kind. Intoxicating liquors, when used to excess, weaken the bowels and spoil the digestion ; they destroy the power of the nerves, and occasion paralytic and convulsive disorders : they likewise heat and inflame the blood, destroy its balsamic quality render it unfit for circulation, and the nourishment of the body. Henue obstructions, atrophies, dropsies, and consumptions of the lungs. These are the common ways in which drunkards make their exit. Diseases of this kind, wtien brought on by hard drinking, seldom admit of a cure. OF INTEMPERANCE. 67 Many people injure their health by drinking, who seldom get drunk. The continual habit of soaking, as it is called, though the effects be not bo violent, is not less pernicious. When the vessels are kept constantly full and upon the stretch, the different digestions can neither be duly performed, nor the humours properly prepared. Hence most people of this character are afflicted with the gout, the gravel, ulcerous sores in the legs, &c. If these disorders do not appear, they are seized with low spirits, hypochondriacal affections, and other symptoms of indigestion. Consumptions are now so common that it is thought one-tenth of the inhabitants of great towns die of that disease. Hard drinking is no doubt one of the causes to which we must impute the increase of consumptions. The great quantities of viscid malt liquor drank by the common people of England, cannot fail to render the blood sizy and unfit for circulation ; from whence proceed obstructions, and inflamma- tions of the lungs. There are few great ale-drinkers who are not phthi- sical : nor is that to be wondered at considering the glutinous and almost indigestible nature of strong ale. Those who drink ardent spirits, or strong wines, run still greater hazard ; these liquors heat and inflariie the blood, and tear the tender vessels of the lungs to pieces; yet so great is the consumption of them m this country, that one would almost be induced to think that the m- habititants lived upon them.* The habit of drinking proceeds frequently from misfortunes in life. The miserable fly to it for relief. It affords them indeed a temporary ease. But, alas ! this solace is short lived ; and when it is over, the spirits sink as much below their usual tone as they had before been raised above it. Hence a repetition of the dose becomes necessary, and every fresh dose makes way for another, till the unhappy wretch becomes a slave to the bottle, and at length falls a sacrifice to what at first perhaps was taken only as a medicine. No man is so dejected as the drunkard when his debauch is gone off. Hence it is, that those who have the greatest flow of spirits while the glass circulates freely, are of all others the most melancholy when sober, and often put an end to their own miserable existence in a fit of spleen or ill humour. Drunkenness not only proves destructive to health, but likewise to the faculties of the mind. It is strange that creatures who value them- selves on account of a superior degree of reason to that of bruteSj ,ons, besides the great quantity ofo'°^'8n.spJr ' COmouted that above two thousand quantity which ^V^^^V^^^«^ U1uor called Mola°8eS' private stills are co"5*"'1^™£°^™My into the habit of drinking this base spi- got molassed. 63 OF INTEMPERANCE. should take pleasure in sinking so far below them. Were such a« voluntarily deprive themselves of the use of reason, to continue ever after in that condition, it would seem but a just punishment. Though this be not the consequence of one act of intoxication, it seldom fails to succeed a course of it. By an habit of drinking, the greatest genius is often reduced to a mere idiot.* Intoxication is peculiarly hurtful to young persons. It heats their blood, impairs their strength, and obstructs their growth ; besides, the frequent use of strong liquors in the early part of life destroys any benefit that might arise from them afterwards. Those who make a practice of drinking generous liquors when young, cannot expect to reap any benefit from them as a cordial in the decline of life. Drunkenness is not only in itself a most abominable vice, but is an inducement to many others. There is hardly any crime so horrid that the drunkard will not perpetrate for the love of liquor. We have known mothers sell their children's clothes, the food that they should have eaten, and afterwards even the infants themselves, in order to purchase the accursed draught. The first propensities to intemperance, both in eating and drinking, ought to be guarded against. The stomach, after being put upon the full stretch feels uneasiness from the least vacuity, and acquires an unnatural craving, the gratification of which produces heaviness, debi- lity, and disease. Frequent indulgence in drinking to excess causes a faintness and depression of the spirits, which can only be removed by having recourse to the favourite liquor, and the drunkard looks upon the repetition of last night's debauch as the best remedy for its con- sequences next day. Mild diluting liquors are rejected as insipid, and a succession of hot stimulants increases the action of the heart and arteries: the lungs become inflamed, and a total relaxation of the system ensues. "* It is amazing that our improvements in arts, learning and politeness, have not put the barbarous custom of drinking to excess out of fashion. It is indeed less common in South Britain than it was formerly; but it still prevails very much in the North, where this relic of barbarity is mistaken for hospitality. There no man is supposed to entertain his guests well, who does not make them drunk. Forcing people to drink is certainly the greatest piece of rudeness that any man can be guilty of. Manliness, complaisance, or mere good-nature, may induce a man to take his glass, if urged to it, at a time when he might as well take poison. The custom of drinking to excess has long been out of fashion in France ; and, as it begins to lose ground among the politer part of the English, we hope it will soon be banished from every part of this island. 69 CHAP. VIII. OF CLEANLINESS. The want of cleanliness is a fault which admits of no excuse. Where water can be had for nothing, it is surely in the power of every person to be clean. The continual discharge from our bodies by perspiration, renders frequent change of apparel necessary. Changing apparel greatly promotes the secretion from the skin, so neeessary for health. When that matter which ought to be carried off by perspiration is either retained in the body, or re-absorbed from dirty clothes, it must occasion diseases. Diseases of the skin are chiefly owing to want of cleanliness.* They may indeed be caught by infection, or brought on by poor living, un- wholesome food, &c.; but they will seldom continue long where clean- liness prevails. To the same cause we must impute the various kinds of vermin which infest the human body, houses, &c. These may always be banished by cleanliness alone, and wherever they abound, we have reason to believe it is neglected. One common cause of putrid and malignant fevers is the want of cleanliness. These fevers commonly begin among those inhabitants of close dirty houses, who breathe unwholesome air, take little exercise, and wear dirty clothes. There the infection is generally hatched, which often spreads far and wide to the destruction of many. Hence cleanliness may be considered as an object of public attention. It is not sufficient that I be clean myself, while the want of it in my neigh- bour affects my health as well as his. If dirty people cannot be re- moved as a common nuisance, they ought at least to be avoided as infectious. All who regard their health should keep at a distance even from their habitations. In places where great numbers of people are collected, cleanliness be- comes of the utmost importance. It is well known that infectious diseases are communicated by tainted air. Every thing, therefore, which tends to pollute the air, or spread the infection, ought with the utmost care to be guarded against. For this reason, in great towns, no * Mr. Pott, in his surgical observations, mentions a disease which he calls the chimne'v-sweeper's cancer, as it is almost peculiar to that unhappy set of people. This he attributes to neglect of cleanliness, and with great justice. I am convinced that if that part of the body which is the seat of this cruel djsease were kept clean by freauent washing, it would never happen. The climbing boys, as they are called, bi-u cirtainly the most miserable wretches on the face of the earth; yet, for cleaning eliiuiuies, no tuch persons are uecesaary. 70 OF CLRAPTLINKSS. filth of any kind should be permitted to lie upon the streets. Nothing is more apt to convey infection than the excrements of the diseased. In many great towns the streets are little better than dung-hills, being frequently covered with ashes, dung, and nastiness of every kind. Even slaughter houses, or killing shambles, are often to be seen in the very centre of great towns. The putrid blood, excrements, &c. with which these places are generally covered, cannot fail to taint the air, and render it unwholesome. How easily might this be prevented by active magistrates, who have it always in their power to make proper *aws relative to things of this nature, and to enforce the observance of them ? We are sorry to say that the importance of general cleanliness does not seem to be sufficienty understood by the magistrates of most great towns in Britain ; though health, pleasure, and delicacy, all conspire to recommend an attention to it. Nothing can be more agreeable to the senses, more to the honour of the inhabitants, or more conducive to their health, than a clean town ; nor can any thing impress a stranger with a more disrespectful idea of any people than its opposite. What- ever pretensions people may make to learning, politeness, or civilization, we will venture to affirm, that while they neglect cleanliness, they are in a state of barbarity.* The peasants in most countries seem to hold cleanliness in a sort of contempt. Were it not for the open situation of their houses, they would often feel the bad effects of this disposition. One seldom sees a farm- house without a dunghill before the door, and frequently the cattle and their master lodge under the same roof. Peasants are likewise ex- tremely careless with respect to change of apparel, keeping their houses, &c. clean. This is merely the effect of indolence and a dirty disposition. Habit may indeed render it less agreeable to them, but no habit can ever make it salutary to wear dirty clothes, or breathe unwholesome air. As many articles of diet come through the hands of peasants, every method should be taken to encourage and promote habits of cleanliness among them. This, for example, might be done by giving a small pre- mium to the person who brings the cleanest and best article of any kind to market, as butter, cheese, &c. and by punishing severely those who bring it dirty. The same method should be taken with butchers, * In ancient Rome the greatest men did not think cleanliness an object unworthy their attention. Pliny says, the Cloaca, or common sewers, for the conveyance ol filth and nastiness from the city, were the greatest of all the public works ; and be- stows higher encomiums upon Tarquinius, Agrippa, and others who made and im- proved them, than on those who achieved the greatest conquests.—How truly great does the emperor Trajan appear, when giving directions to Pliny his proconsul, concerning the making of a common sewer for the health and convenience of a con. miered city! OP CLE.VNL1.VESS. 71 bakers, brewers, and all who are employed in preparing the necessaries of life. In camps the strictest regard should be paid to cleanliness. By neg- ligence in this matter, infectious diseases are often spread amongst a whole army ; and frequently more die of these than by the sword. The Jews, during their encampments in the wilderness, received particular instructions with respect to cleanliness.* The rules enjoined them, ought to be observed by all in the like situation. Indeed the whole system of laws delivered to that people has a manifest tendency to pro- mote cleanliness. Whoever considers the nature of their climate, the diseases to which they were liable, and their dirty disposition, will see the propriety of such laws. It is remarkable, that in most eastern countries, cleanliness makes a great part of their religion. The Mahometan, as well as the Jewish religion, enjoins various bathings, washings, and purifications. No doubt these might be designed to represent inwarfl purity ; but they were at the same time calculated for the preservation of health. How- ever whimsical these washings may appear to some, few thing3 would tend more to prevent diseases than a proper attention to many of them. Were every person, for example, after visiting the sick, hand- ling a dead body, or touching any thing that might convey infection, to wash before he went into company, or sat down to meat, he would run less hazard either of catching the infection himself, or of communicating it to others. Frequent washing not only removes the filth and sordes which ad- here to the skin, but likewise promotes the perspiration, braces the body, and enlivens the spirits. How refreshed, how cheerful aud agreeable does one feel on being shaved, washed, and shifted; espe- cfally when these offices have been neglected longer than usual 1 The eastern custom of washing the feet, though less necessary in this country, is nevertheless a very agreeable piece of cleanliness, and con- tributes greatly to the preservation of health. The sweat and dirt with which these parts are frequently covered, cannot fail to obstruct the perspiration. This piece of cleanliness would often prevent colds and fevers Were people careful to bathe their feet and legs in lukewarm water at night, after being exposed to cold or wet through the day, they would seldom experience the ill effects which often proceed from these causes. , A proper attention to cleanliness is no where more necessary than *< Thou shall have a place also without the camp, whither thou shalt go forth i J. ™d thou shalt have a paddle upon thy weapon ; and it shall be when thou I! Tea,'tiESAbroad thou shalt dig therewith, and shalt turn back, and cover thai which cometh from thee/ &c.-DEox. chap xxn. ver. l£, 13. '2 OF CLEANLINESS. on shipboard. If epidemical distempers break out there, no one can be safe. The best way to prevent them, is to take care that the whole company be cleanly in their clothes, bedding, &c. When infectious diseases do break out, cleanliness is the most likely means to prevent their spreading: it is likewise necessary to prevent their returning afterwards, or being conveyed to other places. For this purpose, the clothes, bedding, &c. of the sick ought to be carefully washed and fu- migated with brimstone. Infection will lodge a long time in dirty clothes, and afterwards break out in the most terrible pjanner. In places where great numbers of sick people are collected together, as gaols, hospitals, &c. cleanliness ought to be most religiously observed. The very smell in such places is often sufficient to make one sick. It is easy to imagine what effect that is likely to have upon the«diseased. In an hospital or infirmary where cleanliness is neglected, a person in perfect health has a greater chance to become sick, than a sick person has to get well. • Few things are more unaccountable than that neglect, or rather dread of cleanliness, which appears among those who have the care of the sick ; they think it almost criminal to suffer any thing that is clean to come near a person in a fever, for example, and would rather allow him to wallow in all manner of filth, than change the least bit of his linen. If cleanliness be necessary for persons in health, it is cer- tainly more so for the sick. Many diseases may be cured by cleanliness alone; most of them might be mitigated by it; and, where it is neg- lected, the slightest disorders are often changed into the most malignant. The same mistaken care which prompted people to prevent the least admission of fresh air to the sick, seems to have induced them to keep them dirty. Both these destructive prejudices will, we hope, be soon entirely eradicated. Cleanliness is certainly agreeable to our nature. We cannot help approving it in others, Oven though we should not practise it our- selves. It sooner attracts our regard than even finery itself, and often gains esteem where that fails. It is an ornament to the highest as well as the lowest station, and cannot be dispensed with in either. Few virtues are of more importance to society than general cleanliness. It ought to be carefully cultivated every where ; but in populous cities it should be almost revered.* * As it is impossible to be thoroughly clean without a sufficient quantity of w«ter, we would earnestly recommend it to the magistrates of great towns to be particularly attentive to this article. Most great towns in Britain are so situated as to be easily supplied with water; and those persons who will not make a proper use of it after it is brought to their hand, certainly deserve to be st\erely punished. The streets of great towns, where water can be had, o%fit to be washed every day. This is the only effectual method for keeping them thoroughly dean ; and, upon trial, we are persuadad it will he found the cheapest.—Souu ol' tho most dreadful diseases imi- Leal to uuuiau nature, might, in my opinion, he entirely eradicated by cleanliness. Or INFECTION. 73 The poor often complain of the want of many things beyond their reach, while they disregard other objects of the first importance which are in their own power ; namely, pure open air, and the comforts of cleanliness. Uncleanliness has been very properly denominated "the worst affliction of indolence and poverty." There is no excuse for dirt. Every body may be clean, even in rags, or in the meanest abode ; and the poor would find such decency not only the best preservative of health, but the strongest recommendation to employment and to pity. CHAP. IX. OF INFECTION Many diseases are infectious. Every person ought therefore, as far as he can, to avoid all communication with the diseased. The common prac- tice of visiting the sick, though often well meant, has many ill conse- quences. Far be it from me to discourage any act of charity or benevolence, especially towards those in distress ; but I cannot help blaming such as endanger their own or their neighbour's lives, by a mistaken friendship or an impertinent curiosty. The houses of the sick, especially in the country, are generally crowded from morning to night with idle Visitors. It is customary, in such places, for servants and young people to wait upon the sick by turns, and even to sit up with them all night. It would be a miracle indeed should such always escape. Experience teaches us the danger of ihis conduct. People often catch fevers in this way, and commu- nicate them to others, till at length they become epidemic. It would be thought highly improper, for one who had not had the small-pox, to wait upon a patient in that disease ; yet many, other fevers are almost as infectious as the small-pox, and not less fatal. Some imagine that fevers prove more fatal in villages than in great towns, for want of proper medical assistance. This may sometimes be the case ; but we are inclined to think it often proceeds from the cause above mentioned. Were a plan to be laid down for communicating infection, it could not be done more effectually than by the common method of visiting the sick. Such visitors not only endanger themselves and their connexions, but likewise hurt the sick. By crowding the house, they render the air unwholesome, and by their private whispers aud dismal countenance*, ?4 OP fNrtCTTON. disturb the imagination of the patient, and depress his spirits. Persons who are ill, especially in fevers, ought to be kept as quiet as possible. The sight of strange faces, and every thing that disturbs the mind, hurts them. The common practice, in country places, of inviting great numbers of people to funerals, and crowding them into the same apartment where the corpse lies, is another way of spreading infection. The infection does not always die with the patient. Every thing that comes into contact with his body while alive, receives the contagion, and some of them, as clothes, blankets, &c. will retain it for a long time. Persons who die of infectious disorders ought not to lie long unburied ; and people should keep as much as possible at a distance from them. It would tend greatly to prevent the spreading of infectious diseases, if those in health were kept at a proper distance from the sick. The Jewish legislator, among many other wise institutions for preserving health, has been peculiarly attentive to the means of preventing in- fection, or defilement, as it is called, either from a diseased person or a dead body. In many cases the diseased were to be separated from those in health ; and it was deemed a crime even to approach their habitations. If a person only touched a diseased or dead body, he was appointed to wash himself in water, and to keep for some time at a distance from society. Infectious diseases are often communicated by clothes. It is extremely dangerous to wear apparel which has been worn by a person who died of an infectious disease, unless it has been washed and fumigated, as infection may lodge a longtime in it, and afterwards produce very tra- gical effects. Th's shows the danger of buying at random the clothes which have been worn by other people. Infectious disorders are frequently imported. Commerce, together with the riches of foreign climes, brings us also their diseases. These do often more than counterbalance all die advantages of that trade by means of which they are introduced. It is to be regretted, that so little care is commonly bestowed, either to prevent the introduction or spreading of infectious maladies. Some attention indeed is generally paid to the plague ; but other diseases pass unregarded.* * Were the tenth, part of the care taken to prevent the importation of disease, that there is to prevent smuggling, it would be attended with many happy consequences. This might easily he done by appointing a physician at every considerable sea port] to Inspect the ships company, passengers, &c. before they came ashore, and, if anv fever or other infectious disorder prevailed, to- order the ship to perforin a short quarantine, and to s.-nd the sick to some hospital or proper place to be cured. He might likewise order all the clothes, bedding, &c. which had been used by the sick during the voyage, to be either destroyed, or thoroughly cleansed by fumigation &c before any of them were sent ashore. A scheme of this kind, if properly conducted' would prevent many fevers, and other infectious diseases, from being brought by eaiiors into sea-port towns, and by this means diffused all over the country. OF INFECTION. 73 Infection is often spread through cities by gaols, hospitals, &c. These are frequently situated in the very middle of populous towns ; and when infectious diseases break out in them, it is impossible for the inhabit- ants to escape. Did magistrates pay any regard to the health of the people, this evil might be easily remedied. Many are the causes which tend to diffuse infection through popu- lous cities. The whole atmosphere of a large town is one contaminated mass, abounding with various kinds of infection, and must be perni- cious to health. The best advice that we can give to such as are obliged to live in large cities, is to chuso an open situation ; to avoid narrow, dirty, crowded streets; to keep their-own house and offices clean ; and to be as much abroad in the open air as their time will permit. It would tend greatly to prevent the spreading of infectious diseases, were proper nurses everywhere employed to take care of the sick. This might often save a family or even a whole town, from being in- fected by one person. We do not mean that people should abandon their friends and relations in distress, but only to put them on their guard against being too much in company with those who are afflicted with diseases of an infectious nature. Such as wait upon the sick in infectious diseases, run very great hazard. They should stuff their noses with tobacco, or some other strong smelling herb, as rue, tansy, or the like. They ought likewise to keep the patient very clean, to sprinkle the room where he lies with vinegar or other strong acids, frequently to admit a stream of fresh air into it, and to avoid the smell of his breath as much as they can. They ought never to go into company without having changed their clothes and washed their hands ; otherwise, if the disease be infectious, they will in all probability carry the contagion along with them.* However trifling it may appear to inconsiderate persons, we will venture to affirm, that a due attention to those things which tend to diffuse infection would be of great importance in preventing diseases. As most diseases are in some degree infectious, no one should continue long with the sick, except the necessary attendants. I mean not, how- ever, by this caution, to deter those whose duty or office leads them to wait upon the sick, from such a laudable and necessary employment. * There is reason to believe that infection is often conveyed from one place to another by the carelessness of the faculty themselves. Many physicians affect a lamiliar way of sitting upon the patient's bedside, and holdiug his arm for a consi- derable time If the patient has the small-pox, or any other infectious disease, there is no doubt but the doctor's hands, clothes, &c. will carry away some of the infection • and if he goes directly to visit another patient without washing his hands, .-li-ineine'his clothes, or being exposed to the open air, which is not seldom the case is it any wonder that he should cany the disease along with him? Physicians not only endanger others, but also themselves, by this practice. And indeed they sometimes suffer for then- want of care. 76 OF INFECTION. Many things are in the power of the magistrate which would tend to prevent the spreading of infection ; as the promoting of public clean- liness ; removing jails, hospitals, burying-grounds, and other places where infection may be generated, at a proper distance from great towns ;* widening the streets ; pulling down useless walls, and taking all methods to promote a free circulation of air through every part of the town, &c. Public hospitals, or proper places of reception for the sick, provided they were kept clean, well ventilated, and placed in an open situation, would likewise tend to prevent the spreading of infec- tion. Such places of reception would prevent the poor, when sick, from being visited by their idle or officious neighbours. They would likewise render it unnecessary for sick servants to be kept in their master s houses. Masters had better pay for having their servants taken care of in an hospital, than run the hazard of having an infectious disease diffused among a numerous family. Sick servants and poor people, when placed in hospitals, are not only less apt to diffuse infection among their neighbours, but have likewise the advantage of being well attended. We are not, however, to learn that hospitals, instead of preventing infection, may become the means of diffusing it. When they are placed in the middle of great towns; when numbers of patients are crowded together in small apartments ; where there is a constant communication kept up between the citizens and the patients ; and when cleanliness and ventilation are neglected, they become nests for hatching diseases, and every one who goes into them not only runs a risk of receiving infection himself, but likewise of communicating it to others. This, however, is not the fault of the hospitals, but of those who have the management of them. It were to be wished, that they were both more numerous, and upon a more respectable footing, as that would induce people to go into them with less reluctance. This is the more to be desired, because most of the putrid fevers and other infections disorders break out amongst the poor, and are by them communicated to the better sort. Were proper attention paid to the first appearances of such disorders, and the patients early conveyed to an hospital, we should seldom see a putrid fever, which is almost as infectious as the plague, become epidemic. The frequent and unnecessary visits made by people in the country to their friends and neighbours when in fevers, are frequently attended with the worst and most fatal consequences. The infection may be carried into the families where the visitors reside, and spread far and wide. In cases of epidemical disease, the servants of a family should * The ancients would not suffer even the temples of their gods, where the sick resorted, to be bunt within the walls of a city. OF THE PASSIONS. 77 naver be suffered to act as nurses or attendants on the sick, even though the latter should be their nearest relations. It were better for masters to hire nurses than to allow their servants to act in that dangerous capacity. CHAP. X. OF THE PASSIONS. The passions have great influence both in the cause and cure of diseases. How the mind affects, the body, will, in all probability, ever remain a secret. It is sufficient for us to know, that there is established a reci- procal influence between the mental and corporeal parts, and tliat whatever injures the one, disoi'ders the other. OF ANGER. The passion of anger ruffles the mind, distorts the countenance, hur- ries on the circulation of the blood, and disorders the whole vital and animal functions. It often occasions fevers, and other acute diseases ; and sometimes even sudden death. This passion is peculiarly hurtful to the delicate, and those of weak nerves. I have known such persons frequently lose their lives by a violent fit of anger, and would advise them to guard against the excess of this passion with the utmost care. It is not indeed always in our power to prevent being angry ; but we may surely avoid harbouring resentment in our breast. Resentment preys upon the mind, and occasions the most obstinate chronical dis- orders, which gradually waste the constitution. Nothing shows true greatness of mind more than to forgive injuries ; it promotes the peace of society, and greatly conduces to our own ease, health, and felicity. Such as valueJiealth should avoid violent gusts of anger, as they would the most deadly poison. Neither ought they to indulge resentment, but to endeavour at all times to keep their minds calm and serene. No- thing tends so much to the health of the body as a constant tranquil- lity of mind. OF FEAR. The influence of fear, both in occasioning and aggravating diseases, b very Teat. No mau ought to be blamed for a decent concern about 78 OF THE PASSIONS. life; but too great a desire to preserve it, is often the cause of losing it. Fear and anxiety, by depressing the spirits, not only dispose us to diseases, but often render those diseases fatal which an undaunted mind would overcome. Sudden fear has generally violent effects. Epileptic fits and other convulsive disorders, are often occasioned by it. Hence the danger of that practice, so common among young people, of frightening one ano- ther. Many have lost their lives, and others have been rendered miserable by frolics of this kind. It is dangerous to tamper with the human passions. The mind may easily be thrown into such dis- order, as never again to act with regularity. But the gradual effects of fear prove more hurtful. The constant dread of some future evil, by dwelling upon the mind, often occasions tiie very evil itself. Hence it comes to pass that so many die of those very diseases of which they long had a dread, or which had been im- pressed on their minds by some accident, or foolish prediction. This, for example, is often the case with women in child-bed. Many of those who die in that situation, are impressed with the notion of their death, a long time before it happens : and there is reason to believe that this impression is often the cause of it. The methods taken to impress the minds of women with the appre- hensions of the great pain and peril of child-birth are very hurtful. Few women die in labour, though many lose their lives after it; which maybe thus accounted for. A woman after delivery,. finding herself weak and exhausted, immediately apprehends she is in danger ; but this fear seldom fails to obstruct the necessary evacuations, upon which her recovery depends. Thus the sex often fall a sacrifice to their own imaginations, when there would be no danger did they apprehend none. It seldom happens, that two or three women in a great town die in child-bed, but their death is followed by many others. Every woman of their acquaintance who is with child dreads the same fate, and the disease becomes epidemical, by the mere force of imagination. This should induce pregnant women to despise fear, and by all means to avoid those tattling gossips who are continually buzzing in their ears the misfortune of others. Every thing that may in the least alarm a preg- nant or child-bed woman, ought with the greatest care to be guarded against. Many women have lost their lives in child-bed by the old superstitous custom, still kept up in most parts of Britain, of tolling the parish bell for every person who dies. People who think themselves in danger are very inquisitive ; and if they come to know that the bell tolls for one who died in the same situation with themselves, what must be the con- OF THE PASSIONS. 79 sequence ! At any rate they are apt to suppose that this is the case, tmd it will often be found a very difficult matter to persuade them of the contrary. But this custom is not pernicious to child-bed women only. It is hurtful in many other cases. When low fevers, in which it is difficult to support the patient's spirits, prevail, what must be the effect of a funeral peal sounding five or six times a-day in his ears! No doubt his imagination will suggest that others died of the same disease under which he labours. This apprehension will have a greater tendency to depress his spirits, than all the cordials of which medicine can boast will have to raise them. The only town which has abolished this custom is Bath. If this useless piece of ceremony cannot be abolished, we ought to keep the sick as much from hearing it as possible, and from every other thing that may tend to alarm them. So far, however, is this from being generally attended to, that they make it their business to visit the sick, on purpose to whisper dismal stories in their ears. Such may pass for sympathizing friends, but they ought rather to be considered as enemies. All who wish well to the sick, ought to keep such persons at the greatest distance from them. A custom has long prevailed among physicians of prognosticating, ns they call it, the patient's fate, or foretelling the issue of the disease. Vauity, no doubt, introduced this practice, and still supports it, in spite of common sense, and the safety of mankind. I have known a physician barbarous enough to boast, that he pronounced more sentences than all his Majesty's judges. Would to God that such sentences were not often equally fatal! It may indeed be alledged, that the doctor does not declare his opinion before the patient. So much the worse. A sen- sible patient had better hear what the doctor says, than learn it from the disconsolate looks, the watery eyes, and the broken whispers, of those about him. It seldom happens, when the docter gives an unfavourable opinion, that it can be concealed from the patient. The very embarrassment which the friends and attendants show in disguising what he has said, is generally sufficient to discover the truth. Kind heaven has, for the wisest ends, concealed from mortals their fate • and we do not see what right any man has to announce the death of another, especially if such a declaration has a chance to kill him. Mankind are indeed very fond of prying into future events, and seldom fail to solicit the physician for his opinion. A doubtful answer, how- ever or one that may tend rather to encourage the hopes of the sick» is surely the most proper. This conduct could neither hurt the patient uoi- the physician. Nothing tends more to destroy the credit of physic, 80 OF THE PASSIONS. than those bold proguosticators, who, by the bye, are generally the most ignorant of the faculty. The mistakes which daily happen in this wayare so many standing proofs of human vanity, aud the weakness of science. We readily admit, that there are cases where the physician ought to gi?e intimation of the patient's danger to some of his near connexions ; though even this ought always to be done with the greatest caution: but it never can be necessary in any case that the whole town and country should know, immediately after the doctor has made his first visit, that he has no hopes of his patient's recovery. Persons whose im. pertinent curiosty leads them to question the physician with.regard to the fate of his patient, certainly deserve no other than an evasive answer. The vanity of foretelling the fate of the sick is not peculiar to the faculty. Others follow their example, and those who think themselves wiser than their neighbours often do much hurt in this way. Humanity surely calls upon every one to comfort the sick, and not to add to their affliction by alarming their fears. A friend, or even a physician, may often do more good by a mild and sympathizing behaviour than by medicine, and should never neglect to adminster that greatest of all cordials, Hope. of GRIEF. Grief is the most destructive of all the passions. Its effects are per- manent ; and when it sinks deep into the mind, it generally proves fatal. Anger and fear, • being of a more violent nature, seldom last long ; but grief often changes into a fixed melancholy, which preys upon the spirits and wastes the constitution. This passion ought not to be indulged. It may generally be conquered at the beginning ; but when it has gained strength, all attempts to remove it are vain. No persons can prevent misfortunes in life ; but it shows true greatness of mind to bear them with serenity. Many persons make a merit of indulging grief, and when misfortunes happen, they obstinately refuse all consolation till the mind, overwhelmed with melancholy, sinks under the load. Such conduct is not only destructive to health but inconsistent with reason, religion, and common sense. Change of ideas is as necessary for health, as change of posture. When the mind dwells long upon one subject, especially of a disa- greeable nature, it hurts the whole functions of the body. Hence grief indulged spoils the digestion, and destroys the appetite; by which means the spirits are depressed, the nerves relaxed, and the bowels in- flated with wind, and the humours, for want of fresh supplies of chyle, OF THE PASSIONS. 81 vitiated. Thus many an excellent constitution has been l-uiued by a family misfortune, or any thing that occasions excessive grief. It is utterly impossible that any person of a dejected mind should enjoy health. Life may indeed be dragged out for a few years ; but whoever would live to a good old age, must be good-humoured and cheerful. This indeed is not altogether in our own power; yet our tem- per of mind as well as actions, depend greatly upon ourselves. We can either associate with cheerful or melancholy companions, mingle in the amusements aud offices of life, or sit still and brood over our calamities as we choose. These, and many such things, are certainly in our power, and from these the mind generally takes its cast. The variety of scenes which present themselves to the senses, were certainly designed to prevent our attention from being too long fixed upon any one object. Nature abounds with variety, and the mind, unless fixed down by habit, delights in contemplating new objects. This at once points out the method of relieving the mind in distress. Turn the attention frequently to new objects. Examine them for some time. When the mind begins to recoil, shift the scene. By this means a constant succession of new ideas may be kept up, till the disagreeable ones entirely disappear. Thus travelling, the study of any art or sci- ence, reading, or writing on such subjects as deeply engage the attention, will sooner expel grief than the most sprightly amusements. It has already been observed, that thebody cannot be healthy un- less it be exercised ; neither can the mind. Indolence nourishes grief. When the mind has nothing else to think of but calamities, no wonder that it dwells there. Few people who pursue business with attention are hurt by grief. Instead therefore of abstracting ourselves from the world or business when misfortune happens, we ought to engage in it with more than usual attention, to discharge with double diligence the functions of our station, and to mix with friends of a cheerful and social temper. . Innocent amusements are by no means to be neglected, these, by leading the mind insensibly to the contemplation of agreeable objects, help to dispel the gloom which misfortunes cast over it. They make time seem less tedious, aud have many other happy effects. Some persons, when overwhelmed with grief, betake themselves to drinking. This is making the cure worse than the disease. It seldom fails to end in the ruin of fortune, character, and constitution. G 82 OF THE PASSIONS. OF LOVE. Love is perhaps the strongest of all the passion?. At least when it becomes violent, it is less subject to the control either of the under- standing or will, than any of the rest. Fear, anger, and several other passions, are necessary for the preservation of the individual, but love is necessary for the continuation of the species itself: it was therefore proper that this passion should be deeply rooted in the human breast. Though love be a strong passion, it is seldom so rapid in its progress as several of the others. Few persons fall desperately in love all at once. We would therefore advise every one before he tampers with this passion, to consider well the probability of his being able to obtain the object of his wishes. When that is not likely, he should avoid every occasion of increasing it. He ought immediately to fly the company of the beloved object ; to apply his mind attentively to business or study ; to take every kind of amusement ; and above all, to endeavour, if pos- sible, to find another object which may engage his affections, and which it may be in his power to obtain. There is no passion with which people are so apt to tamper as love, although none is more dangerous. Some men make love for amusement, others from mere vanity, or on purpose to show their consequence with the fair. This is perhaps the greatest piece of cruelty which any one can be guilty of. What we eagerly wish for, we easily credit. Hence the too credulous fair are often betrayed into a situation which is truly deplorable, before they are able to discover that the pretended lover w as only in jest. But there is no jesting with this passion. When love has got to a certain height, it admits of no other cure but the'possession of its object, which in this case ought always, if possible, to be obtained. OF RELIGIOUS MELANCHOLY. Many persons of a religious turn of mind behave as if they thought it a crime to be cheerful. They imagine the whole of religion consists in certain mortifications, or denying themselves the smallest indulgence, * The conduct of parents with regard to the disposal of their children in marriage, is often very blameable. An advantageous match is the constant aim of parents' while their children often suffer a real martyrdom betwixt their inclination and dutv' The first thing which parents ought to consult in disposing of their children in mar- riage, is certainly their inclinations. Were due regard always paid to these, there would be fewer unhappy couples, and parents would not have so often cause to re- pent the severity of their conduct, after a ruined constitution, a lost character or a distracted mind, ha\e shown them their mistake. OF THE PASSIONS. 93 even of the most innocent amusements. A perpetual gloom hangs over their countenances, while the deepest melancholy preys upon their mind. At length the fairest prospects vanish, every thing puts on a dis- mal appearance, and those very objects which ought to give delight afford nought but disgust. Life itself becomes a burden, and the un- happy wretch, persuaded that no evil can equal what he feels, often puts an end to his miserable existence. It is great pity that ever religion should be so far perverted, as to become the causes of those very evils which it was designed to cure. Nothing can be better calculated than True Religion to raise and sup- port the mind of its votaries under every affliction that can befal them. It teaches men that even the sufferings of this life are preparatory to the happiness of the next; and that all who persist in a course of virtue shall at length arrive at complete felicity. Persons whose business it is to recommend religion to others should beware of dwelling too much on gloomy subjects. That peace and tranquillity of mind, which true religion is calculated to inspire, is a more powerful argument in its favour, than all the terrors that can be uttered. Terror may indeed deter men from outward acts of wicked- ness, but can never inspire them with that love of God, and real good- ness of heart, in which alone true religion consists. To conclude ; the best way to counteract the violence of any passion, is to keep the mind closely engaged in some useful pursuit. It is said, that the late Lord Kaimes, when he saw any literary friends sinking under the pressure of melancholy, or some other cor- roding passion, always gave this advice in a few emphatical words, 'write a book ;' which he believed to be an infallible remedy. A gen- leman devoted to the muses, and the author of a beautiful elegy, was cured of his grief for a wife whom he had tenderly loved, by his anxiety to express, in the most pathetic terms, the poignancy of his sorrow. Indeed, the earnest application of the mind to any important and interesting pursuit, will be found the surest method of conquering passions, which reason may in vain attempt to control. 84 CHAP. XI. OF THE COMMON EVACUATIONS. The principal evacuations from the human body are those by stool% urine, and insensible perspiration. None of these can be long obstructed without impairing the health. When that which ought to be thrown out of the body is too long retained, it not only occasions a plethora, or too great fulness of the vessels, but acquires qualitise which are hurtful to the health, as acrimony, putrescence, &c. OF THE EVACUATION BT STOOL. Few things conduce more to health than keeping the body regular. When the faeces lie too long in the bowels, they vitiate the humours ; and when they are too soon discharged, the body is not sufficiently nourished. A medium is therefore to be desired, which can only be obtained by regularity in diet, sleep, and exercise. Whenever the body is not regular, there is reason to suspect a fault in one or other of these. Persons who eat and drmk at irregular hours, and who eat various kinds of food, and drink of several different liquors at every meal, have no reason to expect either that their digestion will be good, or their discharges regular. Irregularity in eating and drinking disturbs every part of the animal economy, and never fails to occasion diseases. Either too much or too little food will have this effect. The former indeed generally occasions looseness, aud the latter costiveness ; but both have a tendency to hurt the health. It would be difficult to ascertain the exact number of stools which may be consistent with health, as these differ in the different periods of life, in different constitutions, and even in the same constitution under a different regimen of diet, exercise, &c. It is however gener- ally allowed, that one stool a-day is sufficient for an adult, and that more or less is hurtful. But this, like most general rules, admits of many exceptions. I have known persons in perfect health who did nov go to stool above once a-week.* Such a degree of costiveness, however, is not safe ; though the person who labours under it may for some time enjoy tolerable health, yet at length it may occasion diseases. One method of procuring a stool every day is, to rise betimes, and go abroad in the open air. Not only the posture in bed is unfavour-. * Some persons have told me that they did not go to stool above once a-month. OF THE COMMON EVACUATIONS. 85 able to regular stools, but also the warmth. This, by promoting the perspiration, lessens all the other discharges. The method recommended for this purpose by Mr. Locke, is like- wise very proper, viz. to solicit nature, by going regularly to stool every morning whether one has a call or not. Habits of this kind may be acquired which will in time become natural. Persons who have frequent recourse to medicines for preventing cos- tiveness, seldom fail to ruin their constitutions. Purging medicines frequently repeated weaken the bowels, hurt the digestion, and every dose makes way for another, till at length they become as necessary as daily bread. Those who are troubled with costiveness ought rather, if possible, to remove it by diet than drugs. They should likewise go thinly clothed, and avoid every thing of an astringent or of an heating nature. The diet and other regimen necessary in this case will be found under the article Costiveness, where this state of the bowels is treated as a disease. Such persons as are troubled with an habitual looseness, ought like- wise to suit their diet to the nature of their complaint. They should use food which braces and strengthens the bowels, and which is rather of an astringent quality, as wheat bread made of the finest flour, cheese, eggs, rice boiled in milk, &c. Their drink should be red port, claret, brandy, and water in which toasted bread has been boiled, and such like. As an habitual looseness is often owing to an obstructed perspiration, persons affected with it ought to keep their feet warm, to wear flannel next their skin, and to take every other method to promote the perspi- ration. Further directions with regard to the treatment of this com- plaint will be found under the article Looseness. OF URINE. So many things tend to change both the quantity and appearances of the urine, that it is very difficult to lay down any determined rules for judging of either* Dr. Cheyne says the urine ought to be equal to * ,t has long been an observation ^ffg£^J?3?£^££. urine are very uncertain. »n,d ^""•^,bft„^ affected. and consequently prised at this whc•considers h«»™»^^ 7ate of the" atmosphere, the qua/ have its •PI'«™"n«» »1*"~- the Lercise the clothing, the state of the other evacu- tity and quality of the foophere. D2 OF THE COMMON EVACUATIONS. quinsies, and consumptions, have often been occasioned by sitting or standing thinly clothed near an open window. Nor is sleeping with open windows less to be dreaded. That ought never to be done even in the hottest season, unless the window is at a distance. I have known me- chanics frequently contract fatal diseases, by working stripped at an open window, and would advise all of them to beware of such a practice. Few things expose people more to catch cold than keeping their own houses too warm ; such persons may be said to live in a sort of hot- houses : they can hardly stir abroad to visit a neighbour but at the hazard of their lives. Were there no other reason for keeping houses moderately cool, that alone is sufficient: but no house that is too hot can be wholesome ; heat destroys the spring and elasticity of the air, and renders it less fit for expanding the lungs, and the other purposes of respiration. Hence it is that consumptions and other diseases of the lungs prove so fatal to people who work in forges, glass-houses, and the like. Some are even so fool-hardy, as to plunge themselves, when hot, in cold water. Not only fevers, but madness itself, has frequently been the effect of this conduct. Indeed it looks too like the action of a mad- man to deserve a serious consideration. The result of all these observations is, that every one ought to avoid with the utmost attention, all sudden transitions from heat to cold, and to keep the body in as uniform a temperature as possible; or where that cannot be done, to take care, when heated, to let it cool gradually. People may imagine that so strict an attention to these things would tend to render them delicate. So far, however, is this from being my design, that the very first rule proposed- for preventing colds is, to harden the body, by inuring it daily to the open air. I shall put an end to what relates to this part of my subject, by giving an abstract of .the justly celebrated advice of Celsus, with respect to the preservation of health. ' A man,' says he,' who is blessed with good health, should confine himself to no particular rules either with respect to regimen or medicine. He ought frequently to diversify his manner of living ; to be sometimes in town, sometimes in the country ; to hunt, sail, indulge in rest, but more frequently to use exercise. He ought to refuse no kind of food that is commonly used, but sometimes to eat more and sometimes less-; sometimes to make one at an entertainment ; and sometimes to forbear it; to make rather two meals a-day than one, and always to eat heartily, provided he can digest it. He ought neither too eagerly to pursue, nor too scrupulously to avoid intercourse with the fair sex ; pleasures of this kind, rarely indulged, render the body a'ert and active : but when too frequently repeated, weak and languid. He should be careful in time of health not to destroy, by excesses of any kind, that vigour of constitution which should support kirn under sickness.' PAIIT II. OF DISEASES. CHAP. XII. OF THE KNOWLEDGE AND CURE OF DISEASES. The cure of diseases does not depend so jnuch upon scientific principles as many imagine. It is chiefly the result of experience and observation. By attending the sick, and carefully observing the various occurrences in diseases, a great degree of accuracy may be acquired, both in distin- guishing their symptoms, and in the application of medicines. Hence sensible nurses, and other persons who wait upon the sick, often foresee the patient's fate sooner than those who have been bred to physic. We do not, however, mean to insinuate that a medical education is of no use: It is doubtless of the greatest importance, but it can never supply the place of observation and experience. Every disease may be considered as an assemblage of symptoms, and must be distinguished by those which are most obvious and permanent. Instead, therefore, of giving a classical arrangement of diseases, ac- cording to the systematic method, it will be more suitable, in a per- formance of this nature, to give a full and accurate description of each particular disease as it occurs ; and where any of the symptoms of one disease have a near resemblance to those of another, to take notice of that circumstance, and at the same time to point out the pepuliar or characteristic symptoms by which it may be distinguished. By a due attention to these, the investigation of diseases will be found to be a less difficult matter than most people would at first be ready to imagine. A proper attention to the patient's age, sex, temper of mind, consti- tution, and manner of life, will likewise greatly assist, both in the in- vestigation and treatment of diseases. In childhood, the fibres are lax and soft, the nerves extremely irrit- able, and the fluids thin ; whereas in old age, the fibres are rigid, the nerves become almost insensible, and many of the vessels imperviable. Tnese and other peculiarities render the diseases of the young aud aged 94 OF THE KNOWLEDGE very different, and of course they mnst require a different method of treatment. Females are liable to many diseases which do not afflict the other sex : besides, the nervous system being more irritable in them than in men, their diseases require to be treated with greater caution. They are less able to bear large evacuations; and all stimulating medicines ought to be administered to them with a sparing hand. Particular constitutions not only dispose persons to peculiar diseases, but likewise render it necessary to treat these diseases in a peculiar manner. A delicate person, for example, with weak nerves, who lives mostly within doors, must not be treated, under any disease, precisely in the same manner as one who is hardy and robust, and who is much exposed to the open air. The temper and mind ought to be carefully attended to in diseases. Fear, anxiety, and a fretful temper, both occasion and aggravate diseases. In vain do we apply medicines to the body to remove maladies which proceed from the mind. When it is affected, the best medicine is to soothe the passions, to divert the mind from anxious thought, and to keep the patient as easy and cheerful as possible. Attention ought likewise to be paid to the climate, or place where the patient lives, the air he breathes, his diet, &c. Such as live in low marshy situations are subject to many diseases which are unknown to the inhabitants of high countries. Those who breathe the impure air of cities, have many maladies to which the more happy rustics are entire strangers. Persons who feed grossly, and indulge in strong liquors, are liable to diseases which do not affect the temperate and abstemious, &c. It has already been observed, that the different occupations and situations in life dispose men to peculiar diseases. It is therefore necessary to inquire into the patient's occupation, manner of life, &c. This will not only assist us in finding out the disease, but will likewise direct us in the treatment of it. It would be very imprudent to treat the laborious and the sedentary precisely in the same manner, even supposing them to labour under the same disease. It will likewise be proper to inquire, whether the disease be constitu- tional or accidental; whether it has been of long or short duration ; whether it proceeds from any great and sudden alteration in the diet, manner of life, &c. The state of the patient's body, and of the other evacuations, ought also to be inquired into : and likewise whether he can with ease perform all the vital and animal functions, as breathing, digestion, &c. Lastly, it will be proper to inquire to what diseases the patient has AND CURE OF DISEASES. 95 formerly been liable, and what medicines were most beneficial to him ; if he has a strong aversion to any particular drug, &c. As many of the indications of cure may be answered by diet alone, it is always the first thing to be attended to in the treatment of diseases. Those who know no better, imagine that every thing which goes by the name of medicine possesses some wonderful power or secret charm, and think, if the patient swallows enough of drugs, that he must do well. This mistake has many ill consequences ; it makes people trust to drugs, and neglect their own endeavours ; besides it discourages all attempts to relieve the sick where medicines cannot be obtained. Medicines are no doubt useful in their places ; and when adminis- teredwith prudence may do much good ; but when they are put in place of everything else, or administered at random, which is not seldom the case, they must do mischief. We would therefore wish to call the attention of mankind from the pursuit of secret medicines, to such things as they are acquainted with. The proper regulation of these may often do much good, and there is little danger of their ever doing hurt. Every disease weakens the digestive powers. The diet ought, there- fore, in all diseases, to be light and of easy digestion. 11 would be as prudent for a person with a broken leg to attempt to walk, as for one in a fever to eat the same kind of food, and in the same quantity, as when he was in perfect health. Even abstinence alone will cure a fever, especially when it has been occasioned by excess in eating or drinking. In all fevers, attended with inflammation, as pleurisies, peripneu- monies, &c. thin gruels, wheys, watery infusions of mucilaginous plants, roots, &c. are not only proper for the patient's food, but they are like- wise the best medicines that can be administered. In fevers of a slow, nervous, or putrid kind, where there are no symptoms of inflammation, and where the patient must be supported with cordials, that intention can always be more effectually answered by nourishing diet aud generous wines, than by any medicine yet known. Nor is a proper attention to diet of less importance in chronic, than in acute diseases. Persons afflicted with low spirits, wind, weak nerves, and other hypochondriacal affections, generally find more benefit from the use of solid food, and generous liquors, than from all the cordials and carminative medicines which can be administered to them. The scurvy, that most obstinate malady, will sooner yield to a proper vegetable diet, than to all the boasted antiscorbutic remedies of the shops. In consumptions, when the humours are vitiated, and the stomach so much weakened as to be unable to digest the solid fibres of animals, or even to assimilate the juices of vegetables, a diet consisting chiefly of 96 OF THE KNOWLEDGB AND CURE OF DISEASES. «<£/A will not only support the patient, but will often cure the diseare after every other medicine has failed. Nor is the attention of other things of less importance than diet. The strange infatuation which has long induced people to shut up the sick from all communication with the external air, has done great mischief. Not only in fevers, but in many other diseases, the patient will receive more benefit from having the fresh air prudently admitted into his ciiamber, than from all the medicines which can be given him. Exercise may likewise in many cases be considered as a medicine. Sailing, or riding on horseback, for example, will be of more service in the cure of consumptions, glandular obstructions, &c. than any medicine yet known. In diseases which proceed from a relaxed state of the solids, the cold bath, and other parts of the gymnastic regimen, will be found equally beneficial. Few things are of greater importance in the cure of diseases than cleanliness. When a patient is suffered to lie in dirty clothes, what- ever perspires from his body is again absorbed, or taken up into it, which serves to nourish the disease and increase the danger. Many diseases may be cured by cleanliness alone ; most of them may be mitigated by it, and in all of them it is highly necessary both for the patient and those who attend him. Many other observations, were it necessary, might be adduced to prove the importance of a proper regimen in diseases. Regimen will often cure diseases without medicine, but medicine will seldom succee 1 where a proper regimen is neglected. For this reason, in the treat- ment of diseases, we have always given the first to regimen. Those who are ignorant of medicine may confine themselves to it only. For others who have more knowledge, we have recommended some of the most simple but approved forms of medicine in every disease. These, however, are never to be administered but by people of better under- standing ; nor even by them without the greatest precaution. 11 has been objected to this book, that the observations on the preven- tion and cure of diseases serve only to encourage the fatal practice of domestic quackery. Such objections, however, are equally at variance with candour and truth, and must proceed from ignorance of its con- tents, or a desire to mislead. The obvious tendency of the book is to enlighten the minds of the people on a subject of such immediate concern as their health, and thus to guard them against the bad effects of ignorance and rashness on their own part, and of imprudence and deceit on the part of others. Instead of encouraging the use of niedi cine, every person of common understanding, who attends to the remark it contains, will feel his caution increase agaiDst the use of the most OF FEVERS IN GENERAL. 57 simple medicines ; iustead of running the risk of poisoning himself or his family, by drugs and dangerous compounds from the apothe- cary's shop, upon every trifling occasion. One of the chief objects of the author was to explode, as much as pos- sible, the use of medicine, and to direct general attention to the more assured means of preserving health, namely, pure air, cleanliness, diet, moderate exercise, and the control of the passions ; knowing how much easier it is to preveut diseases than to cure them. In cases of actual infirmity and disease, it is recommended to such as are ignorant of physic to confine themselves to regimen only, and to leave the medical treatment of their complaints to persons of better information. The remedies recommended are safe, and though written in plain English^ v ill be found as salutary as if written in the jargon of apothecaries' Latin, accompanied with all their barbarous hieroglyphics. CHAP. XIII. OF FEVERS IN GENERAL. As more than one half of mankind is said to perish by fevers, it is of importance to be acquainted with their causes. The most general cause of fevers are, infection, errors in diet, unwholesome air, violent emotions of the mind, excess or suppression of usual etacutions, external or internal injuries, and extreme degrees of heat or cold. As most of these have already been treated of at considerable length, and then- effects shown, we shall not now resume the consideration of them, but shall only recommend it to all, as they Vould wish to avoid fevers, and other fatal diseases, to pay the most punctual attention to these articles- Fevers are not only the most frequent of all diseases, but they are likewise the most complex. In the most simple species of fever there is always a combination of several different symptoms. The d.st.n- cuishing symptoms of fever are, increased heat, frequency of pulse, loss of appetite, general dr Tn thi> strninett decoction ami a 144 OF THE MILIARY FEVER. Medicine.—If the food and drink be properly regulated, there wi'l be little occasion for medicine in this disease. Should the eruption however not rise, or the spirits flag, it will not only be necessary to support the patient with cordials, but likewise to apply blistering plas- ters. The most proper cordial in this case is good wine, which may e.ther be taken in the patient's food or drink ; and if there be signs of putrescence, the bark and acids may be mixed with wine as directed in the putrid fever. Some recommend blistering through the whole course of this disease ; and where nature flags, and the eruption comes and goes, it may be necessary to keep up a stimulus, by a continual succession cf small blistering-plasters ; but we would not recommend above one at a time. If, however, the pulse should sink remarkably, the pustules strike in, and the head be affected, it will be necessary to apply several blistering plasters to the most sensible parts, as the inside of the legs, thighs, &c. Bleeding is seldom necessary in this disease, and sometimes it does much hurt, as it weakens the patient and depresses the spirits. It is therefore never to be attempted unless by the advice of a physician. We mention this, because it has been customary to treat this disease in child-bed women, by a plentiful bleeding, and other evacuations, as if it were highly inflammatory. But this practice is generally unsafe. Patients in this situation bear evacuations very ill. And indeed the disease seems often to be more of a putrid than of an inflammatory nature. Thogh this fever is often occasioned in child-bed women by too hot a regimen, yet it would be dangerous to leave that off all of a sudden, and have recourse to a very cool regimen, and large evacuations. We have reason to believe, that supporting the patient's spirits, and promoting the natural evacuations, is here much safer than to have recourse to artificial ones, as these, by sinking the spirits, seldom fail to increase the danger. If the disease proves tedious, or the recovery slow, we would recom- December, and January; from which we learn the necessity of a temperate regimen in this malady, and likewise that physicians are not always the first to discover the proper treatment of diseases:—' This fever made terrible havock even among men of robust constitutions, and all medicine proved in vain. They were seized in an instant with shivering, yawning, stretching, and pains in the back, succeeded by a most intense heat; at the same time there was a great loss of strength and appetite. On the seventh or ninth day the miliary eruptions appeared, or spots like flea-bites, with great anxiety, delirium, restlessness, and tossing in bed. Bleeding was fatal. While matters were in this unhappy situation, a midwife, of her own accord, gave to a pa- tient in the height of the disease a clyster of rain water and butter without salt, and for his ordinary drink a quart of spring water, half a pint of generous wine, the juice of a lemon, and six ounces of the whitest sugar, gently boiled till a scum arose, and this with great success; for the belly was soon loosened, the grievous symptoms vanished, and the patient was restored to his senses, and snatched from the j.itts 01 death.' This practice was imitated by others with the like happy effects. OF TlltC REMITTING FEVER. 1 1.3 mend the Peruvian bark, which may either be taken in substance, i r infused in wine or water, as the patient inclines. The miliary fever, like other eruptive diseases, requires gentle purging, which should not be neglected, as soon as the fever is gone off, aud the patient's strength will permit. To prevent this disease, a pure dry air, sufficient exercise, and wholesome food are necessary. Pregnant women should guard against costiveness, and take daily as much exercise as they can bear, avoiding all green and trashy fruits, and other unwholesome things ; and when in childbed, they ought strictly to observe a cool regimen. In this fever the changes are frequent and sudden, and require the most constant attention, in order to change the regimen and medicines, and adapt them to the new symptoms. It often assumes a quite differ- ent character, and the death of the patient would often be the conse- quence of neglect in these circumstances. When this is taken into -consideration, it will evince more strongly the remarks made in a former chapter on the extreme folly and danger of using any general fevc* medicine. CHAP. XXII OF THE REMITTING FEVER. This fever takes its name from a remission of the symptoms, which happens sometimes sooner and sometimes later, but generally belore the eiehth day. The remission is generally preceded by a gentle sweat, after which the patient seems greatly relieved, but in a few hours the fever returns. These remissions return at very irregular periods, and are sometimes of longer, sometimes of shorter duration ; the nearer, however, that the fever approaches to a regular intermittent, the danger ^ cI'sES-Remitting fevers prevailing marshy countries abounding .ith wood and stagnating water ; but they prove most fatal ni ^aces v here greatheat and moisture are combined, as m some parts of Afi.c.t, he province of Bengal in the East Indies, &c. where rem.ttmg fevers ^ ge-raTly of a putrid kind, and prove very fatal. They are mos fluent in close calm weather, especially after rainy seasons, great Sequent in or constitution ls cxeinI»™"er "°"c~ °de their appearance, which ^formed; and at the u>uaP^ .>'« s™ ^o^o confine thePboy an hour to bbel^Norof'tKr r^aUonsVn^'but^disease had come in the natural way tili the boy was well. . d- b a mtle bit of thread dipt in the /.Mr. Tronchi.n communica^™« ™JL^ter. This method may no doubl matter, which be covers ^h. ^^^'^ere U>e p^ient is very much alarmed at be used with advantage in those ciaes wuere w» y Uic »iSht of any cuttmg instrument. 158 OF THE SMALL-POX. Indeed, if fresh matter be applied long enough to the skin, there is no occasion for any wound at all. Let a bit of thread, about half an inch long, wet with the matter, be immediately applied to the arm, midway between the shoulder and the elbow, and covered with a piece of the common sticking plaster, and kept on for eight or ten days. This will seldom fail to communicate the disease. We mention this method, be- cause many people are afraid of a wound; and doubtless the moiv easily the operation can be performed, it has the greatest chance to become general. Some people imagine that the discharge from a wound lessens the eruption ; but there is no great stress to be laid upon this notion ; besides, deep wounds often ulcerate and become troublesome. We do not find that inoculation is at all considered as a medical operation in those countries from whence we learned it. In Turkey it is performed by the women, and in the East Indies by the Brachmins or priests. In this country the custom is still in its infancy ; we make no doubt, however, but it will soon become so familiar that parents will think no more of inoculating their children than at present they do of giving them a purge. No set of men have it so much in their power to render the practice of inoculation general as the clergy, the greatest opposition to it still arising from some scruples of conscience, which they alone can remove. I would recommend it to them not only to endeavour to remove the religious objections which weak minds may have to this salutary prac- tice, but to enjoin it as a duty, and to point out the danger of nc. lecting to make use of a mean which Providence has put in our power for saving the lives of our offspring. Surely such parents as wilfully neglect the means of saving their children's lives are as guilty as those who put them to death. I wish this matter were duly weighed. No one is more ready to make allowance for human weakness and religious prejudices; yet, I cannot help recommending it in the warmest manner, to parents to consider how great an injury they do their children, by neglecting to give them this disease in the early part of their lives. The numerous advantages arising from the inoculation of the small- pox have been pretty fully pointed out by the learned Dr. M'Kenzie, in is History of Health* To those mentioned by the doctor we shall * ' Many and great,' says this humane author, • are the dangers attendine the natural infection, fiom all which the inoculation is quite secure The natufat infection may invude weak or distempered bodies, by no means disposed for its kindly reception. It may attack then, at a season of the year either vtoLntlv hot or intensely cold. It may be communicated from a sort of smaU-Dox nnoreenated with the utmost virulence. It may lay hold on people unexpectedly when a dan- gerous sort is imprudently mported into a maritime *» f»„tf' • alter excesses committed"* luxury, intern™" ice? or fewdueTs" it Tnay3 li.Sew,°se .eixo on the innocent after indispensable watching hu.uTabou,; or nSlJjouS OF THE SMALL-POX. I'll only add, that such as have not had the small-pox in the early period of life, are not only rendered unhappy, but likewise in a great measure unfit for sustaining many of the most useful and important offices. Few people would choose even to hire a servant who had not had the small- pox, far less to purchase a slave, who had the chance of dying of the disease. How could a physician or a surgeon, who had never had the emall-pox himself, attend others under that disease ! How deplorable is the situation of females who arrive at mature age without having had tiie small-pox ! A woman with child seldom survives this disease ; and if an infant happen to be seized with the small-pox upon the mother's breast, who has not had the disease herself, the scene must be dis- tivsuing I if she continue to suckle the child, it is at the peril of her own life ; and if she wean it, in all probability it will perish. How often is the affectionate mother forced to leave her house, and abandon her children, at the very time when her care is most necessary 1 Yet, should parental affection get the better of her fears, the consequence-i would often prove fatal. I have known the tender mother and her Kicking infant laid in the same grave, both untimely victims to this dreadful malady. But these scenes are too shocking to mention. Let parents who run away with their childreu to avoid the small-pox, or who refuse to inoculate them in infancy, consider to what deplorable situa- tions they may be reduced by this mistaken tenderness 1 As the small-pox is now become an epidemical disease in most parts of the known world, no other choice remains but to render the malady as mild as possible. This is the only manner of extiipation now left in our power ; and though it may seem paradoxical, the artificial me- thod of communicating the disease, could it be rendered universal, o. <, An U it a trivial advantage that all these unhappy circumstances can be pre- ^H hv inoculation ? By inoculation numbers are saved from deformity as wen as vented °y 'uoculat on uy i »£ h ft are the flnMt futures, and the ^t^t^^oZFri^toi&rrtt Yhere:^inoculf„onff^.lyaseb:,;! most beaui»ui ^ v number of pusuules on the face has be.-u v^.^.w"nX anarteTAptom. by no means favourable And many o,he, ' S ,. i„„ nlaints that are frequently subsequent to the natural sort, seldom fol- f'wTe an nctd.Dw.nSTlnoSl.liou also prevent those «"«P^to terror, that vLnv harass persons who never had this disease, insomuch that when the perpetually harass persons wno depopulated, markets ruined, and the • ; n„n. ,tlooooned or discouraged, at sessions or assizes when the small-pox 13 f«q Witness^» andjar es dare not appear; and, by reason of the necessary an- l'agM'nfTome gentlemen, our honourable and useful Judbv.are not attended with seiice of some genuemeu,. y office aud merit. Does not inoculation, in that reverence and ■•"•dour due to heir office*»* m w distemper on 11'" hTrTwhereXy Tust qu cVy Jead Z infection among such of the crew who .■upboard. where they «»«£ » »naye gcarce, anv chanCe to escape, being half never had it belore. ana w»«o . indifferently nursed? Lastly, .titled ^»*\^M^^,^,rmU^m.Zdlag these poor creatures, when at- with regard to the so'1''"?' v , are inc0nceival)le. without attendance, w.ihoul \ff£^^^^^''i0 *"oue of tu"COiUU""1>' ***** ICO OF THE SMALLPOX. would amount to nearly the same thing as rooting it out. It is a matter of small consequence, -whether a disease be entirely extirpated or rendered so mild as neither to destroy health nor hurt the constitu- tion : but that this may be done by inoculation does not now admit of a doubt. The numbers who die under inoculation hardly deserve to be named. In the natural way, one in four or five generally dies ; but by inoculation not one in a thousand. Nay, some can boast of having inoculated ten thousand without the loss of a single patient. I have often wished to see some plan established for rendering this salutary practice universal; but am afraid I shall never be so happy. The difficulties are many ; yet the thing is by no means impracti- cable. The aim is great; no less than saving the lives of one fourth part of mankind. What ought not to be attempted in order to accom- plish so desirable an end 1 The first step towards rendering the practice universal must be to remove the religious prejudices against it. This, as already observed, can only be done by the clergy. They must not only recommend it as a duty to others, but likewise practice it on their own children. Ex- ample will ever have more influence than precept. The next thing requisite is to put it in the power of all. For this purpose, we would recommend it to the faculty to inoculate the children of the poor gratis. It is hard that so useful a part of mankind should, by their poverty, be excluded from such a benefit. Should this fail, it is surely in the power of any state.to render the practice general, at least as far as their dominion extends. We do not mean that it ought to be enforced by a law. The best way to pro- mote it would be to employ a sufficient number of operators at the public expense to inoculate the children of the poor. This would onlv be necessary till the practice became general ; afterwards custom, the strongest of all laws, would oblige every individual to inoculate his chil- dren to prevent reflections. It may be objected to this scheme, that the poor would refuse to employ the inoculators: this difficulty is easily removed. A small premium to enable mothers to attend their children while under that disease would be a sufficient inducement ; besides, the success attend- ing the operation would soon banish all objections to it. Even con- siderations of profit would induce the poor to embrace, the plan. They often bring up their children to the age of ten or twelve, and when they come to be useful they are snatched away by this malady, to the great loss of their parents and detriment of the public. The British legislature has of late years shown great attention to tha preservation of infant lives, by supporting the Foundling Hospital, &c. 09 THE SMALL-POX. ^r,^^ But we will venture to fay, if one tenth part of the sums laid out in supporting that institution had been bestowed towards promoting the practice of inoculation of the small-pox among the poor, that not only more useful lives had been saved, but the practice, ere now, rendered quite universal in this island. It is not to be imagined what effect example and a little money will have upon the poor; yet, if left to themselves, they would go on for ever in the old way, without thinking of any improvement. We only mean this as a hint to the hu- mane and public spirited. Should such a scheme be approved, a proper plan might easily be laid down for the execution of it. But as public plans are very difficult to bring about, and often, by the selfish views and misconduct of those intrusted with the execution of them, fail of answering the noble purposes for which they were designed, we shall, therefore, point out some other method by which the benefits of inoculation may be extended to the poor. There is no doubt but inoculators will daily become more numerous. We would, therefore, have every parish in Britain to allow one of them a small salary for inoculating all the children in the parish at a proper age. This might be done at a very trifling expense, and it would enable every one to enjoy the benefit of this salutary invention. Two things chiefly operate to prevent the progress of inoculation. The one is a wish to put the evil day as far off as possible. This is a principle in our nature ; and as inoculation seems rather to be anti- cipating a future evil, it is no wonder mankind are so averse to it. But this objection is sufficiently answered by the success. Who in his senses would not prefer a lesser evil to-day to a greater to-morrow, provided they were equally certain 1 The other obstacle is the fear of reflections. This has a very great weight with the bulk of mankind. Should the child die, they think the world would blame them. This they cannot bear. Here lies the diffi- culty ; and, till that be removed, inoculation will make but small progress. Nothing however can remove it but custom. Make the practice fash- ionable, and all objections will vanish. It is fashion alone that has led the multitude since the beginning of the world, and will lead them to the end. We must, therefore, call upon the more enlightened part of mankind to set a pattern to the rest. Their example, though it may for some time meet with opposition, will at length prevail. I am aware of an objection to this practice from the expense with which it may be attended : this is easily obviated. We do not mean that every parish ought to employ a Sutton or a Dimsdale as inocula- tors. These have by their success already recommended themselves to crowned heads, and are beyond the vulgar reach : but have not oth.-xd 1G2 OF THE SMALL-POX. an equal chance to succeed ? They certainly have. Let them make the same trial, and the difficulties will soon vanish. There is not a parish, and hardly a village in Britain, destitute of some person who can bleed. But this is a far more difficult operation, and requires both more skill and dexterity than inoculation. The persons to whom we would chiefly recommend the performance of this operation are the clergy. Most of them know something of medicine. Almost all of them bleed, and can order a purge, which are all the qualifications necessary for the practice of inoculatian. The priests among the less enlightened Indians perform this office, and why should a Christian teacher think himself above it ? Surely the bodies of men, as well as their souls, merit a part of the pastor's care ; at least the greatest Teacher who ever appeared among men, seems to have thought so. Should all other methods fail, we would recommend it to parents to perform the operation themselves. Let them take any method of communicating the disease *hey please; provided the subjects be healthy, and of proper age, they will soldom fail to succeed to their wish. 1 have known many instances even of mothers performing the operation, and never so much as heard of one bad consequence. A planter in one of the West India islands is said to have inoculated with his own hand, in one year, three hundred of his slaves, who, notwithstanding the warmth of the climate, and other unfavourable circumstances, all did well. Common mechanics have often to my knowledge, performed the operation with as good success as physicians. We do not, however, mean to discourage those who have it in their power, from employing people of skill to inoculate their children, and attend them while under the disease ; but only to show, that, where such cannot be had, the operation ought not upon that account to be neglected. Instead of multiplying arguments to recommend this practice, I shall just beg leave to mention the method which I took with my own son, then an only child. After giving him two gentle purges, I ordered the nurse to take a bit of thread which had been previously wet with fresh matter from a pock, and to lay it upon his arm, covering it with a piece of sticking plaster. This remained on six or seven days, till it was rubbed off by accident. At the usual time the small-pox made their appearance and were exceedingly favourable. Surely this, which is all that is generally necessary, may be done without any skill in medicine. We have been the more full on this subject because the benefits of inoculation cannot be extended to society by any other means thai unking the practice general. While it is confined to a few, it is hurtful 0» THE SMALL POX. 1G3 to the whole. By means of it the contagion is spread, and is commu- nicated to many who might otherwise never have had the disease. Accordingly it is found that nearly the same number die of the small- pox now as before inoculation was introduced ; and this important discovery, by which alone more lives might be saved than by all the endeavours of the Faculty, is in a great measure lost by its bent-fits not being extended to the whole community.* The Bpring and autumn have been usually reckoned the most proper seasons for inoculation, on account of the weather being then most temperate : but it ought to be considered that these are generally the most unhealthy seasons of the whole year. Undoubtedly the best pre- paration for the disease is a previous good state of health. I have always observed that children in particular are more sickly towards the end of summer and autumn than at any other time of the year. On this account, as well as for the advantage of cool air, I would propose winter as the most proper season for inoculation; though, on every other consideration, the spring would seem to be preferable. The most proper age for inoculation is between three and five. Many approve of inoculation on the breast, and where no circum- stances forbid this practice, I have no objection to it. Children, how- ever, are more liable to convulsions at this time than afterwards; besides, the anxiety of the mother or nurse, should the child be iu danger, would not fail to heighten it, by spoiling the milk. Children who have constitutional diseases must nevertheless be inocu- lated. It will often mend the habit of body ; but ought to be per- ' formed at a time when they are most healthy. Accidental diseases should always be removed before inoculation. It is generally thought necessary to regulate the diet for some time before the disease be communicated. In children, however, great al- teration in diet is seldom necessary, their food being commonly of the most simple and wholesome kind, as milk, water-pap, weak broths, bread, light pudding, mild roots, and white meats. But children who have been accustomed to a richer diet, who are of a gross habit, or abound with bad humours, ought to be put upon a spare diet before they are inoculated. Their food should be of a light cooling nature, and their drink whey, butter-milk, and such like. We would recommend no other medicinal preparation but two or three mild purges, which ought to be suited to the age and strength of the patient. °The success of inoculators does not depend on the preparation .. r, 11 i.m ninn for extending inoculation, more lives might be saved at a sm^xpe^'than K-]Served by aU the hospital, in England, wu*h cust the public such an amazing »mu. 164 0F THE MEASLES. of their patients, but on their management of them while under the disease. Their constant care is to keep them cool, and their bodies gently open, by which means the fever is kept low, and the eruption greatly lessened. The danger is seldom great when the pustules are few; and their number is generally in proportion to the fever, which precedes and attends the eruption. Hence the chief secret of inoculation consists in regulating the eruptive fever, which generally may be kept sufficiently low by the methods mentioned above. The regimen during the disease is in all respects the same as under the natural small pox. The patient must be kept cool, his diet should be light, and his drink weak and diluting, &c. Should any bad symp- toms appear, which is seldom the case, they must be treated in the same way as the natural small-pox. Purging is not less necessary after the small-pox by inoculation than in the natural way, and ought by no means to be neglected. [The new method of vaccine inoculation, there is every reason to believe, will prove an infallible preventive against infection by the na- tural small-pox. The numerous testimonies already before the public must convince every impartial inquirer of the high value of this disco- very. This subject will be fully treated of in a separate Chapter On the Cow-pox, which will be found in a subsequent part of this work.] CHAP. XXIV. OF THE MEASLES. The measles appeared in Europe about the same time with the small- pox, and have a great affinity to that disease. They both come from the same quarter of the world, are both infectious, and seldom attack the same person more than once. The measles are most common in the spring season, and generally disappear in summer. The disease itself, when properly managed, seldom proves fatal; but its conse- quences are often very troublesome. Cause—This disease, like the small-pox, proceeds from infection, and is more or less dangerous according to the constitution of the patient, the season of the year, the climate, &c. SYMPTOMS.-The measles, like other fevers, are preceded by alternate fits of heat and cold, with sickness and loss of appetite. The tongue is white, but generally moist. There is a short cough, a heaviness o< or THE MEASLES. 165 the head and eyes, drowsiness, and a running at the nose. Sometimes, indeed, the cough does not como before the eruption has appeared. There is an inflammation and heat in the eyes, accompanied with a de- fluxion of fresh rheum, and great acuteness of sensation, so that they cannot bear the light without pain. The eye-lids frequently swell so as t > occasion blindness. The patient generally complains of his throat; and a vomiting or looseness often precedes the eruption. The stools in children are commonly greenish ; they complain of an itching of the skin, and are remarkably peevish. Bleeding at the nose is common, both before and in the progress of the disease. About the fourth day, small spots resembling flea-bites appear, first upon the face, then npon the breast, and afterwards on the extremi- ties ; these may be distinguished from the small-pox by their scarcely rising above the skin. The fever, cough, and difficulty of breathing, instead of being removed by the eruption, as in the small-pox, are ruther increasd; but the vomiting generally ceases. About the sixth or seventh day from the time of sickening, the measles begin to turn pale on the face, and afterwards upon the body, so that by the ninth day, they entirely disappear. The fever, however, aud difficulty of breathing often continue, especially if the patient has been kept upon too hot a regimen. Petechia, or purple spots, may liuewise be occasioned by this error. A violent looseness sometimes succeeds the measles ; m which case the patient's life is in imminent danger. Such as die of the measles generally expire about the ninth day from the invasion, and are commonly carried off by a peripneumony or in- flammation of the lungs. The most favourable symptoms are a moderate looseness, a moist akin, and a plentiful discharge of urine. When the eruption suddenly falls in, and the patient is seized with a dehr 1, he is hi the greatest danger. If the measles turn too soon of a12 colour, it is an unfavourable symptom, as are also great 1akness VOm,t ng, restlessness, and difficulty of swallowing. Purple IbI loZ appearing among the measles are very ^ourable Whracontinnal'cough, with hoarseness, succeeds the^disease, th« is reason to suspect an approaching consumption of the lungs. Our Z\n this disease is to assist nature, by proper cordials, in throw- tne eruption if her efforts are languid; but when they are too 'Me^ ^ -t bo restrained by evacuations and cool diluting vmlent, they tmust b ^ ^^ to ^^ ^ most urC s>m^toms, as the cough, restiessness, and difficulty of breathing ToiL-The cool regimen is necessary here as well as in the 166 OF TIIE MEASLES. small-pox. The food too must be light, and the drink diluting. Acids, however, do not answer so well in the measles as in the small-pox, as they tend to exasperate the cough. Small beer likewise, though a good drink in the small-pox, is here improper. The most suitable liquors are decoctions of liquorice with marsh-mallow roots and sarsa- parilla, infusions of linseed, or of the flowers of elder, balm-tea, clarified whey, barley-water, and such like. These, if the patient be costive, may be sweetened with honey; or, if that should disagree with the 6tomach, a little manna may occasionally be added to them. Medicine.—The measles being an inflammatory disease, without any critical discharge of matter as in the small-pox, bleeding is commonly necessary, especially when the fever runs high, with difficulty of breathing, and great oppression of the breast. But, if the disease be of a mild nature, bleeding may be omitted.* Bathing the feet and legs frequently in lukewarm water both tends to abate the violence of the fever and to promote the eruption. The patient is often greatly relieved by vomiting. When there is a tendency this way, it ought to be promoted by drinking lukewarm water or weak camomile-tea. When the cough is very troublesome, with dryness of the throat and difficulty of breathing, the patient may hold his head over the steam of warm water, and draw the steam into his lungs. He may likewise lick a little sparmaceti and sugar-candy pounded together; or take now and then a spoonful of the oil of sweet almonds, with sugar-candy dissolved in it. These will soften the throat, and relieve the tickling cough. If at the turn of the disease the fever assumes new vigour, and there appears great danger of suffocation, the patient must be bled according to his strength, and blistering plasters applied, with a view to prevent the load from being thrown on the lungs, where, if an inflammation should fix itself, the patient's life will be in imminent danger. In case the measles should suddenly disappear, it will be necessary to pursue the same method which we have recommended when the small- pox recede. The patient must be supported with wine and cordials. Blistering-plasters must be applied to the legs and arms, and the body rubbed all over with warm flannels. Warm poultices may likewise be applied to the feet and palms of the hands. When purple or black spots appear, the patient's drink should be sharpened with spirits of vitriol; and if the putrid symptoms increase, * I do not know any disease wherein bleeding is more necessary than in the measles, especially when the fever runs high; in this case I have always found it relieve the patient. OF THE SCARLET FEVER. 107 the Peruvian bark must be administered in the same manner as ui- rected in the small-pox. Opiates are sometimes necessary, but should never be given except in cases of extreme restlessness, a violent looseness, or when the cough is very troublesome. For children the syrup of poppies is sufficient. A tea-spoonful or two may be occasionally given, according to the pa- tient's age, or the violence of the symptoms. After the measles are gone off, the patient ought to be purged. This may be conducted in the same manner as directed in the small-pox. If a violent looseness succeed the measles, it may be checked by taking for some days a gentle dose of rhubarb in the morning and an opiate over night ; but if these do not remove it, bleeding will seldom fail to have that effect. Patients recovering after the measles should be careful what they eat and drink. Their food for some time ought to be light, aud in small quantities, and their drink diluting, and rather of an opening nature, as butter-milk, whey, and such like. They ought also to beware of ex- posing themselves too soon to the cold air, lest a suffocating catarrh, an asthma, or a consumption of the lungs should ensue. Should a cough, with difficulty of breathing and other symptoms of a consumption, remain after the measles, small quantities of blood may be frequently let at proper intervals, as the patient's strength and con- stitution will permit. He ought likewise to drink asses' milk, to remove to a free air, if in a large town, and to ride on horseback. He must keep close to a diet consisting of milk and vegetables ; and lastly, if these do not succeed, let him remove to a warmer climate.* OF THE SCARLET FEVER. The scarlet fever is so called from the colour of the patient's skin, which appears as if it were tinged with red wine. It happens at any season of the year, but is most common towards the end of summer ; * Attempts have been made to communicate the measles, as well as the small-pox, bv inoculation, and we make no doubt but in time the practice may succeed. Dr. Home of Edinburgh, says, he communicated the disease by the blood. Others have tried this method, and have not found it succeed. Some think the disease would be more certuiuly communicated by rubbing the skin of a patient who has the measles with cotton, and afterwards applying the cotton to a wound as in the small-pox; while others recommend a bit of flannel which had been applied to the patient s skin all the time of the disease, to be afterwards laid upon the arm or leg of the person to whom the infection is to be communicated. There is no doubt but this disease, „, weii as the small-pox, may be communicated various ways: the most probable, however is either from cotton rubbed upon the skin, as mentioned above, or by introducing a little of the sharp humour which distils from the eyes of the patient into the blood. It is agreed on all hands, that such pationt3as have been mocu'rit-d had the disease very mildly; we therefore wish the practice were more general, M the measles have of late become very fatal. 139 OF tiie scaiil;:t fevbr. at which time it often seizes whole families : children aud young per- sons are most subject to it. It begins, like other fevers, with coldness and shivering, without any violent sickness. Afterwards the skin is covered with red spots, which are broader, more florid, and less uniform than the measles. They con- tinue two or three days, and then disappear; after which the cuticle or scarf-skin falls off. There is seldom any occasion for medicine in this disease. The patient ought, however, to keep within doors, to abstain from flesh, strong liquors, and cordials, and to drink freely of cool diluting liquors. If the fever runs high, the body must be kept gently open by emollient clysters, or small doses of nitre and rhubarb. A scruple of the former and five grains of the latter may be taken thrice a-day, or oftener if necessary. Children and young persons are sometimes seized at the beginning of this disease with a (kind of stupor and epileptic fits. In this case, the feet and legs should be bathed in warm water, a large blistering- piaster applied to the neck, and a dose of the syrup of poppies given every night till the patient recovers.* The scarlet fever, however, is not always of so mild a nature. It is • sometimes attended with putrid or malignant symptoms, in which case it is always dangerous. In the malignant scarlet fever the patient is not only affected with coldness and shivering, but with languor, sickness, and great oppression; to these succeed excesive heat, nausea, and vomiting, with a soreness of the throat; the pulse is extremely quick, but small and depressed ; the breathing frequent and laborious ; the skin hot but not quite dry ; the tongue moist and covered with a whitish mucus ; the tonsils inflamed and ulcerated. When the eruption appears it brings no relief ; on the contrary, the symptoms generally grow worse, and fresh ones come on, as purging, delirium, &c. When this disease is mistaken for simple inflammation, and treated * with repeated bleedings, purging, and cooling medicines, it generally proves fatal. The only medicines that can be depended on in this case are cordials and antiseptics, as the Peruvian bark, wine, snake-root, and the like. The treatment must be in general similar to that of the putrid fever, or of the malignant ulcerous sore throat.f * Sydenham. t In the year 1774, during winter, a very had species of this fever prevailed in Edinburgh: it raged chiefly among young people. The eruption was generally ac- companied with quinsey, and the inflammatory symptoms were so blended with others of a putrid nature as to render the treatment of the disease very difficult. Many of the patients, towards the decline of the fever, were afflicted with large swellings of the submaxilary glands, aud not a few had a suppuration in one of both ears. 1G9 OF THE BILIOUS FEVER. When a continual, remitting, or unremitting fever is accompanied with a frequent or copious evacuation of bile, either by a vomit or stool, the fever is denominated bilious. In Britain, the bilious fever generally makes its appearance about the end of summer, and ceases t.iwards the approach of winter. It is most frequent and fatal in warm countries^ especially where the soil is marshy, and when great rains are succeeded by sultry heats. Persons who work without doors, lie in camps, or who are exposed to the night air, are most liable to this kind of fever. If there are symptoms of inflammation at the beginning of this fever, it will be necessary to bleed, and to put the patient upon the cool di- luting regimen recommended in the inflammatory fever. The saline draught may likewise be frequently administered, and the patient's body kept open by clystera or mild purgatives. But if the fever should remit or intermit, bleeding will seldom be necessary. In this case a vomit may be administered, and, if the body be bound, a gentle purge : after which the Peruvian bark will generally complete the cure. In case of a violent looseness, the patient must be supported with chicken broths, jellies of hartshorn, and the like ; and he may use the tchite decoction for his ordinary drink* If a bloody flux should accom- pany this fever, it must be treated in the manner recommended under the article Dysentery. When there is a burning heat, and the patient does not sweat, that evacuation may be promoted by giving him, three or four times a-day, a table-spoonful of Miuderus's spiritf mixed in a cup of his ordinary drink. If the bilious fever be attended with the nervous, malignant, orputrii] Bymptoms, which is sometimes the case, the patient must be treated in the same manner as directed under these diseases. After this fever, proper care is necessary to prevent a relapse. For this purpose, the patient, especially towards the end of autumn, ought to continue the use of the Peruvian bark for some time after he is well. He should likewise abstain from all trashy fruits, new liquors, and Jtery kind of flatulent' aliment. * See Appendix, Tf "hite Decoction. • See Appendix, Spirit of Mindcrus. 170 CHAP. XXV. OF THE ERYSIPELAS, OR ST. ANTHONY'S FIRE. This disease, which in some parts of Britain is called the rose, attacks persons at any period of life, but is most common between the age of thirty and forty. Persons of a sanguine or plethoric habit are most liable to it. It often attacks young people and pregnant women ; and such as have once been afflicted with it are very liable to have it again. Sometimes it is a primary disease, and at other times only a symptom of some other malady. Every part of the body is liable to be attacked by an erysipelas, but it most frequently seizes the legs or face, espe- cially the latter. It is most common in autumn, or when hot weather is succeeded by cold or wet. Causes.—The erysipelas may be occasioned by violent passions or affections of the mind ; as fear, anger, &c. When the body has been heated to a great degree, and is immediately exposed to the cold air, so that the perspiration is suddenly checked, an erysipelas will often ensue.* It may also be occasioned by drinking to excess, by continuing too long in a warm bath, or by any thing that overheats the blood. If any of the natural evacuations be obstructed, or in too small a quantity, it may cause an erysipelas. The same effect will follow from the stoppage of artificial evacuations ; as issues, setons, or the like. Symptoms.—The erysipelas attacks with a shivering, thirst, loss of strength, pain in the head and back, heat, listlessness, and a quick pulse ; to which may be added, vomiting, and sometimes a delirium. On the second, third, or fourth day, the part swells, becomes red, and small pustules appear; at which time the fever generally abates. When the erysipelas seizes the foot, the parts contiguous swell, the skin shines; and, if the pain be violent, it will ascend to the leg, and will not bear to be touched. When it attacks the face, it swells, appears red, and the skin is covered with small pustules filled with clear water. One or both eyes are generally closed with a swelling ; and there is a.difficulty of breath- * The country people in many parts of Britain call this disease &blast, and imagine it proceeds from foul air, or ill winds, as they term it. The truth is, they often lie down to rest them, when warm and fatigued, upon the damp ground, where they fall asleep, and lie so long as to catch cold, which occasions the erysipelas. This disease may indeed proceed from other causes; but we may venture to say, tint nine times out of ten it is occasioned by cold caught after the body has been greatly heated or fatigued. OF THE ERYSIPELAS, OR ST. ANTHONY'S FIRE. 171 ing. If the mouth and nostrils be very dry, and the patient drowsy, there is reason to suspect an inflammation of the brain. If the erysipelas affects the breast, it swells and becomes exceedingly hard, with great pain, and is apt to suppurate. There is a violent pain in the arm pit on the side affected, where an abscess is often formed. If in a day or two the swelling subsides, the heat and pain abate, the colour of the part turns yellow, and the cuticle breaks and falls off in scales, the danger is over. The event of this disease depends greatly upon the constitution of the patient. It is seldom dangerous ; but when the constitution is bad, the legs will sometimes swell to a prodigious size, and the cure prove extremely difficult. It has often proved fatal to people in tho decline of life, who were of a scorbutic habit, or whose humours were vitiated by irregular living, or unwholesome diet. When the erysipelas is large, deep, and affects a very sensible part of the body, the danger is great. If the red colour changes into a livid or black, it will end in a mortification. Sometimes the inflammation can- not be discussed, but comes to a suppuration ; in which case fistulas, a gangrene, or mortification, often ensue. Such as die of this disease are commonly carried off by the fever, which is attended with difficulty of breathing, and sometimes with a delirium andgreat drowsiness. They generally die about the seventh or eighth day. Regimen.—In the erysipelas the patient must neither be kept too hot nor too cold, as either of these extremes will tend to make it retreat, which is always to be guarded against. When the disease is mild, it will be sufficient to keep the patient within doors, without confining him to his bed, and to promote the perspiration by diluting liquors, &c. The diet ought to be slender, and of a moderately cooling and moist- ening quality, as groat-gruel, panado, chicken or barley-broth, with cooling herbs and fruits, &c. avoiding flesh, fish, strong drink, spices, pickles, and all other things that; may heat and inflame the blood; the drink may be barley-water, and infusion of elder-flowers, common- whey, and such like. But if the pulse be low, and the spirits sunk, the patient must be supported with negus, and other things of a cordial nature. His food may be sago-gruel, with a little wine, and nourishing broths, taken in small quantities, and often repeated. Great care, however, must be taken not to overheat him. Medicine.__In this disease much mischief is often done by medi- cines especially by external applications. People, when they see an inflammation, immediately think that something ought to be applied to 172 OF THE ERYSIPELAS, OR ST. ANTHONY*S FIKE. it. This indeed is necessary in large phlegmons ; but in an erysipelas the safer course is to apply nothing. Almost all ointments, salves, and plasters being of a greasy nature, tend rather to obstruct and repel, than promote any discharge from the part. At the beginning of this disease, it is neither safe to promote a suppuration, nor to repel the matter too quickly. The erysipelas, in many respects, resembles the gout, and is to be treated with the greatest caution. Fine wool, or very soft flannel, are the safest applications to the part. These not only defend it from external air, but likewise promote the perspiration, which has a great tendency to carry off the disease. In Scotland the common people generally apply a mealy cloth to the parts affected, which is far from being improper. It is common to bleed in the erysipelas ; but this likewise requires caution. If, however, the fever be high, the pulse hard and strong, and the patient vigorous, it will be proper to bleed ; but the quantity must be regulated by these circumstances, and the operation repeated as the symptoms may require. If the patient has been accustomed to strong liquors, and the disease attacks his head, bleeding is absolutely necessary. Bathing the feet and legs frequently in lukewarm water, when the disease attacks the face or brain, has an excellent effect. It tends to make a derivation from the head, aud seldom fails to relieve the patient. When bathing proves ineffectual, poultices, or sharp sinapisms may be applied to the soles of the feet,, for the same purpose. In cases where bleeding is requisite, it is likewise necessary to keep the body open. This may be effected by emollient clysters, or small doses of nitre and rhubarb. Some indeed recommend very large doses of nitre in the erysipelas ; but nitre seldom sits easy on the sto- mach when taken in large doses. It is, however, one of the best medi- cines when the fever and inflammation run high. Half a dram of it, with four or five grains of rhubarb may be taken in the patient's ordi- nary drink, three or four times a-day. When the erysipelas leaves the extremities, and seizes the head, so as to occasion a delirium or stupor, it is absolutely necessary to open the body. If clysters and mild purgatives fail to have this effect, stronger ones must be given. Blistering plasters must likewise be ap- plied to the neck, or behind the ears, and sharp cataplasms laid to the soles of the feet. When the inflammation cannot be discussed, and the part has a ten- dency to ulcerate, it will then be proper to promote suppuration, which may be done by the application of ripening poultices, with saffron, warm fomentations, and such like. OF TIIE PnrtKN'ITIS, ETC. 173 When the black, livid, or blue colour of the part shows a tendency to mortification, the Peruvian bark must be administered. It may be taken along with acids, as recommended in the small-pox, or in any other form agreeable to the patient. It must not, however, be trifled with, as the patient's life is at stake. A dram may be given every two hours, if the symptoms be threatening, and cloths dipped in warm camphorated spirits of wine, or the tincture of myrrh and aloes, may be applied to the part, and frequently renewed. It may likewise be proper in this case to apply poultices of the bark, or to foment the part affected with a strong decoction of it. In what is commonly called a scorbutic erysipelas, which continues for a considerable time, it will only be necessary to give gentle laxatives, and such things as purify the blood and promote the perspiration. Thus, after the inflammation has been checked by opening medicines, the decoction of woods* may be drank, after which a course of bitters will be proper. Such as are liable to frequent attacks of the erysipelas ought care- fully to guard against all violent passions; to abstain from strong liquors, and all fat, viscid, and highly nourishing food. They should likewise take sufficient exercise, carefully avoiding the extremes of heat or cold. Their food should consist chiefly of milk, and such fruits, herbs, and roots, as are of a cooling quality; and their drink ought to be small- beer, whey, butter-milk, and such like. They should never suffer themselves to belong costive. If that cannot be prevented by suitable diet, it will be proper to take frequently a gentle dose of rhubarb, cream of tartar, the lenitive electuary, or some other mild purgative. CHAP. XXVI. OF THE PHRENITIS, OR INFLAMMATION OF THE BRAIN. This is sometimes a primary disease, but oftener only a symptom of some other malady, as the inflammatory, eruptive, or spotted fever, &c. It is very common, however, as a primary disease in warm cli- mates, and is most incident to persons about the prime or vigour of life. The passionate, the studious, and those whose nervous system is irritable in a high degree, are most liable to it. Causes.—This disease is often occasioned by night watching, espe- * bee Appendix. *'* OF THE PHRENITIS, cially when joined with hard study ; it may likewise proceed from hard drinking, anger, grief, anxiety. It is often occasioned by the stoppage of usual evacuations : as the bleeding piles in men, the customary discharges of women, &c. Such as imprudently expose themselves to the heat of the sun, especially by sleeping without doors in a hot season, with their heads uncovered, are often suddenly seized with an inflammation of the brain, so as to awake quite delirious. When re- pliants are imprudently used in an erysipelas, an inflammation of the brain is sometimes the consequence. It may likewise be occasioned by external injuries, as blows, or bruises upon the head, &c. Symptoms.—The symptoms which usually precede a true inflamma- tion of the brain, are pain of the head, redness of the eyes, a violent flushing of the face, disturbed sleep, or a total want of it, great dryness of the skin, costiveness, retention of urine, a small dropping of blood from the nose, singing of the ears, and extreme sensibility of the ner- vous system. When the inflammation is formed, the symptoms in general are similar to those of an inflammatory fever. The pulse indeed is often weak, irregular, and trembling; but sometimes it is hard and con- tracted. When the brain itself is inflamed, the pulse is always soft and low ; but when the inflammation only affects the integuments of the brain, viz. the dura and pia matter, it is hard. A remarkable quickness of hearing is a common symptom of this disease ; but that seldom con- tinues long. Another usual symptom is a great throbbing or pulsation in the arteries of the neck and temples. Though the tongue is often black and dry, yet the patient seldom complains of thirst, and even refuses drink. The mind chiefly runs upon such objects as have before made a deep impression on it; and sometimes, from a sullen silence, the patient becomes all of a sudden quite outrageous. A constant trembling and starting of the tendons is an unfavourable symptom, as are also a suppression of urine; a total want of sleep; a constant spitting ; a grinding of the teeth ; which last may be consi- dered as a kind of convulsion. When a phrenitis succeeds an inflam- mation of the lungs, of the intestines, or of the throat, &c. it is owing to a translation of the disease from these parts to the brain, and generally proves fatal. This shows the necessity of proper evacuations, and the danger of repellants in all inflammatory diseases. The favourable symptoms are, a free perspiration, a copious dis- charge of blood from the nose, the bleeding piles, a plentiful discharge of urine, which lets fall a copious sediment. Sometimes the disease is carried off by a looseness, and in women by an excessive flow of the menses. OR INFLAMMATION" OF THE BRAIN. 175 As this disease often proves fatal in a few days, it requires the most speedy applications. When it is prolonged, or improperly treated, it 6' metimesends in madness, or a kind of stupidity which continues for life. In the cure two things are chiefly to be attended to, viz. to lessen the quantity of blood in the brain, and to retard the circulation towards the head. Regimen.—The patient ought1 to be kept very quiet. Company, noise, and every thing that affects the senses, or disturbs the imagination, increases the disease. Even too much light is hurtful; for which reason the patient's chamber ought to be a little darkened, and he should neither be kept too hot nor too cold. It is not, however, necessary to exclude the company of an agreeable friend, as this has a tendency to soothe and quiet the mind. Neither ought the patient to be kept too much in the dark, lest it should occasion a gloomy melancholy, which is too often the consequence of this disease. The patient must, as far as possible, be soothed and humoured in every thing. Contradiction will ruffle his mind, and increase his ma- lady. Even when he calls for things which are not to be obtained, or which might prove hurtful, he is not to be positively denied them, but rather put off with the promise of having them as soon as they can be procured, or by some other excuse. A little of any thing that the mind is set upon, though not quite proper, will hurt the patient less than a positive refusal. In a word, whatever he was fond of, or used to be delighted with, when in health, may here be tried; as pleasing stories, soft music, or whatever has a tendency to soothe the passions, and compose the mind. Boerhaave proposes several mechanical expe- riments for this purpose ; as the soft noise of water distilling by drops into a bason, and the patient trying to reckon them, &c. Any uniform sound, if low and continued, has a tendency to procure sleep, and conse- quently may be of service. The aliment ought to be light, consisting chiefly of farinaceous sub- stances ; as panado, and water-gruel, sharpened with jelly of currants, or juice of lemons, ripe fruits roasted or boiled, jellies, preserves, &c. The drink small, diluting and cooling ; as whey, barley-waters, or decoctions of barley and tamarinds, which latter not only render the liquor more palatable, but likewise more beneficial, as they are of an opening nature. Medicine.—In an inflammation of the brain, nothing more certainly relieves the patient than a free discharge of blood from the nose. When this comes of its own accord, it is by no means to be stopped, but rather promoted, by applying cloths dipped in warm water to the part. When bleedin" at the nose does not happen spontaneously, it may be provoked by putting a straw, or any other sharp body up the nostril. 176 OF THK PHRENITIS, ETC. Bleeding in the temporal arteries greatly relieves the head ; but as this operation cannot always be performed, we would recommend in its stead bleeding in the jugular veins. When the patient's pulse and spirits are so low that he cannot bear bleeding with the lancet, leeches may be applied to the temples. These not only draw off the blood more gradually, but, by being applied nearer to the part affected, generally give more immediate relief. A discharge of blood from the hsemorrhoidal veins is likewise of great service, and ought by all means to be promoted. If the patient has been subject to the bleeding piles, and that discharge has been stopped, every method must be tried to restore it; as the application of leeches to the parts, sitting over the steam of warm water, sharp clysters, or suppo- sitories made of honey, aloes, and rock-salt. If the inflammation of the brain be occasioned by the stoppage of evacuations either natural or artificial, as the menses, issues, setons, or such like, all means must be used to restore them as soon as possible,, or to substitute others iu their stead. The patient's body must be kept open by stimulating clysters or smart purges, and small quantities of nitre ought frequently to be mixed with his drink. Two or three drams, or more if the case be dangerous, may he used in the space of twenty-four hours. The head should be shaved, and frequently rubbed with vinegar and rose water. Cloths dipped in this mixture may likewise be applied to tho temples. The feet ought frequently to be bathed in lukewarm water, and soft poultices of bread and milk may be kept constantly applied to them. If the disease proves obstinate, and does not yield to these medicines, it will be necessary to apply a blistering plaster to the whole head. This species of inflammation requires a treatment similar to that recommended in other inflammatory disorders ; more than ordinary care should be used to keep the patient in a state of ease, composure, and tranquillity : an attentive and sensible nurse will here often be of as much service as the most enlightened physician. The least irritation, even light, noise, or any thing that suddenly or strongly impresses the senses, is carried so rapidly to the brain as to increase the inflamma- tion, and disorder even the organs by which it was conveyed. 177 CHAP. XXVII. OF THE OPHTHALMIA, OR INFLAMMATION OF THE EYES. This disease may be occasioned by external injuries ; as blows, burn-', bruises, and the like. It may likewise proceed from dust, quick-lime, or other substances, getting into the eyes. It is often caused by the stoppage of customary evacuations ; as the healing of old sores, drying up of issues, the suppressing of gentle morning sweats, or of the sweating of the feet, &c. Long exposure to the night air, especially in cold northerly winds, or whatever suddenly checks the perspiration, especially after the body has been much heated, is very apt to cause an inflammation of the eyes. Viewing snow or other white bodies for a long time, or looking steadfastly at the sun, a clear fire, or any bright object, will likewise occasion this malady. A sudden transition from darkness to very bright light will often have the same effect. Nothing more certainly occasions an inflammation of the eyes than night-watching, especially reading or writing by candle-light. Drinking spirituous liquors, and excess of venery, are likewise very hurtful to the eyes. The acrid fumes of metals, and of several kinds of fuel, are also pernicious. Sometimes an inflammation of the eyes proceeds from a venereal taint, and often from a scrofulous or gouty habit. It may likewise be occasioned by hairs in the eye-lids turning inwards and hurting the eyes. Sometimes the disease is epidemic, especially after wet seasons: and I have frequently known it prove infectious, par- ticularly to those who lived in the same house with the patient. It may be occasioned by moist air, or living in low damp houses, especially in persons who are not accustomed to such situations. In children it often proceeds from imprudently drying up scabbed heads, a running behind the ears, or any other discharge of that kind. Inflammations of the eyes often succeed the small-pox or measles, especially in chil- dren of a scrofulous habit. Symptoms.—An inflammation of the eyes is attended with acute pain, heat redness, and swelling. The patient is not able to bear the light, and sometimes he feels a pricking pain, as if his eyes were pierced with a thorn. Sometimes he imagines his eyes are full of motes, or thinks he sees flies dancing before him. The eyes are filled with scildin" rheum, which rushes forth in great quantities whenever tua N *'8 OF THE OPHTHALMIA, patient attempts to look up. The pulse is generally quick and hard, with some degree of fever. When the disease is violent, the neibouring parts swell, and there is a throbbing or pulsation in the temporal arteries, &c. A slight inflammation of the eyes, especially from an externul cause, is easily cured ; but when the disease is violent, and continues long, it leaves often specks upon the eyes, or dimness of sight, and sometimes total blindness. If the patient be seized with a looseness, it has agood effect; and when the inflammation passes from one eye to another, as it were by infection, it is no unfavourable symptom. But when the disease is ac- companied with a violent pain in the head, and continues long, the patient is in danger of losing his sight. Regimen.—The diet, unless in scrofulas cases, can hardly be too spare, especially at the beginning. The patient must abstain from every thing of a heating nature. His food should consist chiefly of mild vege- tables, weak broths, and gruels. His drink may be barley-water, balm- tea, common whey, and such like. The patient's chamber must be darkened, or his eyes shaded with a cover, so as to exclude the light, but not to press upon the eyes. He should not look at a candle, the fire, or any luminous object; and ought to avoid all smoke, as the fnmes of tobacco, or any thing that may cause coughing, sneezing, or vomiting. He should be kept quiet, avoiding all violent efforts either of body or mind, and encouraging sleep as much as possible. Medicine.—This is one of those dieases wherein great hurt is often done by external applications. Almost every person pretends to be possessed of a remedy for the cure of sore eyes. These remedies ge- nerally consist of eye-waters and ointments, with other external appli- cations, which do mischief twenty times for once they do good. People ought therefore to be very cautious how they use such things, as even the pressure upon the eyes often increases the malady. Bleeding, in a violent inflammation of the eyes, is always necessary. This should be performed as near the part affected as possible. An adult may lose ten or twelve ounces of blood from the jugular vein and the operation may be repeated according to the urgency of the symptoms. If it should not be convenient to bleed in the neck, the same quantity may be let from the arm, or any other part of the body. Leeches are often applied to the temples, or under the eyes, with good effect. The wounds must be suffered to bleed for some hours, and if the bleeding stop soon, it may be promoted by the application of cloths dipt in warm water. In obstinate cases, it will be necessary to repcai this operation sever:.! times. OR INFLAMMATION OF THE EYES. 179 Opening and diluting medicines are by no means to be neglected. The patient may take a small dose of Glauber's salts, and cream of tartar, every second or third day, or a decoction of tamarinds with senna. If these be not agreeable, gentle doses of rhubarb and nitre, a little of the lenitive electuary, or any other mild purgative, will answer the same end. The patient, at the same time, must drink freely of water- gruel, tea, whey, or any other weak diluting liquor. He ought likewise to take, at bed-time, a large draught of very weak wine-whey, in order to promote perspiration. His feet and legs must frequently be bathed in lukewarm water, and his head shaved twice or thrice a-week, and afterwards washed in cold water. This has often a remarkably good effect. If the inflammation does not yield to these evacuations, blistering- plasters must be applied to the temples, behind the ears, or upon the neck, and kept open for some time by the mild blistering-ointment. I have seldom known these, if long enough kept open, fail to remove the most obstinate inflammation of the eyes : but for this purpose it is often necessary to continue the discharge for several weeks. When the disease has been of long standing, I have seen very ex- traordinary effects from a seton in the neck, or between the shoulders, especially the latter. It should be put upwards and downwards, or hi the direction of the spine, and in the middle between the shoulder blades. It may be dressed twice a-day with yellow basilicon. I have known patients who had been blind for a considerable time, recover sight by means of a seton placed as above. When the seton is put across the neck, it soon wears out, and is both more painful and trou- blesome than between the shoulders ; besides, it leaves a disagreeable mark, and does not discharge so freely. When the heat i i pain'of the eyes are very great, a poultice of bread and milk, softenei. with sweet oil or fresh butter, may be applied to them, at least all night ; and they may be bathed with lukewarm milk and water in the morning. If the patient cannot sleep, which is sometimes the case, he may take twenty or thirty drops of laudanum, or two spoonfuls of syrup of poppies, over night, more or less according to his age, or the violence of the symptoms. After the inflammation is gone off, if the eyes still remain weak and tender, they may be bathed every night and morning with cold water, and a little brandy, six parts of the former to one of the latter. A method should be contrived by which .the eye can be quite immersed in the brandy and water, where it should be kept for some time. I have generally found this, or cold water and vinegar, as good a Btren"thener of the eyes as any of the most celebrated collyriums. *°" OF THE OPHTHALMIA, ETC. When an inflammation of the eye proceeds from a scrofulous habit, it generally proves very obstinate. In this case the patient's diet must not be too low, and he may be allowed to drink small negus, or now and then a glass of wine. The most proper medicine is Peruvian bark, which may either be given in substance, or prepared in the following manner :— Take an ounce of the bark in powder, with two drams of Winter's bark, and boil them in an English quart of water to a pint: when it has boiled nearly long enough, add half an ounce of liquorice root sliced. Let the liquor be strained. Two, three, or four table-spoonfuls, ac- cording to the age of the patient, may be taken three or four times a-day. It is impossible to say how long this medicine should be continued, as the cure is sooner performed in some than in others; but, in general, it requires a considerable time to produce any lasting effects. Dr. Cheyne says,' that ^Ethiop's mineral never fails in obstinate in- flammations of the eyes, even scrofulous ones, if given in a sufficient dose, and duly persisted in.' There is no doubt but this and other preparations of mercury may be of singular service in ophthalmias of long continuance, but they ought always to be administered with the greatest caution, or by persons of skill in physic. It will be proper frequently to look into the eye, to see if any hairs be turned inwards, or pressing upon them.* These ought to be re- moved by plucking them out with a pair of small pincers. Those who are liable to frequent returns of this disease, ought con- stantly to have an issue in one or both arms. Bleeding or purging in the spring and autumn will be very beneficial to such persons. They ought likewise to live with the greatest regularity, avoiding strong liquor, and every thing of a heating quality. Above all let them avoid the night air and late studies.f * Any foreign body lodged in the eye may be expeditiously removed by passing a 6mall hair pencil between the eye-lid and the ball of the eye. In some places the peasants do this very effectually, by using their tongue in the same manner. f As most people are fond of using eye-waters and ointments in this and other diseases of the eyes, we have inserted some of the most approved forms of these medicines in the Appendix. See Appendix, Eye-water, and Eye-salve. 1S1 CHAP. XXVIII. OF THE QUINSEY, OR INFLAMMATION OF THE THROAT. This disease is very common in Britain, and is frequently attended with great danger. It prevails in the .winter and spring, and is most fatal to young people of a sanguine temperament. Causes.—In general it proceeds from the same causes as other inflam- matory disorders, viz. an obstructed perspiration, or whatever heats or inflames the blood. An inflammation of the throat is often occasioned by omitting some part of the covering usually worn about the neck, by drinking cold liquor when the body is warm, by riding or walking against a cold northerly wind, or any thing that greatly cools the throat, and parts adjacent. It may likewise proceed from the neglect of bleeding, purging, or any customary evacuation. Singing, speaking loud and long, or whatever strains the throat, may likewise cause an inflammation of that organ. I have often known the quinsey prove fatal to jovial companions, who, after sitting long in a warm room drinking hot liquors, and singing with vehemence, were so imprudent as to go abroad in the cold night air. Sitting with wet feet or keeping on wet clothes, are very apt to occasion this malady. It is likewise frequently occasioned by continuing long in a moist place, sitting near an open window, sleeping in a damp bed, sitting in a room that has been newly plastered, &c. I know people who never fail to have a sore throat if they sit even but a short time in a room that has been lately washed. Acrid or irritating food may likewise inflame the throat, and occa- sion a quinsey. It may also proceed from bones, pins, or other sharp substances sticking in the throat, or from the caustic fumes of metals, or minerals, as arsenic, antimony, &c. taken in by the breath. This disease is sometimes epidemical and infectious. Symptoms.—The inflammation of the throat is evident from inspec- tion the parts appearing red and swelled ; besides, the patient complains of pain in swallowing. His pulse is quick and hard, with other symp- toms of a fever. If blood be let it is generally covered with a tough coat, of a wllkish colour, and the patient spits a tough phlegm. As the swelling and inflammation increase, the breathing and swallowing be- come more difficult; the pain affects the ears; the eyes generally ap- pear red ; and the face swells. The patient is often obliged to keep 182 OF THE ftriNSET, himself in an erect posture, being in-danger of suffocation ; there is a constant nausea, or inclination to vomit; and the drink, instead of passing into the stomach, is often returned by the nose. The patient is sometimes starved at last, merely from an inability to swallow any kind of food. When the breathing is laborious, with straitness of the breast, and anxiety, the danger is great. Though the pain in swallowing be very great, yet while the patient breathes easy, there is not so much danger. An external swelling is no unfavourable symptom ; but if it suddenly falls, and the disease affects the breast, the danger is very great. When a quinsey is the consequence of some other disease, which has already weakened the patient, his situation is dangerous. A frothing at the mouth, with a swelled tongue, a pale, ghastly countenance, and coldness of the extremities, are fatal symptoms. Regimen.—The regimen in this disease is in all respects the same as in the pleurisy, or peripneumony. The food must be light, and in small quantity, and the drink plentiful, weak, and diluting, mixed with acids. It is highly necessary that the patient be kept easy and quiet. Violent affections of the mind, or great efforts of the body, may prove fatal. He should not even attempt to speak but in a low voice. Such a degree of warmth as to promote a constant, gentle sweat, is proper. When the patient is in bed, bis head ought to be raised a little higher than usual. It is peculiarly necessary that the neck be kept warm; for which pur- pose several folds of soft flannel may be wrapt round it. That alone will often remove a slight complaint of the throat, especially if applied in due time. We cannot here omit observing the propriety of a custom which prevails among the peasants in Scotland. When they feel any uneasiness of the throat, they wrap a stocking about it all night. So effectual is this remedy, that, in many places, it passes for'a charm, and the stocking is applied with particular ceremonies: the custom, however, is undoubtedly a good one, and should never be neglected. When the throat has been thus wrapped up all night, it must not be exposed to the cold air through the day, but a handkerchief, or a piece of flannel, kept about it till the inflammation be removed. The jelly of black currants is a medicine very much in esteem for complaints of the throat; and indeed it is of some use. It should be almost constantly kept in the mouth and swallowed down leisurely. It may likewise be mixed in the patient's drink, or taken any other way. When it cannot be obtained, the jelly of currants, or of mulberies, may be used in its stead. » OR INFLAMMATION of the throat. 193 C.argles for the throat are very beneficial. They may be made ;if sage-tea, with a little vinegar, and honey, or by adding to half an English pint of the pectoral decoction two or three spoonfuls of houey, and the same quantity of currant-jelly. This may be used three or four times a-day ; and if the patient be troubled with tough viscid phlegm, the gargle may be rendered more sharp and cleansing, by adding to it the spirit of sal ammoniac. Some recommend gargles made of a decoction of the leaves or bark of the black-currant bush ; but where the jelly can be had, these are unneccessary. There is no disease wherein the benefit of bathing the feet and legs in lukewarm water is more apparent ; that practice ought therefore never to be neglected. If people were careful to keep warm, to wrap up their throats with flannel, to bathe their feet and legs in warm water, and to use a spare diet, with diluting liquors, at the beginning of this disease, it would seldom proceed to a great height, or be attended with any danger ; but when these precautious are neglected, and the disease becomes violent, more powerful medicines are necessary. Medicine.—An inflammation of the throat being a most acute and dangerous distemper, which sometimes takes off the patient very sud- denly, it will be proper, as soon as the symptoms appear, to bleed in the arm, or rather in the jugular vein, aud to repeat the operation if circumstances require. The body shou d likewise be kept gently open. This may either be done by giving the patient, for his ordinary drink, a decoction of figs and tamarinds, or small doses of rhubarb and nitre, as reconmiended in the erysipelas. These may be increased according to the age of the patient, and repeated till they have the desired effect. I have often known very good effects from a bit of sal prune', or purified nitre, held in the mouth, and swallowed down as it nieheu. This promotes the discharge of saliva, by which means it answers the end of a gargle, while at the same time it abates the fever, by promoting the discharge of urine, &c. The throat ought likewise to be rubbed twice or thrice a-day with a little of the volatile liniment. This seldom fails to produce some good effects. At the same time the neck ought to be carefully covered with wool or flannel, to preveut the cold from penetrating the skin, as this application renders it very tender. Many other external applica- tions are recommended in this disease, as a swallow's nest, poultices made of the fungus called Jew's ears, album Gracum, &c But as we do not look upon any of these to be preferable to a common poultice of bread and milk, we shall take no further notice of them. borne recommend the gum-guaiacum as a specific in this disease. 1P4 of the (*UINSET, Half a dram of the gum in powder may be made into an electuary with the rob of elder-berries, or the jelly of currants, for a dose, and repeated occasionally.* Blistering upon the neck, or behind the ears, in violent inflammations of the throat, is very beneficial ; and in bad cases, it will be necessary to lay a blistering-plaster quite across the throat, so as to reach from ear to ear. After the plasters are taken off, the parts ought to be kept discharging by the application of issue ointment, till the inflammation is gone ; otherwise upon their drying up, the patient will be in danger of a relapse. When the patient has been treated as above, a suppuration seldom happens. This, however, is sometimes the case, in spite of all endea- vours to prevent it. When the inflammation and swelling continue, and it is evident that a suppuration will ensue, it ought to be promoted by drawing the steam of warm water into the throat through a tunnel or the like. Soft poultices ought likewise to be applied outwardly, and the patient may keep a roasted fig constantly in his mouth. It sometimes happens, before the tumour breaks, that the swelling is so great, as entirely to prevent any thing from getting down into the stomach. In this case the patient must inevitably perish, unless he can be supported in some other way. This can only be done by nou- rishing clysters of broth, or gruel, with milk, &c. Patients have often been supported by these for several days, till the tumour has broke ; and afterwards they have recovered. Not only the swallowing but the breathing is often prevented by the tumour. In this case nothing can save the patient's life, but opening the trachea or windpipe. As that has been often done with success, no person, in such desperate circumstances, ought to hesitate a moment about the operation ; but as it can only be performed by a surgeon, it is not necessary here to give any directions about it. When a difficulty of swallowing is not attended with an acute pain or inflammation, it is generally owing to an obstruction of the glands about the throat, and only requires that the part be kept warm, and the throat frequently gargled with something that may gently stimulate the glands, as a decotion of figs with vinegar and honey ; to which may be added a little mustard, or a small quantity of spirits. But this gargle is never to be used where there are no signs of an inflam- mation. This species of angina has various names among the common people, as the pap of the throat, the falling down of the almonds of the ears, &c. Accordingly, to remove it, they lift up the patient by the hair of the head, and thrust their fingers under his jaws, &c. all which prac- tices arc at best useless, and often hurtful. » Dr. Home. 0E TIIE MALIGNANT QX'INSEY, ETC. 185 Those who are subject to inflammations of the throat, in order to avoid that disease, ought to live temperate. Such as do not choose to observe this rule, must have frequent recourse to purging and other evacuations to discharge the superfluous humours. They ought like- wise to beware of catching cold, and should abstain from aliment or medicines of an astringent or stimulating nature. Violent exercise, by increasing the motion and force of the blood, is apt to occasion an inflammation of the throat, especially if cold liquor be drank immediately after it, or the body suffered suddenly to cool. Those who would avoid this disease ought therefore after speaking aloud, singing, running, drinking warm liquor, or doing any thing that may strain the throat, or increase the circulation of the blood towards it, to take care to cool gradually, and to wrap some additional covering about their necks. I have often known persons who had been subject to sore throats, entirely freed from that complaint by only wearing a riband, or a bit of flannel, constantly about their necks, or by wearing thicker shoes, a flannel waistcoat, or the like. These may seem trifling, but they have agreat effect. There is danger indeed in leaving them off after persona have been accustomed to them ; but surely the inconveniency of using such things for life, is not to be compared with the danger which may attend the neglect of them. Sometimes after an inflammation, the glands of the throat continue swelled, and become hard and callous. This complaint is not easily removed, and is often rendered dangerous by the too frequent appli- cation of strong stimulating and stypic medicines. The best method is to keep it warm, and to gargle it twice a-day with a decoction of figs, snarpeued a little with the elixir or spirit of vitriol. OF THE MALIGNANT QUINSEY, OR PUTRID ULCEROUS SORE THROAT. This kind of quinsey is but little known in the northern parts of Bri- tain, though for some time past it has been fatal in the more southern counties. Children are more liable to it than adults, females than males, and the delicate than those who are hardy and robust. It pre- vails chiefly in autumn, and is most frequent after a long course of damp sultry weather. Causes.—This is evidently a contagious distemper, and is generally commun cated by infection. Whole families, and even entire villages, often receive the infection from one person. This ought to put people upon their guard against going near such patients as labour under the 186 OF THE MALIGNANT dUINSEY, disorder ; as by that means they endanger not only their own lives, but likewise those of their friends and connexions. Whatever tends to produce putrid or malignant fevers, may likewise occasion the putrid ulcerous sore throat, as unwholesome air, damaged provisions, neglect of cleanliness, &c. Symptoms.—It begins with alternate fits of shivering and heat. The pulse is quick, but low and unequal, and generally continues so through the whole course of the disease. The patient complains greatly of weakness and oppression of the breast ; his spirits are low, and he is apt to faint away when set upright; he is troubled with a nausea, aud often with a vomiting or purging. The two latter are most common in children. The eyes appear red and watery, and the face swells. The urine is at first pale and crude ; but, as the disease advances, it turns more of a yellowish colour. The tongue is white, and generally moist, which distinguishes this from an inflammatory disease. Upon looking into the throat, it appears swelled, and of a florid red colour* Pale or ash coloured spots, however, are here and there interspersed, and sometimes one broad patch or spot, of an irregular figure, and pale white colour, surrounded with florid red, only appears. These whitish spots or sloughs cover so many ulcers. An efflorescence, or eruption upon the neck, arms, breast, and fin- gers, about the second or third day, is a common symptom of this dis- ease. When it appears, the purging and vomiting generally cease. There is often a slight degree of delirium, and the face frequently appears bloated, and the inside of the nostrils red and inflamed. The patient complains of a disagreeable putrid smell, and his breath is very offensive. The putrid ulcerous sore throat may be distinguished from the inflam- matory, by the vomiting and looseness with which it is generally ushered in ; the foul ulcers in the throat covered with a white or livid coat; and by the excessive weakness of the patient; with other symp- toms of a putrid fever. Unfavourable symptoms are, an obstinate purging, extreme weak- ness, dimness of the sight, a livid or black colour of the spots, and fre- quent shiverings, with a weak, fluttering pulse. If the eruption upon the skin suddenly disappears, or becomes of a livid colour, with a dis- charge of blood from the nose or mouth, the danger is very great. If a gentle sweat break out about the third or fourth day, and con- tinue with a slow, firm and equal pulse ! if the sloughs cast off in a kindly maimer, and appear clean and florid at the bottom : and if the breath- ing is soft and free, with a lively colour of the eyes, there is reason to hope for a salutary crisis. OR PUTRID ULCEROUS SORE THROAT. 197 Recimen.—The patient must be kept quiet, and for the most part in bed, as he will be apt to faint when taken out of it. His food must be nourishing and restorative; as sago-gruel with red wine, jellies, strong broths, &c. His drink ought to be'generous, and of au antiseptic quality ; as red wine negus, white wine whey, and such like. Medicine.—The medicine in this kind of quinsey is entirely different from that which is proper in the inflammatory. All evacuations, bleed- ing, purging, &c. which weaken the patient must be avoided. Cooling medicines, as nitre and cream of tartar, are likewise hurtful. Strength- ening cordials alone can be used with safety ; and these ought never to be neglected. If at the beginning there is a great nausea, or inclination to vomit, the patient must drink an infusion of green tea, camomile flowers, or carduus benedictus, in order to cleanse the stomach. If these are not sufficient, he may take a few grains of the powder of ipecacuanha, or any other gentle vomit. If the disease be mild, the throat may be gargled with an infusion of sage and rose leaves, to a gill of which may be added a spoouful or two of honey, and as much vinegar as will make it agreeably acid ; but when the symptoms are urgent, the sloughs large and thick, and the breath very offensive, the following gargle may be used :— To six or seven ounces of the pectoral decoction, when boiling, add half an ounce of contrayerva-root; let it boil for some time, and after- wards strain the liquor ; to which add two ounces of white-wine vinegar^ an ounce of fine honey, and an ounce of the tincture of myrrh. This ought not only to be used as a gargle, but a little of it should frequently be injected with a syringe to clean the throat before the patient takes any meat or drink. This method is peculiarly necessary for children, who cannot use a gargle. It will be of great benefit if the patient frequently receives into his mouth, through an inverted funnel the steams of warm vinegar, myrrh, and honey. But when the putrid symptoms run high, and the disease is attended with danger, the only medicine that can be depended upon is the Peru- vian bark. It may be taken in subsance, if the patient's stomach will bear it. If not, an ounce of bark grossly powdered, with two drains of Virginian snake-root, may be boiled with an English pint and a half of water to a half pint; to which a tea spoonful of the elixir of vitriol may be added, and an ordinary tea cupful of it taken every three or four hours. Blistering-plasters are very beneficial in this disease, espe- cially when the patient's pulse and spirits are low. They may be applied to the throat, behind the ears, or upon the back part of the neck. 188 OF THE MALIGNANT OUINSEY, ETC. Should the vomiting prove troublesome, it will be proper to give the patient two table-spoonfuls of the saline julap, every hour. Tea made of mint and a little cinnamon will be very proper for his ordinary drink, especially if an equal quantity of red wine be mixed with it. In case of a violent looseness, the size of a nutmeg of diascordium, or the japonic confection, may be taken two or three times a-day, or oftener, if necessary. If a discharge of blood from the nose happens, the steams of warm vinegar may be received up the nostrils frequently ; and the drink must be sharpened with spirits of vitriol, or tincture of roses. In cases of a strangury, the belly must be fomented with warm water, and emollient clysters given three or four times a-day. After the violence of the disease is over, the body should still be kept open with mild purgatives ; as manna, senna, rhubarb, or the like. If great weakness and dejection of spirits, or night-sweats, with other symptoms of a consumption, should ensue, we would advise the patient to continue the use of the Peruvian bark, with the elixir of vitriol, and to take frequently a glass of generous wine. These, together with a nourishing diet, and riding on horeback, are the most likely means for recovering his strength. The quinsey is generally caught by exposing the throat to a current of cold air from an open window in a room, or still more in a carriage, especially in cold damp weather, or in the night. The inflammatory sore throat is generally cured by the method of treatment recommended above ; yet sometimes there are cases where the patient loses the power of swallowing, and dies from the mere want of sustenance. An ingenious surgeon, in a case of this kind, saved his patient by fastening a funnel to the skin of an eel, open at both ends, and, by means of a flexible probe, pushing one end down the gullet till it entered the stomach, by which channel the proper sustenance was conveyed. In the malignant quinsey not a moment should be lost in procuring the best medical assistance that can be obtained ; the smallest delay may be attended with irreparable injury. 1S9 CHAP. XXIX. OF COLDS AND COUGHS. It has already been observed, that colds are the effect of an obstructed perspiration: the common causes of which we have likewise endea- voured to point out, and shall not here repeat them. Neither shall we spend time in enumerating all the various symptoms of colds, as they are pretty generally known. It may not however, be amiss to observe, that almost every cold is a kind of fever, which only differs in degree from some of those that have already been treated of. No age, sex, or constitution, is exempted from this disease ; neither is it in the power of any medicine or regimen to prevent it. The in- habitants of every climate are liable to catch cold, nor can even the greatest circumspection defend them at all times from its attacks. Indeed, if the human body could be kept constantly in an uniform degree of warmth, such a thing as catching cold would be impossible; but as that cannot be effected by any means, the perspiration must be liable to many changes. Such changes, however, when small, do not affect the health ; but, when great, they must prove hurtful. When oppression of the breast, a stuffing of the nose, unusual weari- ness, pain of the head, &c. give ground to believe that the perspiration is obstructed, or, in other words, that the person has caught cold, he ought immediately to lessen his diet, at least the usual quantity of his solid food, and to abstain from all strong liquors. Instead of flesh, fish, eggs, milk, and other nourishing diet, he may eat light bread- pudding, veal or chicken broth, panado, gruels, and such like. His drink may be water-gruel sweetened with a little honey; an infusion of balm, or linseed sharpened with the juice of bitter orange or lemoii; a decoction of barley and liquorice with tamarinds, or any other cool, diluting, acid liquor. Above all, his supper should be light; as small posset, or water-grnej sweetened with honey, and a little toasted bread in it. If honey should disagree with the stomach, the gruel may be sweetened with treacle or coarse sugar, aud sharpened with the jelly of currants. Those who have been accustomed to generous liquors may take wine-whey instead of gruel, which may be sweetened as above. The patient ought to lie longer than usual in bed, and to encourage a gcntla sweat, which is easily brought on towards morning by drinking tea or any kind of warm diluting liquor. I have often known thia 190 OF COLDS AN'/ COUUHS, practice carry off a cold in one day, which in all probability, had it been neglected, would have cost the patient his life, or have confined him for some months. Would people sacrifice a little time to ease and warmth, and practice a moderate degree of abstinence when the first symptoms of a cold appear, we have reason to believe that most of the bad effects which flow from an obstructed perspiration might be pre- vented. But after the disease has gathered strength by delay, all at- tempts to remove it often prove vain. A pleurisy, a peripneumony, or a fatal consumption of the lungs, are the common effects of colds which have either been totally neglected, or treated improperly. Many attempt to cure a cold by getting drunk ; but this, to say no worse of it, is a very hazardous experiment. No doubt it may some- times succeed, by suddenly restoring the perspiration ; but when there is any degree of inflammation^ which is frequently the case, strong liquors, instead of removing the malady, will increase it. By this means a common cold may be converted into an inflammatory fever. When those who labour for their daily bread have the misfortune to catch cold, they cannot afford to lose a day or two, in order to keep themselves warm, and take a little medicine ; by which means the dis- order is often so aggravated as to confine them for a long time, or even to render them ever after unable to sustain hard labour. But even such of the labouring poor as can afford to take care of themselves, are often too hardy to do it; they affect to despise colds, and as long as they can crawl about, scorn to be confined by what they call a common cold. Hence it is that colds destroy such numbers of mankind. Like an enemy despised, they gather strength from delay, till at length they become invincible. We often see this verified in travellers, who, rather than lose a day in the prosecution of their business, throw away their lives by pursuing their journey, even in the severest weather, with this disease upon them. It is certain, however, that colds may be too much indulged. When a person for every slight cold, shuts himself up in a warm room, and drinks great quantities of warm liquor, it may occasion such a general relaxation of the solids as will not be easily removed. It will, therefore, be proper, when the disease will permit, and the weather is mild, to join to the regimen mentioned above, gentle exercise; as walking, riding on horseback, &c. An obstinate cold, which no medicine will re- move, will yield to gentle exercise and a proper regimen of the diet. Bathing the feet and legs in warm water has a great tendency to restore the perspiration. But care must be taken that the water be not too warm, otherwise it will do hurt. It should never be much warmer than the blood, and the patient should go immediately to bed after using OF COLDS AND COUGHS. 191 it. Bathing the feet in warm water, lying in bed, and drinking warm water-gruel, or other weak liquors, will sooner take off a spasm, and restore perspiration, than all the hot sudorific medicines in the world. This is all that is necessary for removing a common cold : and if this course be taken at the beginning, it will seldom fail. But when the symptoms do not yield to abstinence, warmth, and diluting liquors, there is reason to fear the approach of some other dis- ease, as an inflammation of the breast, an ardent fever, or the like. If the pulse, therefore, be hard and frequent, the skin hot and dry, and the patient complains of his head, or breast, it will be necessary to bleed, and to give the cooling powders recommended in the scarlet fever, every three or four hours, till they give a stool. It will likewise be proper to put a blistering-plaster on the backi to give two table-spoonfuls of the saline mixture every two hours, and in short to treat the patient in all respects as for a slight fever. I have often seen this course, when observed at the beginning, remove the complaint in two or three days, when the patient had all the symptoms tf an approaching ardent fever, or an inflammation of the breast. The chief secret of preventing colds lies in avoiding, as far as pos- sible, all extremes either of heat or cold, and in taking care, when the body is heated, to let it cool gradually. These and other circumstances relating to this important subject are so fully treated of under the article Obstructed Perspiration, that it is needless here to resume the consideration of them. OF A COMMON COUGH. A cough is generally the effect of a cold, which has either been im- properly treated, or entirely neglected. When it proves obstinate, there is always reason to fear the consequences, as this shows the weak state of the lungs, and is often the forerunner of consumption. If the cough be violent, and the patient young and strong, with a hard quick pulse, bleeding will be proper; but in weak and relaxed habits, bleeding rather prolongs the disease. When the patient spits freely, bleeding is unnecessary, and sometimes hurtful, as it tends to lessen that discharge. When the cough is not attended with any degree of fever, and the Bpittle is viscid and tough, sharp pectoral medicines are to be adminis- tered ; as gum-ammoniac, squills, &c. Two table-spoonfuls of the solu- tion of gum-ammoniac may be taken three or four times a-day, more or less according to the age and constitution of the patient. Squills may be riven various ways, two ounces of the vinegar, the oxymel, or the 192 OF COLDS AND COUGHS. syrup, may be mixed with the same quantity of simple cinnamon water, to which may be added an ounce of balsamic syrup. Two table-spoon- fuls of this mixture may be taken three or four times a-day. A syrup made of equal parts of lemon juice, honey, and sugar-candyi is likewise very proper in this kind of cough. A table-spoonful of it may be taken at pleasure. But when the defluxion is sharp and thin, these medicines rather do hurt. In this case gentle opiates, oils, and mucilages, are more proper. A cup of an infusion of wild poppy leaves, and marsh-mallow roots, or the flowers of colts-foot, may be taken frequently ; or a tea-spoonful of paregoric elixir may be put into the patient'3 drink twice a-day. Ful- ler's Spanish infusion is also a very proper medicine in this case, and may be taken in the quantity of a tea-cupful three or four times a-day.* When a cough is occasioned by acrid humours tickling the throat and fauces, the patient should keep some soft pectoral lozenges almost con- stantly in his mouth : as the Pontefract liquorice-cakes, barley-sugar, the common balsamic lozenges, Spanish juice, &c. These blunt the acrimony of the humours, and, by taking off their stimulating quality, help to appease the cough.f In obstinate coughs, proceeding from a flux of humours upon the lungs, it will often be necessary besides expectorating medicines, to have recourse to issues, setons, or some other drain. In this case I have often observed the most happy effects from a Burgundy pitch plaster applied between the shoulders. I have ordered this simple remedy in the most obstinate coughs, in a great number of cases, and in many different constitutions, without ever knowing it fail to give relief, unless where there were evident signs of an ulcer in the lungs. About the bulk of a nutmeg of Burgundy pitch may be spread thin npon a piece of soft leather, about the size of the hand, and laid be- tween the shoulder-blades. It may be taken off and wiped every three or four days, and ought to be renewed once a fortnight or three weeks. This is indeed a cheap and simple medicine, and consequently apt to be despised; but we will venture to affirm, that the whole materia medica does not afford an application more efficacious in almost every kind of cough. It has not indeed always an immediate effect; but, if kept on for some time, it will succeed where most other medicines fail. * See Appendix, Spanish Infusion. t In a former edition of this book I recommended for an obstinate tickling cough, an oily emulsion, made with the paregoric elixir of the Edinburgh Dispensatory, instead of the common alkaline spirit. I have since been told by several practition- ers, that they found it to be an excellent medicine in this disorder, and every way deserving of the character which I had given it. Where this elixir is not kept, its piace may be supplied by adding to the common oily emulsion, an udequate propor- tion of the Thebaic Tincture, or liquid laudunum. OF COLDS AND COUGHS. 103 The only inconveniency attending this plaster is the itching which it occasions ; but surely this may be dispensed with, considering the ad- vantage which the patient may expect to reap from the application ; besides, when the itching becomes very uneasy, the plaster may be taken off, and the part rubbed with a dry cloth, or washed with a little warm milk and water. Some caution indeed is necessary in disconti- nuing the use of such a plaster : this, however, may be safely done by making it smaller by degrees, and at length quitting it altogether in a warm season.* But coughs proceed from many other causes besides defluxions upon the lungs. In these cases the cure is not to be attempted by pectoral medicines. Thus, in a cough, proceeding from a foulness and debility of the stomach, syrups, oils, mucilages, and all kinds of balsamic medi- cines do hurt. The stomach cough may be known from one that is owing to a fault in the lungs by this, that in the latter the patient coughs whenever he inspires, or draws in his breath fully ; but in the former that does not happen. The cure of this cough depends chiefly upon cleansing and strength- ening the stomach ; for which purpose gentle vomits and bitter purga- tives are most proper. Thus, after a vomit or two, the sacred tincture, as it is called, may be taken for a considerable time in the dose of one or two table spoonsful twice a-day, or as often as it is found necesary, to keep the body gently open. People may make this tincture them- selves, by infusing an ounce of hierapicraf in an English pint of white wine, letting it stand a few days, and then straining it off for use. In coughs which proceed from a debility of the stomach, the Peru- vian bark is likewise of considerable service. It may either be chewed, taken in powder, or made into a tincture along with other stomachic bitters. . A nervous cough can only be removed by change of air and proper exercise ; to which may be added the use of gentle opiates. Instead of the saponaceous pill, paragoric elixir, &c. which are only opium disguised, ten, fifteen, twenty, or twenty-five drops of liquid laudanum, more or less, as circumstances require, may be taken at bed-time, or when the cough is most troublesome. Immersing the feet and hauda in warm water will often appease the violence of a nervous cough. When a cough is only the symptom of some other malady, it is vain to attempt to remove it without first curing the disease from which id l-i- thot tl,p nitch Blaster adheres too fast, while others rind ditii- ,* S°mLCPe H on. T , s p oceeSs from the afferent kinds of pitch made use of, culty m keeprig it on. 11 » v j u>rall. flud it aiiswer best when a"d HUwut a Httfe V"; Xx. an™ spread at. cool a. po»ible. The clear, hard, transparent pitch answers the purpose best. fiSee AU'«ndix> ■"'"** ■P,,ra- O 134 OF THE HOOPING-COUGH, proceeds. Thus when a cough is occasioned by teething,—keeping the body open, scarifying the gums, or whatever facilitates the cutting of the teeth, likewise appeases the cough. In like manner, when worms occasion a cough, such medicines as remove those vermin will generally cure the cough ; as bitter purgatives, oily clysters, and such like. Women, during the last months of pregnancy, are often greatly afflicted with a cough, which is generally relieved by bleeding and keep- ing the body gently open. They ought to avoid all flatulent food, and to wear a loose easy dress. A cough is not only a symptom, but is often likewise the forerunner of diseases. Thus the gout is frequently ushered in by a very trouble- some cough, which affects the patient for some days before the coming on of the fit. This cough is generally removed by a paroxysm of the gout, which should therefore be promoted, by keeping the extremi- ties warm, drinking warm liquors, and bathing the feet and legs fre- quently in lukewarm water. OF THE HOOPING-COUGH, OR CHIN-COUGH. This cough seldom affects adults, but proves often fatal to children. Such children as live upon thin watery diet, who breathe unwholesome air, and have too little exercise, are most liable to this disease, and generally suffer most from it. The chin-cough is so well known even to nurses, that a description of it is unnecessary. Whatever hurts the digestion, obstructs the per- spiration, or relaxes the solids, disposes to this disease ; consequently its cure must depend upon cleansing and strengthening the stomach, bracing the solids, and at the same time promoting perspiration and the different secretions. The diet must be light, and of easy digestion ; for children, 'good bread made into pap or pudding, chicken-broth, with other light spoon- meats, are proper ; but those who are farther advanced may be allowed sago-gruel, and if the fever be not high, a little boiled chicken, or other white meats. The drink may be hyssop, or penny-royal tea sweetened with honey or sugarcandy, small wine whey, or, if the patient be weak, he may sometimes be allowed a little negus. One of the most effectual remedies in the chin-cough is change of air. This often removes the malady, even when the change seems to be from a purer to a less wholesome air. This may in some measure depend on the patient's being removed from the place where the in- fection prevails. Most of the diseases of children are infectious ; nor is it at all uncommon to find the chin-cough prevailing in one town or OR CHIN-COUGH. 195 Tillage, when another at a very small distance is quite free from it. But whatever be the cause we are sure of the fact. No time ought therefore to be lost in removing the patient to some distance from the place where he caught the disease, and, if possible, into a more pure and warm air.* When the disease proves violent, and the patient is in danger of being suffocated by the cough, he ought to be bled, especially if there be a fever with a hard full pulse. But the chief intention of bleeding is to prevent an inflammation of the lungs, and to render it more safe to give vomits, it will seldom be necessary to repeat the operation ; yet if there are symptoms of an inflammation of the lungs, a second or even a third bleeding may be requisite. It is generally reckoned a favourable symptom when a fitof coughing makes the patient vomit. This cleanses the stomach, and greatly relieves the cough. It will therefore be proper to promote this discharge, either by small doses of ipecacuanha, or the vomiting julap recommended in the Appendix.f It is very difficult to make children drink after a vomit. I have often seen them happily deceived, by infusing a scruple or half a dram of the powder of ipecacuanha in a teapot, with half an English pint of boiling water. If this be disguised with a few drops of milk and a little sugar, they will imagine it tea, and drink very greedily. A small teacupful of this may be given every ten minutes, till it operates. When the child begins to puke, there will be no occasion for drinking any more, as the water already on the stomach will be sufficient. Vomits not only cleanse the stomach, which in this disease is gene- rally loaded with viscid phlegm, but they likewise promote the perspira- tion and other secretions, aud oaght therefore to be repeated according to the obstinacy of the disease. They should not however be strong ; gentle vomits frequently repeated are both less dangerous and beneficial than strong ones. The body ought to be kept gently open. The best medicines for this purpose are rhubarb and its preparations, as the syrup, tincture, &c Of these a tea-spoonful or two may be given to an infant twice or thrice a-day, as there is occasion. To such as are further advanced, the dose must 'be proportionably increased, and repeated till it has the desired effect. Those who cannot be brought to take the bitter tincture, may * Some think the air ought not to be changed till the disease is on the decline j ■. ? Z™ seems to be no sufficient reason for this opinion, as patients have been but there seems ™R™rom ft cnange of air at all periods of the disease. It is n..t *^o„t to take the patient out daily in a carriage. This seldom answers any good purpose ; but often does hurt .by gi.lng him cold. P t See Appendix, VomUmg Julap. 196 OF THE HOOPING-COUGH, ETC have an infusion of 6enna and prunes, sweetened with manna, coarse sugar, or honey, or a few grains of rhubarb mixed with a tea-spoonful or two of syrup, or currant-jelly, so as to disguise the taste. Most children are fond of syrups and jellies, and seldom refuse even a disa- greeable medicine when mixed with them. Many people believe that oily, pectoral, and balsamic medicines pos- sess wonderful virtues for the cure of the chin-cough, and accordingly exhibit them plentifully to patients of every age and constitution, with- out considering that every thing of this nature must load the stomach, hurt the digestion, and of course aggravate the disorder.* The millepedes, or wood-lice, are greatly recommended for the cure of a chin-cough. Those who choose to make use of these insects may infuse two ounces of them bruised in an English pint of small white wine for one night. Afterwards the liquor may be strained through a cloth, and a table-spoonful of it given to the patient three or four times a-day. Opiates are sometimes necessary to allay the violence of the cough. For this purpose a little of the syrup of poppies, or five, six, or seven drops of laudanum, according to the age of the patient, may be taken in a cup of hyssop or penny-royal tea, and repeated occasionally.* The garlic ointment is a well known remedy in North Britain, for the chin-cough. It is made by beating in a mortar garlic with an equal quantity of hogslard. With this the soles of the feet may be rubbed twice or thrice a-day : but the best method is to spread it upon a rag, and apply it in the form of a plaster. It should be renewed every night and morning at least, as the garlic soon loses its virtues. This is an exceeding good medicine both in the chin-cough,J and in most other coughs of an obstinate nature. It ought not, however, to be used when the patient is very hot and feverish, lest it should increase these symptoms. The feet should be bathed once every two or three days in luke- warm water ; and a Burgundy-pitch plaster kept constantly between the shoulders. But when the disease proves very violent, it will be neces- sary, instead of it, to apply a blistering-plaster, and to keep the part open for some time with issue ointment. * Dr. Duplanil says, he has seen many good effects from the kermes mineral in this complaint, the cough being frequently alleviated even by the first dose. The dose for a child of one year old is a quarter of a grain dissolved in a cup of any liquid, repeated two or three times a-day. For a child of two years the dose is half a grain ; and the quantity must be thus increased in proportion to the age of the patient. t Some recommend the extract of hemlock as an extraordinary remedy in the hooping cough; but. so far as I have been able to observe, it is no way superior to opium, which, when properly administered, will often relieve some of the most troublesome symptoms of this disorder. X As this disease is evidently spasmodic, I am inclined to think that tonic medi« eines wiil in time be found the most proper for its cure. INFLAMMATION OF THE STOMACH, ETC. 197 When the disease is prolonged, and the patient is free from fever, the Peruvian bark and other bitters are the most proper medicines. The bark may either be taken in substance, or in a decoction or infusion, as is most agreeable. For a child, ten, fifteen, or twenty grains, ac- cording to the age of the patient, may be given three or four times a-day. For an adult, half a dram or two scruples will be proper. Some give the extract of the bark with cantharides ; but to manage this requires a considerable attention. It is more safe to give a few grains of castor along with the bark. A child of six or seven years of age may take seven or eight grains of castor, with fifteen grains of powdered bark, for a dose. This may be made into a mixture, with two or three ounces of any simple distilled water, and a little syrup, and taken three or four times a-day. CHAP. XXX, INFLAMMATION OF THE STOMACH AND OTHER VISCERA. All inflammations of the bowels are dangerous, and require the most speedy assistance ; as they frequently end in a suppuration, and some- times in a mortification, which is certain death. Causes.—An inflammation of the stomach may proceed from any of the causes which produce an inflammatory fever; as cold liquor drank while the body is warm, obstructed perspiration, or the sudden striking in of any eruption. It may likewise proceed from the acri- mony of the bile, or from acrid and stimulating substances taken into the stomach ; as strong vomits or purges, corrosive poisons, and such like. When the gout has been repelled from the extremities, either by cold or improper applications, it often occasions an inflammation of the stomach. Hard or indigestible substances taken into the stomach, as bones, the stones of fruits, &c. may likewise have that effect. Symptoms.—It is attended with a fixed pain and burning heat in the stomach: great restlessness and anxiety ; a small, quick, and hard milse • vomiting, or at least a nausea, and sickness ; excessive thirst; coldness of the extremities: difficulty of breathing ; cold clammy sweats; and sometimes convulsions and fainting fits. The stomach is swelled, and often feels hard to the touch. One of the most certain signs of tins disease is the sense of pain which the patient feels upon taking any kind „f food, or drink, especially if it be either too hot or too cold. 198 INFLAMMATION OF THE STOMACH, ETC. When the patient vomits every thing he eats or drinks, is extremely restless, has a hiccup, with an intermitting pulse, and frequent fainting fits, the danger is very great. Regimen.—All acrimonious, heating, and irritating food and drink are carefully to be avoided. The weakness of the patient may deceive the by-standers, and induce them to give him wines, spirits, or other cordials ; but these never fail to increase the disease, and often occa- sion sudden death. The inclination to vomit may likewise impose on the attendants, and make them think a vomit necessary ; but that too is almost certain death. The food must be light, thin, cool, and easy of digestion. It may be given in small quantities, and should neither be quite cold, nor too hot. Thin gruel made of barley or oat-meal, light toasted bread dissolved in boiling water, or very weak chicken-broth, are the most proper. The drink should be clear whey, barley-water, water in which toasted bread has been boiled, or decoctions of emollient vegetables, as liquorice, and marshmallow roots, sarsaparilla, or the like. Medicine.—Bleeding in this disease is absolutely necessary, and is almost the only thing that can be depended on. When the disease proves obstinate, it will often be proper to repeat this operation several times; nor must the low state of the pulse deter us from doing so. The pulse indeed generally rises upon bleeding, and as long as that is the case, the operation is safe. Frequent fomentations with lukewarm water, or a decoction of emol- lient vegetables, are likewise beneficial. Flannel cloths dipped in these must be applied to the region of the stomach, and removed as they grow cool. They must neither be applied too warm, nor be suffered to continue till they become quite cold, as either of these extremes would aggravate the disease. The feet and legs ought likewise to be frequently bathed in luke- warm water, and warm'bricks or poultices may be applied to the soles of the feet. The warm bath, if it can be conveniently used, will be of great service. In this, and all other inflammations of the bowels, an epispastic or blistering-plaster applied over the part affected, is one of the best reme- dies I know. I have often used it, and do not recollect one instance wherein it did not give relief to the patient. The only internal medicines which we shall venture to recommend in this disease, are mild clysters. These may be made of warm water, or thin water-gruel ; and if the patient be costive, a little sweet oil, honey, or manna, may be added. Clysters answer the purpose of an internal fomentation, while they keep the body open, and at the same INFLAMMATION OF THE INTESTINE1?. 1^9 time nourish the patient, who is often in this. disease unable to retain any food upon his stomach. For these reasons they must not be neg- lected, as the patient's life may depend on them. INFLAMMATION OF TIIE INTESTINES. This is one of the most painful and dangerous diseases to which man- kind are liable. It generally proceeds from the same causes as the inflammation of the stomach ; to which may be added costiveness, worms, eating unripe fruits, or great quantities of nuts, drinking hard windy malt liquors, as stale bottled beer or ale, sour wine, cider, &c. It may likewise be occasioned by a rupture, by schirrous tumours of the intestines, or by their opposite sides growing together. The inflammation of the intestines is denominated Iliac Passion, Enteritis, 8cc. according to the name of the parts affected. The treat- ment, however, is nearly the same whatever part of the intestinal canal be the seat of the disease ; we shall therefore omit these distinctions, lest they should perplex the reader. The symptoms here are nearly the same as in the foregoing disease ; only the pain, if possible, is more acute, and is situated lower. The vomiting is likewise more violent, and sometimes even the excrements, together with the clysters, are discharged by the mouth. The patient is continually belching up wind, and has often an obstruction of his urine. While the pain shifts, and the vomiting only returns at certain inter- vals, and while the clysters pass downwards, there is ground for hope ; but when the clysters and faeces are vomited, and the patient is exceeding weak, with a low fluttering pulse, a pale countenance, and a disagree- able or stinking breath, there is great reason to fear the consequences will prove fatal. Clammy sweats, black foetid stools, with a small inter- mitting pulse, and a total cessation of pain, are the signs of a mortifi- cation already begun, and of approaching death. RiiGiMEN.—The regimen in this disease is in general the same as in an inflammation of the stomach. The patient must be kept quiet, avoiding cold, and all violent passions of the mind. His food ought to be very light, and given in small quantities; his drink weak and diluting; as clear whey, barley-water, and such like. Medicine-Bleeding in this, as well as in the inflammation of the rtomach, is of the greatest importance. It should be performed as soon as the symptoms appear, and must be repeated according to the Btrensth of the patient, and the violence of the disease. A blistering-plaster is here likewise to be applied immediately over the part where the most violent pain is. £0f> INFLAMMATION OF THE INTESTINES. This not only relieves the pain of the bowels, but even clysters, and purgative medicines, which before had no effect, will operate when the blister begins to rise. Fomentations and laxative clysters are by no means to be omitted. The patient's feet and legs should frequently be bathed in warm water ; and cloths dipped in it applied to his belly. Bladders filled with warm water may likewise be applied to the region of the navel, and warm bricks, or bottles filled with warm water, to the soles of the feet. The clysters may be made of barley-water, or thin gruel with salt, and soft- ened with sweet oil or fresh butter. These may be administered every two or three hours, or oftener, if the patient continues costive. If the disease does not yield to clysters and fomentations, recourse must be had to pretty strong purgatives ; but as these, by irritating-the bowels, often increase their contraction, and by that means frustrate their own intention, it will be necessary to join them with opiates, which by allaying the pain, and relaxing the spasmodic contractions of the guts, greatly assist the operation of purgatives in this case. What answers the purpose of opening the body very well is a solution of the bitter purging salts. Two ounces of these may be dissolved in an English pint of warm water or thin gruel, aud a tea-cupful of it taken every half hour till it operates. At the same time fifteen, twenty, or twenty-five drops of laudanum may be given in a glass of peppermint or simple cinnamon-water, to appease the irritation, and prevent the vomiting, &c. Acids have often a very happy effect in staying the vomiting, and appeasing the other violent symptoms of this disease. It will therefore be of use to sharpen the patient's drink with cream of tartar, juice of lemon, or, when these cannot be obtained, with vinegar. But it often happens that no liquid whatever will stay on the stomach. In this case the patient must take purging pills. I have generally found the following answer very well: Take julap in powder, and vitriolated tartar, of each half a dram, opium one grain, Castile soap as much as will make the mass fit for pills. These must be taken at one dose, and if they do not operate in a few hours, the dose may be repeated. If a stool cannot be procured by any of the above means, it will be necessary to immerse the patient in warm water, up to the breast. I have often seen this succeed when other means had been tried in vain. The patient must continue in the water as long as he can easily bear it without fainting, and if one immersion has not the desired effect, it may be repeated as soon as the patient's strength and spirits are recruited. It is more safe for him to go frequently into the bath, OF THE COLIC. 201 than to continue long at a time ; and it is often necessary to repeat it several times before it has the desired effect. It has sometimes happened, after all other means of procuring a Btool had been tried to no purpose, that this was brought about by im- mersing the patient's lower extremities in cold water, or making him walk upon a wet pavement, and dashing his legs and thighs with the cold water. This method, when others fail, at least merits a trial. It is indeed attended with some danger: but a doubtful remedy is better than none. In desperate cases it is common to give quicksilver. This may be given to the quantity of several ounces, or even a pound, but should not exceed that.* When there is reason to suspect a mortfication of the guts, this medicine ought not to be tried. In that case it cannot cure the patient, and will only hasten his death. But when the obstruction is occasioned by any cause that can be removed by force, quicksilver is not only a proper medicine, but the best that can be administered, as it is the fittest body we know for making its way through the intestinal canal. If the disease proceeds from a rupture, the patient must be laid with his head very low, and the intestines returned by gentle pressure with his hand. If this, with fomentations and clysters, should not succeed, recourse must be had to surgical operation, which may give the patient relief. Such as would avoid this excruciating and dangerous disease, must take care never to be too long without a stool. Some who have died of it have had several pounds of hard dry faces taken out of their guts. They should likewise beware of eating too freely of sour or unripe fruits, or drinking stale windy liquors, &c. I have known it brought on by living too much on baked fruits, which are seldom good. It like- wise proceeds frequently from cold caught by wet clothes, &c. but especially from wet feet. OF THE COLIC. The colic has a great resemblance to the two preceding diseases, both in its symptoms and method of cure. It is generally attended with costiveness and acute pain of the bowels ; and requires diluting diet, evacuations, fomentations, &.c. Colics are variously denominated according to their causes, as the flatulent, the bilious, the hysteric, the nervous, &c. As each of these * When quicksilver is given in too large quantities it defeats its own intention, as it drags down the bottom of the stomach, which prevents its getting over the Pylo- rus. In thi< case the patient should be suspended by the heels, in order that the quicksilver may be disobliged by the mouth. 202 OF TIIE COLIC. requires a particular method of treatment, we shall point out their most general symptoms, and the means to be used for their relief. The flatulCnt, or wind colic, is generally occasioned by an indiscreet use of unripe fruits, meats of hard digestion, windy vegetables, fermented 'iquors, and such like. It may likewise proceed from an obstructed perspiration, or catching cold. Delicate people, whose digestive powers are weak, are most liable to this kind of colic. The flatulent colic may either affect the stomach or intestines. It is attended with a painful stretching of the affected part. The patient feels a rumbling in his bowels, and is genereally relieved by a discharge of wind either upwards or downwards. The pain is seldom confined to any particular part, as the vapour wanders from one division of the bowels to another, till it finds a vent. When the disease proceeds from windy liquor, green fruits, sour herbs, or the like, the best medicine on the first appearance of the symptoms is a dram of brandy, gin, or any good spirits. The patient should likewise sit with his feet upon a warm hearth-stone, or apply warm bricks to them : and warm cloths may be applied to his stomach and bowels. This is the only colic wherein ardent spirits, spiceries, or any thing of a hot nature, may be ventured upon. Nor indeed are they to be used here unless at the very beginning, before any symptoms of inflamma- tion appear. We have reason to believe that the colic occasioned by windy or flatulent food might always be cured by spirits and warm liquors, if they were taken immediately upon perceiving the first unea- siness ; but when the pain has continued for a considerable time, aud there is reason to fear an inflammation of the bowels is already begun, all hot things are to be avoided as poison, and the patient is to be treated in the same manner as for the inflammationof the intestines. Several kinds of food, as honey, eggs, &c. occasion colics in some particular constitutions. I have generally found the best method of cure for these was to drink plentifully of small diluting liquors, as water- gruel, small posset, toast and water, &c. Colics which proceed from excess and indigestion, generally cure themselves by occasioning vomiting or purging. These discharges are by no means to be stopped, but promoted by drinking plentifully of warm water or weak posset. When their violence is over, the patient may take a dose of rhubarb, or any other gentle purge, to carry off the dregs of his debauch. Colics which are occasioned by wet feet, by catching cold, may ge- nerally be removed at the beginning by bathing the feet and legs in warm water, and drinking such warm diluting liquors as will promote OF THE COLIC. 203 the perspiration, as weak wiue-whey, or water gruel, with a small quantity of spirits in it. Those flatulent colics which prevail so much among country people, might generally be prevented were they careful to change their clothes when they get wet. They ought likewise to take a dram, or to drink 6ome warm liquor after eating any kind of green trash. We do not mean to recommend the practice of dram drinking, but in this case ardent spirits prove a real medicine. A glass of good peppermint water will have nearly the same effect as a glass of brandy, and in some cases is rather to be preferred. The bilious colic is attended with very acute pains about the region of the navel. The patient complains of great thirst, and is generally costive. He vomits a hot, bitter, yellow-coloured bile, which, being discharged, seems to afford some relief, but is quickly followed by the same violent pain as before. As the distemper advances, the propensity to vomit sometimes increases so as to become almost continual, and the proper motion of the intestines is so far perverted that there are all the symptoms of an impending iliac passion. If the patient be young and strong, and the pulse full and frequent, it will be proper to bleed, after which clysters niay be administered. Clear whey or gruel, sharpened with the juice of lemon,] or cream of tartar, must be drank freely. Small chicken-broth, with a little manna dis- solved in it, or a slight decoction of tamarinds, is likewise very proper, or any other thin, acid, opening liquor. Besides bleeding and plentiful dilution, it will be necessary to foment the belly with cloths dipped in warm water, and if this should not suc- ceed, the patient must be immersed up to the breast in warm water. In the bilious colic the vomiting is often very difficult to restrain. When this happens, the patient may drink a decoction of toasted bread, or an infusion of garden mint in boiling water. Should these not have the desired effect, the saline draught, with a few drops of laudanum in it, may be given aud repeated according to the urgency of the symptoms. A small quantity of Venice treacle may be spread in form of a cataplasm, and applied to the pit of the stomach. Clysters, with a proper quantity of Venice treacle, or liquid laudanum in them, may likewise be frequently administered. The hysteric colic bears a great resemblance to the bilious. It is attended with acute pains about the region of the stomach, vomiting, &c. What the patient vomits in this case is commonly of a greenish colour. There is a great sinking of .the spirits, with dejection of mind and difficulty of breathing, which are the characteristic symptoms of this disorder. Sometimes it is accompanied with the jaundice, but this generally goes off of its own accord in a few days. 204 OF THE COLIC. In this colic all evacuations, as bleeding, purging, vomiting, &c. do hurt. Every thing that weakens the patient, or sinks the spirits, is to be avoided. If, however, the vomiting should prove violent, luke- warm water, or small posset, may be drank to cleanse the stomach- Afterwards the patient may take fifteen, twenty, or twenty-five drops of liquid laudanum in a glass of cinnamon-water. This may be repeated every ten or twelve hours, till the symptoms abate. The patient may likewise take four or five of the foetid pills every six hours, and drink a cup of penny-royal tea after them. If assafoetida should prove disagreeable, which is sometimes the case, a tea-spoonful of the tincture of castor in a cup of penny-royal tea, or thirty or forty drops of the balsam of Peru, dropped upon a bit of loaf-sugar, may be taken in its stead. The anti-hysteric plaster may also be used, which has often a good effect.* The nervous colic prevails among miners, smelters of lead, plumbers, and manufacturers of white lead, &c. It is very common in the cider counties of England, and is supposed to be occasioned by the leaden vessels used in preparing that liquor. It is likewise a frequent disease in the West Indies, where it is termed the dry belly ache. No disease of the bowels is attended with more excruciating pain than this. Nor is it soon at an end. I have known it continue eight or ten days with very little intermission, the body all the while con- tinuing bound in spite of medicine, yet at length yield, and the patient recover.T It generally, however, leaves the patient weak, and often ends in a palsy. Tiie general treatment of this disease is so nearly the same with that of the iliac passion, or inflammation of the bowels, that we shall not insist upon it. The body is to be opened by mild purgatives given in small doses, and frequently repeated, and their operation must be assisted by soft oily clysters, fomentations, &c. The castor oil is reckoned peculiarly proper in this disease. It may be both mixed with the clysters and given by the mouth.J The Barbadoes tar .is said to be an efficacious medicine in this com- plaint. It may be taken to the quantity of two drams three times a- day, or oftener if the stomach will bear it. This tar, mixed with an equal quantity of strong rum, is likewise proper for rubbing the spine, ill case any tingling, or other symptoms of the palsy, are felt. When * See Appendix, Anti-hysteria Plaster. t As the smoke of tobacco thrown into the bowels will often procure a stool when all other means have failed, an apparatus for this purpose ought to be kept by every surgeon. It may be purchased at a small expense, and will be of service in several other cases, as the recovery of drowned persons, 4c. $ The dose is from one table-spooiitul to two or three, if necessary, to open the bod/. INFLAMMATION OF THE KIDNEYS. 205 the tar cannot be obtained, the back may be rubbed with strong spirits, or a little oil of nutmegs, or of rosemary. If the patient remain weak and languid after this disease, he must take exercise on horseback, and an infusion of the Peruvian bark in wine. When the disease ends in a palsy, the Bath waters are found to be extremely proper. To avoid this kind of colic, people must shun all sour fruits, acid and austere liquors, &c. Those who work in lead ought never to go to their business fasting, and their food should be oily or fat. They may take a glass of salad oil, with a little brandy or rum, every morning, but should never take spirits alone. Liquid aliment is best for them; as fat broths, &c. but low living is bad. They should frequently go a little out of the tainted air; and should never suffer themselves to be costive. In the West Indies, and on the coast of Guinea, it has been found of great use, for preventing this colic, to wear a piece of flannel round the waist, and to drink an infusion of ginger by way of tea. Sundry other kinds of this disease might be mentioned; but too many distinctions would tend only to perplex the reader. Those already mentioned are the most material, and should indeed be attended to, as their treatment is very different. But even persons who are not in a condition to distinguish very accurately in these matters, may never- theless be of great service to patients in colics of every kind, by only observing the following general rules, viz. To bathe the feet and legs iu warm water ; to apply bladders filled with warm water or cloths wrung out of it, to the stomach and bowels ; to make the patient drink freely of diluting mucilaginous liquors ; and to give him an emollient clyster every two or three hours. Should these not succeed, the patient ought to be immersed in warm water. INFLAMMATION OF THE KIDNEYS.' Causes.__This disease may proceed from any of those causes which produce an inflammatory fever. It may likewise be occasioned by wounds or bruises of the kidneys ; small stones or gravel lodging within them ; by strong diuretic medicines; as spirits of turpentine, tincture of cantharides, &c. Violent motion, as hard riding or walking, especially in hot weatln r, or whatever drives the blood too forcibly into the kid- neys, may occasion this malady. It may likewise proceed from lying too soft, too much on the back, involuntary contractions, or spasms, in the urinary vessels. Symptoms.—There is a sharp pain about the region of the kidneys, v ith some degree of fever, and a stupor or dull pain in the (high of the £06 INFLAMMATION OF THE KIDNEYS. affected side. The urine is at first clear, and afterwards of a reddish colour; but in the worst kind of the disease it generally continues pale, is passed with difficulty, and commonly in small quantites at a time. The patient feels great uneasiness when he endeavours to sit or walk upright. He lies with most ease on the affected side, and has generally a nausea or vomiting, resembling that which happens in the colic. This disease, however, may be distinguished from the colic by the pain being seated farther back, and by the difficulty of passing urine, with which it is constantly attended. Regimen.—Every thing of a heating or stimulating nature is to be avoided. The food must be thin and light ; as panado, small broths, with mild vegetables, and the like. Emollient and thin liquors must be plentifully drank ; as clear whey, or balm-tea sweetened with honey, decoctions of marsh-mallow roots, with barley and liquorice, &c. The patient, notwithstanding the vomiting, must constantly keep sipping small quantities of these or other diluting liquors. Nothing so safely and certainly abates the inflammation, and expels the obstructing cause as copious dilution. The patient must be kept easy, quiet, and free from cold, as long as any symptoms of inflammation remain. Medicine.—Bleeding is generally necessary, especially at the be- ginning. Ten or twelve ounces may be let from the arm or foot with a lancet; and if the pain and inflammation continue, the operation may be repeated in twenty-four hours, especially if the patient be of a full habit. Leeches may likewise be applied to the haemorrhoidal veins, as a discharge from these will greatly relieve the patient. Cloths dipped in warm water, or bladders filled with it, must be ap- plied as near as possible to the part affected, and renewed as they grow cool. If the bladders be filled with a decoction of mallows and camo- mile-flowers, to which a little saffron is added, and mixed with about a third part of new milk, it will be still more beneficial. Emollient clysters ought frequently to be administered : and if these do not open the body, a little salt and honey, or manna, may be added to them. The same course is to be followed where gravel or a stone is lodged in the kidney, but when the gravel or stone is separated from the kidney, and lodges in the ureter,* it will be proper, besides the fomen- tations, to rub the small of the back with sweet oil, and to give gentle diuretics ; as juniper-water, sweetened with the syrup of marsh-mal- * The ureters are two long and slender canals, one on each side, which carry the urine from the basin of the kidneys to the bladder. They are sometimes obstructed by small pieces, of gravel falling down from the kidceys, uud lodging in them. INFLAMMATION OF THE BLADDER. 207 lows ; a tea-spoonful of the sweet spirits of nitre, with a few drops oi laudanum may now and then be put in a cup of the patient's drink. 11 e ought likewise to take exercise on horseback, or in a carriage, if he be able to bear it. When the disease is protracted beyond the seventh or eighth dayf and the patient complains of a stupor or heaviness of the part, has fre- quent returns of chilliness, shivering, &c. there is reason to suspect that matter is forming in the kidney, and that an abscess will ensue. When matter in the urine shows that an ulcer is already formed in the kidney, the patient must be careful to abstain from all acrid, sour, and salted provisions; and to live chiefly upon mild mucilaginous herb3 and fruits, together with the broth of young animals, made with barley aud common pot-herbs, &c. His drink may be whey and butter- milk that is not sour. The latter is by some reckoned a specific remedy in ulcers of the kidney. To answer this character, however, it must be drank for a considerable time. Chalybeate waters have likewise been found beneficial in this disease. This medicine is easily obtained, as it is found in every part of Great Britain. It must likewise be used for a considerable time, in order to produce any salutary effects. Those who are liable to frequent returns of inflammation, or obstruc- tions of the kidneys, must abstain from wines, especially such as abound with tartar; and their food ought to be light and easy of digestion. They should use moderate exercise, not lie too hot, nor too much on their back, and avoid costiveness. INFLAMMATION OF THE BLADDER. The inflammation of the bladder proceeds in a great measure from the same causes as that of the kidneys. It is known by an acute pain towards the bottom of the belly, and difficulty of passing urine, with some degree of fever, a constant inclination to go to stool, and a perpe- tual desire to make water. This disease must be treated on the same principles as the one imme- diately preceding. The diet must be light and thin, and the drink of a cooling nature. Bleeding is very proper at the beginning, and in robust constitutions it will often be necessary to repeat it. The lower part of the body should be fomented with warm water, or a decoction of mild vcetables ; and emollient clysters ought frequently to be administered. The patient should abstain from every thiDg that is of a hot, acrid, and stimulating quality ; and should live entirely upon small broths, gruels, or mild vegetables. A stoppage of urine may proceed from other causes besides an in- *Ui!> INFLAMMATION OF THE LIVER. flammation of the bladder ; as a swelling of the hsemorrhoirfal veins ; hard faxes lodged in the rectum ; a stone in the bladder, excrescences in the urinary passages, a palsy of the bladder, hysteric affections, &c. Each of these requires a particular treatment, which does not fall nnder our present consideration. We shall only observe, that in all of them mild and gentle applications are the safest, as strong diuretic medicines, or things of an irritating nature, generally increase the danger. I have known some persons kill themselves by introducing probes into the urinary passages, to remove, as they thought, somewhat that obstructed the discharge of urine ; and others bring on a violent inflammation of the bladder, by using strong diuretics, as oil of turpen- tine, &c. for that purpose. INFLAMMATION OF THE LIVER. The liver is less subject to inflammation than most of the other viscera, as in it the circulation is slower; but when an inflammation does happen, it is with difficulty removed, and often ends in a suppuration or schirrus. Causes.—Besides the common causes of inflammation, we may here reckon the following, viz. excessive fatness, a schirrus of the liver itself, violent shocks from strong vomits when the liver was before un- sound, an adust or atrabilarian state of the blood, any thing that sud- denly cools the liver after it has been greatly heated, stones obstruct- ing the course of the bile, drinking strong wines and spirituous liquors, using hot, spicy aliment, obstinate hypochondriacal affections, &c. Symptoms.—This disease is known by a painful tension of the righs side under the false ribs, attended with some degree of fever, a sense of weight, or fulness of the part, difficulty of breathing, loathing of food, great thirst, with a pale or yellowish colour of the skin and eyes. The symptoms here are various, according to the degree of inflamma- tion, and likewise according to the particular part of the liver where the inflammation happens. Sometimes the pain is so inconsiderable that an inflammation is not so much as suspected ; but when it happens in the upper or convex part of the liver, the pain is more acute, the pulse quicker, and the patient is often troubled with a dry cough, a hiccup, and a pain extending to the shoulder, with difficulty of lying on the left side, &c. This disease may be distinguished from the pleurisy by the pain being less violent, seated under the false ribs, the pulse not so hard, and by the difficulty of lying on the left side. It may be distinguished from the hysteric and hypochondriac disorders by the degree of feve* with which it is always attended. INFLAMMATION OF THE LIVER. 209 This disease, if properly treated, is seldom fatal. A constant hiccup- ing violent fever, and excessive thirst, are bad symptoms. If it end3 in a suppuration, and the matter cannot be discharged outwardly, the danger is great. When a schirrus of the liver ensues, the patient, if he observes a proper regimen, may nevertheless live a number of years tolerably easy ; but if ho indulges in animal food and strong liquors, or takes medicines of an acrid or irritating nature, the schirrus will be converted into a cancer, which must infallibly prove fatal. Regimen.—The same regimen is to be observed in this as in other inflammatory disorders. All hot things are to be carefully avoided, and cool diluting liquors, as whey, barley water, &c. drank freely. The food must be light and thin, and the body, as well as the mind, kept easy and quiet. Medicinb.—Bleeding is proper at the beginning of this disease, and it will often be necessary, even though the pulse should not feel hard, to repeat it. All violent purgatives are to be avoided ; the bod}', how- ever, must be kept gently open. A decoction of tamarinds, with a little honey or manna, will answer this purpose very well. The side affected must be fomented in the same manner directed in the foregoing dis- eases. Mild laxative clysters should be frequently administered ; and if the pain should notwithstanding continue violent, a blistering plaster may be applied over the part affected; or rather a plaster made of gum- ammoniac and vinegar of squills. Medicines which promote the secretion of urine have a very good effect here. For this purpose, half a dram of purified nitre, or a tea- spoonful of the sweet spirits of nitre, may be taken in a cup of the pa- tient's drink three or four times a-day. \\ hen there is an inclination to sweat, it ought to be promoted, but not by warm sudorifics. The only thing to be used for that purpose is plenty of diluting liquor drank about the warmth of the human blood. Indeed the patient in this case, as well as in all other topical inflam- mations, ought to drink nothing that is colder than the blood. If the stools should be loose, and even streaked with blood, no means must be used to stop them, unless they be so frequent as to weaken the patient. Loose stools often prove critical, and carry off the disease. If an abscess or imposthume is formed in the liver, all methods should be tried to make it break and discharge itself outwardly, as fomentations, the application of poultices, ripening cataplasms, &c. Sometimes, indeed, the matter of an abscess comes away in the urine, and sometimes it is discharged by stool ; but these are efforts of nature, which no means can promote. When the abscess bursts into the cavitv of the abdomen at large, death must ensue ; nor will the event 210 INFLAMMATION OF THE LIVER. be more favourable when the abscess is opened by an incision, unless iu cases where the liver adheres to the peritoneum, so as to form a bag for the matter, and prevent it from falling into the cavity of the abdo- men ; in which case opening the abscess by a sufficiently large incision will probably save the patient's life.* If the disorder, in spite of all endeavours to the contrary, should end inaschirrus, the patient must be careful to regulate his diet, &c. in such a manner as not to aggravate the disease. He must not indulge in flesh, fish, strong liquors, or any highly-seasoned or salted provisions ; but should, for the most part, live on mild vegetables, as fruits and roots, taking gentle exercise, and drinking whey, barley-water, or butter-milk. If he takes any thing stronger, it should be fine mild ale, which is less heating than w ines or spirits. We shall take no notice of inflammations of the other viscera. They must in general be treated upon the same principles as those already mentioned. The chief rule with respect to all of them is, to let blood, to avoid every thing that is strong or of a heating nature, to apply warm fomentations to the part affected, and to cause the patient to drink a sufficient quantity of warm diluting liquors. Warm fomentations, frequently repeated, are the best means of relief for the disease here treated of. These are made in a variety of ways ; the Anodyne Fomentation, mentioned in the Appendix, to which a hand- ful of camomile-flowers may be added occasionally, will answer as well as any. If the fomentations are not effectual, the warm bath must be resorted to, in which the patient ought to remain as long as his strength will permit. To supply the want of a proper bath, a cask or tub may be used. The costiveness accompanying inflammation of the stomach and bowels often requires great skill and perseverance for its removal. A very mild medicine will sometimes succeed where a powerful one has failed. Different medicines should be tried and persisted in till the effect be produced, and even external applications may sometimes be administered with effect when the best internal remedies have been used in vain. * I know a gentleman who has had several abscesses of the liver opeued, and ii now a strong and healthy man, though above eighty years of age. 211 CHAP. XXXI. OF THE CHOLERA MORBUS, AND OTHER EXCESSIVE DIS- CHARGES FROM THE STOMACH AND BOWELS. The cholora morbus is a violent purging and vomiting, attended with gripes, sickness, and a constant desire to go to stool. It comes on sud- denly, and is most common in autumn. There is hardly any disease that kills more quickly than this, when proper means are not used in due time for removing it. Causes.—It is occasioned by a redundancy and putrid acrimony of the bile; cold ; food that easily turns rancid or sour on the stomach, as butter, bacon, sweetmeats, cucumbers, melons, cherries, and other cold fruits.* It is sometimes the effect of strong acrid purges or vomits ; or of poisonous substances taken into the stomach. It may likewise proceed from violent passions or affections of the mnid ; as fear, anger, &c. &c. Symptoms.—It is generally preceded by a cardialgia, or heart-burn, sour belchings, and flatulencies, with pain of the stomach and intes- tines. To these succeed excessive vomiting, and purging of green, yellow, or blackish coloured bile, with a distension of the stomach, and violent griping pains. There is likewise a great thirst, with a very unequal pulse, and often a fixed acute pain about the region of the navel. As the disease advances, the pulse often sinks so low as to become quite imperceptible, the extremities grow cold, or cramped, and are often covered with a clammy sweat, the urine obstructed, and there is a palpitation of the heart. Violent hiccupiug, fainting, and convulsions, are the signs of approaching death. Medicine.—At the beginning of this disease, the efforts of nature to expel the offending cause should be assisted by promoting the purging and vomiting. For this purpose the patient must drink freely of diluting liquors ; as whey, butter-milk, warm water, thin water-gruel, small posset, or, what is perhaps preferable to any of them, very weak chicken- broth. This should not only be drank plentifully to promote the vomit- ing, but a clyster of it given every hour in order to promote the purging. After these evacuations have been continued for some time, a decoc- tion of toasted oat-bread may be drank to stop the vomiting. The bread should be toasted till it is of a brown colour, and afterwards boiled in * I have been twice brought to the gates of death by this disease, and both timet it was occasioned by eating tancid bacon. 212 OF A DIARRHCEA, OR LOOSENx.00. spring water. If oat-bread cannot be had, wheat bread, or oatmeal well toasted, may be used in its stead. If this does not put a stop to the vomiting, two table-spoonfuls of the saline julap, with ten drops of laudanum, may be taken every hour till it cease3. The vomiting and purging, however, ought never to be stopped too soon. As long as these discharges do not weaken the patient, they are salutary, and may be allowed to go on, or rather ought to be promoted. But when the patient is weakened by the evacuations, which may be known from the sinking of his pulse, &c. recourse must immediately be had to opiates, as recommended above ; to which may be added strong wines, with spirituous cinnamon-water, and other generous cordials. Warm negus, or strong wine-whey, will likewise be necessary to support the patient's spirits, and promote the perspiration. His legs should be bathed in warm water, and afterwards rubbed with flannel cloths, or wrapped in warm blankets, and warm bricks applied to the soles of the feet. Flannels wrung out of warm spirituous fomentations should likewise be applied to the region of the stomach. When the violence of the disease is over, to prevent a relapse it will be necessary for some time to continue the use of small doses of lau- danum. Ten or twelve drops may be taken in a glass of wine, at least twice a-day, for eight or ten days. The patient's food ought to be nourishing, but taken in small quantities, and he should use moderate exercise. As the stomach and intestines are generally much weakened, an infusion of the bark, or other bitter, in small wine, sharpened with the elixir of vitriol, may be drank for some time. Though physicians are seldom called in due time in this disease, they ought not to despair of relieving the patient even in the most des- perate circumstances. Of this I lately saw a very striking proof in an old man and his son, who had been both seized with it about the middle of the night. I did not see them till next morning, when they had much more the appearance of dead than of living men. No pulse could be felt; the extremities were cold and rigid, the countenance was ghastly, and the strength almost quite exhausted. Yet from this de- plorable condition they were both recovered by the use of opiates and cordial medicines. OF A DIARRHOEA, OR LOOSENESS. A looseness, in many cases, is not to be considered as a disease, but rather as a salutary evacuation. It ought therefore never to be stopped, unless when it continues too long, or evidently weakens the patient. As this, however, sometimes happens, we shall point out the most common causes of a looseness, with the proper method of treatment. OF A DIARRHOEA, OH LOOSENESS. 213 When a looseness is occasioned by catching cold, or an obstructed perspiration, the patient ought to keep warm, to drink freely of weak diluting liquors, to bathe his feet and legs frequently in lukewarm water, to wear flannel next his skin, and to take every other method to restore the perspiration. In a looseness which proceeds from excess or repletion, a vomit is the proper medicine. Vomits not only cleanse the stomach, but pro- mote all the secretions, which render them of great importance in carrying off a debanch. Half a dram of ipecacuanha in powder will answer this purpose very well. A day or two after the vomit, the same quantity of rhubarb may be taken, and repeated two or three times, if the looseness continues. The patient ought to live upon light vegeta- ble food of easy digestion, and to drink whey, thin-gruel, or barley- water. A looseness occasioned by the obstruction of any customary evacuation generally requires bleeding. If that does not succeed, other evacuations may be substituted in the room of those which are obstructed. At the same time, every method is to be taken to restore the usual discharges, as not only the cure of the disease, but the patient's life, may depend on this. A periodical looseness ought never to be stopped. It is always an effort of nature to carry off some offending matter, which, if retained in the body, might have fatal effects. Children are very liable to this kind of looseness, especially while teething. It is, however, so far from being hurtful to them, that such children generally get their teeth with least trouble. If these loose stools should at any time prove sour or griping, a tea-spoonful of magnesia alba with four or five grains of rhubarb, may be given to the child in a little panado, or any other food. This, if repeated three or four times, will generally correct the acidity, and carry off the griping stools. The potio cretacea, or chalk julap, may be administered in doses of two or three spoonfuls after each evacuation ; or a tea-spoonful of fine powdered chalk may be mixed in a tea-cupful of water-gruel, and given occasionally. A diarrhoea, or looseness, which proceeds from violent passions or affections of the mind, must be treated with the greatest caution. Vomits in this case are highly improper. Nor are purges safe, unless they be mild, and given in small quantities. Opiates, and other antispasmodic medicines are most proper. Ten or twelve drops of liquid laudanum may be taken in a cup of valerian or penny-royal tea every eight or ten hours, till the symptoms abate. Ease, cheerfulness, and tranquillity of mind, are here of the greatest importance. When a looseuees proceeds from acrid or poisonous substances taken 214 OF A DIARRHCEA, OR LO0SENES8. into the stomach, the patient must drink large quantities of diluting liquors, with oil or fat broths, to promote vomiting and purging. After- wards, if there be reason to suspect that the bowels are inflamed, bleed- ing will be necessary. Small doses of laudanum may likewise be taken to remove their irritation. When the gout, repelled from the extremities, occasions a looseness, it ought to be promoted by gentle doses of rhubarb, or other mild purga- tives. The gouty matter is likewise to be solicited towards the extre- mities by warm fomentations, cataplasms, &c. The perspiration ought at the same time to be promoted by warm diluting liquors ; as wine- whey, with spirits of hartshorn, or a few drops of liquid laudanum in it. When a looseness proceeds from worms, which may be known from the sliminess of the stools, mixed with pieces of decayed worms, &c. medicines must be given to kill and carry off these vermin, as the powder of tin with purges of rhubarb and calomel. Afterward^ lime-water, either alone or with a small quantity of rhubarb infused, will be proper to strengthen the bowels, and prevent the new generation of worms. A loosness is often occasioned by drinking bad water. When this is the case, the disease generally proves epidemical. When there is reason to believe that this or any other disease proceeds from the use of un- wholesome water, it ought immediately to be changed, or if that can- not be done it may be corrected by mixing it with quicklime, chalk, or the like. In people whose stomachs are weak, violent exercise immediately after eating will occasion a looseness. Though the cure of this is obvious, yet it will be proper, besides avoiding all exercise, to use such medicines as tend to brace and strengthen the stomach, as infusions of the bark, with other bitter and astringent ingredients, in white-wine. Such persons ought likewise to take frequently a glass or two of old red port, or good claret. From whatever cause a looseness proceeds, when it is found necessary to check it, the diet ought to consist of rice boiled with milk, and fla- voured with cinnamon : rice-jelly, sago with red port, and the lighter sorts of flesh meat roasted. The drink may he thin water-gruel, rice- water, or weak broth made from lean veal, or with a sheep's head, as being more gelatinous than mutton, beef, or chicken broth. Persous who, from a particular weakness, or too great an irritability of the bowels, are liable to frequent returns of this disease, should live temperately, avoiding crude summer fruits, all unwholesome foods, and meats of hard digestion. They ought likewise to beware of cold, moisture, or whatever may obstruct the perspiration, and should wear flannel next to the skin. All violent passions, as fear, anger, &c. are likewise carefully to be guarded against. 215 OF VOMITING. Vomiting may proceed from various causes ; as excess in eating and drinking ; foulness of the stomach ; the acrimony of the aliments ; a translation of the morbific matter of ulcers, of the gout, the erysipelas, or other diseases of the stomach. It may likewise proceed from a looseness having been too suddenly stopped ; from the stoppage of any customary evacuation, as the bleeding piles, the menses, &c. from a weakness of the stomach, the colic, the iliac passion, a rupture, a fit of the gravel, worms; or from any kind of poison taken into the stomach. It is a usual symptom of injuries done to the brain; as contusions, compressions, Ac. It is likewise a symptom of wounds or inflammations of the diaphragm, intestines, spleen, liver, kidneys, &c. Vomiting may be occasioned by unusual motions, as sailing, being drawn backwards in a carriage, &c. It may likewise be excited by violent passions, or by the idea of nauseous or disagreeable objects, especially of such things as have formerly produced vomiting. Some- times it proceeds from a regurgitation of the bile into the stomach: in this case, what the patient vomits is generally of a yellow or greenish colour, and has a bitter taste. Persons who are subject to nervous affections are often suddenly seized with violent fits of vomiting. Lastly, vomiting is a common symptom of pregnancy. In this case it generally comes on about two weeks after the stoppage of the menses, and con- tinues during the first three or four months. When vomiting proceeds from a foul stomach or indigestion, it is not to be considered as a disease, but as the cure of a disease. It ought therefore to be promoted, by drinking lukewarm water or thin gruel. If this does not put a stop to the vomiting, a dose of ipecacuanha may betaken, and worked off with weak camomile-tea. When the retrocession of the gout, or the obstruction of customary evacuations, occasions vomiting, all means must be used to restore these discharges; or, if that cannot be effected, their place must be supplied by others, as bleeding, purging, bathing the extremities in warm water, opening issues, setons, perpetual blisters, &c. When vomiting is the effect of pregnancy, it may generally be mitigated by bleeding, and keeping the body gentl y open. The bleed- in <*, however, ought to be in small quantities at a time, and the purgatives should be of the mildest kind, as figs, stewed prunes, manna or senna. Pregnant women are most apt to vomit in the morning immediately after getting out of bed, which is owing partly to the change of posture, but more to the emptiness of the stomach. It may 216 OF A VOMIT. generally be prevented, by taking a dish of coffee, tea, or some litht breakfast, in bed. Pregnant women who are afflicted with vomiting, ought to be kept easy both in body and mind. They should neither allow their stomachs to be quite empty, nor should they eat much at once. Cold water is a very proper drink in this case ; if the stomach be weak, a little brandy may be added to it. If the spirits be low, and the person apt to faint, a spoonful of cinnamon-water, with a little mar- malade of quinces or oranges, may be taken. If vomiting proceeds from weakness of the stomach, bitters will be of service. Peruvian bark infused in wine or brandy, with as much rhu- barb as will keep the body gently open, is an excellent medicine in this case. The elixir of vitriol is also a good medicine. It may be taken in the dose of fifteen or twenty drops, twice or thrice a-day, in a glass of wine or water. Habitual vomitings are sometimes alleviated by making oysters a principal part of diet. A vomiting which proceeds from acidities in the stomach, is relieved by alkaline purges. The best medicine of this kind is the magnesia alba, a tea-spoonful of which may be taken in a dish of tea, or a little milk, three or four time3 a-day, or oftener if necessary, to keep the body c^ien. When vomiting proceeds from violent passions or affections of the mind, all evacuants must be carefully avoided, especially vomits. These are exceedingly dangerous. The patient in this case ought to be kept perfectly easy and quiet, to have the mind soothed, and to take some gentle cordials, as negus, or a little brandy and water, to which a few drops of laudanum may occasionally be added. When vomiting proceeds from spasmodic affections of the stomach musk, castor, and other antispasmodic medicines are of use. Warm aud aromatic plasters have likewise a good effect. The stomach plaster of the London or Edinburgh dispensatory may be applied to the pit Oi" the stomach, or a plaster of theriaca, which will answer rather better. Aromatic medicines may likewise be taken inwardly as cinnamon or mint-tea, wine with spiceries boiled in it, &c. The region of the sto- mach may be rubbed with aether, or, if that cannot be had, with strong brandy, or other spirits. The belly should be fomented with warm water, or the patient immersed up to the breast in a warm bath. I have always found the saline draughts taken in the act of efferves- cence, of singular use in stopping a vomiting, from whatever cause it proceeded. These may be prepared by dissolving a dram of the salt of tartar in an ounce aud a half of fresh lemon juice, and adding to it an ounce of peppermint water, thesame quantity of simple cinnamon-water, and a little white sugar. This draught must bo swallowed before Ilia OF THE DIABETES, ETC. 217 effervescence is quite over, and may be repeated every two hours, or oftener, if the vomiting be violent. A violent vomiting has sometimes been stopped by cupping on the region of the stomach, after all other means had failed. As the least motion will often bring on the vomiting again, even after it has been stopped, the patient must avoid all manner of action. The diet must be so regulated as to sit easy upon the stomach, and no- thing should be taken that is of hard digestion. We do not, however, mean that the patient should live entirely upon slops. Solid food, in this case, often sits easier on the stomach than liquids. CHAP. XXXII. OF THE DIABETES, AND OTHER DISORDERS OF THE KIDNEYS AND BLADDER. The diabetes is a frequent and excessive discharge of urine. It is seldom to be met with among young people ; but often attacks persons in the decline of life, especially those who follow the more violent employ. inents, or have been hard drinkers in their youth. Causics.—A diabetes is often the consequence of acute diseases, as fevers, fluxes, &c. where the patient has suffered by excessive evacua- tions ; it may also be occasioned by great fatigue, as riding long jour- neys upon a hard-trotting horse, carrying heavy burdens, running, &c. It may be brought on by hard drinking, or the use of strong stimulant diuretic medicines, as tincture of cantharides, spirits of tur- pentine, and such like. It is often the effect of drinking too great quantities of mineral waters. Many imagine that these will do them no service unless they be drank in great quantities, by which mistake it often happens that they occasion worse diseases than those they were intended to cure. In a word, this disease may either proceed from too great a laxity of the organs which secrete the urine, from something which stimulates the kidneys too much, or from a thin dissolved state of the blood, which makes too great a quantity of it run off by the urinary passages. Symptoms.—In a diabetes, the urine generally exceeds in quantity all the liquid food which the patient takes. It is thin and pale, of a sweetish taste, and agreeable smell. The patient has a continual thirst, with some degree of fever ; his mouth is dry, and he spits frequently 218 OF TnE DIABETES. ETC. a frothy spittle. The strength fails, the appetite decays, and the flesh wastes away, till the patient is reduced to skin and bone. There is a heat of the bowels ; and frequently the loins, testicles, and feet, are swelled. This disease may generally be cured at the beginning; but after it has continued long, the cure becomes very difficult. In drunkards, and very old people, a perfect cure is not to be expected. Regimen.—Every thing that stimulates the urinary passages, or tends to relax the habit, must be avoided. For this reason, the patient should live chiefly on solid food. His thirst may be quenched with acids; as sorrel, juice of lemon, or vinegar. The mucilaginous vegeta- bles, as rice, sago, and salop, with milk, are the most proper food. Of animal substances, shell-fish are to be preferred ; as oysters, crabs, &c. The drink may be Bristol-water. When that cannot be obtained, lime-water, in which a due proportion of oak-bark has been macerated, maybe used.* The white decoction, with isinglass dissolved in it, is like- wise a very proper drink. The patient ought daily to take exercise, but it should be so gentle as not to fatigue him. He should lie upon a hard bed or mattress. No- thing hurts the kidneys more than lying too soft. A warm dry air, the use of the flesh brush, and every thing that promotes perspiration, is of service. For this reason, the patient ought to wear flannel next his skin. A large strengthening-plaster may be applied to the back ; or what will answer better, a great part of the body may be wrapped in plaster. Medicine.—Gentle purges, if the patient be not too much weakened by the disease, have a good effect. They may consist of rhubarb, with cardamum-seeds, or any other spiceries, infused in wine, and may be taken in such quantities as to keep the body gently open. The patient must next have recourse to astringents and corrobor- ants. Half a dram of powder made of equal parts of alum, and the inspissated juice, commonly called Terra Japonica, may be taken four times aday, or oftener, if the stomach will bear it. The alum must first be melted in a crucible : afterwards they may be both pounded together. Along with every dose of this powder the patient may take a tea-cupful of the tincture of roses.f If the patient's stomach cannot bear the alum in substance, whey may be made of it, and taken in the dose of a tea-cupful three or four times a-day. The alum whey is prepared by boiling two English quarts of milk over a slow fire, with three drams of alum, till the curd separates. • See Appendix, White Decootion. \ See Appendix, Tincture of Rose*. OF A SUPPRESSION OF URINE. 219 Opiates are of service in this disease, even though the patient rests well. They take off spasm and irritation, and at the same time lessen the force of the circulation. Ten or twelve drops of liquid laudanum may be taken in a cup of the patient's drink three or four times a-day. The best corroborants which we know, are the Peruvian bark and wine. A dram of bark may be taken in a glass of red port or claret, three times a-day. The medicine will be both more efficacious and less disagreeable, if fifteen or twenty drops of the acid elixer of vitriol be added to each dose. Such as cannot take the bark in substance may use the decoction, mixed with an equal quantity of red wine, and sharp- ened as above. There is a disease incident to labouring people in the decline of life, called an Inconstancy of Urine. But this is very different from a diabetes, as the water passes off involuntarily by drops, and does not exceed the usual quantity. The disease is rather troublesome than dangerous. It is owing to a relaxation of the sphincter of the bladder, and is often the effect of a palsy. Sometimes it proceeds from hurts, or injuries occasioned by blows, bruises, preternatural labours, &c. Sometimes it is the effect of a fever. It may likewise be occasioned by a long use of strong diuretics, or of stimulating medicines injected into the bladder. This disease may be mitigated by the use of astringent and corro. borating medicines, such as have been mentioned above ; but we do not remember ever to have seen it cured. In an incontinency of urine, from whatever cause, a piece of sponge ought to be worn, or a bladder applied in such a manner as to prevent the urine from galling and excoriating the parts* OF A SUPPRESSION OF URINE. It has already been observed, that a suppression of urine may pro- ceed from various causes ; as an inflammation of the kidneys, or blad- der ; small stones or gravel lodging in the urinary passages, hard faces lying in the rectum, pregnancy, a spasm or contraction of the neck of the bladder, clotted blood in the bladder itself, a swelling of the hemorrhoidal veins, &c. Some of these cases require the catheter, both to remove the ob- structing matter and to draw off the urine; but as this instrument can onWbe managed with safety by persons skilled in surgery, we shall bay nothing further of its use. A bougee may be used by any cautious hand, and°will often succeed better than the catheter. * a' bottle made of the India rubber, and properly applied, answers this purpose beit. 220 OF THE GRAVEL AND STONE. We would chiefly recommend, in all obstructions of urine, fomenta- tions and evacuants. Bleeding, as far as the patients's strength will permit, is necessary, especially where there are symptoms of topical inflammation. Bleeding in this case not only abates the fever, by les- sening the force of the circulation, but, by relaxing the solids, it takes off the spasm or stricture upon the vessel which occasioned the ob- struction. After bleeding fomentations must be used. These may either con- sist of warm water alone, or a decoction of mild vegetables : as mallows, camomile-flowers, &c. Cloths dipped in these may either be applied to the part affected, or a large bladder filled with the decoction may be kept continually upon it. Some put the herbs themselves into a flannel bag, and apply them to the part, which is far from being a bad method. These continue longer warm than cloths dipped in the decoction, and at the same time keep the part equally moist. In all obstructions of urine, the body ought to be kept open. This is not, however, to be attempted by strong purgatives, but by emollient clysters, or gentle infusions of senna and manna. Clysters in this case not only open the body, but answer the purpose of an internal fomenta- tion, and greatly assist in removing the spasms of the bladder and parts adjacent. The food must be light and taken in small quantities. The drink may be weak broth, or decoctions and infusions of mucilaginous vegetables, or marsh-mallow roots, lime-tree buds, &c. A tea-spoonful of the sweet spirits of nitre, or a dram of Castile soap, may be frequently put into the patient's drink ; and, if there be no inflammation, he may drink small gin punch. Persons subject to a suppression of urine ought to live very temperate. Their diet should be light, and their liquor diluting. They should avoid all acid aud austere wines, should take sufficient exercise, lie hard, and avoid study and sedentary occupations. OF THE GRAVEL AND STONE. When small stones are lodged in the kidneys, or discharged with the urine, the patient is said to be afflicted with the gravel. If one of these stones happen to make a lodgment in the bladder for some time, it accu- mulates fresh matter, and at length becomes too large to pass off with the urine. In this case the patient is said to have the stone. Causes.—The stone and gravel may be occasioned by high living ; the use of strong astringent wines ; a sedentary life ; lying too hot, soft, or too much on the back; the c nstaut use of water impregnated with. OF THE GRAVEL AND STONE. 221 earthy or stony particles ; aliments of an astringent or windy nature &c. 11 may likewise proceed from an hereditary disposition. Persons in the decline of life, and those who have been much afflicted with the gout or rheumatism, are most liable to it. Symptoms.—Small stones or gravel in the kidneys occasion pain in the loins, sickness, vomiting, and sometimes bloody urine. When the stone descends into the ureter, and is too large to pass along with ease, all the above symptoms are increased ; the pain extends towards the bladder; the thigh and leg of the affected side are benumbed; the testicles are drawn upwards, and the urine is obstructed. A stone in the bladder is known from a pain at the time, as well as before and after making water ; from the urine coming away by drops, or stopping suddenly when it was running in a full stream ; by a violent pain in the neck of the bladder upon motion, especially on horseback, or in a carriage on a rough road ; or from a white, thick, copious stinking mucous sediment in the urine ; from an itching in the top of the penis; from bloody urine ; from an inclination to go to stool during the discharge of urine ; from the patient's passing his urine more easily when lying than in an erect posture ; from a kind of convulsive motion occasioned by the sharp pain in discharging the last drops of the urine ; aud lastly, from sounding or searching with the catheter. Regimen.—Persons afflicted with the gravel or stone should avoid aliment of a windy or heating nature, as salt meats, sour fruits, &c. Their diet ought chiefly to consist of such things as tend to promote the secretion of urine, and to keep the body open. Artichokes, asparagus^ spinage, lettuce, parsley, succory, purslain, turnips, potatoes, carrots, and radishes, may be safely eaten. Onions, leeks, and cellery are, in this case, reckoned medicinal. The most proper drinks are whey, butter- milk, milk and water, barley-water, decoctions or infusions of the roots of marsh-mallows, parsley, liquorice, or of other mild mucilaginous vegetables, as linseed, lime-tree buds or leaves, &c. If the patient has been accustomed to generous liquors, he may drink gin and water not too strong. Gentle exercise is proper; but violent motion is apt to occasion bloody urine. We would therefore advise that it should be taken in moderation. Persons afflicted with the gravel often pass a great num- ber of stones after riding on horseback, or in a carriage ; but those who have a stone in the bladder are seldom able to bear these kinds of exercise. Where there is an hereditary tendency to this disease, a sedentary life ought never to be indulged. Were people careful, upon the first symptoms of gravel, to observe a proper regimen of diet, and to take sufficient exercise, it might often be carried off, or at least pre- 222 OF THE GRAVEL AND STONE. vented from increasing; but if the same course which occasioned the disease is persisted in, it must be aggravated. Medicine.—In what is called a fit of the gravel, which is commonly occasioned by a stone sticking in the ureter or some part of the urinary passages, the patient must be bled ; warm fomentations should likewise be applied to the part affected, emollient clysters administered, aud diluting mucilaginous liquors drank, &c. The treatment in this case has been fully pointed out under the articles inflammation of the kidneys and bladder, to which we refer. Dr. Whyte advises patients who are subject to frequent fits of gravel in the kidneys, but have no stone in the bladder, to drink every morning, two or three hours before breakfast, an English pint of oyster or cockle- shell lime-water. The Doctor very justly observes, though this quan- tity might be too small to have any sensible effect in dissolving a stone in the bladder, yet it may very probably prevent its growth. When a stone is formed in the bladder, the Doctor recommends Spanish soap, and oyster or cockle-shell lime-water,* to be taken in the following manner : The patient must swallow every day, in any form that is least disagreeable, an ounce of the internal part of Alicant soap, and drink three or four English pints of oyster or cockle-shell lime- water ; the soap is to be divided into three doses; the largest to be taken fasting in the morning early, the second at noon, and the third at seven in the evening; drinking above each dose a large draught of the lime-water; the remainder of which he may take any time betwixt dinner and supper, instead of other liquors. The patient should begin with a smaller quantity of the lime-water and soap than that mentioned above : at first an English pint of the former, and three drams of the latter, may be taken daily. This quan- tity, however, he may increase by degrees, and ought to persevere in the use of these medicines, especially if he finds any abatement of his com- plaints, for several months ; nay, if the stone be very large, for years. It may likewise be proper for the patient, if he be severely pained, not only to begin with the soap and lime-water in small quantities, but to take the second or third lime-water instead of the first. However, after he has been some time accustomed to these medicines, he may not only take the first water, but, if he finds he can easily bear it, heighten its dissolving power still more by pouring it a second time on fresh calcined shells. The caustic alkali, or soap lees, is the medicine chiefly in vogue at pre- sent for the stone. It is of a very acrid nature, and ought therefore to be given in some gelatinous or mucilaginous liquor; as veal broth, * See Appendix, Lime-water. OF THE GRAVEL AND STONE. 223 new milk, linseed-tea, a solution of gum arabic, or a decoction of marsh- mallow roots. The patient must begin with small doses of the lees, as thirty or forty drops, and increase by degrees, as far as the stomach can bear it.* Though the soap-lees and lime-water are the most powerful medi- cines which have hitherto been discovered for the stone, yet there are some things of a more simple nature, which in certain cases are found to be beneficial, and therefore deserve a trial. An infusion of the seeds of daucus sylvestris, or wild carrot, sweetened with honey, has been found to give considerable ease in cases where the stomach could not bear any thing of an acrid nature. A decoction of raw coffee- berries taken morning and evening, to the quantity of eight or ten ounces, with ten drops of sweet spirit of nitre, has likewise been found very efficacious in bringing large quantities of earthy matter in flakes. Honey is likewise found to be of considerable service, and may be taken in gruel, or any other form that is more agreeable. The only other medicine which we shall mention is the uva ursi. 11 has been greatly extolled of late both for the gravel and stone. It seems, however, to be in all respects inferior to the soap and lime- water ; but it is less disagreeable, and has frequently, to my know- ledge, relieved gravelly complaints. It is generally taken in powder from half a dram to a whole dram, two or three times a-day. It may, however, be taken to the quantity of seven or eight drams a-day, with great safety and good effect. No means have hitherto been devised for removing the tormenting disorder of the stone in the bladder. The British Parliament once paid five thousand pounds for a pretended solvent, long since forgotten ; which proves with what caution the efficacy of specifics is to be be- lieved. Our efforts to procure a remedy, however, ought by no means to be discontinued, as a solvent may yet be discovered. The consistence of the stones varies so much that there is reason to fear no medicine will be found powerful enough to dissolve the hardest of them without de- stroying the bladder ; although some hard substances are known to be soluble in seemingly mild ones. Instances have occurred where stones, after getting into the urethra, were brought away by means of a bent probe. This can only happen where the stones are small: though some flatfish stones have been brought away in this manner that measured two inches round. Riding * The caustic alkali may be prepared by mixing two part* of quick-lime with one of pot-ashes, and suffering them to stand till the lixivium be formed, which must be r-.refuUy filtrated before it be used. If the solution does not happen readily, a sluuU quantity of water may be added to the mixture. 224 INVOLUNTARY DISCHARGES, ETC. on a hard-trotting horse, or in a carriage on a rough road, might bring down a small stone. Persons troubled with the stone should not delay the operation of cutting too long, when it is known there is a stone in the bladder too large for passing along the urethra, as it will quickly increase so that it cannot be extracted without a laceration of the parts, and that too at a time when the patient's habit has become too irritable. CHAP. XXXIII. OF INVOLUNTARY DISCHARGES OF BLOOD. Spontaneous or involuntary discharges of blood often happen from various parts of the body. These, however, are so far from being always dangerous, that they often prove salutary. When such dis- charges are critical, which is frequently the case in fevers, they ought not to be stopped. Nor indeed is it proper at any time to stop them, unless they be so great as to endanger the patient's life. Most people, afraid of the smallest discharge of blood from any part of the body, fly immediately to the use of styptic and astringent medicines, by which means an inflammation of the brain, or some other fatal disease, is occasioned, which, had the discharge been allowed to go on, might • have been prevented. Periodical discharges of blood, from whatever part of the body they proceed, must not be stopped. They are always the efforts of nature to relieve herself; and fatal diseases have often been the consequences of obstructing them. It may, indeed, be sometimes necessary to check the violence of such discharges; but even this requires the greatest caution. Instances might be given where the stopping of a small peri- odical flux of blood from one of the fingers has proved fatal to the health. In the early period of life, bleedingat the nose is very common. Those who are farther advanced in years are more liable to hsemoptoe, or dis- charge of blood from the lungs. After the middle period of life, h». morrhoidal fluxes are most common ; and, in the decline of life, dis- charges of blood from the urinary passages. Involuntary fluxes of blood may proceed from very different, and often from quite opposite causes. Sometimes they are owing to a parti- cular construction of the body, as a sanguine temperament, a laxity of the vessels, a plethoric habit, &c. At other timej they proceed from INVOLUNTARY DISCHARGES, ETC. 225 a determination of the blood towards one particular part, as the head, the haemorrdoidal veins, &c. They may likewise proceed from an inflammatory disposition of the blood, in which case there is generally some degree of fever: this likewise happens when the flux is occasioned by an obstructed perspiration, or a striature upon the skin, the bowels, or any particular part of the system. But a dissolved state of the blood will likewise occasion haemorrhages. Thus, in putrid fevers, the dysentery, the scurvy, the malignant small- pox, &c. there are often very great discharges of blood from d.fferent parts of the body. They may likewise be brought on by too liberal a use of medicines which tend to dissolve the blood, as cantharides, the volatile alkaline salt, &c. Food of an acrid or irritating quality may likewise occasion haemorrhages; as also strong purges and vomits, or any thing that greatly stimulates the bowels. Violent passions or agitations of the mind will likewise have thiseffect. These often cause bleeding at the nose ; and I have known them some- times occasion an haemorrhage in the brain. Violent efforts of the body, by overstraining or hurting the vessels, may have the same effect, especially when the body is long kept in an unnatural posture, as hanging the head very low, &c. The cure of an haemorrhage must be adapted to its cause. When it proceeds from too much blood, or a tendency to inflammation,— bleeding with gentle purges and other evacuations will be necessary It will likewise be proper for the patient in this case to live chiefly upon a vegetable diet, to avoid all strong liquors, and food that is of an acrid, hot, or stimulating quality. The body should be kept cool, and the mind easy. When an haemorrhage is owing to a putrid or dissolved state of the blood, the patient ought to live chiefly upon acrid fruits, with milk, and vegetables of a nourishing nature, as sago, salop, &c. His drink may be wine diluted with water, and sharpened with the juice of lemon, vinegar, or spirits of vitriol. The best medicine in this case is the Peruvian bark, which may be taken according to the urgency of the symptoms. When a flux of blood is the effect of acrid food, or of strong stimu- lating medicines, the cure is to be effected by soft and mucilaginous diet. The patient may likewise take frequently about the bulk of a nutmeg of Locatelli's balsam, or the same quantity of spermaceti. When an obstructed perspiration, or a stricture upon any part of the svstem, is the cause of an haemorrhage, it may be removed by drinking warm diluting liquors, lying a-bed, bathing the extremities in warm water, &c. G 226 OF BLEEDING AT THE NOSE. Bleeding at the nose is commonly preceded by some degree of quick* Iiess of the pulse, flushing in the face, pulsation of the temporal arte- ries, heaviness in the head, dimness of the sight, heat and itching of the nostrils, &c. To persons who abound with blood this discharge is very salutary. It often cures a vertigo, the head-ache, a frenzy, and even an epilepsy" In fevers, where there is a great determination of blood towards the head, it is of the utmost service. It is likewise beneficial in inflam- mations of the liver and spleen, and often in the gout and rheumatism. In all diseases where bleeding is necessary, a spontaneous discharge of blood from the nose is of much more service than the same quantity let with a lancet. In a discharge of blood from the nose, the great point is to determine whether it ought to be stopped or not. 11 is a common practice to stop the bleeding, without considering whether it be a disease, or the cure of a disease. This conduct proceeds from fear, but it has often bad and sometimes fatal consequences. When a discharge of blood from the nose happens in an inflammatory disease, there is always reason to believe that it may prove salutary ; and therefore it should be suffered to go on, at least as long as the pa- tient is not weakened by it. When it happens to persons in perfect health, who are full of blood it ought not to be suddenly stopped, especially if the symptoms of pie. thora mentioned above have preceded it. In this case it cannot be stopped without risking the patient's life. In fine, whenever bleeding at the nose relieves any bad symptom, and does not proceed so far as to endanger the patient's life, it ought not to be stopped. But when it returns frequently, or continues till the pulse becomes low, the extremities begin to grow cold, the lips pale, or the patient complains of being sick or faint, it must immediately be stopped. For this purpose the patient should be set nearly upright, with his head reclining a little, and his legs immersed in water about the warmth of new milk. His hands ought likewise to be put in lukewarm water, and his garters may be tied a little tighter than usual. Liga- tures may be applied to the arms, about the place where they are usually made for bleeding, and with nearly the same degree of tight- ness. These may be gradually slackened, as the blood begins to stop, and removed entirely as soon as it gives over. OF BLEEDING AT THE NOSE. 227 Sometimes dry lint put up the nostrils will stop the bleeding. When this does not succeed, dossils of lint dipped in strong spirits of wine may be put up the nostrils, or if that cannot be had they must be dipped in brandy. Blue vitriol dissolved in water may likewise be used for this purpose, or a tent dipped in the white of an egg, well beat up, may be rolled in a powder made of equal parts of white sugar, burnt alum, and white vitriol, and put up the nostril from whence the blood issues. Internal medicines can hardly be of use here, as they have seldom time to operate. It may not, however, be amiss to give the patient half an ounce of Glauber's salt, and the same quantity of manna, dis- solved in four or five ounces of barley-water. This may be taken at a draught, and repeated if it does not operate in a few hours. Ten or twelve grains of nitre may be taken in a glass of cold water and vinegar every hour, or oftener if the stomach will bear it. If a stronger medi- cine be necessary, a tea-cupful of the tincture of roses, with twenty or thirty drops of the weak spirit of vitriol, may be taken every hour. When these things cannot be had, the patient may drink water with a little common salt in it, or equal parts of water and vinegar.* If the genitals be immersed for some time in cold water, it will . generally stop a bleeding at the nose. I have not known this fail. Sometimes, when the bleeding is stopped outwardly, it continues in- wardly. This is very troublesome, and requires particular attention, as the patient is apt to be suffocated with the blood, especially if he falls asleep, which he is very ready to do after losing a great quantity of blood. When the patient is in danger of suffocation from the blood getting into his throat, the passages may be stopped by drawing threads up the nostrils, and bringing them out at the mouth, then fastening pieces of sponge or small rolls of linen cloth to their extremities: afterwards drawing them back, and tying them on the outside with a sufficient degree of tightness. After the bleeding is stopped, the patient ought to be kept as easy and quiet as possible. He should not pick his nose, nor take away the tents or clotted blood till they fall off of their own accord, and should not he with his head low. Those who are affected with frequent bleeding at the nose, ought to bathe their feet often in warm water, and keep them warm and dry They ought to wear nothing tight about their necks, to keep the body as much in an erect posture as possible, and never to view any object * From ten to twenty drops of the spirits of turpentine in a little water, givea frequently, seldom fails to stop a bleeding at the note, or from any other part. 228 BLEEDING AND BLIND TILE9. obliquely. If they have too much blood, a vegetable diet, with now and then a cooling purge, is the safest way to lessen it. But when the disease proceeds from a thin dissolved state of the blood, the diet should be rich and nourishing ; as strong broths and jellies, sago gruel, with wine aud sugar, &c. Infusions of the Peruvian bark in wine ought likewise to be taken, and persisted in for a consi- derable time. OF THE BLEEDING AND BLIND PILES. A discharge of blood from the haemorrhoidal vessels is called the Heeding piles. When the vessels only swell and discharge no blood, but are exceedingly painful, the disease is called the blind piles. Persons of a loose spongy fibre, of a bulky 6ize, who live high, and lead a sedentary, inactive life, are most subject to this disease. It is often owing to an hereditary disposition. Where this is the case, it attacks persons more early in life than when it is accidental. Men are more liable to it than women, especially those of a sanguine, plethoric, or a scorbutic habit, or of a melancholy disposition. The piles may be occasioned by an abscess of blood, by strong aloetio purges, high seasoned food, drinking great quantities of sweet wine, the neglect of bleeding or other customary evacuations, much riding, great costiveness, or any thing that occasions hard or difficult stools. Anger, grief, or other violent passions, will likewise occasion the piles. I have often known them brought on by sitting on the damp ground. A pair of thin breeches will excite the disorder in a person who is subject to it, and sometimes even in those who never had it before. Pregnant women are often afflicted with the piles. A flux of blood from the anus is not always to be treated as a disease. It is even more salutary than bleeding at the nose, and often prevents or carries off diseases. It is peculiarly beneficial in the gout, rheumatism, asthma, and other hypochondriacal complaints, and often proves critical in colics and inflammatory fevers. In the management of the patient, regard must be had to his habit of body, his age, strength, and manner of living. A discharge which might be excessive and prove hurtful to one, may be very moderate and even salutary to another. That only is to be esteemed dangerous, which continues too long, and is in such quantity as to waste the pa- tient's strength, hurt the dig%stion, nutrition, and other functions ne- cessary to life. When this is the case, the discharge must be checked by a proper regimen and astringent medicines. The diet must be cool but uou- BLEEDING AND BLISTD PILES. 229 fishing, consisting chiefly of bread, milk, cooling vegetables and broths. The drink may be chalybeate water, orange-whey, decoctions or infu- sions of the astringent and mucilaginous plants, as the tormentil root, bistort, the marsh-mallow roots, &c. Old conserve of red roses is a very good medicine in this case. It may be mixed with new milk aud taken in the quantity of an ounce three or four times a-day. This medicine is in no great repute, owing to it being seldom taken in such quantity as to produce any effects; but when taken as here directed, and duly persisted in, I have known it perform very extraordinary cures in violent haemorrhages, especially when assisted by the tincture of roses ; a tea-cupful of which may be taken about an hour after every dose of the conserve. The Peruvian bark is likewise proper in this case, both as a strength- ener and astringent. Half a dram of it may be taken in a glass of red wine, sharpened with a few drops of the elixir of vitriol, three or four times a-day. The bleeding piles are sometimes periodical, and return regularly once a-month, or once in three weeks. In this case they are always to be considered as a salutary discharge, and by no means to be stopped. Some have entirely ruined their health by stopping a periodical dis- charge of blood from the haemorrhoidal veins. In the blind piles bleeding is generally of use. The diet must be light and thin, and the drink cool and diluting. It is likewise neces- sary that the body be kept gently open. This may be done by smal1 doses of the flower of brimstone and cream of tartar. These may be mixed in equal quantities, and a tea-spoonful taken three or four times a-day, or oftener if necessary. Or an ounce of the flower (f brimstone and half an ounce of purified nitre maybe mixed with three or four ounces of the lenitive electuary, and a tea-spoonful of it taken three or four times a-day. Emollient clysters are here likewise beneficial; but there is some- times such an astriction of the anus, that they cannot be throwu up. In this case I have known a vomit have a very good effect. When the piles ure exceeding painful aud swelled, but discharge no thing, the patient must sit over the steams of warm water. He may likewise apply a linen cloth dipped in warm spirits of wine to the part, or poultices made of bread and milk, or of leeks fried with butter If these do not produce a discharge, and the piles appear large, leeches must be applied as near as possible, or if they will fix upon the piles themselves so much the better. When leeches will not fix, the piiea may be opened with a lancet. The operation is very easy, and is at- tended with no danger. 230 BLEEDING AND BLIND PILES. Various ointments and other external applications are recommended in the piles ; but I do not remember to have seen any effects from these worth mentioning. Their principal use is to keep the part moist, which may be done as well by a soft poultice or an emollient cataplasm. When the pain, however, is very great, a liniment made of two ounces of emollient ointment, and half an ounce of liquid laudanum, beat up with the yolk of an egg, may be applied. Aloes, which form a principal part of most of the advertised purgative pills, are frequently the cause of the piles. An habitual costiveness is much more effectually aud safely removed by a spoonful of castor oil taken occasionally in an evening. A weak solution of sugar of lead with a little laudanum is the best external remedy when the piles are very painful. A ointment made of one third finely powdered galls, and two thirds hogslard, is likewise of great service. An injection of lime-water, or an infusion of galls, may be used with advantage when the piles are seated high. The pain is often removed by an emetic, or taking twice a-day thirty drops of balsam of copaiva on a little moist sugar. A pile having a narrow neck is best extirpated by the knife ; if it be large, or have a broad basis, a double ligature may be passed through it, and tied on each side. Piles ought to be carefully attended to, as when they are neglected they are very «pt to produce a fistula. This painful disorder may be discovered by stains on the linen, proceeding from a small orifice near the anus. Such stimulants should be applied as will produce a more active inflammation on the sides of the ulcer, so as to make them ad. here together. Irritating injections, when duly persisted in, have some- times been found effectual for this purpose. A wine glass of sea water, taken every night for several weeks, has likewise been found useful. The best means of curing a fistula is a surgical operation. By the operation of cutting, the ulcer is reduced to the state of a simple wound, aud is healed as such. If this remedy is neglected too long, the disease gradually diffuses itself in various directions through the cellular sub- stance surrounding the rectum : and new openings are formed, which render the complaint more difficult to cure. This operation is sometimes performed by passing a silk thread, or a piece of flexible gold wire, in at the external orifice of the fistula, and bringing it out at the anus, and twisting the ends together, which is daily repeated till it cuts its way out. The incision, however, is a more certain and effectual way of eradicating the disease. 231 SPITTING OF BLOOD. We mean here to treat of that discharge of blood from the lungs only which is called a hmmoptoe, or spitting of blood. Persons of a slender make, and lax fibre, who have long necks and strait breasts, are most liable to this disease. It is most common in the spring, and generally attacks people before they arrive at the prime or middle period of life. It is a common observation, that those who have been subject to bleeding at the nose when young, are afterwards most liable to a hsemoptoe. Causes.—A hsemoptoe may proceed from excess of blood, from a peculiar weakness of the lungs, or a bad conformation of the breast. It is often occasioned by excessive drinking, running, wrestling, sing- ing, or speaking aloud. Such as have weak lungs, ought to avoid all violent exertions of that organ, as they value life. They should likewise guard against violent passions, excessive drinking, and every thing that occasions a rapid circulation of the blood. This disease may likewise proceed from wounds of the lungs. These may either be received from without, or they may be occasioned by hard bodies getting up the windpipe, and so falling down upon the lung*, and hurting that tender organ. The obstruction of any customary evacuation may occasion a spitting of blood ; as neglect of bleeding or purging at the usual seasons, the stoppage of the bleeding piles in men, or the menses in women, &c. It may likewise proceed from a polypus, schirrhous concretion, or any thing that obstructs the circulation of the blood in the lungs. It is often the effect of a long and violent cough ; in which case it is generally the forerunner of a consumption. A violent degree of cold suddenly applied to the external part of the body will occasion a huemoptoe. It may likewise be occasioned by breathing air which is too much rarified to be able properly to expand the lungs. This is often the case with those who work in hot places, furnaces, glass-houses, or the like. It is likewise said to happen to such as ascend to the top of very high mountains, as the Peak of Teneriffe, &c. Spitting of blood is not always to be considered as a primary disease. It is often only a symptom, and in some diseases not an unfavourable one. This is the case in pleurisies, peripneumoies, and sundry other fevers. In a dropsy, scurvy, or consumption, it is a bad symptom, and shows that the lungs are ulcerated. Symptoms.—Spitting of blood is generally preceded by a sense of weight and oppression of the breast, a dry tickling cough, hoarseness, md°a difficulty of breathing. Sometimes it is ushered in with shiver- 232 SPITTING OF BLOOD. ing, coldness of the extremities, costiveness, great lassitude, flatulence, pain of the back and loins, &c. As these show a tendency of the blood to inflammation, they are commonly the forerunners of a copious dis- charge. The above symptoms do not attend a discharge of blood from the gums or fauces, by which means they may always be distinguished from a hsemoptoe. Sometimes the blood that is spit up is thin, and of a florid red colour ; and at other times it is thick, and of a dark or black- ish colour ; nothing however can be inferred from this circumstance, but that the blood has laiu a longer or shorter time in the breast before it ivas discharged. Spitting of blood, in a strong healthy person, of a sound constitu- tion, is not very dangerous ; but when it attacks the tender and delicate, or persons of a weak lax fibre, it is with difficulty removed. When jt proceeds from a schirrus or polypus of the lungs, it is bad. The dan- ger is greater when the discharge proceeds from the rupture of a large vessel than of a small one. When the extravasated blood is not spit up, but lodges in the breast, it corrupts, and greatly increases the danger. When the blood proceeds from an ulcer in the lungs, it is generally fatal. Regimen.—The patient ought to be kept cool and easy. Every thing that heats the blood, or quickens the circulation, increases the danger. The mind ought likewise to be soothed, and every occasion of exciting the passions avoided. The diet should be soft, cooling, and slender ; as rice boiled with milk, small broths, barley-gruel, panado, &c.—The diet in this case can scarcely be too low. Even water-gruel is sufficient to support the patient for some days. All strong liquors must be avoided. The patient must drink miik and water, barley-water, whey, butter-milk, and such like. Every thing, however, should be drank cold, and in small quantities at a time, lie should observe the strictest silence, or at least speak with a very low voice. Medicine.—This,likethe other involuntary discharges of blood, ought not to be suddenly stopped by astringent medicines : more mischief is done by these, than if it were suffered to go on. It may, however, pro- ceed so far as to weaken the patient, and even endanger his life ; in which case proper means must be used for restraining it. The body should be kept gently open by laxative diet; as roasted apples, stewed prunes, and such like. If these should not have the desired effect, a tea-spoonful of the lenitive electuary may be taken twice or thrice a-day as is found necessary. If the bleeding proves violent, ligatures may be applied to the extremities, as directed for a bleeding at the nose. If the patient be hot or feverish, bleeding and small doses of nitre will be of use ; a scruple or half a dram of nitre may be taken in a cup VOMITING OF BLOOD. 233 of his ordinary drink twice or thrice a-day. His drink may likewise be sharpened with acids, as juice of lemon, or a few drops of the spirit of vitriol; or he may take frequently a cup of the tincture of roses. Bathing the feet and legs in lukewarm water has likewise a very good effect in this disease. Opiates too are sometimes beneficial; but these must be administered with caution. Ten or twelve drops of laudanum may be given in a cup of barley-water twice a-day, and continued for some time, provided they be found beneficial. The conserve of roses is likewise a very good medicine in this case, provided it be taken in sufficient quantity, and long enough persisted in. It may be taken to the quantity of three or four ounces a day ; and if the patient be troubled with a cough, it should be made into an elec- tuary with balsamic syrup and a little of the syrup of poppies. If stronger astringents be necessary, fifteen or twenty drops of the elixir of vitriol may be given in a glass of water three or four times a-day. Those who are subject to frequent returns of this disease should avoid all excess. Their diet should be light and cool, consisting chiefly of milk and vegetables. Above all, let them beware of vigorous efforts of the body aud violent agitations of the mind. VOMITING OF BLOOD. This is not so common as the other discharges of blood which have already been mentioned ; but it is very dangerous, and requires parti- cular attention. Vomiting of blood is generally preceded by pain of the stomach, sickness, and nausea ; and is accompanied with great anxiety and fre- quent fainting fits. This disease is sometimes periodical; in which case it is less danger- ous. It often proceeds from the stopping of the haemorrhoidal flux in men. It may be occasioned by any thing that greatly stimulates or wounds the stomach, &c. It is often the effect of obstructions in the liver, the spleen, or some of the other viscera. It may likewise proceed from external violence, as blows or bruises, or from any of the causes which produce inflammation. In hysteric women vomiting of blood is a very common but by no means a dangerous symptom. A great part of the danger in this disease arises from the exasperated blood lodging in the boweis, and becoming putrid, by which means a dysentery or putrid fever may be occasioned. The best way of pre- venting this is to keep the body gently open by frequently exhibiting emollient clysters. Purges must not be given till the discharge is Btopt, otherwise they will irritate the stomach, and increase the disorder- 234 OF BLOODY URINE» All the food and drink must be of a mild nature, and taken in small quantities. Even drinking cold water has sometimes proved a remedy, but it will succeed better with the weak spirits of vitriol. When there are signs of an inflammation, bleeding may be necessary ; but the pa- tient's weakness will seldom permit it. Opiates may be of use ; but they must be given in very small doses, as four or five drops of liquid laudanum twice or thrice a-day. After the discharge is over, as the patient is generally troubled with gripes, occasioned by the acrimony of the blood lodged in the intestines, gentle purges will be necessary. OF BLOODY URINE. This is a discharge of blood from the vessels of the kidneys or blad- der, occasioned by their being either enlarged, broken, or eroded. It is more or less dangerous according to the different circumstances which attend it. When pure blood is voided suddenly, without interruption and with- out pain, it proceeds from the kidneys; but if the blood be in small quantity, of a dark colour, and emitted with heat and pain about the bottom of the belly, it proceeds from the bladder. When bloody urine is occasioned by a rough stone descending from the kidneys to the blad- der, which wounds the ureter, it is attended with a sharp pain in the back, and difficulty of making water. If the coats of the bladder are hurt by a stone, and the bloody urine follows, it is attended with the most acute pain, and a previous stoppage of urine. Bloody urine may likewise be occasioned by falls, blows, the lifting or carrying of heavy burdens, hard riding, or any violent motion. It may also proceed from ulcers of the bladder, from a stone lodged in the kidneys, or from violent purges, or sharp diuretic medicines, espe- cially cautharides. Bloody urine 'is always attended with some degree of danger, but it is peculiarly so when mixed with purulent matter, as this shows an ulcer somewhere in the urinary passages. Sometimes this discharge proceeds from excess of blood, in which case it is rather to be consi- dered as a salutary evacuation than a disease. If the discharge, how- ever, be very great, it may waste the patient's strength, and occasion an ill habit of body, a dropsy, or a consumption. The treatmentof this disorder must be varied according to the differ- ent causes from which^it proceeds. When it is owing to a stone in the bladder, the cure depends upon an operation, a description of which would be foreign to our purpose. OF THE DYSENTERY, OR BLOODY FLUX, 235 If it be attended with a plethora and symptoms of inflammation, bleeding will be necessary. The body must likewise be kept open by emollient clysters or cooling purgative medicines ; as cream of tartar, rhubarb, manna, or small doses of lenitive electuary. When bloody urine proceeds from a dissolved state of the blood, it is commonly the symptom of some malignant disease ; as the small-pox, a putrid fever, or the like. In this case the patient's life depends on the liberal use of the Peruvian bark, wine and acids, as has already been shown. When there is reason to suspect an ulcer in the kidneys or bladder, the patient's diet must be cool, and his drink of a soft, healing, balsamic quality, as decoctions of marshmallow roots, with liquorice, solutions of gum-arabic, &c. Three ounces of marsh-mallow roots, and half an ounce of liquorice, may be boiled in two English quarts of water to one ; two ounces of gum-arabic, and half an ounce of putrified nitre, may be dissolved in the strained liquor, and a teacupful of it taken four or five times a-day. The early use of astringents in this disease has often bad conse- quences. When the flux is stopped too soon, the grumous blood, by being confined in the vessels, may produce inflammations, abscess, and ulcers. If, however, the case be urgent, or the patient seems to suffer from the loss of blood, gentle astringents may be necessary. In this case the patient may take three or four ounces of lime-water, with half an ounce of the tincture of Peruvian bark, three times a-day ; or he may take an ounce or two of the conserve of roses three or four times a-day, drinking a teacupful of the tincture of roses after it; or if stronger styptics be necessary, a dram of Armenian bole in a cup of whey may be taken three or four times a-day. OF THE DYSENTERY, OR BLOODY FLUX. This disease prevails in the spring and autumn. It is most common in marshy countries, where, after hot and dry summers, it is apt to become epidemic. Persons are most liable to it who are much exposed to the night-air, or who live in places where the air is confined and un- wholesome. Hence it often proves fatal in camps, on shipboard, in gaols, hospitals, and such like places. Causes.—The dysentery may be occasioned by any thing that ob- structs the perspiration, or renders the humours putrid : as damp beds, wet clothes, unwholesome diet, bad air, &c. But it is most frequently communicated by infection. This ought to make people extremely cautious in going near such persons as labour under the disease. Even 236 OF THE DYSENTERY, OR BLOODY FLUX. the smell of the patient's excremeuts has been known to communicate the infection. Symptoms.—It is known by a flux in the belly, attended by violent pain in the bowels, a constant inclination to go to stool, and generally more or less blood in the stools. It begins, like other fevers, with chill- ness, loss of strength, a quick pulse, great thirst, and an inclination to vomit. The stools are at first greasy and frothy, afterwards they are streaked with blood, and at last have frequently the appearance of pure blood, mixed with small filaments resembling bits of skin. Worms are sometimes passed both upwards and downwards through the whole course of the disease. When the patient goes to stool, he feels a bearing down, as if the whole bowels were falling out, and some- times a part of the intestine is actually protruded, which proves ex- ceedingly troublesome, especially in children. Flatulency is likewise a troublesome symptom, especially towards the end of the disease. This disease may be distinguished from a diarrhoea, or looseness, by the acute pain of the bowels, and the blood which generally appears in the stools. It may be distinguished from the cholera morbus by its not being attended with such violent and frequent fits of vomiting, &c. When the dysentery attacks the old, the delicate, or such as have been wasted by the gout, the scurvy, or other lingering diseases, it generally proves fatal. Vomiting and hiccuping are bad signs, as they show an inflammation of the stomach. When the stools are green, black, or have an exceedingly disagreeable cadaverous smell, the danger is very great, as it shows the disease to be of a putrid kind. It is an un- favourable symptom when clysters are immediately returned ; but still more so when the passage is so obstinately shut that they cannot be in- jected. A feeble pulse, coldness of the extremities, with difficulty of swallowing, and convulsions, are signs of approaching death. Regimen.—Nothing is of more importance in this disease than clean- liness. It contributes greatly to the recovery of the patient, and no less to the safety of such as attend him. In all contagious diseases the danger is increased, and the infection spread, by the neglect of clean- liness ; but in no one more than this. Every thing about the patient should be frequently changed. The excrement should never be suffered to continue in his chamber, but removed immediately, and buried under ground. A constant stream of fresh air should be admitted into his chamber; and it ought frequently to be sprinkled with vinegar, juice of lemon, or some other strong acids. The patient must not be discouraged, but his spirits kept up in hopes of a cure. Nothing tends more to render any putrid disease mortal, than the fears and apprehensions of the sick. All diseases of this nature OF THE DYSENTERY, OR BLOODY FLUX. 237 have a tendency to sink and depress the spirits, and when that is in- creased by fears and alarms from those whom the patient believes to be persons of skill, it cannot fail to have the worst effect. A flannel waistcoat worn next the skin has often a very good effect in the dysentery. This promotes the perspiration without over-heating the body. Great caution, however, is necessary in leaving it off. I have often known a dysentery brought on by imprudently throwing off a flannel waistcoat before the season was sufficiently warm. For whatever purpose this piece of dress is worn, it should never be left off but in a warm season. In this disease the greatest attention must be paid to the patient's diet. Flesh, fish, and every thing that has a tendency to turn putrid or rancid on the stomach, must be abstained from. Apples boiled in milk, water-pap, and plain light pudding, with broth made of the gelatinous parts of animals, may constitute the principal part of the patient's food. Gelatinous broth not only answers the purpose of food, but is likewise a medicine. I have often known dysenteries, which were not of a putrid nature, cured by it, after pompous medicines had proved ineffectual.* Another kind of food very proper in the dysentery, which may be used by such as cannot take the broth mentioned above, is made by boiling a few handfuls of fine flour tied in a cloth, for six or seven hours, till it becomes as hard as starch. Two or three table-spoonfuls of this may be grated down, and boiled in such a quantity of new-milk and water as to be of the thickness of pap. This may be sweetened to the patient's taste, and taken for his ordinary food.f In a putrid dysentery the patient may be*allowed to eat freely of most kinds of good ripe fruit; as apples, grapes, gooseberries, currant- * The manner of making this broth is, to take a sheep's head and feet, with the Bkin upon them, and to burn the wool off with a hot iron ; afterwards to boil them till the broth is quite a jelly. A little cinnamon or mace may be added, to give the broth an agreeable flavour, and the patient may take a little of it warm with toasted bread three or four times a-day. A clyster of it may likewise be given twice a-day. Such as cannot use broth made in this way, may have the bead and feet skinned; but we have reason to believe that this injures the medicine. It is not our business here to reason upon the nature and qualities of medicine, otherwise this might be shown to possess virtues every way suited to the cure of a dysentery which does not proceed from a putrid state of the humours. One thing we know, which is prefer- able to all reasoning, that whole families have often be.-n cured by it, after they had used many other medicines in vain. It will, however, be proper that the patient take a vomit, and a dose or two of rhubarb, before he begins to use the broth. It will likewise be necessary to coutiuue the use of it for a considerable time, and to make it the principal food. > The learned and humanf Dr. Rutherford, late professor of medicine in the University of Edinburgh, used to mention this food in his public lectures with great encomiums, lie directed it to be made by tying a pound or two of the finest flour, as tight as possible, in a linen rag, afterwards to dip it frequently in water, and to dridge the outside with flour till a cake or crust was formed around it, which pre- vents the water from soaking into it while boilini'. It is then to be boiled till it becomes a hard dry mass, as directed above. This, when mixed with milk and viii^cr will not only answer the purpose of food, but may likewise be given in clyster* 238 OF THE DYSENTERY, OR BLOODY FLUX. berries, strawberries, &c. These may either be eaten raw or boiled, with or without milk, as the patient chooses. The prejudice against fruit in this disease is so great, that many believe it to be the common cause of dysenteries. This however is an egregious mistake. Both reason and experience show, that good fruit is one of the best medi- cines, both for the prevention and cure of the dysentery. Good fruit is in every respect calculated to counteract that tendency to putrefac- tion, from whence the most dangerous kind of dysentery proceeds. The patient in such a case ought therefore to be allowed to eat as much fruit as he pleases, provided it be ripe.* The most proper drink in this disorder is whey. The dysentery has often been cured by the use of clear whey alone. It may be taken both for drink, and in form of clyster. When they cannot be had, barley- water sharpened with cream of tartar may be drank, or a decoction of barley and tamarinds ; two ounces of the former and one of the latter may be boiled in two English quarts of water to one. Warm water, water-gruel, or water wherein hot iron has been frequently quenched are all very proper, and may be drank in turns. Camomile-tea, if the stomach will bear it, is an exceeding proper drink. It both strength- ens the stomach, and by its antiseptic quality tends to prevent a mor- tification of the bowels. Medicine.—At the beginning of this disease it is always necessary to cleanse the first passages. For this purpose a vomit of ipecacuanha must be given, and wrought off with weak camomile-tea. Strong vomits are seldom necessary here. A scruple, or at most half a dram, of ipecacuanha, is generally sufficient for an adult, and sometimes a very few grains will suffice. The day after the vomit, half a dram or two scruples of rhubarb, must be taken ; or what will answer the pur- pose rather better, an ounce, or an ounce and a half, of Epsom salts. This dose may be repeated every other day for two or three times. Afterwards small doses of ipecacuanha may be taken for some time. Two or three grains of the powder may be mixed in a table-spoonful of the syrup of poppies, and taken three times a-day. These evacuations, and the regimen prescribed above, will often be * I lately saw a young man who had been seized with a dysentery in North Ame - rica. .Many things had been tried there for his relief but to no purpose. At length tired out with disappointments from medicine, and reduced to skin and bone, he came over to Britain, rather with a view to die among his relations, than with any hopes of a cure. After taking sundry medicines here with no better success than abroad, I advised him to leave off the use of drugs, and to trust eutirely to a diet of milk aud fruits with gentle exercise. Strawberries was the only fruit he could pro- cnre at that season. These he ate with milk twice and sometimes thrice a-day. The consequence was, that in a short time his stools were reduced from upwards of twenty in a day, to three or four, and sometimes not so many. He used the ithet fruits as they came in, and was in a few weeks so well as to leave that part of the ■ouiitry where he was, with a view to return to America. OF THE DYSENTERY, OR BLOODY FLUX, 239 sufficient to effect a cure. Should it, however, happen otherwise, the following astringent medicines may be used :— A clyster of starch or fat mutton broth, with thirty or forty drops of liquid laudanum in it, may be administered once a-day. At the same time an ounce of gum-arabic, and half an ounce of gum-tragacanth, may be dissolved in an English pint of barley-water, over a slow fire, and a table spoonful of it taken every hour. If these have not the desired effect, the patient may take, four times a-day, about the bulk of a nutmeg of the Japonic confection, drinking after it a tea-cupful of the decoction of logwood.* Persons who have been cured of this disease are very liable to relapse; to prevent which, great circumspection with respect to diet is necessary. The patient must abstain from all fermented liquors, except now and then a glass of good wine : but he must drink no kind of malt liquor. He should likewise abstain from animal food, as fish and flesh, and live principally on milk and vegetables. Gentle exercise and wholesome air are likewise of importance. The patient should go to the country as soon as his strength will permit, and should take exercise daily on horseback, or in a carriage. He may likewise use bitters infused in wine or brandy, and may drink twice a-day a gill of lime-water mixed with an equal quantity of new milk. When dysenteries prevail, we would recommend a strict attention to cleanliness, a spare use of animal food, and the free use of sound ripe fruits, and other vegetables. The night air must be carefully avoided, and all communication with the sick. Bad smells are likewise to be shunned, especially those which arise from putrid animal substances. The necessaries where the sick go are carefully to be avoided. When the first symptoms of the dysentery appear, the patient ought immediately to take a vomit, to go to bed, and drink plentifully of weak warm liquor, to promote a sweat. This, with a dose or two of rhubarb at the beginning, would often carry off the disease. In countries where dysenteries prevail, we would advise such as are liable to them, to take either a vomit or a purge every spring or autumn, as a preventive. There are sundry other fluxes of the belly, as the Lientery and CffiLiAC Passion, which, though less dangerous than the dysentery, yet merit consideration. These diseases generally proceed from a relaxed state of the stomach and intestines, which is sometimes so great, that the food passes through them with hardly any sensible alteration ; and the patient dies mereley from the want of nourishment. When the lientery or cceliac passion succeed to a dysentery, the case is bad. They are always dangerous in old age, especially when the * See Appendix, Decoction of Logwood. 249 of the head ache. constitution has been broken by excess or acute diseases. If the stools be very frequent and quite crude, the thirst great, with little urine, the mouth ulcerated, and the face marked with spots of different colours, the danger is very great. The treatment of the patient is in general the same as in the dysentery. In all obstinate fluxes of the belly, the cure must be attempted, by first cleansing the stomach and bowels, with gentle vomits and purges ; afterwards such a diet as has a tendency to heal and strengthen the bowels, with opiates and astringent medicines, will generally complete the cure. The same observation holds with respect to a Tenesmus, or frequent desire to go to stool. This disease resembles the dysentery so much. both in its symptoms and method of cure, that we think it needless to insist upon it. CHAP. XXXIV. OF TIIE HEAD-ACHE. Aches and pains proceed from very different causes, and may affect any part of the body : but we shall point out those only which occur most frequently, and are attended with the greatest danger. When the head-ache is slight, and affects a particular part of the head only, it is called cephalgia ; when the whole head is affected ce- phalaa; and when one side only, hemicrania. A fixed pain in the forehead, which may be covered with the end of the thumb, is called the clavus hystericus. There are also other distinctions. Sometimes the pain is internal, sometimes external ; sometimes it is an original disease, and at other times only symptomatic. When the head-ache proceeds from a hot bilious habit, the pain is very acute and throbbing, with a considerable heat of the part affected. When from a cold phlegmatic habi:, the pa- tient complains of a dull heavy pain, and has a sense of coldness iii the part. This kind of head-ache is sometimes attended with a decree of stupidity or folly. Whatever obstructs the free circulation of the blood through the vessels of the head, may occasion a head-ache. In persons of a M\ habit, who abound with blood, the head-ache often proceeds from a suppression of cu.stoiuary evacuations ; as bleeding at the nose, sweat- OF THE HKAD-ACHE. 241 Ing of the feet, &c. It may likewise proceed from any cause that de- termines a great flux of blood towards the head; as coldness of the extremities, or hanging down of the head for a long time. Whatever prevents the return of the blood from the head, will likewise occasion a head-ache ; as looking long obliquely at one object, wearing any thing tight about the neck, a new hat, or the like. Wiien a head-ache proceeds from the stoppage of a running at the nose, there is a heavy, obtuse pressing pain in the fore-part of the head in which there seems to be such a weight, that the patient can scarcely hold it up. When it is occasioned by the caustic matter of the venereal disease, it generally affects the skull, and often produces a caries of the bones. Sometimes the head-ache proceeds from the repulsion or retrocension of the gout, the erysipelas, the small-pox, measles, itch, or other eruptive diseases. What is called a hemicrania generally proceeds from crudi- ties or indigestion. Inanition, or emptiness, will occasion head aches. I have often seen instances of this in nurses who gave suck'long, or who did not take a sufficient quantity of solid food. There is likewise a most violent, fixed, constant, and almost intoler- able head-ache, which occasions great debility both of body and mind, prevents sleep, destroys the appetite, causes a eeTtigo, dimness of sight, a noise in the ears, convulsions, epileptic fits, and sometimes vomiting, costiveness, coldness of the extremities, &c. The head-ache is often symptomatic in continual and intermitting fevers, especially quartans. It is likewise a very common symptom in hysteric and hypochondriac complaints. When an head-ache attends an acute fever, with pale urine, it is an unfavourable symptom. In excessive head-aches, coldness of the extre- mities is a bad sign. When the disease continues long, and is very violent, it often termi- nates in blindness, an apoplexy, deafness, a vertigo, the palsy, or the epilepsy. In this disease the cool regimen in general is to be observed. The diet ought to consist of such emollient substances as will corrupt the acrimony of the humours, and keep the body open ; as apples boiled in milk, spinage, turnips, and such like. The drink ought to be diluting, as barley-water, infusions of mild mucilaginous vegetables, decoctions of the sudorific woods, &c. The feet and legs ought to be kept warm and frequently bathed in lukewarm water ; the head should be shaved, and bathed with vinegar. The patient ought, as much as possible, to keep in an erect posture, and not to lie with his head too low. When the head-ache is owing to excess of blood, or an hot bilious B 242 of the head-ache, constitution, bleeding is necessary. The patient may be bled in the jugular vein, and the operation repeated if there be occasion. Cupping also, or the application of leeches to the temples, and behind the ears, will be of service. Afterwards a blistering-plaster may be applied to the neck, behind the ears, or to any part of the head that is most affect- ed. In some cases it will be proper to blister the whole head. In per- sons of a gross habit, issues, or perpetual blisters, will be of service. The body ought likewise to be kept open by gentle laxatives. But when the head-ache proceeds from a copious vitiated serum, stagnating in the membranes, either within or without the skull, with a dull, heavy, continual pain, which will neither yield to bleeding nor gentle laxatives, then more powerful purgatives are necessary, as pills made of aloes, resign of jalap, or the like. It will also be necessary in this case to blister the whole head, and to keep the back part of the neck open for a considerable time by a perpetual blister. When the head-ache is occasioned by the stoppage of a running at the nose, the patient should frequently smell to a bottle of volatile salts : he may likewise take snuff, or any thing that will irritate the nose, so as to promote a discharge from it; as the herb mastich, ground ivy, &c. A hemicrania, especially a periodical one, is generally owing to a foulness of the stomach, for which gentle vomits must be administered, as also purges of rhubarb. After the bowels have been sufficiently cleared, chalybeate waters, and such bitters as strengthen the sto- mach, will be necessary. A periodical head-ache has been cured by wearing a piece of flannel over the forehead during the night. When the head-ache arises from a vitiated state of the humours, as in the scurvy, and venereal disease, the patient, after proper evacu- ations, must drink freely of the decoction of woods, or the decoction of sarsaparilla, with raisins and liquorice.* These, if duly persisted in, will produce very happy effects. When a collection of matter is felt under the skin, it must be discharged by an incision, otherwise it will ren- der the bone carious. When the head-ache is so intolerable as to endanger the patient's life, or is attended with continual watching and delirium, recourse must be had to opiates. These, after proper evacuations by clysters, or mild purgatives, may be applied both externally and internally. The affected part may be rubbed with Bate's anodyne balsam, or a cloth dipped in it may be applied to the part. The patient may, at the same time, take twenty drops of laudanum, in a cup of valerian or pen- ny-royal tea, twice or thrice a-day. This is only to be done iu case ol * See Appendix, Decoction of Sarsaparilla. o» the tooth-achk. 243 extreme pain. Proper evacuations ought always to accompany and follow the use of opiates.* When the patient cannot bear the loss of blood, his feet ought fre- quently to be bathed in lukewarm water, and well rubbed with a coarse cloth. Cataplasms with mustard or horse-radish ought likewise to be applied to them. This course is peculiarly necessary when the pain proceeds from a gouty humour affecting the head. When the head-ache is occasioned by great heat, hard labour, or violent exercise of any kind, it may be allayed by cooling medicines ; as the saline draught with nitre, and the like. A little aether dropt into the palm of the hand, and applied to the forehead, will sometimes remove a violent head-ache. OF THE TOOTH-ACHE. This disease 'is so well known that it needs no description. It has great affinity with the rheumatism, and often succeeds pains of the shoulders, and other parts of the body. It may proceed from obstructed perspiration, or any of the other causes of inflammation. I have often known the tooth-ache occasioned by neglecting some part of the usual coverings of the head, by sitting with the head bare near an open window, or exposing it to a draught of cold air. Food or drink taken either too hot or too cold, is very hurtful to the teeth. Great quantities of sugar, or other sweetmeats, are likewise hurtful. Nothing is more destructive to the teeth than cracking nuts, or chewing any kind of hard substances. Picking the teeth with pins, needles, or any thing that may hurt the enamel with which they are covered, does great mischief, as the tooth is sure to be spoiled whenever the air gets into it. Breeding women are very subject to the tooth-ache, especially during the first three or four months of pregnancy. The tooth-ache often proceeds from scorbutic humours affecting the gums. In this case the teeth are sometimes wasted, and fall out without any considerable degree of pain. The more immediate cause of the tooth-ache is a rotten or carious tooth. In order to relieve the tooth-ache, we must first endeavour to lessen the flux of humours to the part affected. This may be done by mild purgatives, scarifying the gums, or applying leeches to them, and bathing the feet in warm water. The perspiration ought likewise to be promoted, by drinking freely of white wine-whey, or other diluting * When the pain is very violent, and does not yield to small doses of laudanum, the quantity may be increased. I have known a patient in extreme pain take three hundred drops in twenty-four hour*; but such doses ought only to be administered by a parson of skill. 244 OP THE TOCTH-ACHB. liquors, with small doses of nitre. Vomits too have often an exceeding good effect in the tooth-ache. It is seldom safe to administer opiates, or any kind of heating medicines, or even to draw a tooth, till proper eva- cuations have been premised ; and these alone will often effect the cure. If thisfaihand the pain and inflammation still increase, a suppuration may be expected, to promote which a toasted fig should be held be- tween the gum and the cheek ; bags filled with boiled camomile flow- ers, flowers of elder, or the like, may be applied near the part affected, with as great a degree of warmth as the patient can bear, and renewed as they grow cool; the patient may likewise receive the steams of warm water into his mouth through an inverted funnel, or by holding his head over the mouth of a porringer filled with warm water. Gargles are likewise of use to promote a discharge. Rob of elder dissolved in small beer makes a very proper gargle, or an infusion of sage or mul- berry leaves. Such things as promote the discharge of saliva, or cause the patient to spit, are generally of service. For this purpose, bitter, hot, or pun- gent vegetables may be chewed; as gentian, calamus arromaticus, or pellitory of Spain. Allen recommends the root of yellow water flower- de-luce in this case. This root may either be rubbed upon the tooth, or a little of it chewed. Brookes says, he hardly ever knew it fail to cure the tooth-ache. It ought, however, to be used with caution. Many other herbs, roots, and seeds, are recommended for curing the tooth-ache ; as the leaves or roots of millefoil or yarrow chewed, to- bacco smoked or chewed, staves-acre, or the seed of mustard chewed, &c. These bitter, hot, and pungent things, by occasioning a greater flow of saliva, frequently give ease in the tooth-ache. Opiates often relieve the tooth-ache. For this purpose a little cotton wet with laudanum may be held between the teeth ; or a piece of stick- ing-plaster, about the bigness of a shilling, with a bit of opium in the middle of it, of a size not to prevent the sticking of the other may be laid on the temporal artery, where the pulsation is most sensible. De la Motte affirms, that there are few cases wherein this will not give relief. If there be a hollow tooth, a small pill made of equal parts of camphire and opium, or a small piece of assafoetida, put into the hollow, is often beneficial. When this cannot be had, the hollow tooth may be filled with gum mastich, wax, lead, cork, or any substance that will stick in it, and keep out the external air. Few applications give more relief in the tooth-ache than blistering plasters. These may be applied between the shoulders ; but they have the best effect when put behind the ears, and made so large as to cover a great part of the lower jaw. Burning the nerve within the affected OF TH« EAR-ACHE. 245 tooth with a hot iron, has frequently given ease; but this operation ought to be performed with care. After all, when the tooth is carious, it is often impossible to remove the pain without extracting it; and as a spoiled tooth never becomes Bound again, it is prudent to draw it soon, lest it should affect the rest. Tooth-drawing, like bleeding, is very much practised by mechan- ics, as well as persons of the medical profession. The operation, how- ever, is not without danger, and ought always to be performed with care. A person unacquainted with the structure of the parts, will be in danger of hurting the jaw-bone, or of drawing a sound tooth instead of a rotten one.* When a sound tooth has been drawn, if it be replaced immediately it will grow again. When the tooth-ache returns periodically, and the pain chiefly affects the gums, it may be cured by the bark. Some pretend to have found great benefit in the tooth-ache, from the application of an artificial magnet to the affected tooth. We shall not attempt to account for its mode of operation ; but, if it be found to an- swer, though only in particular cases, it certainly deserves a trial, as it is attended with no expense, and cannot do any harm. Electricity has likewise been recommended, and particular instruments have been invented for sending a shock through the affected tooth. Persons who have returns of the tooth- ache at certain seasons, as spring and autumn, might often prevent it by taking a purge at these times. Keeping the teeth clean has no doubt a tendency to prevent the tooth-ache. The best method of doing this is to wash them daily with salt and water, a decoction of the bark, or with cold water alone. All brushing and scraping of the teeth is dangerous, and, unless it be per- formed with great care, does mischief. OF THE EAR-ACHE. This disorder chiefly affects the membrane which lines the inner cavity of the ear called the meatus auditorius. It is often so violent as to occasion great restlessness, anxiety, and even delirium. Sometimes epileptic fits, and other convulsive disorders, have been brought on by extreme pain in the ear. The ear-ache may proceed from any of the causes which produce inflammation. It often proceeds from a sudden suppression of perspi- ration or from the head being exposed to cold when covered with sweat. * This may always be prevented by the operator striking upon the teeth with any piece of metal, aa this never fails to eicite the pain in the carious tooth. 246 PAIX OF THE STOMACH, ETC. It may also De occasioned by worms, or other insects getting into the ear, or being bred there ; or from any hard body sticking in the ear. Sometimes it proceeds from the translation of morbific matter to the ear. This often happens in the decline of malignant fevers, and occa- sions deafness, whch is generally reckoned a favourable symptom. When the ear-ache proceeds from insects, or any hard body sticking in the ear, every method must be taken to remove them as soon as possible. The membrane may be relaxed by dropping into the ear oil of sweet almonds, or olive oil. Afterwards the patient should be made to sneeze, by taking snuff, or some strong sternutatory. If this should not force out the body, it must be extracted by art. I have seen in- sects, which had got into the ear, come out of their own accord upon pouring in oil. When the pain "of the ear proceeds from inflammation, it must be treated like other topical inflammations, by a cooling regimen, and opening medicines. Bleeding at the beginning, either in the arm or jugular vein, or cupping in the neck, will be proper. The ear may likewise be fomented with the steams of warm water ; or flannel bags filled with boiled mallows and camomile-flowers may be applied to it warm ; or bladders filled with warm milk and water. An exceeding good method of fomenting the ear is to apply it close to the mouth of a jug filled with warm water, or a strong decoction of camomile flowers. The patient's feet should be frequently bathed in lukewarm water, and he ought to take small doses of nitre and rhubarb, viz. a scruple of the former, and ten grains of the latter, three times a-day. His drink may be whey, or decoctions of barley and liquorice, with figs or raisins. The parts behind the ear ought frequently to be rubbed with camphorated oil, or a little of the volatile liniment, and a few drops of the camphorated spirit of wine may be put into the ear with wool or cotton. A blister behind the ear, if applied early, will sometimes re- move this complaint. When the inflammation cannot be discussed, a poultice of bread and milk, or roasted onions, may be applied to the ear, and frequently re- newed till the abscess breaks, or can be opened. Afterwards the hu- mours may be diverted from the part by gentle laxatives, blisters, or issues; but the discharge must not be suddenly dried up by any exter- nal application. PAIN OF THE STOMACH, &c. This may proceed from various causes, as indigestion ; wind ; the acrimony of the bile ; sharp, acrid, or poisonous substances taken into PAIN OF THE STOMACH, ETC. 247 the stomach, &c. It may likewise be occasioned by worms ; the sto,. page of customary evacuations; or from a translation of gouty matter to the stomach, the bowels, &c. Women in the decline of life are very liable to pains of the stomach and bowels, especially such as are afflicted with hysteric complaints. It is likewise very common to hypochondriac men of a sedentary and luxu- rious life. In such persons it often proves so extremely obstinate as to baffle all the powers of medicine. When the pain in the stomach is most violent after eating, there is reason to suspect that it proceeds from some fault either in the digestion or the food. In this case the patient ought to change his diet, till he finds what kind of food agrees best with his stomach, and should con- tinue chiefly to use it. If a change of diet does not remove the com- plaint, the patient may take a gentle vomit, and afterwards a dose or two of rhubarb. He ought likewise to take an infusion of camomile- flowers, or some other stomachic bitter, either in wine or water. I have often known exercise remove this complaint, especially sailing, or a long journey on horseback, or in a carriage. When a pain of the stomach proceeds from a flatulency," the patient is constantly belching up wind, and feels an uneasy distention of the stomach after meals. This is a most deplorable disease, and is seldom thoroughly cured. In general, the patient ought to avoid all windy diet, and every thing that sours on the stomach, as greens, roots, &c. This rule, however, admits of some exceptions. There are many in- stances of persons much troubled with wind, who have received great benefit from eating parched pease, though that grain is generally sup- posed to be of a windy nature.* This complaint may likewise be greatly relieved by labour, especially digging, reaping, mowing, or any kind of active employment by which the bowels are alternately compressed and dilated. The most obsti- nate case of this kind I ever met with was in a person of sedentary oc- cupation, whom I advised, after he had tried every kind of medicine in vain, to turn gardener; which he did, and has ever since enjoyed good health. When a pain of the stomach is occasioned by the swallowing of acrid or poisonous substances, they must be discharged by vomit; this may be excited by butter, oils, or other soft things, which sheath and defend the stomach from the acrimony of its contents. When a pain of the stomach proceeds from a translation of gouty matter, warm cordials are necessary, as generous wines, French brandy. * These are prepared by steepine or soaking pease in water, and afterwards drying them in a pot or kiln till they burst. They may be used at pleasure. "O FAIN OF THE STOMACH, ETC. &c. Some have drank a whole bottle of brandy or rum in this case in a few hours, without being in the least intoxicated, or even feeling the stomach warmed by it. It is impossible to ascertain the quantity ne- cessary upon these occasions. This must be left to the feelings and discretion of the patient. The safer way however is not to go too far. When there is an inclination to vomit, it may be promoted by drink- ing an infusion of camomile-flowers, or carduus benedictus. If a pain of the stomach proceed from the stoppage of customary eva- cuations, bleeding will be necessary, especially in sanguine and very full habits. It will likewise be of use to keep the body gently open by mild purgatives ; as rhubarb or senna. When the disease affects women in the decline of life, after the stoppage of the menses, making an issue in the leg or arm will be of peculiar service. When the disease is occasioned by worms, they must be destroyed, or expelled by such means as are recommended in the following «ection. When the stomach is greatly relaxed, and the digestion bad, which often occasion flatulencies, the elixir of vitriol will be of singular ser- vice. Fifteen or twenty drops of it may be taken in a glass of wine or water twice or thrice a-day. Persons afflicted with flatulency are generally unhappy unless they be taking some purgative medicines ; these, though they may give immediate ease, tend to weaken and relax the stomach and bowels, and consequently increase the disorder. Their best method is to mix pur- gatives and stomachics together. Equal parts of Peruvian bark and rhubarb may be infused in brandy or wine, and taken in such quantity as to keep the body gently open. It is difficult to prescribe a general medicine for a disorder arising from such a variety of causes ; a plaster may be recommended which seldom fails to give relief. It is made of any kind of adhesive plaster spread upon leather, with the addition of a dram and a half, or two drams of powdered opium, while warm. It should be of a size large enough to cover the whole stomach, and should be allowed to remaiu on as long as it will stick. 249 CHAP. XXXV. OF WORMS. Tn ese are chiefly of three kinds, viz. the lania, or tape-worm : the teres, or round and long worm ; and the ascarides, or round and short worm. There are many other kinds of worms found in the human body ; but as they proceed in a great measure from similar causes, have nearly the same symptoms, and require almost the same method of treatment as those already mentioned, we shall not speud time in enumerating them. The tapV worm is white, is very long and full of joints. It is generally bred either in the stomach or small intestines. The round and long worm is likewise bred in the small guts, and sometimes in the sto- mach. The round and short worms commonly lodge in the rectum, or what is called the endgut, and occasion a disagreeable itching about the seat. The long round worms occasion squeamishness, vomiting, a disa- greeable breath, gripes, looseness, swelling of the belly, swoonings, loathing of food, and at other times a voracious appetite, a dry cough, convulsions, epileptic fits, and sometimes a privation of speech. These worms have been known to perforate the intestines, and get into the cavity of the belly. The effects of the tape-worm are nearly the same with those of the long and round, but rather more violent. Andry says, the following symptoms particularly attend the solium, which is a species of the tape-worm, viz. swoonings, privation of speech, and a voracious appetite. The round worms called ascarides, besides an itching of the anus, cause swoonings, and tenesmus, or an inclination to go to stool. Causks.—Worms may proceed from various causes ; but they are seldom found except in weak and relaxed stomachs, where the digestion is bad. Sedentary persons are more liable to them than the active and laborious. Those who eat great quantities of unripe fruit, or who live much on raw herbs and roots, are generally subject to worms. There seems to be an hereditary disposition in some persons to this disease. I have often seen all the children of a family subject to worms of a particular kind. They seem likewise frequently to be owing to the nurse. Children of the same family nursed by one woman have often worms, when those nursed by another have none. 250 OF WORMS. Symptoms.—The common symptom of worms are, paleness of tho countenance, aud, at other times, an universal flushing of the face ; itching of the nose ; (this, however, is doubtful, as children pick their noses in all diseases ;) starting and grinding of the teeth in sleep ; swelling of the upper lip ; the appetite sometimes bad, and at other times quite voracious ; looseness ; a sour or stinking breath ; a hard swelled belly ; great thirst; the urine frothy, and sometimes of a whitish colour; griping, or colic pains; an involuntary discharge of saliva, especially when asleep ; frequent pains of the side, with a dry cough, and unequal pulse; palpitations of the heart; swoonings ; drowsiness ; cold sweats; palsy ; epileptic fits, with many other un- accountable nervous symptoms, which were formerly attributed to witchcraft, or the influence of evil spirits. Small bodies in the excre- ments resembling melon or cucumber seeds are symptoms of the tape- worm. There is no certain symptom of worms but passing j^em. I lately saw some very surprising effects of worms in a girl about five years of age, who used to lie for whole hours as if dead. She at last expired, and, upon opening her body, a number of the teres, or long round worms, were found in her intestines, which were considerably inflamed; and what anatomists call an intus susceptio, or involving of one part of the gut within another, had taken place in no less than four different parts of the intestinal canal.* Medicine.—Though numberless medicines are extolled for expelling and killing worms, f yet no disease more frequently baffles the physi- cian's skill. In general, the most proper medicine for their expulsion are strong purgatives ; and to prevent their breeding, stomachic bitters with now and then a glass of good wine. The best purge for an adult is jalap and calomel. Five-and-twenty or thirty grains of the former, with six or seven of the latter, mixed in syrup, maybe taken early in the morning for a dose. It will be pro- per that the patient keep the house all day, and drink nothing cold. The dose may be repeated once or twice a-week, for a fortnight or three weeks. On the intermediate days the patient may take a dram of the filings of tin, twice or fhrice a-day, mixed with syrup, honey, or treacle. * That worms exist in the human body there can be no doubt, and that they must sometimes be considered as a disease, is equally certain : but this is not the case so often as people imagine. The idea that worms occasion many diseases, gives an opportunity to the professed worm doctors of imposing upon the credulity of man- kind, and doing much mischief. They find worms in every case, and liberally throw in their antidotes, which generally consist of strong drastic purges. I have kuown these given in delicate constitutions to the destruction of the patient, where there was not the least symptom of worms. f A medical writer of the present age has enumerated upwards of fifty British plants, all celebrated for killing and expelling worms. of worms. 231 Those who do not choose to take calomel, may make use of the bitter purgatives; as aloes, hiera-picra, tincture of senna and rhubarb, &c. Oily medicines are sometimes found beneficial for expelling worms. An ounce of salad oil, and a table-spoonful of common salt, may be taken in a glass of red port wine thrice a-day, or oftener if the sto- mach will bear it. But the more common form of using oil is in clys- ters. Oily clysters, sweetened with sugar or honey, are very efficacious in bringing away the short round worms called ascarides, and likewise the teres. The Harrogate water is an excellent medicine for expelling worms, especially the ascarides. As this water is impregnated with sulphur, we hence infer, that sulphur alone must be a good medicine in this case, which is found to be a fact. Many practitioners give flour of sulphur in very large doses, and with great success. It should be made into an electuary with honey or treacle, and taken in such quantity as to purge the patient. Where Harrogate water cannot be obtained, sea-water may be used, which is far from being a contemptible medicine in this case. If sea- water cannot be had common salt dissolved in water may be drank. I have often seen this used by country nurses with very good effect. Some flower of sulphur may be taken over-night, and the salt-water in he morning. But worms, though expelled, will soon breed again, if the stomach remain weak and relaxed ; to prevent which, we would recommend the Peruvian bark. Half a dram of bark in powder may be taken in a glass of red port wine three or four times a-day, after the above medicines have been used. Lime-water is likewise good for this pur- pose, or a table-spoonful of the chalybeate wine taken twice or thrice a-day. Infusions or decoctions of bitter herbs may likewise be drank ; as the infusion of tansy, water trefoil, camomile-flowers, tops of worm- wood, the lesser centaury, &c. The above directions are intended for adults ; but for children the medicines must be more agreeable, and in smaller doses. For a child of four or five years old, six grains of rhubarb, five of jalap, and two of calomel, may be mixed in a spoonful of syrup or honey, and given in the morning. The child should keep the house all day, and take nothing cold. This dose may be repeated twice a-week for three or four weeks. On the intermediate days, the child may take a scruple of powdered tin, and ten grains of iEthiop's mineral, in a spoonful of treacle, twice a-day. This dose must be increased or diminished ac- cording to the age of the patient. Bisset says, the great bastard black hellebore, or bear's foot, is a most 252 OF WORM*. powerful vermifuge for the long round worms. He orders the decoc- tion of about a dram of the green leaves, or about fifteen grains of the dried leaves in powder, for a dose to a child between four and seven years of age, This dose is to be repeated two or three times. He adds, that the green leaves made into a syrup with coarse sugar, is almost the only medicine he has used for round worms for three years past. Before pressing out the juice, he moistens the bruised leaves with vinegar, which corrects the medicine. The dose is a tea-spoonful at bed-time, and one or two next morning. I have frequently known those big bellies which, in children, are commonly reckoned a sign of worms, quite removed by giving them white soap in their pottage, or other food. Tansy, garlic, and rue, are all good against worms, and may be used various ways. We might here mention many other plants, both for external and internal use, as the cabbage bark, &c. but think the filings of tin with iEthiop's mineral, and the purges of rhubarb and calomel, are more to be depended on. Ball's purging vermifuge powder is a very powerful medicine. It is made of equal parts of rhubarb, scammony, and calomel, with as much double refined sugar as is equal to the weight of all the other ingredients. These must be well mixed together, and reduced to a fine powder. The doses for a child is from ten grains to twenty, once or twice a-week. An adult may take a dram for a dose.* Parents who would preserve their children from worms, ought to allow them plenty of exercise in the open air ; to take care that their food be wholesome and sufficiently solid; and, as far as possible, to prevent their eating raw herbs, roots, or green trashy fruits. It will not be amiss to allow a child who is subject to worms, a glass of red wine after meals ; as every thing that braces and strengthens the stomach, is good both for preventing and expelling these vermin. + In recommending solid food, it may be proper to observe, that chil- dren should by no means be crammed twice or thrice a-day with meat, but that they should not be fed with slops. Meat should be given them only at dinner, and in a moderate quantity, for excess would promote instead of preventing worms. The meat should always be accompanied with plenty of good bread, and young, tender, and well boiled vegeta" * A powder for the tape-worm resembling this, was long kept a secret on the con- tinent ; it was lately purchased by the French King, and will be found under the article Powder, in the Appendix. f We think it necessary here to warn people of their danger who buy cakes, pow. ders, and other worm medicines, at random from quacks, and give them to their children without proper care. Theprincipal ingredient in most of these medicines is mercury, which is never to be trifled with. I lately saw a shocking instance of the danger of this conduct. A girl who had taken a dose of worm-powder, bought of a travelling quack, went out, and perhaps was so imprudent as to drink cold water during its operation; she immediately swelled, aud died on the following day, with all ike symptoms oi having bteu puisoucd. OF THE JAUNDICE. 253 hies, especially in the spring, when these are poured forth from the bosom of the earth in such profusion. They promote the end in view, by keeping the body gently open, without having recourse to purgatives. Ripe fruits are also highly beneficial for this purpose, and are as whole- some as the unripe fruits are pernicious. When the first symptoms of worms appear, parents should confine themselves to a proper diet and regimen, and not apply to the quack, or apothecary for drugs, until they have unequivocal proofs of the na- ture of the complaint. The danger of advertised nostrums is sufficiently pointed out and exemplified in the preceding note. CHAP. XXXVI. OF THE JAUNDICE. This disease is first observable in the white of the eye, which appears yellow. Afterwards the whole skin puts on a yellow appearance. The urine too is of a saffron hue, and dyes a whitecloth, if put into it, of the same colour. There is likewise a species of this disease called the Black Jaundice. Causes.—The immediate cause of the jaundice is an obstruction of the bile. The remote or occasional causes are, the bites of poisonous animals, as the viper, mad-dog, &c. the bilious or hysteric colic ; violent passions, as grief, anger, &c. Strong purges or vomits will likewise occasion the jaundice. Sometimes it proceeds from obstinate agues, or from that disease being prematurely stopped by astringent medicines. In infants, it is often occasioned by the meconium not being sufficiently purged off. Pregnant women are very subject to it. It is likewise a symptom in several kinds of fever. Catching cold, or the stoppage of the customary evacuations, as the menses, the bleeding piles, issues, &c. will occasion the jaundice. Symptoms.—The patient at first complains of excessive weariness, and has great aversion to every kind of motion. His skin is dry, and he generally feels a kind of itching or pricking pain over the whole body. The stools are of a whitish or clay colour, and the urine, as was observed above, is yellow. The breathing is difficult, and the patient complains of an unusual load or oppression on his breast. There is a heat in the nostrils, a bitter taste in the mouth, loathing of food, sick- ness of the stomach, vomiting, flatulency, and other symptoms of indigestion. 254 OF THE JACNDICB. If the patient be young, and the disease complicated with no other malady, it is seldom dangerous ; but in old people, where it continues long, returns frequently, or is complicated with the dropsy or hypo- chondriac symptoms, it generally proves fatal. The black jaundice is more dangerous than the yellow. Regimen.—The diet should be cool, light, and diluting, consisting chiefly of ripe fruits and mild vegetables; as apples boiled or roasted, stewed prunes, preserved plums, boiled spinage, &c. Veal or chicken- broth, with light bread, are likewise very proper. Many have been cured by living almost wholly for some days on raw eggs. The drink should be butter-milk, whey sweetened with honey, or decoctions of cool opening vegetables ; as marsh-mallow roots, with liquorice, &c. The patient should take as much exercise as he can bear, either on horseback or in a carriage; walking, running, and even jumping, are likewise proper, provided he can bear them without pain, and there be no symptoms of inflammation. Patients have been often cured of this disease by a long journey, after medicines had proved ineffectual. Amusements are likewise of great use in the jaundice. The disease is often occasioned by a sedentary life, joined to a dull melancholy dis- position. Whatever therefore tends to promote the circulation, and to cheer the spirits, must have a good effect; as dancing, laughing, singing, &c. Medicine.—If the patient be young, of a full sanguine habit, and complains of pain in the right side, about the region of the liver, bleeding will be necessary. After this, a vomit must be administered ; and if the disease proves obstinate, it may be repeated once or twice. No medicines are more beneficial in the jaundice than vomits, especially where it is not attended with inflammation. Half a dram if ipecacu- anha in powder will be a sufficient dose for an adult. It may be wrought off with weak camomile-tea, or lukewarm water. The body must like- wise be kept open by taking a sufficient quantity of Castile soap, or the pills for the jaundice recommended in the Appendix. Fomenting the parts about the region of the stomach and liver, and rubbing them with a warm hand or flesh-brush, are likewise beneficial; but it is still more so for the patient to sit in a bath of warm water up to the breast. He ought to do this frequently, and should continue in it as long as his strength will permit. Many dirty things are recommended for the cure of the jaundice ; as lice, millipedes, &c. But these do more harm than good, as people trust in them, and neglect more valuable medicines ; besides, they are seldom taken in sufficient quantity to produce any effects. People always expect that such things should act as charms, and consequently seldom OF THE DROPST. 255 persist in the use of them. Vomits, purges, fomentations, and exercise, will seldom fail to cure the jaundice when it is a simple disease; and when complicated with the dropsy, a schirrous liver, or other chronic complaints, it is hardly to be cured by any means. Numberless British herbs are extolled for the cure of this disease- The author of the Medicina Britannica mentions near a hundred, all famous for curing the jaundice. The fact is, the disease often goes off of its own accord ; iu which case, the last medicine is always said to have performed the cure. I have sometimes, however, seen consider- able benefit, in a very obstinate jaundice, from a decoction of hemp- seed. Four ounces of the seed may be boiled in two English quarts of ale, and sweetened with coarse sugar. The dose is half an English pint every morning. It may be continued for eight or nine days. I have likewise known Harrogate sulphur water cure jaundice of very long standing. It should be used for some weeks, aud the patient must both drink and bathe. The soluble tartar is a very proper medicine in the jaundice. A dram of it may be taken every night and morning in a cup of tea or water-gruel. I f it does not open the body, the dose may be increased. Persons subject to the jaundice ought to take as much exercise as possible, and to avoid all heating and astringent aliment. Taking exercise, and keeping the body open, is the best and most rational cure for this complaint, which generally arises from an obstruc- tion of the biliary ducts. Though some of the medicines here enumer- ated may be of great service, particularly the decoction of hempseed, yet exercise is the grand specific, which may be taken with safety and benefit, in every stage of this disorder. CHAP. XXXVII. OF THE DROPSY. The dropsy is a preternatural swelling of the whole body, or some part of it occasioned by a collection of watery humour. It is distinguished by different names, according to the part affected, as the anasarca, or a collection of water under the skin ; the ascites, or a collection of water in the belly; the hydrops pectoris, or dropsy of the breast; the hydro- cephalus, or dropsy of the brain, &c 253 OF THE DROPST. Causes.—The dropsy is often owing to an hereditary disposition. I: may likewise proceed from drinking ardent spirits, or other strong liquors. It is true, almost to a proverb, that great drinkers die of a dropsy. The want of exercise is also a very common cause of the dropsy. Hence it is justly reckoned among the diseases of the sedentary. It often pro- ceeds from excessive evacuations, as frequent and copious bleedings, strong purges often repeated, frequent salivations, &c. The sudden stoppage of customary or necessary evacuations, as the menses, the hemorrhoids, fluxes of the belly, &c. may likewise cause a dropsy. I have known the dropsy occasioned by drinking large quantities of cold weak watery liquor, when the body was heated by violent exercise. A low, damp, or marshy situation is likewise a frequent cause of it. Hence it is a common disease in moist, flat, fenny countries. It may also be brought on by a long use of poor watery diet, or of viscous aliment that is hard of digestion. It is often the effect of other diseases, as the jaundice, a schirrus of the liver, a violent ague of long continu- ance, diarrhoea, a dysentery, an empyema, or a consumption of the lungs. In short, whatever obstructs the perspiration or prevents the blood from being duly prepared, may occasion a dropsy. Symptoms.—The anasarca generally begins with a swelling of the feet and ancles towards night, which for some time disappears in the morning. In the evening the parts, if pressed with the finger, will p:t. The swelling gradually ascends, and occupies the trunk of the body, ths arms, and the head. Afterwards the breathing becomes difficult, the urine is in small quantity, and the thirst great ; the body is bound, and the perspiration is greatly obstructed. To these succeed torpor, heaviness, a slow wasting fever, and a troublesome cough. This last is generally a fatal symptom, as it shows that the lungs are affected. In an ascetis, besides the above symptoms, there is a swelling of the belly, and often a fluctuation, which may be perceived by striking the belly on one side, and laying the hand on the opposite side. This may be distinguished from ^tympany by the weight of the swelling, as well as by the fluctuation. When the anasarca and ascites are combined, the case is very dangerous. Even a simple ascites seldom admits of a radical cure. Almost all that can be done is, to let off the water by tapping, which seldom affords more than a temporary relief. When the disease comes suddenly on, and the patient is young and Btrong, there is reason to hope for a cure, especially if medicine be given early. But if the patient be old, has led an irregular or a sedentary life, or if there be reason to suspect that the liver, lungs, or any of the viscera are unsound, there is great reason to fear that the consequences will prove fatal. OF THE DROPSY*. 207 Regimen.—The patient must abstain, as much as possible, from all drink, especially weak and watery liquors, and must quench his thirst with mustard-whey, or acids, as juice of lemons, oranges, sorrel, or such like. His aliment ought to be dry, of a stimulating and diuretic quality, as toasted bread, the flesh of birds, or other wild animals, roasted ; pungent and aromatic vegetables, as garlic, mustard, onions, cresses, horse-radish, rocambole, shalot, &c. He may also eat sea-biscuits dipped in wine or a little brandy. This is not only nourishing, but tends to quench the thirst. Some have been actually cured of a dropsy by a total abstinence from all liquids, and living entirely upon such things as are mentioned above. If the patient must have drink, the Spa-water, or Rhenish wine, with diuretic medicines infused in it, are the best- Exercise is of the greatest importance in the dropsy. If the patient be able to walk, dig, or the like, he ought to continue these exercises as long as he can. If he be not able to walk or labour, he must ride on horseback, or in a carriage, and the more violent the motion so much the better, provided he can bear it. His bed ought to be hard, and the air of his apartment warm and dry. If he live in a damp country, he ought to be removed into a dry one, and if possible into a warmer climate. In a word, every method should be taken to promote the per- spiration, and to brace the solid3. For this purpose it will likewise be proper to rub the patient's body two or three times a-day, with a hard cloth, or the flesh-brush ; and he ought constantly to wear flannel next his skin. Medicine.—If the patient be young, his constitution good, and the disease has come on suddenly, it may generally be removed by strong vomits, brisk purges, and such medicines as promote a discharge by sweat and urine. For an adult, half a dram of ipecacuanha in powder, and half an ounce of oxymel of squills, will be a proper vomit. This may be repeated as often as is found necessary, three or four days intervening between the doses. The patient must not drink much after taking the vomit, otherwise he destroys its effect. A cup or two of camomile tea will be sufficient to work it off. Between each vomit, on one of the intermediate days, the patient may take the following purge : Jalap in powder half a dram, creanj of tartar two drams, calomel six grains. These may be made into a bolus with a little syrup of pale roses and taken early in the morning. The less the patient drinks after it the better. If he be much griped, he may now and then take a cup of chicken-broth. The patient may likewise take, every night at bed time, the following bolus : To four or five grains of camphire add one grain of opium, an 1 sb much syrup of orange peel as is sufficient to make them into a 253 of the dropsy. bolus. This will generally promote a gentle sweat, which should bn encouraged by drinking now and then a small cup of wine-whey, with a tea-spoonful of the spirits of hartshorn in it. A tea-cupful of the fol- lowing diuretic infusion may likewise be taken every four or five hours through the day : Take juniper-berries, mustard-seed, and horse- radish, of each half an ounce, ashes of broom half a pound ; infuse them in a quart of Rhenish wine or strong ale for a few days, and after- wards strain off the liquor. Such as cannot take this infusion, may use the decoction of seneka root, which is both diuretic and sudorific. I have known an obstinate anasarca cured by an infusion of the ashes of broom in wine. The above course will often cure an incidental dropsy, if the constitu- tion be good ; but when the disease proceeds from a bad habit, or an unsound state of the viscera, strong purges and vomits are not to be ventured upon. In this case, the safer course is to palliate the symp- toms by the use of such medicines as promote the secretions, and to support the patient's strength by warm and nourishing cordials. The secretion of urine may be greatly promoted by nitre. Brookes says, he knew a young woman who was cured of a dropsy by taking a grain of nitre every morning in a draught of ale, after she had been given over as incurable. The powder of squills is likewise a good diuretic. Six or eight grains of it with a scruple of nitre, may be given in a glass of strong cinnamon water. Ball says, a large spoonful of un- brnised mustard-seed taken every night and morning, and drinking half an English pint of the decoction of the tops of green broom after it, has performed a cure after other powerful medicines have proved ineffectual. I have sometimes seen good effects from cream of tartar in this dis- ease. It promotes the discharge by stool and urine, and will at least palliate, if it does not perform a cure. The patient may begin by taking an ounce every second or third day, and may increase the quan- tity to two or even to three ounces, if the stomach will bear it. This quantity is not, however, to be taken at once, but divided into three or four doses. To promote perspiration, the patient may use the decoction of seneka root, as directed above ; or he may take two table-spoonfuls of Minde- rerus's spirit in a cup of wine-whey three or four times a-day. To pro- mote a discharge of urine, the following infusion of the London hospitals will likewise be beneficial. Take of zedoary-root two drams ; dried squills, rhubarb, and juni- per-berries bruised, of each a dram ; cinnamon in powder, three drains ; salt of wormwood, a dram and a half; infuse in an English OF TIIE GOUT. 259 pint and half of old hock wine, and, when fit for use, filter the liquor. A wine glass of it may be taken three or four times a-day. In the anasarca it is usual to scarify the feet and legs. By this means the water is often discharged ; but the operator must be cautious not to make the incision too deep. They ought barely to pierce through the skin, and especial care must be taken, by spirituous fomentations and proper digestives, to prevent a gangrene. In an ascites, when the disease does not evidently and speedily give way to purgative and diuretic medicines, the water ought to be let off by tapping. This is a very simple and safe operation, and would often succeed, if it were performed in due time ; but if it be delayed till the humours are vitiated, or the bowels spoiled, by long soaking in water, it can hardly be expected that any permanent relief will be procured.* After the evacuation of the water, the patient is to be put on a course of strengthening medicines ; as the Peruvian bark ; the elixir of vitriol; warm aromatics, with a due proportion of rhubarb, infused in wine, and such like. His diet ought to be dry and nourishing, such as is recom- mended in the beginning of the chapter ; and he should take as much exercise as he can bear without fatigue. He should wear flannel, or rather fleecy hosiery, next his skin, and make daily use of the flesh- Lrush. CHAP. XXXVIII. OF THE GOUT. There is no disease which shows the imperfection of medicine, or Bets the advantages of temperance and exercise in a stronger light, than the gout. Excess and idleness are the true sources from whence it originally sprung, and all who would avoid it must be active and tem- perate. Though idleness and intemperance are the principal causes of the gout, ye°t many other things may contribute to bring on the disorder in those who are not, and to induce a paroxysm in those who are sub- ject to it; as intense study ; excess of venery ; too free an use of aci- * ThP verv name of an operation is dreadful to most people, and they wish to try every thing before they have recourse to it. This is the reason why tapping so s- .- Hnm « rceeds to our wish. I had a patient who was regularly tapped once a moiuh for .«^eraUeVrs, and who used to eat her dinner as well after the operation .. if MtWus bad happened. She died at last rather worn out by age than by thv urease. 2G0 OF THE OOUT. dulated liquors; night-watching; grief or uneasiness of mind ; aud ob- struction or defect of any of the customary discharges, as the menses, sweating of the feet, perspiration, &c. Symptoms.—A fit of the gout is generally preceded by indigestion, drowsiness, belching of wind, slight head-ache, sickness, and sometimes vomiting. The patient complains of weariness and dejection of spirits, and has often a pain in the limbs, with a sensation as if wind or cold water were passing down the thigh. The appetite is often remarkably keen a day or two before the fit, and there is a slight pain in passing urine, and frequently an involuntary shedding of tears. Sometimes these symptoms are much more violent, especially upon the near ap- proach of the fit; and it has been observed, that as is the fever which ushers in the gout, so will the fit be ; if the fever be short and sharp, the fit will be so likewise ; if it be feeble, long, and lingering, the fit will be such also. But this observation can only hold with respect to very regular fits of the gout. The regular gout generally makes its attack in the spring or begin- ning of winter, in the following manner: About two or three in the morning, the patient is seized with a pain in his great toe, sometimes in the heel, and at other times in the ancle or calf of the leg. This pain is accompanied with a sensation as if cold water were poured upon the part, which is succeeded by a shivering, with some degree of fever. Afterwards the pain increases, and fixing among the small bones of the foot, the patient feels all the different kinds of torture, as if the part were stretched, burnt, squeezed, gnawed, or torn in pieces. The part at length becomes so exquisitely sensible, that the patient cannot bear to have it touched, or even suffer any person to walk across the room. The patient is generally in exquisite torture for twenty-four hours, from the time of the coming on of the fit: he then becomes easier, the part begins to swell, appears red, and is covered with a little moisture. Towards morning he drops asleep, aud generally falls into a gentle breathing sweat. This terminates the first paroxysm, a number of which constitutes a fit of the gout; which is longer or shorter accord- ing to the patient's age, strength, and season of the year, aud the dis- position of the body to this disease. The patient is always worse towards night, and easier in the morning. The paroxysms, however, generally grow milder every day, till at length the disease is carried off by perspiration, urine, and the otherevacuations. In some patients this happens in a few days; in others, it requires weeks, and in some months, to finish the fit. Those whom age and frequent fits of the gout have greatly debilitated, seldom get free from it before the approach of summer, and sometimes not till it be pretty far advanced. OF THF. GOUT. 261 Regimen.—As there are no medicines yet known that will cure the gout, we shall confine our observations chiefly to regimen, both in and out of the fit. In the fit, if the patient be young and strong, his diet ought to be thin snd cooling, and his drink of a diluting nature ; but where the consti- tution is weak, and the patient has been accustomed to live high, this is not a proper time to retrench. In this case he must keep nearly to his usual diet, and should take frequently a cup of strong negus, or a glass of generous wine. Wine-whey is a very proper drink in this case, as it promotes the perspiration without greatly heating the patient. It will answer this purpose better if a tea-spoonful of sal volatile oleo- sum, or spirits of hartshorn, be put into a cup of it twice a-day. It will likewise be proper to give at bed-time a tea-spoonful of the volatile tincture of guaiacum, in a large draught of warm wine-whey. This will greatly promote perspiration through the night. As the most safe and efficacious method of discharging the gouty matter is by perspiration, this ought to be kept up by all means, espe- cially in the affected part. For this purpose the leg and foot should be wrapt in soft flannel, fur, or wool. The last is most readily ob- tained, and seems to answer the purpose better than any thing else. The people of Lancashire look upon wool as a kind of specific in the gout. They wrap a great quantity of it about the leg and foot affected, and cover it with a skin of dressed leather. This they suffer to continue for eight or ten days, and sometimes for a fortnight or three weeks, or longer, if the pain does not cease. I never knew any external appli- cation answer so well in the gout. I have often seen it applied when the swelling and inflammation were very great, with violent pain, and have found all these symptoms relieved by it in a few days. The wool which they generally use is greased, and carded or combed. They choose the softest which can be had, and seldom or never remove it till the fit be entirely gone off. The patient ought likewise to be kept quiet and easy during the fit. Every thing that affects the mind disturbs the paroxysm, and tends to throw the gout upon the nobler parts. All external applications that repel the matter are to be avoided as death. They do not cure the disease, but move it from a safer to a more dangerous part of the body, where it often proves fatal. A fit of the gout is to be considered as na- ture's method of removing something that might prove destructive to the body, aud all that we can do with safety is to promote her inten- tions, and assist her in expelling the enemy in her own way. Evacua- tions by bleeding, stool, &c. are likewise to be used with caution ; they do not remove the cause of the disease, and sometimes by 2G2 OF THE GOUT. weakening the patient prolong the fit; but where the constitution is able to bear it, it will be of use to keep the body gently open by diet, or very mild laxative medicines. Many things will indeed shorten a fit of the gout, and some will drive it off altogether; but nothing has yet been found which will do this with safety to the patient. In pain we eagerly grasp at any thing that promises immediate ease, and even hazard life itself for a temporary relief. This is the true reason why so many infallible remedies have been proposed for the gout, and why such numbers have lost their lives by the use of them. Notwithstanding the acknowledged and frequently .experienced danger of tampering with the gout, such is the effect of intense pain, that I never met with more than two patients who could bear their sufferings with rational composure, or, what is the same thing, without frantic attempts to alleviate them. When the seat of the complaint is in torture, a promise to afford relief, though made by the greatest impostor upon earth, is listened to ; and present ease is sought for, at the risk of any future consequences. It is not many years since some persons of the first rank in the kingdom fell victims to the deceptions of a foreign quack, who soothed their impatience of pain, amused them with the charm of fancied recovery, and rendered momentary ease the fatal prelude to inevitable death. It would be as prudent to stop the small-pox from rising, and to drive them into the blood, as to attempt to repel the gouty matter after it has been thrown upon the extremities. The latter is as much an effort of nature to free herself from an offending cause as the former, and ought equally to be promoted. When the pain, however, is very great, and the patient is restless, thirty or forty drops of laudanum, more or less according to the violence of the symptoms, may be taken at bed-time. This will ease the pain, procure rest, promote perspiration, and forward the crisis of the disease- After the fit is over, the patient ought to take a gentle dose or two of the bitter tincture of rhubarb, or some other warm stomachic purge He should also drink a weak infusion of stomachic bitters in small wine or ale, as the Peruvian bark with cinnamon, Virginian snake-root, and orange-peel. The diet at this time should be light but nourishing, and gentle exercise ought to be taken on horseback, or in a carriage. Out of the fit, it is in the patient's power to do many things towards preventing a return of the disorder, or rendering the fit, if it should l eturn, less severe. This, however, is not to be attempted by medicine, 1 have frequently known the gout kept off for several years by the Peru- vian bark and other astringent medicines ; but in all the cases where ] had occasion to see this tried, the person died suddenly, and to all an- OF THE GOUT. 203 pearance for want of a regular fit of the gout. One would be apt, from hence, to conclude, that a fit of the gout, to some constitutions; in the decline of life, is rather salutary than hurtful. Though it may be dangerous to stop a fit of the gout by medicine, yet if the constitution can be so changed by diet and exercise, as to lessen or totally prevent its return, there certainly can be no danger in fol- lowing such a course. It is well known, that the whole habit may bo so altered by a proper regimen, as quite to eradicate this disease ; and those only who have sufficient resolution to persist in such a course have reason to expect a cure. The course which we would recommend for preventing the gout, is as follows : In the first place, universal temperance. In the next place, sufficient exercise.* By this we do not mean sauntering about in an indolent manner, but labour, sweat, and toil. These only can render the humours wholesome, and keep thdm so. Going early to bed, and rising betimes, are also of great importance. It is likewise proper to avoid night studies and intense thinking. The supper should be light and taken early. The U3e of milk, gradually increased, till it becomes the principal part of diet, is particularly recommended. All strong liquors, especially generous wines and sour punch, are to be avoided. We would likewise recommend some doses of magnesia alba and rhu- barb to be taken every spring and autumn ; and afterwards a course of stomachic bitters, as tansy or water-trefoil tea, an infusion of gentian and camomile flowers, or a decoction of burdock root, &c. Any of these, or an infusion of any wholesome bitter that is more agreeable to the patient, may be drank for two or three weeks in March and October twice a-day. An issue or perpetual blister has a great ten- dency to prevent the gout. If these were more generally used in tiie decline of life, they would not only often prevent the gout, but also other chronic maladies. Such as can afford to go to Bath, will find great benefit from bathing and drinking the water. It both promotes digestion aud invigorates the habit. Though there is little room for medicine during a regular fit of the gout, yet when it leaves the extremities, and falls on some of the inter- nal parts, proper applications to recal and fix it become absolutely ne- cessary. When the gout affects the head, the pain of the joints ceases and the swelling disappears, while either severe head-ache, drowsiness, trembling, giddiness, convulsions, or delirium, come on. When it seizes the lungs, great oppression, with cough, and difficulty of breath- * Some make a secret of curing the gout by muscular exercise. This secret, how. ever, is as old as OImis, who strongly recouuneuds that mode of cure; and whoever Mill submit to it in Uie lultest extent, iuay expect to reap solid iind permanent cuvauUiye. 254 OF THE RHEUMATISM. ing, ensue. If it attacks the stomach, extreme sickness, vomiting, anx- iety, pain in the epigastric region, and total loss of strength will succeed. When the gout attacks the head or lungs, every method must be taken to fix it in the feet. They must be frequently bathed in warm water, and acrid cataplasms applied to the soles. Blistering-plasters ought likewise to be applied to the ancles or calves of the legs. Bleeding in the feet or ancles is also necessary, and warm stomachic purges. The patient ought to keep in bed for the most part, if there be any signs of inflammation, and should be very careful not to catch cold. If it attacks the stomach, with a sense of cold, the most warm cordials are necessary ; as strong wine boiled up with cinnamon or other spices' cinnamon-water ; peppermint-water ; and even brandy or rum.* The patient should keep his bed, and endeavour to promote a sweat by drinking warm liquors ; and if he should be troubled with a nausea, or inclination to voimt, he may drink camomile-tea, or any thing that will make him vomit freely. When the gout attacks the kidneys, ami imitates gravel-pains, the ' patient ought to drink freely of a decoction of marsh-mallows, and to have the parts fomented with warm water. An emollient clyster ought likewise to be given, and afterwards an opiate. If the pain be very violent, twenty or thirty drops of laudanum may be taken in a cup of the decoction. Persons who have had the gout should be very attentive to any com- plaints that may happen to them about the time when they have reason to expect a return of the fit. The gout imitates many other disorders, and, by being mistaken for them, and treated improperly, is often diverted from its regular course, to the great danger of the patient's life. Those who never had the gout, but who, from their constitution or manner of living, have reason to expect it, ought likewise to be very circumspect with regard to its first approach. If the disease, by wrong conduct or improper medicines, be diverted from its proper course, the miserable patient has a chance to be ever after tormented with head- aches, coughs, pains of the stomach and intestines ; and to fall at last a victim to its attack upou some of the more noble parts. OF TIIE RHEUMATISM. This disease has often a resemblance to the gout. It generally at- tacks the joints with exquisite pain, and is sometimes attended with inflammation and swelling. It is most common in spring, and towards the end of autumn. It is usually distinguished into acute and chronic ; or the rheumatism with and without a fever. * .dither is found to be an efficacious remedy in this disease. CF THE RHEUMATISM. 2G5 CaUsfs.—The cause of a rheumatism are frequently the same as those of an inf ammatory fever, viz. an obstructed perspiration, the immoderate use of strong liquors, and the like. Sudden changes of the weather, and all quick transitions from heat to cold, are very apt to occasion the rheumatism. The most extraordinary case of a rheuma- tism that ever I saw, where almost every joint in the body was dis- torted, was a man who used to work one part of the day by the fire, nnd the other part in the water. Very obstinate rheumatisms have likewise been brought on by persons not accustomed to it, allowing their feet to continue long wet. The same effects are often produced by wet clothes, damp beds, sitting or lying on the damp ground, travelling in the night, &c. The rheumatism may likewise be occasioned by excessive evacuations, or the stoppage of customary discharges. It is often the effcet of chronic diseases, which vitiate the humours ; as the scurvy, the lues venerea, obstinate autumnal agues, &c. The rheumatism prevails in cold, damp, marshy countries. It is most common among the poorer sorts of peasants, who are ill clothed, live in low damp houses, and eat coarse and unwholesome food, which con- tains but little nourishment, and is not easily digested. Symptoms.—The acute rheumatism commonly begins with weariness* shivering, a quick pulse, restlessness, thirst, and other symptoms of fever. Afterwards the patient complains of flying pains, which are increased by the least motion. These at length fix in the joints, which are often affected with swelling and inflammation. If blood be let in this disease, it has generally the same appearance as in the pleurisy. In this kind of rheumatism the treatment of the patient is nearly the same as in an acute or inflammatory fever. If he be young and strong, bleeding is necessary which may be repeated according to the exigencies of the case. The body ought likewise to be kept open by emollient clvsteip, or cool opening liquors ; as decoctions of tamarinds, cream of tartar, whey, senna tea, and the like. The diet should be light, and in small quantity, consisting chiefly of roasted apples, groat-gruel, or weak chicken-broth. After the feverish symptoms have abated, if the pain still continues, the patient must keep his bed, and take such things as promote perspiration ; as wine whey, with spiritus mendereri, &c. He may likewise take for a few nights, at bed-time, in a cup of wine-whey, a dram of the cream of tartar, and half a dram of gum guaiacum in powder. Warm bathing, after proper evacuations, has often an exceeding good effect. The patient may either be put into a bath of warm water, or have cloths wrung out of it applied to the parts affected. Great care Diust be tak-.»u that he ao not catch cold atar bathing. 2G6 OF THE RHEUMATISM. The chronic rheumatism is seldom attended with any considerable de- gree of fever, and is generally confined to some particular part of the body, as the shoulders, the back, or the loins. There is seldom any inflammation or swelling in this case. Persons in the decline of life are most subject to the chronic rheumatism. In such patients it often proves extremely obstinate, and sometimes incurable. In this kind of rheumatism the regimen should be nearly the same as in the acute. Cool and diluting diet, consisting chiefly of vegetable substances, as stewed prunes, coddled apples, currants or gooseberries boiled in milk, is most proper. Arbuthnot says, ' If there be a specific in aliment for the rheumatism, it is certainly whey;' and adds, ' That he knew a person subject to this disease, who could never be cured by any other method but a diet of whey and bread.' He likewise says, ' That cream of tartar in water-gruel, taken for several days, will ease rheumatic pains considerably.' This I have often experienced, but found it always more efficacious when joined with gum guaiacum, as already directed. In this case the patient may take the dose formerly mentioned twice a-day, and likewise a tea-spoonful of the volatile tincture of gum guaiacum at bedtime in wine whey. This course may be continued for a week, or longer, if the case proves obstinate, and the patient's strength will permit. It ought then to be omitted for a few days, and repeated again. At the same time leeches, or a blistering-plaster, may be applied to the part affected. What I have generally found answer better than either of these, in obstinate fixed rheumatic pains, is the warm plaster.* I have likewise known a plaster of Burgundy pitch worn for some time on the part affected give great relief in rheumatic pains. My ingenious friend, Dr. Alexander, of Edinburgh, says, he has frequently cured very obstinate rheumatic pains, by rubbing the parts affected with tincture of cantharides. When the common tincture did not succeed*, he used it of a double or treble strength. Cupping upon the part affected is likewise very beneficial, and so is the application of leeches. Though this disease may not seem to yield to medicines for some time, yet they ought still to be persisted in. Persons who are subject to frequent returns of the rheumatism, will often find their account in using medicines, whether they be immediately affected with the disease or not. The chronic rheumatism is similar to the gout in this respect, that the most proper time for using medicines to extirpate it, is when the patient is free from the disorder. To those who can afford the expense, I would recommend the warm baths of Buxton or Matlock, in Derbyshire. These have often, to my * See Appendix, Warm Flatter, OF THE RHEUMATISM. . ..0/ knowledge, cured very obstinate rheumatisms, aud are always safe either in or out of the fit. When the rheumatism is complicated with scorbutic complaints, which is not seldom the case, the Harrogate waters, and those of Moffat, are proper. They should both be drank and used as a warm bath. There are several of our own domestic plants which may be used with advantage in the rheumatism. One of the best is the white mus- tard. A table-spoonful of the seed of this plant may be taken twice or thrice ;i» lay in a glass of water or small wine. The water-trefoil is likewise of great use in this complaint. It may be infused in wine or ale, or drank in the form of tea. The ground ivy, camomile, and several other bitters, are also beneficial, and may be used in the same manner. No benefit, however, is to be expected from these, unless they be taken for a considerable time. Excellent medicines are often despised in this disease, because they do not perform an immediate cure ; whereas nothing would be more certain than their effect, were they duly persisted in. Want of perseverance in the use of medicines is one reason why chronic diseases are so seldom cured. Cold bathing, especially in salt water, often cures the rheumatism. Wo would also recommend riding on horseback, and wearing flannel next the skin. Issues are likewise very proper, especially in chronic cases. If the pain affects the shoulders, an issue may be made in the arm ; but if it affects the loins, it should be put into the leg or thigh. Persons afflicted with the scurvy are very subject to rheumatic com- plaints. The best medicines in this case are bitters and mild purgatives. These may either be taken separately or together, as the patient in- clines. An ounce of Peruvian bark, and half an ounce of rhubarb in powder, may be infused in a bottle of wine ; and one, two, or three wine glasses of it taken daily, as shall be found necessary for keeping the body gently open. In cases where the bark itself proves sufficiently purgative, the rhubarb may be omitted. Such as are subject to frequent attacks of the rheumatism ought to make choice of a dry, warm situation, to avoid the night air, wet clothes and wet feet, as much as possible. Their clothing should be warm, and they should wear flannel next their skin, and make frequent use of the flesh brush. Wearing fleecy hosiery next the skin, is the best and most effectual means for the prevention and cure of rheumatism. In marshy countries, where the inhabitants are subject to ague and rheumatism, the use of this article of dress cannot be too strongly recommended ; in such situa- tions persons in good circumstances could not exert their beneficence to better purpose than in supplying their poor neighbours with so cheap and simple a preservative. 2G8 CHAP. XXXIX. OF THE SCURVY. This disease prevails chiefly in cold northern countries ; especially in low, damp situations, near large marshes or great quantities of stag- nating water. Sedentary people, of a dull melancholy disposition, are most subject to it. It proves often fatal to sailors on long voyages, particularly in ships that are not properly ventilated, have many people on board, or where cleanliness is neglected. It is not necessary to mention the different species into which this disease has been divided, as they differ from one another chiefly in de- gree. What is called the land scurvy, however, is seldom attended with those highly putrid symptoms which appear in patients who have been long at sea, and which, we presume, are rather owing to confined air, want of exercise, and the unwholesome food eaten by sailors on long voyages, than to any specific difference in the disease. Causes.—The scurvy is occasioned by cold moist air; by the long use of salted or smoke-dried provisions ; or any kind of food that is hard of digestion, and affords little nourishment. It may also proceed from the suppression of customary evacuations ; as the menses, the hsemor- rhoidal flux, &c. It is sometimes owing to an hereditary taint, in which case a very small cause will excite the latent disorder. Grief, fear, and other depressing passions, have a great tendency both to excite and aggravate this disease. The same observation holds with regard to neglect of cleanliness ; bad clothing ; the want of proper exercise ; confined air ; unwholesome food ; or any disease which greatly weakens the body or vitiates the humours. Symptoms.—This disease may be known by unusual weariness, hea- viness, and difficulty of breathing, especially after motion ; rottenness of the gums, which are apt to bleed on the slightest touch ; a stinking breath ; frequent bleeding at ,the nose ; crackling of the joints ; diffi- culty of walking ; sometimes a swelling and sometimes a falling away of the legs, on which there are livid, yellow, or violet-coloured spots ; the face is generally of a pale or leaden colour. As the disease advances, other symptoms come on ; as rottenness of the teeth ; haemorrhages, or discharges of blood from different parts of the body, foul obstinate ulcers, pains in various parts, especially about the breast; dry scaly eruptions all over the body, <&c. At last a wasting or hectic fever comes on, and the miserable patient is carried off by a dysentery, a 07 THE SCUltVT. 2G9 diarrhoea, a dropsy, the palsy, fainting fits, a mortification of some of the bowels. Curb.—We know no way of curing this disease but by pursuing a plan directly opposite to that which brings it on. It proceeds from a vitiated state of the humours, occasioned by errors in diet, air, and exercise; and this cannot be removed but by a proper attention to these mportant articles. If the patient has been obliged to breathe a cold, damp, or confined air, he should be romoved, as soon as possible, to a dry, open, and moderately warm one. If there is reason to believe that the disease proceeds from a sedentary life, or depressing passions, as grief, fear, &c. the patient must take daily as much exercise in the open air as he can boar, and his mind should be diverted with cheerful companyj and other amusements. Nothing has a greater tendency cither to prevent or remove this disaaso, than constant cheerfulness and good humour. But this, al is ! is seldom the lot of persons afflicted with the scurvy; they are generally surly, peevish, and morose. When the scurvy has been brought on by a long use of salted pro- visions, the proper medecino is a diet consisting chiefly of fresh vegetables; as oranges, apples, lemons, limes, tamarinds, water-cres- ses scurvy-grass, brook-lime, &c. The use of these, with milk, pot- herbs, new bread, and fresh beer or cider, will seldom fail to remove a scurvy of this kind, if taken before it be too far advanced ; but, to have this effect, they must he persisted in for a considerable time. When fresh vegetables cannot he obtained pickled or preserved ones may be used; and where these are wanting, recourse may be had to the chemical acids. All the patient's food and drink should in this case bo sharpened with cream of tartar, elixir of vitrol, vinegar, or the Bpirit of sea-s ilt. These things, however, will more certainly prevent than cure the Bcury; for which reason sea-faring people, especially in long voyages, ought to lay in plenty of them. Cabbages, onions, gooseberries, and many other vegetables, may be kept a long time by pickling, preserv- ing &c. and when these fail, the chemical acids recommended above, which will keep for any length of time, may be used. We have reason to believe, if ships were well ventilated, had got stores of fruits, greens, cider &c. laid in, and if proper regard were paid to cleanliness and warmth that sailors would be the most healthy people in the world, and would seldom suffer from scurvy or putrid fevers, which are so fatal to that usual class of men; but it is too much the temper of such people to despise all precaution; they will not think of any calamity till it overtakes them, when it is too late to ward off the blow. It must indeed be owned, that many of them have it not in their • 270 OF THE SCURVY. power to make the provision we are speaking of ; but in this cnse it ia the duty of their employers to make it for them ; and no man ought to engage in a long voyage without having these articles secured. I have often seen very extraordinary effects in the land-scurvy from a milk diet. This preparation of nature is a mixture of animal and vegetable properties, which of all others is the most fit for restoring a decayed constitution, and removing that particular acrimony of the hu- mours, which seems to constitute the very essence of the scurvy, and many other diseases. But people despise this wholesome and nourish- in" food, because it is cheap, and devour with greediness flesh and fermented liquors, while milk is only deemed fit for their hogs. The most proper drink in the scurvy is whey or butter-milk. When these cannot be had, sound cider, perry, or spruce-beer, may be used. Wort has likewise been found to be a proper drink in the scurvy, and may be used at sea, as malt will keep during the longest voyage. A decoction of the tops of spruce-fir is likewise proper. It may be drank in the quantity of an English pint twice a-day. Tar-water may be used for the same purpose, or decoctions of the mild mucilaginous vege- tables ; as sarsaparilla, marsh-mallow roots, &c. Infusions of the bitter plants, as ground-ivy, the lesser centaury, marsh-trefoil, &c. are like- wise beneficial. I have seen the peasants in some parts of Britain ex- press the juice of the last mentioned plant, and drink it with good effect in those foul scorbutic eruptions with which they are often troubled in the spring season. Harrogate water is certainly an excellent medicine in the land scurvy. I have often seen patients who had been reduced to the most deplora- ble condition by this disease, greatly relieved by drinking the sulphur- water, and bathing in it. The chalybeate water may also be used with advantage, especially with a view to brace the stomach after drinking the sulphur-water, which though it sharpen the appetite, never fails to weaken the power of digestion. A slight degree of scurvy may be carried off by frequently sucking a little of the juice of a bitter orange or a lemon. When the disease affects the gums only, this practice, if continued for some time, will ge- nerally carry it off. We would, however, recommend the bitter orange as greatly preferable to lemon ; it seems to be as good a medicine, and is not near so hurtful to the stomach. Perhaps our own sorrel may be little inferior to either of them. All kinds of salad are good in the scurvy, and ought to be eaten very plentifully, as spinnage, lettuce, parsley, celery, endive, radish, dande- lion, &c. It is amazing to see how soon fresh vegetables in the spring cure the brute animals of any scab or foulness which is upon their • OF TIIE SCROFULA, ETC. 271 Bkins. It is reasonable to suppose that their effects would be as great upon the human Bpecies, were they used in proper quantity for a suffi- cient length of time. I have sometimes seen good effects in scorbutic complaints of very long standing, from the use of a decoction of the roots of water-dock. It i» usually made by boiling a pound of the fresh root in six English pints of water, till about one third of it be consumed. The dose is from half a pint to a whole pint of the decoction every day. But in all cases where I have seen it prove beneficial, it was made much stronger and drank in large quantities. The safest way, however, is for the pa- tient to begin with small doses, and increase them both in strength and quantity as he finds his stomach will bear it. It must be used for a considerable time. I have known some take it for many months, and have been told of others who had used it for several years, before tliey were sensible of any benefit, but who nevertheless were cured by it at length. The leprosy, which was so common in this country long ago, seems to have been near a-kin to the scurvy. Perhaps its appearing so sel- dom now, may be owing to the inhabitants of Britain eating more vege- table food than formerly, living more upon tea and other diluting diet, usinsr less salted meat, being more cleanly, better lodged and clothed, kc.__For the cure of this disease we would recommend the same course of diet and medicine as iu the scurvy. OF THE SCROFULA, OR KING'S EVIL. This disease chiefly affects the glands, especially those of the neck. Children, and young persons of a sedentary life, are very subject to it. It is one of those diseases which may be removed by proper regimen, but seldom yields to medicine. The inhabitants of cold, damp, marshy countries, are most liable to the scrofula. Causes.—This disease may proceed from a hereditary taint, infection, a scrofulous nurse, &c. Children who have the misfortune to be born of sickly parents, whose constitutions have been greatly injured by the pox, or other chronic diseases, are apt to be affected with the scrofula. It may likewise proceed from such diseases as weaken the habit or vitiate the humours, as the small pox, measles, &c. External injuries, as blows, bruu-es, and the like, sometimes produce scrofulous ulcers ; but we have reason to believe, when this happens, that there has been a predisposition in the habit to this disease. In short, whatever tends to vitiato the humours or relax the solids, paves the way to the scrofula ; a . the want of proper exercise, too much heat or cold, confined air, 272 OF THE SCROFULA, ETC unwholesome food, bad water, the long use of poor weak watery aliments, the neglect of cleanliness, &c. Nothing tends more to induce this disease in children than allowing them to continue long wet.* Symptoms.—At first, small knots appear under the chin, or behind the ears, which gradually increase in number and size, till they form one large hard tumour. This often continues for a long time without breaking, and when it does break, it only discharges a thin sanies, or watery humour. Other parts of the body are likewise liable to its attack, as the arm-pUs, groins, feet, hands, eyes, breast, &c. Nor are the internal parts exempt from it. It often affects the lungs, liver,or spleen, and I have frequently seen the glands of the mysentery greatly enlarged by it. Those obstinate ulcers which break out upon the feet and hands with swelling, and little or no redness, are of the scrofulous kind. They sel- dom discharge good matter, and are exceedingly difficult to cure. The white swellings of the joints seem likewise to be of this kind. They are with difficulty brought to a suppuration, and when opened they only discharge a thin ichor. There is not a more general symptom of the scrofula than a swelling of the upper lip and nose. It sometimes begins in a toe or finger, which continues long swelled, with no great degree of pain, till the bone becomes carious. Regimen.—As this disease proceeds, in a great measure, from a re- laxation, the diet ought to be generous and nourishing, but at the same time light and of easy digestion ; as well fermented bread made of sound grain, the flesh and broth of young animals, with now and then a glass of generous wine or good ale. The air ought to be open, dry, and not too cold, and the patient should take as much exercise as he can bear. This is of the utmost importance. Children who have sufficient exercise are seldom troubled with the scrofula. Meoicine.—The vulgar are remarkably credulous with regard to the cure of the scrofula ; many of them believing in the virtue of the royal touch, that of the seventh son, &c. The truth is, we know but little of the nature or cure of this disease, and where reason or medicine fail, superstition always comes in their place. Hence it is, that in diseases which are the most difficult to understand, we generally hear of the greatest number of miraculous cures being performed. Here, however, the deception is easily accounted for. The scrofula, at a certain period of life, often cures of itself; and if the patient happens to be touched about this time, the cure is imputed to the touch, and hot to nature, who is really the physician. In the same way the insignificant nostrums of quacks and old women often gain applause when they deserve none. * The scrofula, as well as the rickets, is found to prevail in large manufacturing to«vus, where people live j;ro-s, and lead sedentary lives. OF t:ie SCROFULA, ETC. 273 There is nothing more peru'cious than the custom of plying children in the scrofula with strong purgative medicines. People imagine it proceeds from humours which must be purged off, without considering that these purgatives increase the debility and aggravate the disease. It has indeed been found that keeping the body gently open for snine time, especially with sea-water, has a good effect ; but this should only bo given in gross habits, and in such quantities as to procure one, or at most two ttools every day. Bathing in the salt-water has likewise a very good effect, especially in the warm season. I have often known a course of bathing in the salt- water, and drinking it in such quantities as to keep the body gently open, cure a scrofula, after many other medicines had been tried in vain. When salt water cannot be obtained, the patient m iy be bathed in fresh water, and his body kept open by small quantities of salt and water, or some other mild purgative. Next to cold bathing, and drinking the salt-water, we would recom- mend the Peruvian bark. The cold bath may be used in summer, and the bark in winter. To an adult half a dram of the bark in powder may be given in a glass of red wine four or fire times a-day. Children, aud such as cannot take it in substance, may use the decoction made in the following manner : Boil an ounce of Peruvian bark and a drain of Winter's bark, both grossly powdered, in an English quart of water to a pint; towards the end, half an ounce of sliced liquorice-root and a handful of raisins may be added, which will both render the decoction less disagreeable, and make it take up more of the bark. The liquor must be strained, and two, three, or four table-spoonfuls, according to the age of the patient, given three times a-day ; but, in place of this, I now use the c impound tincture of bark. The Moffat and Harrogate waters, especially the latter, are likewise very proper medicines in the scrofula. They ought not, however, to be drank in large quantities, but should be taken so as to keep the body gently open, and must be used for a considerable time. The hemlock may sometimes be used with advantage in the scrofula. Some lay it down as a general rule that the sea water is most proper before there are any suppuration or symptoms of tabes; the Peruvian b-irk, when there are running sores, and a degree of hectic fever ; and the hemlock in old inveterate cases, approaching to the schirrous or c-uicerousstate. Either the extract or the fresh juice of tins plat.t may be used. The dose may be small at first, and increased gradually as far as the stomach is able to bear it. External applications are of little use. Before the turner breaks, 274 OF THE SCROFULA, ETC. nothing ought to be applied to it, unless apiece of flannel, or some thins to keep it warm. After it breaks, the sore may be dressed with some digestive ointment. What I have always found to answer best, was the yellow basilicon mixed with about a sixth or eighth part of its weight of red precipitate of mercury. The sore may be dressed with this twice a-day ; and if it be very fungous, and does not digest well, a larger proportion of the precipitate may be added. Medicines which mitigate this disease, though they do not cure it, are not to be despised. If the patient can be kept alive by any means till he arrives at the age of puberty, he has a great chance to get well; b.ut if he does not recover at this time, in all probability he never will. There is no malady which parents are so apt to communicate to their offspring as the scrofula, for which reason people ought to beware of marrying into families affected with this disease. For the means of preventing the scrofula, we must refer the reader to the observations on nursing at the beginning of the book. OF THE ITCH. Though this disease is commonly communicated by infection, yet it seldom prevails where due regard is paid to cleanliness, fresh air, and wholesome diet. It generally appears in form of small watery pustules, first about the wrists, or between the fingers : afterwards it affects the arms, legs, thighs, &c. These pustules are attended with an intolerable itching, especially when the patient is warm in bed, or sits by the fire. Sometimes, indeed, the skin is covered with large blotches or scabs^ and at other times with a white scurf, or scaly eruption. This last is called the Dry Itch, and is the most difficult to cure. The itch is seldom a dangerous disease, unless when it is rendered bo by neglect or improper treatment. If it be suffered to continue too lon<*, it may vitiate the whole mass of humours ; and, if it be suddenly driven in, without proper evacuations, it may occasion fevers, inflam- mations of the viscera, or other internal disorders. The best medicine yet known for the itch is sulphur, which ought to be used both externally and internally. The parts most affected may be rubbed with an ointment made of the flower of sulphur, two ounces ; crude sal ammoniac finely powdered, two drams ; hogs-lard or butter, four ounces. If a scruple or half a dram of the essence of lemon be added, it will entirely take away the disagreeable smell. About the bulk of a nutmeg of this may be rubbed upon the extremities at bed-time twice or thrice a-week. It is seldom necessary to rub the whole bod'" ; but, when it is, it ought not to be done all at once, but by turns, as i; ia dangerous to sto^< too many pores at the same time. OF THE ITCH. 273 Before the patient begins to use the ointment, he ought, if he be of a full habit, to bleed or take a purge or two. It will likewise be pro. per, during the use of it, to take every night and morning as much of the flower of brimstone and cream of tartar, in a little treacle or new milk, as will keep the body gently open. He should beware of catching cold, should wear more clothes than usual, and take every thing warm. The same clothes, the linen excepted, ought to be worn all the time of using the ointment; and such clothes as have been worn while the patient was under the disease, are not to be used again, unless they have been fumigated with brimstone, and thoroughly cleansed, otherwise they will communicate the infection anew.* I never knew brimstone, when used as directed above, fail to cure the itch ; and I have reason to believe, that if duly persisted in, it never will fail : but if it be only used once or twice, and cleanliness neglected, it is no wonder if the disorder returns. The quantity of ointment mentioned above will generally be sufficient for the cure of one person ; but, if any symptoms of the disease should appear again, the medicine must be repeated. It is both more safe and efficacious when persisted in for aconsiderable time, than when a large quantity is applied at once. As most people dislike the smell of sulphur, they may use in its place the powder of white hellebore root made up into an ointment, in the same manner, which will seldom fail to cure the itch. People ought to be extremely cautious lest they take other eruptions for the itch ; as the stoppage of these may be attended with fatal con- ocqueiices. Many of the eruptive disorders to which children are liable, have a near resemblance ; and 1 have often known infants killed by being rubbed with greasy ointments that make these eruptions strike suddenly in, which nature had thrown out to preserve the patient's life. or prevent some other malady. Much mischief is likewise done by the use of mercury in this disease. Some persons are so fool-hardy as to wash the parts affected with a btron- solution of the corrosive sublimate. Others use the mercurial ointment without taking the least care either to avoid cold, keep the body open, or observe a proper regimen. The consequences of such conduct may be easily guessed. I have known even the mercurial girdles produce bad effects, and would advise every person, as he values his health, to beware how he uses them. Mercury ought never to be used as a medicine without the greatest care. Ignorant people look a. c- i.i,B Princle observes, that though this disease may seem trifling, there is S'rJ^h. armvtha!Ts more troublesome to cure, as the infection often lurk, no one in the »rl^ th»l ! outT Becoud or even a third time. The same incoave- '" ^^.*Cin pm "f. miUesa u"l°es, a particular regard be pud to the chafing ^XansTng of tile clothes, which hut i* hy uo meaus an ea y op.ia:.oa. 276 OF THF. ASTHMA. upon these girdles as a kind of charm, without considering that the mer- cury enters the body. It is not to be told what mischief is done by using mercurial oint- ment for curing the itch, and killing vermin ; yet it is unnecessary for either : the former may be alwavs more certainly cured by sulphur, and the latter will never be found where due regard is paid to cleanliness. Those who would avoid this detestable disease, ought to beware of infected persons, to use wholesome food, and to study universal cleau- liuess.* CHAP. XL. OF THE ASTHMA. The asthma is a disease of the lungs, which seldom admits of a cure. Persons in the decline of life are most liable to it. It is distinguished into the moist and dry, or humoral and nervous. The former is at- tended with expectoration or spitting ; but in the latter the patient seldom spits, unless sometimes a little tough phlegm by the mere force pf coughing. Causes.—The asthma is sometimes hereditary. It may likewise proceed from a bad formation of the breast; the fumes of metals or minerals taken into the lungs ; violent exercise, especially running ; the obstruction of customary evacuations, as the menses, haemorrhoids, &c. the sudden retrocession of the gout, or striking in of eruptions, as the small-pox, measles, &c. violent passions of the mind, as sudden fear or surprise. In a word, the disease may proceed from any cause that either impedes the circulation of the blood through the lungs, or pre- vents their being duly expanded by the air. Symptoms.—An asthma is known by a quick laborious breathing, which is generally performed with a kind of wheezing noise. Sometimes the difficulty of breathing is so great, that the patient is obliged to keep in an erect posture, otherwise he is in danger of being suffocated. A fit or paroxysm of the asthma generally happens after a person has been * The itch is now by cleanliness banished from every genteel family in Britain. It still, however, prevails among the poorer sorts of peasants in Scotland, and among the manufacturers in England. These are not only sufficient to keep the seeds of the disease alive, but to spread the infection among others. It were to be wished that some effectual method could be devised for extirpating it altogether. Svsveral country clergymen have told me, that by getting such as were infected cured, jnd strongly recommending an attention to cleanliness, they have banished the itch entirely out of their parishes. Why might not others do the same f OF THE ASTHMA. 277 exposed to cold easterly winds, or has been abroad in thick fogjy weather, or has got wet, or continued long in a damp place under ground, or has taken some food which the stomach could not digest, as pastries, toasted cheese, or the like. The paroxysm is commonly ushered in with listlessness, want of Bleep, hoarseness, a cough, belching wind, a sense of heaviness about the breast, and difficulty of breathing. To these succeed heat, fever, pain of the head, sickness and nausea, great oppression of the breast, palpita- tion of the heart, a weak and sometimes intermitting pulse, an invo- luntary flow of tears, bilious vomitings, &c. All the symptoms grow worse toward night; the patient is easier when up than in bed, and is very desirous of cool air. Regimen.—The food ought to be light and of easy digestion. Boiled meats are to be preferred to roasted, and the flesh of young animals to that of old. All windy food, and whatever is apt to swell in the stomach, is to be avoided. Light puddings, white broths, and ripe fruits baked, boiled, or roasted, are proper. Strong liquors of all kinds, especially malt-liquor, are hurtful. The patient should eat a very light supper, or rather none at all, and should never suffer himself to be long costive. His clothing should be warm, especially in the winter season. As all disorders of the breast are much relieved by keeping the feet warm, and promoting the perspiration, a flannel shirt or waistcoat, and thick shoes, will be of singular service. But nothing is of so great importance in the asthma as pure and moderately warm air. Asthmatic people can seldom bear either the close heavy air of a large town, or the sharp keen atmosphere of a bleak hilly country ; a medium, therefore, between these is to be chosen. The air near a large town is often better than at a distance, provided the patient be removed so far as not to be affected by the smoke. Some asthmatic patients indeed breathe easier in town than in the country ; but this is seldom the case, especially in towns where much coal is burnt. Asthmatic persons who are obliged to be in town all day, ought at least to sleep out of it. Even this will ofteu prove of great service. Those who can afford it ought to travel into a warmer climate. Many asthmatic persons who cannot live in Britain, enjoy very good health in the south of France, Portugal, Spain, or Italy. Exercise is likewise of very great importance in the asthma, as it promotes the digestion, and greatly assists in the preparation of the blood. The blood of asthmatic persons is seldom duly prepared, owing to the'proper action of the lungs being impeded. For this reason such people ought daily to take as much exercise, either on foot, horseback, or in a carriage, as they can bear. 2/8 OF THE ASTnMA. Medicine.—Almost all that can be done by medicine in this disease, is to relieve the patient when seized with a violent fit. This indeed re- quires the greatest expedition, as the disease often proves suddenly fatal. In the paroxysm or fit the body is generally bound, a purging- c'yster, with a solution of assafoetida, ought therefore to be administered, and, if there be occasion, it may be repeated two or three times. The patient's feet and legs ought to be immersed in warm water, and after- wards rubbed with a warm hand or dry cloth. Bleeding, unless extreme weakness or old age should forbid it, is highly proper. If there he a violent spasm about the breast or stomach, warm fomentations, or bladders filled with warm milk and water, may be applied to the part affected, and warm cataplasms to the soles of the feet. The patient must drink freely of diluting liquors, and may take a tea-spoonful of the tincture of castor and saffron mixed together in a cup of valerian tea, twice or thrice a-day. Sometimes a vomit has a very good effect, and snatches the patient, as it were, from the jaws of death. This, however, will be more safe after other evacuations have been premised. A very strong infusion of roasted coffee is said to give ease in an asthma- tic paroxysm. Inthe moist asthma, such things as promote expectoration or spittinn-, ought to be used ; as the syrup of squills, gum-ammoniac, and such like. A common spoonful of the syrup or oxymel of squills, mixed with an equal quantity of cinnamon-water, may be taken three or four times through the day, and four or Ave pills made of equal parts of assafoetida and gum- ammoniac at bedtime.* For the convulsive or nervous asthma, antispasmodics and bracers are ttie most proper medicines. The patient may take a tea-spoonful of the paregoric elixir twice a-day. The Peruvian bark is sometimes found to be of use in this case. It may be taken in substance, or in- fused in wine. In short, every thing that braces the nerves or takes off sp'ism may be of use in the nervous asthma. It is often relieved by the use of ass's milk ; I have likewise known cow's milk drank warm in the morning have a very good effect in this case. In every species of asthma, setons and issues have a good effect ; they may either be set in the back or side, and should never be allowed to dry up. We shall here once for all, observe, that not only in the asthma, but in most chronic diseases, issues are extremely proper. They are both a safe and efficacious remedy; and though they do not always cure the disease, yet they will often prolong the patient's life. * After copious evacuations, large do3es of aether have been found very efficacious In removing a tit of the asthma. I have likewise known the following mixture pro- duce very happy effects : To four or five ounces of the solution or milk of gum. ammoniac add two ounces of simple cinnamon-water, the same quantity of balsamic syrup, and half an ounce of paregoric elixir. Of this two sable-spoonfuls may be Uiieu every three hours. OF THE ATOPLEXY. 270 This disease, common as it is in Great Britain, is almost unknown in milder climates ; hence, a change of climate is always advisable, and though neither that nor medicine can ever eradicate the disease, yet the change to a warmer country, with proper attention to regimen, may enable an asthmatic person to live many years in tolerable health. In this, as in most other disorders, no general rules can be laid down for every situation, but the patient's ease and constitution must be parti- cularly consulted. CHAP. XLI. OF THE APOPLEXY. The apoplexy is a sudden loss of sense and motion, during which tho patient is to all appearance dead : the heart and lungs still continue to move. Though this disease often proves fatal, yet it may sometimes be removed by proper care. It chiefly attacks sedentary persons of a gross habit, who use a rich and plentiful diet, and indulge in strong liquors. People in the decline of life are most subject to the apoplexy. It pre- vails most in winter, especially in rainy seasons and very low states of the barometer. Causes.—The immediate cause of an apoplexy is a compression of the brain, occasioned by an excess -of blood, or a collection of watery humours. The former is called a sanguine, and the latter a se-ous apoplexy. It may be occasioned by any thing that increases the circu- lation towards the brain, or prevents the return of the blood from the head • as intense study; violent passions,* viewing objects for a long time obliquely ; wearing any thing too tight about the neck ; a rich and lux- urious dief; suppression of urine ; suffering the body to cool suddenly after having been greatly heated ; continuing long in a warm or cold bath • the excessive use of spiceries, or high-seasoned food ; excess of venery ; the sudden striking in of any eruption ; suffering issues, setons, &c suddenly to drv up, or the stoppage of any customary evacuation ; a mercurial salivation pushed too far, or suddenly checked by cold ; * I I new a woman who in a violent fit of anger was seiz-1 w^th a sang"}™ ap..- nl. v She at hr"t complained of extreme pain, .u ./ dagger, had been thrust throng Pi' Jr .. ,h« axnresied it. Afterwards she became comatose, her pulse sunU *'"*■ f3i' *„rt w^s exceeding slow. By bleeding blistering, and other evacuations, x?> l01'n?a]r™ for abou a fortnight When her head was opened, a large quaa S JSS"too 1 was found'in the left ventric'.o of the brain. 230 OF THE APOPLEXY. wounds or bruises on the head ; long exposure to excessive cold ; poisonous exhalations, &c. Symptoms, and method of cure.—The nsual forerunners of an apo- plexy are giddiness, pain and swimming of the head ; loss of the memo- ry ; drowsiness ; noise in the ears ; the night-mare ; a spontaneous flux of tears and laborious perspiration. When persons of an apoplectic make, observe these symptons, they have reason to fear the approach of a fit, and should endeavour to prevent it by bleeding, a slender diet, and opening medicines. In the sanguine apoplexy, if the patient does not die suddenly, the countenance appears florid, the face is swelled or puffed up, and the blood vessels, especially about the neck and temples, are turgid ; the pulse beats strong ; the eyes are prominent and fixed, and the breath- ing is difficult, and performed with a snorting noise. The excrements and urine are often voided spontaneously, and the patient is sometimes seized with vomiting. In this species of apoplexy every method must be taken to lessen the force of circulation towards the head. The patient should be kept perfectly easy and cool. His head should be raised pretty high, and his feet suffered to hang down. His clothes ought to be loosened, espe- cially about the neck, and fresh air admitted into his chamber. His garters should be tied pretty tight, by which means the motion of the blood from the lower extremities will be retarded. As soon as the patient is placed in a proper posture, he should be bled freely in the neck or arm, and, if there be occasion, the operation may be repeated in two or three hours. A laxative clyster, with plenty of sweet oil, or fresh butter, and a spoonful or two of common salt in it, may be admi- nistered every two hours, and blistering-plasters applied between the shoulders, and to the calves of the legs. As soon as the symptoms are a little abated, and the patient is able to swallow, he ought to drink freely of some diluting opening liquor ; as a decoction of tamarinds and liquorice, cream-tartar whey, or com- mon whey with cream of tartar dissolved in it. Or he may take any cooling purge, as Glauber's salts, manna dissolved in an infusion of senna, or the like. All spirits, and other strong liquors, are to be avoided. Even volatile salts held to the nose do mishief. Vomits, for the same reason, ought not to be given, or any thing that may increase the motion of the blood towards the head. Iu the serous apoplexy, the symptoms are nearly the same, only the puhe is not so strong, the countenance is less florid, and the breathing less difficult. Bleeding is not so necessary here as in the former case. It may, however, generally be performed once with safety and advan- OF COSTIVENESS, ETC. 2^1 fnge, but should not be repeated. The patient should be placed in the Batne posture as directed above, and should have blistering-plasters applied, and receive opening clysters in the same manner. Purges are here likewise necessary, and the patient may drink balm-tea. If he be inclined to sweat, it ought to be promoted by drinking small wine- whey, or an infusion of carduus benedictus. A plentiful sweat kept up for a considerable time has often carried off a serous apoplexy. When apoplectic symptoms proceed from opium, or other narcotic Bubstances taken into the stomach, vomite are necessary. The patient is generally relieved as soon as he has discharged the poison in this way. Persons of an apoleptic make, or those who have been attacked by it, ought to use a very spare and slender diet, avoiding all strong liquors, Bpiceries, and high-seasoned food. They ought likewise to guard against all violent passions, and to avoid the extremes of heat and cold. The head should be shaved, and daily washed with cold water. The feet ought to be kept warm, and never suffered to continue long wet. The body must be kept open either by food or medicine, and a little blood may be be let every spring and fall. Exercise should by no means bo neglected ; but it ought to be taken in moderation. Nothing has a more happy effect in preventing an apoplexy than perpetual issues or setons ; great care, however, must be taken not to suffer them to dry up, without opening others in their stead. Apoplectic persons ought never to go to rest with a full stomach, or to lie with their heads luw, or wear any thing too tight about their necks. The above observations are of the greatest importance. A full sto- mach impedes the circulation, which is naturally slower during sleep than when awake. The head lying low seems to invite stagnation, and tight ligatures around the neck impede the return of the blood from the brain, and can hardly fail to produce an apoplexy. CHAP. XLII. OF COSTIVENESS, AND OTHER AFFECTIONS OF TIIE STOMACH AND BOWELS. Wf do not here mean to treat of those astrictions of the bowels which are'the symptoms of diseases, as of the colic, the iliac passion &c. but only to take notice of^hat infrequency of stools which sometimes happens, uud which in some particular constitutions may occasion disease* C°* •'-» COSTIVENESS, ETC. Costiveness may proceed from drinking rough red wines, or other astringent liquors ; too much exercise, especially on horseback. It may likewise proceed from a long use of cold insipid food, which does not sufficiently stimulate the intestines. Sometimes it is owing to the bile not descending to the intestines, as in the jaundice ; and at other times it proceeds from diseases of the intestines themselves, as a palsy, spasms, torpor, tumours, a cold dry state of the intestines, &c. Excessive costiveness is apt to occasion pains of the head, vomiting, colics, and other complaints of the bowels. It is peculiarly hurtful to hypochondriac and hysteric complaints, as it generates wind and other grievous symptoms. Some people, however, can bear costiveness to a great degree. I know persons who enjoy pretty good health, yet do not go to stool above once a-week, and others not above once a-fortnight. Indeed, I have heard of some who do not go to stool above once a-month. Persons who are generally costive should live upon a moistening and laxative diet; as roasted or boiled apples, pears, stewed prunes, raisins, gruels with currants, butter, honey, sugar, and such like. Broths with spinage, leeks, and other soft pot-herbs, are likewise proper. Rye-bread, or that which is made of a mixture of wheat and rye together, ought to be eaten. No person troubled with costiveness should eat white bread alone, especially that which is made of fine flour. The best bread for keeping the body soluble is what, in some parts of England, they call meslin. It is made of a mixture of wheat and rye, and is very agree- able to those who are accustomed to it. Costiveness is increased by keeping the body too warm, and by every thing that promotes the perspiration ; as wearing flannel, lying too long in bed, &c. Intense thought and a sedentary life are likewise hurtful. All the secretions and excretions are promoted by moderate exercise without doors, and by a gay, cheerful, sprightly temper of mind. The drink should be of an opening quality. All ardent spirits, aus- tere and astringent wines, as port, claret, &c. ought to be avoided. Malt- liquor that is fine, and of a moderate strength, is very proper. But- ter-milk, whey, and other watery liquors, are likewise proper, and may be drank in turns, as the patient's inclination directs. Those who are troubled with costiveness, ought, if possible, to re- medy it by diet, as the constant use of medicines for that purpose is attended with many inconveniencies, and often with bad consequences.* * The learned Dr. Arbuthnot advises those who are troubled with costiveness to use animal oils, as fresh butter, cream, marrow, fat broths, especially those made of the internal parts of animals, as the liver, heart, mid riff, &c. He likewise recom. mends the expressed oils of mild vegetables, as olives, almonds, pistachios, and the fruits themselvej; all oily and mild fruits, as ft^s ; decoctions of mealy vegetables; these lubricate the intestines ; some saponaceous substances which stimulate gontty^ WANT OF APPETITE. 283 I never knew any one get into a habit of taking medicine for keeping the body open, who could leave it off. In time the custom becomes necessary, and generally ends in a total relaxation of the bowels, indi- gestion, loss of appetite, wasting of the strength, and death. When the body cannot be kept open without medicine, we would recommend gentle doses of rhubarb to be taken twice or thrice a-week. This is not near so injurious to the stomach, as aloes, jalap, or the other drastic purgatives so much in use. Infusions of senna aud manna may likewise be taken, or half an ounce of soluble tartar dissolved in water-gruel. About the size of a nutmeg of lenitive electuary taken twice or thrice a-day generally answers the purpose very well. WANT OF APPETITE This may proceed from a foul stomach ; indigestion ; the want of free air and exercise ; grief, fear, anxiety, or any of the depressing passions ; excessive heat; the use of strong broths, fat meat, or any thing that palls the appetite, or is hard of digestion ; the immoderate use of strong liquors, tea, tobacco, opium, &c. The patient ought, if possible, to make choice of an open dry a.r ; to take exercise daily on horseback or in a carriage ; to rise betimes ; and to avoid all intense thought. He should use a diet of easy digestion ; and should avoid excessive heat and great fatigue. If want of appetite proceed from errors in diet, or any other part of the patient's regimen, it ought to be changed If nausea and,retchings show that the stomach is loaded with crudit.es, a vomit w,l be of si vice. After this a gentle purge or two of rhubarb, or any of the bitter purging salts may be taken. The patient ought next touse some of Stomachic bitters infused in wine. Though gentle evacuation b necessary, yet strong purges and vomits are to be avoided, as they raCtlie'stomachrand hurt digestion. After proper evacuations, hitter elixirs and tinctures with aromatics may be used. El xrof vitriol is an excellent medicine in most cases of indigestion, JJnTof the stomach, or want of appetite. From twenty to hirty Tit may be taken twice or thrice a-day in a glass of wine or 'Ter It ly l^wise * »»«* ^ *» **« " *" ^ °M lhoney hydromel. or boiled honey and wate,■• ^'^^i fe aTra\En ''?"!/' that such lenitive substances are-proper tor person. 01 ry ^ Sve die? hurts*those wl,o*e bowels are .««.»- ^ "-^ whev, Sour hat aU eatery substances are ^{»^t,-Thlt new-milk. especially ass's milk. ^^Xo^n^^L stomach , and ,,., whey turned sour «U purge strongly. ^"4 OF THE HEART-BURN. dram of the former to an ounce of the latter, and two tea-spoonfuls of it taken in wine and water, as above. The chalybeate waters, if drank in moderation, are generally of considerable service in this case. The salt-water has likewise good effects ; but it must not be used too freely. The waters of Harrogate, Scarborough, Moffat, and most other spas in Britain, may be used with advantage. We would advise all who are afflicted with indigestion and want of appetite, to repair to these places of public rendezvous. The very change of air, and the cheerful company, will be of service ; not to mention the exercise, dissipation, amusements, &c. OF THE HEART-BURN. What is commonly called the heart-burn, is not a disease of that organ, but an uneasy sensation of heat or acrimony about the pit of the sto- mach, which is sometimes attended with anxiety, nausea, and vomiting. It may proceed from a debility of the stomach, indigestion, bile, the abounding of an acid in the stomach, &c. Persons who are liable to this complaint ought to avoid stale liquors, acids, windy or greasy aliments, and should never use violent exercise soon after a plentiful meal. I know many persons who never fail to have the heart-burn if they ride soon after dinner, provided they have drank ale, wine, or any fermented liquor ; but are never troubled with it when they have drank rum or brandy and water without any sugar or acids. When the heart-burn proceeds from debility of the stomach, or indigestion, the patient ought to take a dose or two of rhubarb ; after- wards he may use infusions of the Peruvian bark, or any other of the stomachic bitters, in wine or brandy. Drinking a cup of camomile-tea, with fifteen or twenty drops of the elixir of vitriol in it, twice or thrice a-day, will strengthen the stomach and promote digestion. Exercise in the open air will likewise be of use. When bilious humours occasion the heart-burn, a tea-spoonful of the sweet spirit of nitre in a glass of water, or a cup of tea, will generally give ease. If it proceeds from the use of greasy aliments, a dram of brandy or rum may be taken. If acidity or sourness of the stomach occasions the heart-burn, ab- sorbents are the proper medicines. In this case an ounce of powdered chalk, half an ounce of fine sugar, and a quarter of an ounce of gum- arabic, may be mixed in an English quart of water, and a tea-cupful of it taken as often as is necessary. Such as do not choose chalk, may take a tea-spoonful of prepared oyster shells, or of the powder called Crab's-eyes, aud a glass of cinnamon or peppermint water. But the OF NERVOUS DISEASES. 285 safest and best absorbent is magnesia alba. This not only act3 as an absorbent, but likewise as a purgative ; whereas chalk and other absorb. ents of that kind, are apt to lie in the intestines and occasion obstruc- tions. This powder is not disagreeable, and may be taken in a cup of tea, or a glass of mint water. A large tea-spoonful is the usual dose ; but it may be taken in a much greater quantity when there is occasion. These things are now generally made up into lozenges for the conveni. ency of being carried in the pock-t, and taken at pleasure. If wind be the cause of this complaint, the most proper medicines are those called carminatives; as aniseeds, juniper-berries, ginger, c:mella alba, cardamom seeds, &c. These may either be chewed, or infused in wine, brandy, or other spirits ; but these ought never to be used, unless they are absolutely necessary, as they are only drams in a dry form, and very pernicious to the stomach. One of the safest medi- cines of this kind is the tincture made by infusing an ounce of rhubarb, and a quarter of an ounce of the lesser cardamom seeds, in an English pint of brandy. After this has digested for two or three days, it ought to be strained, and four ounces of white sugar-candy added to it. It must stand to digest a second time till the sugar be dissolved. A table spoonful of it may be taken occasionally for a dose. I hav« frequently known the heart-burn cured, particularly in preg- nant women, by chewing green tea. Two table-spoonfuls of what is called the milk gum-ammoniac, taken once or twice a-day, will some- times cure the heart-burn. CHAP. XLIII. OF NERVOUS DISEASES. Of all diseases incident to mankind, those of the nervous kind are the most complicated and dificult to cure. A volume would not be sufficient to point out their various appearances. They mutate almost every dis- ease ; and are seldom alike in two different persons, or even the same PetsVu at different times. Proteus-like, they are continually changing P, L,\ noon every fresh attack, the patient thinks he feels symp- IJ whl h^rnever"fenced before. Nor do they only affect the bX- * .m»d likewise suffers, aud is often thereby rendered ex- Lemejy weak and peevish. The low spirits, Umorousness, melancholy *0D OF NERVOE9 DISEASES. and fickleness of temper, which generally attend nervous disorders, induce many to believe that they are entirely diseases of the mind ; but this change of temper is rather a consequence than the cause of nervous diseases. Causes.—Every thing that tends to relax or weaken the body dis- poses it to nervous diseases, as indolence, excessive venery, drinking too much tea, or other weak watery liquors warm, frequent bleeding, purging, vomiting, &c. Whatever hurts the digestion, or prevents the proper assimilation of the food, has likewise this effect; as long fasting, excess in eating or drinking, the use of windy, crude, or unwholesome aliments, an unfavourable posture of the body, &c. Nervous disorders often proceed from intense application to study. Indeed, few studious persons are entirely free from them. Nor is this at all to be wondered at; intense thinking not only preys upon the spi- rits, but prevents the person from taking proper exercise, by which means the digestion is impaired, the nourishment prevented, the solids relaxed, and the whole mass of humours vitiated. Grief and disap- pointment likewise produce the same effects. I have known more ner- vous patients who dated the commencement of their disorders from the loss of a husband, a favourite child, or from disappointment in life, than from any other cause. In a word, whatever weakens the body, or depresses the spirits, may occasion nervous disorders ; as unwholesome air, want of sleep, great fatigue, disagreeable apprehensions, anxiety, vexation, &c. Symptoms.—We shall only mention some of the most general symp- toms of these disorders, as it will be both a useless and impracticable task to enumerate the whole. They generally begin with w.ndy infla- tions or distensions of the stomach and intestines ; the appetite and digestion are usually bad ; yet sometimes there is an uncommon craving for food, and a quick digestion. The food often turns sour on the stomach; and the patient is troubled with vomiting of clear water, tough phlegm, or a blackish-coloured liquor resembling the grounds of coffee. Excruciating pains are often felt about the navel, attended with a rumbling or murmuring noise in the bowels. The body is some- times loose, but more commonly bound, which occasions a retention of wind and great uneasiness. The urine is sometimes in small quantity, at other times very co- pious and quite clear. There is a great tightness of the breast, with difficulty of breathing ; violent palpitations of the heart ; sudden flush- rigs of heat in various parts of the body ; at other times a sense of cold, as if water were poured on them ; flying pains in the arms and limbs, pains in the back and belly, resembling those occasioned by gia- OF NERVOUS DISEASES. 287 rel ; the pulse very variable, sometimes uncommonly slow, and at other t mes very quick ; yawning, the hiccup, frequent sighing, and a sense of suffocation, as if from a ball or lump in the throat; alternate fits of crying and convulsive laughing ; the sleep is unsound, and seldom re- freshing ; and the patient is often troubled with the night-mare. As the disease increases, the patient is molested with head-aches, cramps, and fixed pains in various parts of the body ; the eyes are clouded, and often affected with pain and dryness ; there is a noise ill the ears, aud often a dullness of hearing; in short, the whole animal functions are impaired. The mind is disturbed on the most trivial occasions, and is hurried into the most perverse commotions, inquie- tudes, terror, sadness, anger, diffidence, &c. The patient is apt to en. t«-rtain wild imaginations, and extravagant fancies ; the memory be- comes weak, and the judgment fails. Nothing is more characteristic of this disease than a constant dread of death. This renders those unhappy persons who labour under it peevish, fickle, impatient, and apt to run from one physician to another ; which is one reason why they seldom reap any benefit from medicine, as they have not sufficient resolution to persist in any one course till ic has time to produce its proper effects. They are likewise apt to ima- gine that they labour under diseases from which they are quite free ; and are very angry if any one attempts to set them right, or laugh them out of their ridiculous notions. Regimen.—Persons afflicted with nervous diseases ought never to fast Ion"'. Their food should be solid and nourishing, but of easy digestion. Fat meats and heavy sauces are hurtful. All excess should be carefully avoided. They ought never to eat more at a time than they can easily digest; and heavy suppers are to be avoided. If they feel themselves weak and faiut between meals, they ought to eat a bit of bread, and drink a glass of wine. Though wine, in excess, enfeebles the body, and impairs the faculties of the mind, yet, taken in modera- tion, it strengthens the stomach, and promotes digestion. Wine and water is a very proper drink at meals ; but if wine sours on the sto- mach, or the patient is much troubled with wind, brandy and water will answer better. Every thing that is windy or hard of digestion must be avoided. AH weak and warm liquors are hurtful; as tea, coffee, punch, Ac. People may find a temporary relief in the use of these,but they always increase the malady, as they weaken the stomach, and hurt digestion. Above all things, drams are to be avoided. What- ever immediate ease the patient may feel from the use of ardent spi- rits, they are sure to aggravate the malady, and prove certain poisons a: last. These cautious iwe the more necessary, as most nervous i.^.ie *oa OF NERVOUS DISEASES. are peculiarly fond of tea and ardent spirits ; to the use of which many of them fall victims. Exercise in nervous disorders is superior to all medicines. Riding on horseback is generally esteemed the best, as it gives motion to the whole body without fatiguing it. I have known some patients, however, with whom walking agreed better, and others who were most benefited by riding in a carriage. Every one ought to use that which he finds most beneficial. Long sea-voyages have an excellent effect; and to those who have sufficient resolution, we would by all means recommend this course. Even change of place, and the sight of new objects, by diverting the mind, have a great tendency to remove these complaints. For this reason a long journey, or a voyage, is of much more advantage than riding short journies near home. A cool and dry air is proper, as it braces and invigorates the whole body. Few things tend more to relax and enervate than hot air, espe- cially that which is rendered so by great fires or stoves in small apart- ments. But when the stomach and bowels are weak, the body ought to be well guarded against cold, especially in winter, by wearing a thin flannel waistcoat next the skin. This will keep up an equal perspiration, and defend the alimentary canal from many impressions to which it would otherwise be subject upon every sudden change from warm to cold weather. Rubbing the body frequently with a flesh-brush, or a coarse linen cloth, is likewise beneficial; as it promotes the circulation, perspiration, &c. Persons who have weak nerves ought to rise early, and take exercise before breakfast, as lying too long in bed cannot fail to relax the solids. They ought likewise to be diverted, and to be kept as easy and cheerful as possible. There is not any thing which hurts the nervous system, or weakens the digestive powers more than fear, grief, or anxiety. Medicines.—Though nervous diseases are seldom radically cured, yet their symptoms may sometimes be alleviated, and the patient's life rendered at least more comfortable, by proper medicines. When the patient is costive he ought to take a little rhubarb, or some other mild purgative, and should never suffer his body to be long bound. All strong and violent purgatives are, however, to be avoided ; as aloes, jalap, &c. I have generally seen an infusion of senna aud rhubarb in brandy answer very well. This may be made of any strength, and taken in such a quantity as the patient finds necessary. When the digestion is bad, or the stomach relaxed and weak, the following infusion of Peruvian bark and other bitters may be used with advantage. Take of Peruvian bark an ounce, gentian-root, orange-peel, and corian- der-seed, of each an ounce ; let these ingred eiits be all bruised in a OF MELANCHOLY. CTtJ mortar, and infused in a bottle of brandy or rum, for the space of five or six days. A table spoonful of the strained liquor may be taken in half a glass of water, an hour before breakfast, dinner, and supper. Few tilings tend more to strengthen the nervous system than cold bathing. This practice, if duly persisted in, will produce very extra- ordinary effects ; but when the liver or other viscera are obstructed, or otherwise unsound, the cold bath is improper. It is therefore to be used with very great caution. The most proper seasons for it are summer and autumn. It will be sufficient, especially for persons of a s; are habit, to go into the cold-bath three or four times a week. If the patient be weakened by it, or feels chilly for a long time after coming out, it is improper. In patients afflicted with wind, I have always observed the greatest benefit from the elixir of vitriol. It may be taken in the quantity of fifteen, twenty, or thirty drops, twice or thrice a-day, in a glass of water. This both expels wind, strengthens the stomach, and promotes digestion. Opiates are generally extolled in these maladies ; but as they only palliate the symptoms, and generally afterwards increase the dUeai-c, we would advise people to be extremely sparing in the use of them, lest habit should at last render them absolutely necessary* It would be an easy matter to enumerate many medicines which have been extolled for relieving the nervous disorders ; but whoever wishes for a thorough cure, must expect it from regimen alone : we shall, therefore, omit mentioning more medicines, and again recommend the Btrictest attention to diet, air, exercisk, and amusements. OF MELANCHOLY. Melancholy is that state of alienation or weakness of mind which renders people incapable of enjoying the pleasures or performing the duties of life. It is a degree of insanity, and often terminates in abso- lute madness. Causes.—It may proceed from a hereditary disposition ; intense thinking, especially where the mind is long occupied about one object; violent passionsor affections of the miud, as love, fear, joy, grief, pnde, and such like. It may also be occasioned by excessive venery ; nar- cotic or stupefactive poisons ; a sedentary life ; solitude ; the .uppres- * Faw days have passedI f o,• a^^^™l&^t£X£ recommend theflowingtoneuie to some of layatr P tincture „f „,„ „lrk *£$X^'ot Xi^rrounce ; mi. them ; u„ a toa-^oaCul in a gLus of wine or water three or four time, .-day. 290 OF MELANCHOLY. sion of customary evacuations ; acute fevers ; or other diseases. Violent anger will change melancholy into madness ; and excessive cold, espe- cially of the lower extremities, will force the blood into the brain, and produce all the symptoms of madness. It may likewise proceed from the use of aliment that is hard of digestion, or which cannot be easily assimilated ; from a callous state of the integuments of the brain, or a dryness of the brain itself. To all which we may add gloomy and mis- taken notions of religion. Symptoms.—When persons begin to be melancholy, they are dull; dejected ; timorous ; watchful; fond of solitude ; fretful; fickle ; cap- tious and inquisitive ; solicitous about trifles ; sometimes niggardly, and other times prodigal. The body is generally bound ; the urine thin, and in small quantity ; the stomach and bowels inflated with wind ; the complexion pale ; the pulse slow and weak. The functions of the mind are also greatly perverted, insomuch that the patient oftens imagines himself dead, or changed into some other animal. Some have imagined their bodies made of glass, or other brittle substances, and were afraid to move lest they should be broken to pieces. The unhappy patient, in this case, unless carefully watched, is apt to put an end to his own miserable life. When the disease is owing to any obstruction of customary evacua- tions, or any bodily disorder, it is easier cured than when it proceeds from affections of the mind, or a hereditary taint. A discharge of blood from the nose, looseness, scabby eruptions, the bleeding piles, or the menses, sometimes carry off this disease. Regimen.—The diet should consist chiefly of vegetables of a cool- ing and opening quality. Animal food, especially salted, or smoke-dried fish or flesh, ought to be avoided. All kinds of shell-fish are bad. Aliments prepared with onions, garlic, or any thing that generates thick blood are likewise improper. All kinds of fruit that are wholesome may be eaten with advantage. Boerhaave gives an instance of a patient who, by a long use of whey, water, and garden fruit, recovered, after having evacuated a great quantity of black coloured matter. Strong liquors of every kind ought to be avoided as poison. The most proper drink is water, whey, or very small beer. Tea and coffee are improper. If honey agrees with the patient, it may be eaten freely, or his drink may be sweetened with it. Infusions of balm- leaves, penny-royal, the roots of wild valerian, or the flowers of the lime tree, may be drank freely, either by themselves, or sweetened with honey, as the patient shall choose. The patient ought to take as much exercise in the open air as he can bear. This helps to dissolve the viscid humours, it removes obstrue- OF MELANCHOLY. 201 tions, promotes the perspiration and all the other secretions. Every kind of madness is attended with a diminished perspiration ; all means ought therefore to be used to promote that necessary and salutary discharge. Nothing can have a more direct tendency to increase the disease than confining the patient to a close apartment. Were he forced to ride or walk a certain number of miles every day, it would tend greatly to alleviate his disorder ; but it would have a still better effect if he were obliged to labour a piece of ground. By digging, hoeing, planting, sowing, &c. both the body and mind would be exercised. A long journey, or a voyage, especially towards a warmer climate, with agreeable companions, has often very happy effects. A plan of this kind, with a strict attention to diet, is a much more rational method of cure, than confining the patient within doors, and plying him with medicines. Medicine.—In the cure of this disease, particular attention must be paid to the mind. When the patient is in a low state, his mind ought to be soothed and diverted with variety of amusements, as entertaining stories, pastimes, music, &c. This seems to have been the method of curing the melanclioly among the Jews, as we learn from the story of King Saul ; and, indeed, it is a very rational one. Nothing can remove diseases of the mind so effectually as applications to the mind itself, the most efficacious of which is music. The patient's company ought like- wise to consist of such persons as are agreeable to him. People hi this state are apt to conceive unaccountable aversions against parti- cular persons ; and the very sight of such persons is sufficient to dis- tract their minds, and throw them into the utmost perturbation. In all kinds of madness, it is better to soothe and calm the mind, than to ruffle it by contradiction. When the patient is high, evacuations are necessary. In this case he must be bled, and have his body kept open by purging medicines, as manna, rhubarb, cream of tartar, or the soluble tartar. I have seen the last have very happy effects. It may be taken in the dose of half an ounce, dissolved in water gruel, every day, for several weeks, or even for months, if necessary. More or less may be given according as it operates. Vomits have likewise a good effect; but they must be pretty strong, otherwise they will not operate. Whatever increases the evacuation of urine, or promotes perspira- tion, has a tendency to remove this disease. Both these secretions may be promoted by the use of nitre and vinegar. Half a dram of purified nitre may be given three or four times a-day, in any manner that is most agreeable to the patient; and an ounce and a half of dis- 2$2 OF THE PALSY. tilled vinegar may be daily mixed with his drink. Dr. Locker seem3 to think vinegar the best medicine that can be given in this disease. Camphire and musk have likewise been used in this case with ad- vantage. Ten or twelve grains of camphire may be rubbed in a mortar with half a dram of nitre, and taken twice a-day, or oftener, if the stomach will bear it. If it will not sit upon the stomach in this form, it may be made into pills with gum assafoetida and Russian castor, and taken in the quantity above directed. If musk is to be administered, a scruple or twenty-five grains of it may be made into a bolus with a little honey or common syrup, and taken twice or thrice a-day. The antimonial wine is by some extolled for the cure of madness ; it may be taken in a dose of forty or fifty drops twice or thrice a day in a cup of tea. We do not mean that all these medicines should be administered at once ; but whichever of them is given must be duly persisted in, and where one fails another may be tried. As it is very difficult to induce patients in this disease to take medi- cines, we shall mention a few outward applications which sometimes do good ; the principal of these are issues, setons, and warm bathing. Issues may be made in any part of the body, but they generally have the best effect near the spine. The discharge from these may be greatly promoted by dressing them with the mild blistering ointment, and keep- ing what are commonly called the orrispeas in them. The most pro- per place for a seton is between the shoulder blades ; and it ought to be placed upwards and downwards, or in the direction of the spine. OF THE PALSY. The palsy is a loss or diminution of sense and motion, or of both, in one or more parts of the body. Of all the affections called nervous, this Is the most suddenly fatal. It is more or less dangerous, according to the importance of the part affected. A palsy of the heart, lungs, or any other part necessary to life, is mortal. When it affects the stomach, the intestines, or the bladder, it is highly dangerous. If the face be affected, the case is bad, as it shows that the disease proceeds from the brain. When the part affected feels cold, is insensible, or wastes away, or when the judgment and memory begin to fail, there is small hope of a cure. Causes.—The immediate cause of palsy is any thing that prevents the regular exertion of the nervous power upon any particular muscle or part of the body. The occasional and predisposing causes are vari- ous, as drunkenness; wounds of the brain and spinal marrow; pressure upon the brain or nerves; very cold or damp air; the suppression oi OF THE FALSY. 293 nistomary evacuations; sudden fear; want of exercise ; or whatever greatly relaxes the system, as drinking much tea,* or coffee. The palsy may likewise proceed from wounds of the nerves themselves, from the poisonous fumes of metals or minerals, as mercury, lead, arsenic, &c. In young persons of a full habit, the palsy must be treated in the same manner as the sanguine apoplexy. The patient must be bled, blistered, and have his body opened by sharp clysters or purgative medicines. But in old age, or when the disease proceeds from relaxa- tion or debility, which is generally the case, a quite contrary course must be pursued. The diet must be warm and invigorating, seasoned with spicy and aromatic vegetables, as mustard, horse-radish, &c. The drink may be generous wine, mustard-whey, or brandy and water. Friction, with the flesh-brush or a warm hand, is extremely proper, especially on the parts affected. Blistering plasters may likewise be applied to the affected parts with advantage. When this cannot be done, they may be rubbed with the volatile liniment, or the nerve oint- ment of the Edinburgh Dispensary. One of the best external appli- cations is electricity. The shocks, or rather vibrations, should be re- ceived on the part affected; and they ought daily to be repeated for several weeks. Vomits are very beneficial in this kind of palsy, and ought frequently to be administered. Cephalic snuff, or anything that makes the patient sneeze, is likewise of use. Some pretend to have found great benefit from rubbing the parts affected with nettles ; but this does not seem to be any way preferable to blistering. If the tongue be affected, the patient may gargle his mouth frequently with brandy and mustard. or he may hold a bit of sugar in his mouth, wet with the palsydrops, or compound spirit of lavender. The wild valerian-root is a very proper medicine in this case. It may either be taken in an infusion with sage- leaves, or half a dram of it in powder may be given in a glass of wine three or four times a-day. If the patient cannot use the valerian, he may take of**/ volatile oleosum, compound spirits of lavender, aud tinc- ture of castor, each half an ounce; mix these together, and take forty or fifty drops in a glass of wine three or four times a-day. A table- spoonful of mustard-seed taken frequently is a very good medicine. The patient ought likewise to chew cinnamon bark, ginger, or other warm spiceries. i i„„„i„» tlmt ton. has no tendency to hurt the nerves, and that sight, sickness, OF SWOONINGS. 290 glass of brandy, and is much safer. After a person of weak digestion, however, has eaten flatulent food, a dram may be necessary ; m this case we would recommend it as the most proper meaicine. Persons who are young, and full of blood, if troubled with the night- mare, ought to take a purge frequently, and use a spare diet. OF SWOONINGS. People of weak nerves or delicate constitutions are liable to swoon- ings or fainting fits. These, indeed, are seldom dangerous when duly attended to ; but when wholly neglected, or improperly treated, they often prove hurtful, and sometimes fatal. The general causes of swoonings are sudden transitions from cold to heat; breathing air that is deprived of its proper spring or elasticity ; great fatigue ; excessive weakness ; loss of blood ; long fasting ; fear, grief, and other violent passions or affections of the mind. It is well known, that persons who have been long exposed to cold, often faint or fall into a swoon, upon coming into the house, especially if they drink hot liquor, or sit near a large fire. This might easily be prevented by people taking care not to go into a warm room immedi- ately after they have been exposed to the cold air, to approach the fire gradually, and not to eat or drink any thing hot, till the body has been gradually brought into a warm temperature. When any one, in consequence of neglecting these precautions, falls into a swoon, he ought immediately to be removed to a cooler apart- ment, to have ligatures applied above the knees and elbows, and to have his hands and face sprinkled with vinegar or cold water. He should likewise be made to smell to vinegar, and should have a spoonful or two of water, if he can swallow, with about a third part of vinegar mixed with it, poured into his mouth. If these should not remove the com- plaint, it may be necessary to bleed the patient, and afterwards to give him a clyster. As air that is breathed frequently loses its elasticity or spring, it is no wonder if persons who respire in it often fall into a swoon or fainting fit. They are in this case deprived of the very principle of life. Hence it is that fainting fits are so frequent in all crowded assemblies, espe- cially in hot seasons. Such fits, however, must be considered as a kind of temporary death ; and, to the weak and delicate, they sometimes prove fatal. They ought therefore with the utmost care to be guarded Uunst The method of doing this is obvious. Let assembly-rooms, and all other places of public resort, be large and well ventilated ; and let the weak aud delicate avoid such places, particularly in warm seasons / 300 OP FLATULENCIES, OR WINIk A person who faints in such a situation, ought immediately to ha carried into the open air ; his temples should be rubbed with strong vinegar or brandy, and volatile spirits or salts held to his nose. He should be laid upon his back with his head low, and have a little wine or some other cord-'al, as soon as he is able to swallow it, poured into his mouth. If the person has been subject to hysteric fits, castor or asafoetida should be applied to the nose, or burnt feather?, horn, or leather, &c. When fainting fits proceed from mere weakness or exhaustion, which is often the case after great fatigue, long fasting, loss of blood, or the like, the patient must be supported with generous cordials, as jellies, wines, spiritous liquors, and such like. These, however, must be given at first in very small quantities, and increased gradually as the patient is able to bear them. He ought to be allowed to lie quiet, still and easy, upon his back, with his head low, and should have fresh air admitted into his chamber. His food should consist of nourishing broths, sago-gruel with wine, new milk, and other things of a light and cordial nature. These things are to be given out of the fit. All that can be done in the fit is, to let him smell to a bottle of Hungary-water, eau de luce, or spirits of hartshorn, and to rub his temples with warm brandy, or to lay a compress dipped in it to the pit of the stomach. In fainting fits that proceed from fear, grief, or other violent passions or affections of the mind, the patient must be very cautiously managed. He should be suffered to remain at rest, and only made to smell to some vinegar. After he has come to himself, he may drink freely of warm lemonade, or balm-tea, with some orange or lemon peel in it. It will likewise be proper, if the fainting fits have been long and severe, to cleanse the bowels by throwing in an emollient clyster. It is common in fainting fits, from whatever cause they proceed, to bleed the patient. The practice may be very proper in strong per- sons of a full habit; but in those who are weak and delicate, or subject to nervous disorders, it is dangerous. The proper method with such people is to expose them to the free air, and to use cordial and stimu- lating medicines, as volatile salts, Hungary-water, spirits of lavender, tincture of castor, and the like. OF FLATULENCIES, OR WIND. All nervous patients, without exception, are afflicted with wind or flatulencies in the stomach and bowels, which arise chiefly from the want of tone or vigour in these organs. Crude flatulent aliment, as green peas, beans, coleworts, cabbages, and such like, may increase OF FLATULENCIES, OR WIND. 301 this complaint; but strong and healthy people are seldom troubled with wind, unless they either overload their stomachs, or drink liquors that are in a fermented state, and consequently full of elastic air. While therefore the matter of flatulence proceeds from our aliments, the cause which makes air separate from them in such quantity as to occasion complaints, is almost always a fault of the bowels themselves, which are too weak either to prevent the production of elastic air, or to expel it after it is produced. To relieve this complaint, such medicines ought to be used as have a tendency to expel wind, and by strengthening the alimentary canal, to prevent its being produced there.* The list of medicines for expelling wind is very numerous; they often however disappoint the expectations of both the physician and his patient. The most celebrated among the class of carminatives are juni- per-berries ; the roots of ginger and zedoary ; the seeds of anise, caraway, and coriander ; gum assafoetida and opium ; the warm waters, tinctures, and spirits, as the aromatic water, the tincture of wood-foot, the volatile aromatic spirit, sether, &c. Dr. Whyto says, he found no medicine more efficacious in expelling wind than ajther and laudanum. He generally gave the laudanum in a mixture with pepper-mint-water, and tincture of castort or sweet spi- rits of nitre. Sometimes, in place of this, he gave opium in pills with i.safcetida. He observes, that the good effects of opiates are equally conspicuous, whether the flatulence be contained in the stomach or in- testines; whereas those warm medicines, commonly called carminatives, do not often give immediate relief, except when the wind is in the stomach With regard to nther, the Doctor says, he has often seen very good effects from it in flatulent complaints, where other medicines faded. The dose is a tea-spoonful mixed with two table-spoonfuls of water.f In Eouty cases he observes, that »ther, a glass of French brandy, or of the aromatic water, or ginger, either taken in substance, or infused in boiling water, are among the best medicines for expelling wind. When the case of flatulent patients is such as makes it improper to give them warm medicines inwardly, the Doctor recommends external applications, which are sometimes of advantage Equal parts of Uie ami-hystericand stomach plaster maybe spread upon apiece of. leather, of such size as to cover the greater part of the belly. This ■ * Many ^^w™&^TJft£ £»« ^Z**^^^™^™**"of the 8tomach'ari81U5 flatulence, indigestion, &c. quantity, it will be necessary to increase tl + dTfrata^Momfch S* hear T J&* is ucw Siveu in consider.,* Ir'atr dosli Uian it was in Dr. Vkjte 8 tin*. 302 OF LOW SPIRITS. should be kept on for a considerable time, provided the patient be able to bear it; if it should give great uneasiness, it may be taken off, and the following liniment used in its stead :— Take of Bate's anodyne balsam an ounce; of the ex pressed oil of mace half an ounce; oil of mint two drams. Let these ingredients be mixed together, and about a table-spoonful well rubbed on the parts at bed-time. For strengthening the stomach and bowels, and consequently for lessening the production of flatulence, the Doctor recommends the Pe- ruvian bark, bitters, chalybeates, and exercise. In flatulent cases, he thinks some nutmeg or ginger should be added to the tincture of the bark and bitters, and that the aromatic powder should be joined with the filings of iron. When windy complaints are attended with costiveness, which is often the case, few things will be found to answer better than four or five of the following pills taken every night at bed-time :— Take of asafcetida two drams ; succotrine aloes, salt of iron, and powdered ginger, of each one dram ; as much of the elixis propristatis as will be sufficient to form them into pills. On the other hand, when the body is too open, twelve or fifteen grains of rhubarb, with half a dram, or two scruples of the Japonic confection, given every other evening, will have very good effects. In those flatulent complaints which come on about the time the menses cease, repeated small bleedings often give more relief than any other remedy. With regard to diet, the Doctor observes that tea, and likewise all flatulent aliments, are to be avoided ; and that for drink, water with a little brandy or rum, is not only preferable to malt liquor, but in most cases also to wine. As Dr. Whyte has paid great attention to this subject, and as his sen- timents upon it in a great measure agree with mine, I have taken the liberty to adopt them ; and shall only add to his observations, that ex- ercise is, in my opinion, superior to all medicine, both for preventing the production, and likewise for expelling of all flatulencies. These effects, however, are not to be expected from sauntering [about or lolling in a carriage ; but from labour, or such active amusements as give exercise to every part of the body. OF LOW SPIRITS. All who have weak nerves are subject to low spirits in a greater or less degree. Generous diet, the ©old bath, exercise, and amusements, OF HYSTERIC AFFECTIONS. 303 are the most likely means to l-emove this complaint. It is greatly in- creased by solitude and indulging gloomy ideas, but may often be re- lieved by cheerful company and sprightly amusements. When low spirits are owing to a weak relaxed state of the stomach and bowels, an infusion of the Peruvian bark with cinnamon or nutmeg will be proper. Steel joined with aromatics may likewise in this case be used with advantage ; but ridinr, and a proper diet, are most to be depended on. When they arise from a foulness of the stomach and intestines, or obstructions in the hypochondriac viscera, aloetie purges will be proper. I have sometimes known the Harrogate or Tunbridge water of service in this case. When low spirits proceed from a suppression of the menstrual or of the hsemorrhoidal flux, these evacuations may either be restored, or some others substituted in their place, as issues, setons, or the like. Dr. Whyte observes, that nothing ha3 such sudden good effects in this case as bleeding. When low spirits have been brought on by long continued grief, Rnxiety, or other .distress of mind, agreeable company, variety of amuso- . ments, and change of place, especially travelling into foreign countries, will afford the most certain relief. Persons afflicted with low spirits should avoid all kinds of excess, espe- cially of venery and strong liquors. The moderate use of wine and other strong liquors is by no means hurtful; but when taken to excess they weaken the stomach, vitiate the humours, and depress the spirits. This caution is the more necessary, as the unfortunate and melancholy often fly to strong liquors for relief, by which means they never fail to precipitate their own destruction. OF HYSTERIC AFFECTIONS. These likewise belong to the numerous tribe of nervous diseases which may be justlv reckoned the reproach of medicine. Women of a delicate habit, whose stomach and intestines are relaxed, and whose nervous system is extremely sensible, are most subject to hysteric complaints; In such persons an hysteric fit, as it is called, may be brought on by an irritation of the nerves of the stomach or intestines, by wind, acrid humour, or the like. A sudden suppression of the Jenses often gives rise to hysteric fits. They may likewise be excited ^ violent passions or affections of the mind, as fear, grief, anger, or g^rr l^ic fit resembles a swoon or fainting fit, duriu, 304 OF HYSTERIC AFFECTIONS. which the patient lies as in a sleep, only the breathing is so low as scarcely to be perceived. At other times the patient is affected with catchings and strong convulsions. The symptoms which precede hys- teric fits are likewise various in different persons. Sometimes the fits come on with coldness of the extremities, yawning and stretching, low- ness of spirits, oppression and anxiety. At other times the approach of the fit is foretold by a feeling, as if there were a ball at the lower part of the belly, which gradually rises towards the stomach, where it occasions inflation, sickness, and sometimes vomiting ; afterwards it rises into the throat, and occasions a degree of suffocation, to which quick breathing, palpitation of the heart, giddiness of the head, dimness of the sight, loss of hearing, with convulsive motions of the extremi- ties and other parts of the body, succeed. The hysteric paroxysm is often introduced by an immoderate fit of laughter, and sometimes it goes off by crying. Indeed there is not much difference between the laugh- ing and crying of an hysteric lady. Our aim in the treatment of this disease must be to shorten the fit or paroxysm when present, and to prevent its return. The longer the fits continue, and the more frequently they return, the disease becomes the more obstinate. Their strength is increased by habit, and they induce so great a relaxation of the system, that it is with difficulty removed. It is customary, during the hysteric fit or paroxysm, to bleed the patient. In strong persons of a plethoric habit, and where the pulse is full, this may be proper: but in weak and delicate constitutions, or where the disease has been of long standing, or arises from inanition, it is not safe. The best course in such cases is to rouse the patient by strong smells, as burnt feathers, asafoetida, or spirits of hartshorn, held to the nose. Hot bricks may also be applied to the feet, and the legs, arms, and belly, may be strongly rubbed with a warm cloth. But the best application is, to put the feet and legs into warm water. This is peculiarly proper when the fits precede the flow of the menses. In case of costiveness, a laxative clyster with asafoetida will be pro- per : and as soon as the patient can swallow, two table-spoonfuls of a solution of asafoetida, or of some cordial julep, may be given frequently.* The radical cure of this disorder will be best attempted at a time when the patient is most free from the fits. It will be greatly promoted by a * When hysteric fits are occasioned hy sympathy, they may be cured by exciting nn opposite passion. This is suid to have been the case of a whole school of young ladies in Holland, who were all cured by being told that the first who was seized should he burnt to death. But this method of cure, to my knowledge, will not al- ways succeed. I would therefore advise, that young ladies, who are subject to hys- teric fits, should not be sent to boarding-schools, as the disease may be caught by. imitation. I have known madness itself brought on by sympathy. OF HYSTERIC AFFECTI0N3. 305 proper attention to diet. A milk and vegetable diet, when duly persisted in, will often perforin a cure. If, however, the patient has been accus- tomed to a more generous diet, it will not be safe to leave it off all at once, but by degrees. The most proper drink is water with a small quantity of spirits. A cool dry air is the best. Cold-bathing, and every thing that braces the nerves, and invigorates the system, is benefi- cial ; but lying too long in bed, or whatever relaxes the body, is hurt- ful. It is of the greatest importance to have the mind kept constantly easy and cheerful, and, if possible, to have it always engaged in some agreeable and interesting pursuit. The proper medicines are those which strengthen the alimentary canal, and the whole nervous system, as the preparations of iron, the Peruvian bark, and other bitters. Twenty drops of the elixir of vitriol, in a cup of the infusion of the bark, may be taken in substance, pro- vided the stomach can bear them ; but they are generally given in too small doses to have any effect. The chalybeate waters generally prove beneficial in this disorder. If the stomach is loaded with phlegm, vomits will be of use, but they should not be too strong, nor frequently repeated, as they tend to relax and weaken the stomach. If there is a tendency to costiveness, it must be removed either by diet, or by taking an opening pill as often as it shall be found necessary. To lessen the irritability of the system, antispasmodic medicines will be of use. The best antispasmodic medicines are musk, opium, and castor. When opium disagrees with the stomach, it may either be ap- plied externally, or given in clysters. It is often successful in remov- ing those periodical head-aches to which hysteric and hypochondiiac patients are subject. Castor has in some cases been found to procure sleep where opium failed ; for which reason Dr. Whyte advises, that they should be joined together. He likewise recommends the anti- hysteric plaster to be applied to the abdomen.* Hysteric women are often afflicted with cramps in various parts of the body, which are most apt to seize them in bed, or when asleep. The most efficacious medicines in this case are opium, blistering-plas- ters, and warm bathing or fomentations. When the cramp or spasm is very violent, opium is the remedy most to be depended on. In milder cases, immersing the feet and legs in warm water, or applying a blistering-plaster to the part affected, will often be sufficient to re- move the complaint. In patients whose nerves are uncommonly deli- * Thouch antispasmodics and anodynes are universally recommended in this dis- ease vet all the extraordinary cures that I ever knew in hysteric cases, were per- formed by tonic and corroborating medicines. 306 OF HYPOCHONDRIAC AFFECTIONS. cate and sensible, it will be better to omit the blistering-plaster, and to attempt the cure by opiates, musk, camphire, and the warm bath. Cramps are often prevented or cured by compression. Thus cramps in the legs are prevented, aud sometimes removed, by tight bandages ; and when convulsions arise from a flatulent distention of the intestines, or from spasms beginning in them, they may be often lessened or cured by making a pretty strong compress-on upon he abdomen by means of a broad belt. A roll of brimstone held in the hand is frequently nsed as a remedy for cramps. Though this seems to owe its effect chiefly to imagination, yet, as it sometimes succeeds, it merits a trial.* When spasms or convulsive motions arise from sharp humours in the stomach or intestines, no lasting relief can be procured till these are either cor- rected or expelled. The Peruvian bark has sometimes cured periodic convulsions after other medicines had failed. OF HYPOCHONDRIAC AFFECTIONS. This disease generally attacks the indolent, the luxurious, the nn» fortunate, and the studious. It becomes daily more common in this country, owing, no doubt, to the increase of luxury and sedentary em- ployments. 11 has so near a resemblance to the immediately preceding, that many authors consider them as the same disease, and treat them accordingly. They require, however, a very different regimen ; and the symptoms of the latter, though less violent, are more permanent than those of the former. Men of a melancholy temperament, whose minds are capable of great attention, and whose passions are not easily moved, are, in the adva: eel period of life, most liable to this disease. It is usually brought on by long and serious attention to abstruse subjects, grief, the suppres- Bion of customary evacuations, excess of venery, the repulsion of cuta- neous eruptions, long continued evacuations, obstructions in some of the viscera, as the liver, spleen, &c. Hypochondriac persons ought never to fast long, aud their food should be solid and nourishing. All acescent and windy vegetables are to be avoided. Flesh meats agree best with them, and their drink should be old claret, or good Maderia. Should these disagree with the stomach, water with a little brandy or rum in it may be drank. Cheerfulness aud serenity of mind are by all means to be cultivated. Exercise of every kind is useful. The cold-bath is likewise beneficial ; and where it does not agree with the patient, friction with the flesh- * Some persons afflicted with cramps prvtend to reap ereat benefit from small bui:iiiej of rosemary tied all night about their feet, ancles, aud kuees. OF HYPOCHONDRIAC 4.FFECTIONS. 307 brush or a coarse cloth may be tried. If the patient has it in his power, he ought to travel either by sea or land. A voyage, or a long journey, especially towards a warmer climate, will be of more service than any medicine. The general intentions of cure in this disease, are to strengthen the alimentary canal, and to promote the secretions. These intentions will be best answered by the different preparations of iron and the Peruvian bark, which, after proper evacuations, may be taken in the same man- ner as directed in the preceding disease. If the patient be costive, it will be necessary to make use of some gentle opening medicine, as pills composed of equal parts of aloes, rhu- barb, and asafoetida, with as much of the elixir proprietors as is neces- sary to form the ingredients into pills. Two, three, or four of these may be taken as often as it shall be found needful to keep the body gently open. Such as cannot bear the asafoetida may substitute Spa- nish soap in its place. Though a cheerful glass may have good effects in this disease, yet all manner of excess is hurtful. Intense study, and every thing that depresses the spirits, are likewise pernicious. Though the general symptoms and treatment of nervous disorders were pointed out in the beginning of this chapter, yet, for the benefit of the unhappy persons afflicted with those obstinate and complicated maladies, I have treated several of their capital symptoms under distinct or separate heads. These, however, are not to be considered as different diseases, but as various modifications of the same disease. They all arise from the same general cause, and require nearly the same method of treatment. There are many other symptoms that merit particular attention, which the nature of my plan will not permit me to treat of at full length. I shall therefore omit them altogether, and conclude this chapter with a few general remarks on the most obvious means of preventing or avoiding nervous disorders. In all persons afflicted with nervous disorders, there is a great deli- cacy and sensibility of the whole system, and an uncommon degree of weakness of the organs of digestion. These may be either natural or acquired. When owing to a defect in the constitution, they are hardly to be removed, but may be mitigated by proper care. When induced by diseases, as long or repeated fevers, profuse haemorrhages, or the like, they prove also very obstinate, and will yield only to a course of regimen calculated to restore and invigorate the habit. But nervous affections arise more frequently from causes, which it is in a great measure in our own power to avoid, than.from diseases, or an original fault in the constitution, &c. Excessive grief, intense study, 308 OF HYPOCHONDRIAC AFFECTIONS. improper diet, and neglect of exercise, are the great sources of this extensive class of diseases. It has been already observed, that grief indulged destroys the appe* tite and digestion, depresses the spirits, and induces an universal relax- ation and debility of the whole system. Instances of this are daily to be seen. The loss of a near relation, or any other misfortunes in life, is often sufficient to occasion the most complicated series of nervous Bymptoms. Such misfortunes indeed are not to be avoided, but surely their effects, by a vigorous and proper exertion of the mind, might be rendered less hurtful. For directions in this matter we must refer the reader to the article Grief, in the chapter on the Passions. The effects of intense study are pretty similar to those occasioned by grief. It preys upon the animal spirits, and destroys the appetite or digestion. To prevent these effects, studious persons ought, according to the poet, to toy with their books.* They should never study too long at a time ; nor attend long to one particular subject, especially if it be of a serious nature. They ought likewise to be attentive to their posture, and should take care frequently to unbend their minds by music, diversions, or going into agreeable company. With regard to diet, I shall only observe, that nervous diseases may be induced either by excess or inanition. Both of these extremes hurt the digestion, and vitiate the humours. When nature is oppressed with fresh loads of food, before she has had time to digest and assimilate the former meal, her powers are weakened, and the vessels are filled with crude humours. On the other hand, when the food is not suffi- ciently nourishing, or is taken too seldom, the bowels are inflated with wind, and the humours, for want of regular fresh supplies of wholesome chyle, are vitiated. These extremes are therefore with equal care to be avoided. They both tend to induce a relaxation and debility of the ner- vous system, with all its dreadful train of consequences. But the most general cause of nervous disorders is indolence. The active and laborious are seldom troubled with them. They are reserved for the children of ease and affluence, who generally feel their keenest force. All we shall say to such persons is, that the means of prevention and cure are both in their own power. If the constitution of human nature be such, that man must either labour or suffer diseases, surely do individual has any right to expect an exemption from the general rule. Those, however, who are willing to take exercise, but whose occupa- tions confine them to the house, and perhaps to an unfavourable pos- ture, really deserve our pity. We have in a former part of the book endeavoured to lay down rules for their conduct \ and shall only add, * Armstrong on Health. DISORDERS OF THE SENSES—OF THE EYE. 309 lliat where these cannot be complied with, their place may, In some measure, be supplied by the use of bracing and strengthening medicines, as the Peruvian bark, with other bitters ; the preparations of steel; the elixir of vitriol, and such like. CHAP. XLIV. DISORDERS OF THE SENSES. We do not mean to treat of the nature of our sensations, or to give a minute description of the various organs by which they are performed 5 but to point out some of the diseases to which these organs are most liable, and to show how they may be prevented or remedied. OF THE EYE. No organ of the body is subject to more diseases than the eye ; nor is there any one of which the diseases are more difficult to cure. Though more ignorant persons pretend to cure these than any other class of dis- eases, yet a very superficial acquaintance with the structure of the eye, and the nature of vision, will be sufficient to convince any one of the danger of trusting to them. These diseases often exceed the skill of the most learned physician ; hence we may easily infer the danger of trusting them to ignorant quacks, who, without all peradventure, put out more eyes than they cure. But, though the diseases of the eye can seldom be cured, they might often, by due care, be prevented ; and, even where the sight is totally lost, many things might be done, which are generally neglected, to render the unhappy person both more useful to himself and to society.* The eyes are hurt by viewing bright or luminous objects ; keeping the head too long in a hanging posture ; violent head-aches ; excessive venery ; the long use of bitters ; the effluvia from acrid or volatile * It is a pity those who have the misfortune to be born blind, or who lose their sizht when young, should be suffered to remain in ignorance or to beg. This is both cruelty and want of economy. There are many employments of which blind persons are very capable, as knitting, carding, turning a wheel, teaching languages, &c. Nor are instances wanting of persons who have arrived at the highest pitch of learn- ing, without having the least idea of light. Witness the late famous Nicholas San- derson, of Cambridge, and my worthy friend Dr. Thomas Blacklock, of Edinburgh. The former was one of the first mathematicians of his a,-r, and the latter, Iks idea being a good poet and philosopher, was master of all the Lamed languages, and A very considei able adept in the liberal arts. 310 OF THE EYE. substances ; various diseases ; as the small-pox, measles, &c.; but above all, from night-watching, and candle-light studies. Long fasting is likewise hurtful to the eyes, and frequent heats and colds are no less pernicious. The eyes are often hurt by the stoppage of customary eva« cuations; as morning sweats ; sweating of the feet; the menses in women ; and the bleeding piles in men. All kinds of excess are like- wise hurtful to the sight, particularly the immoderate use of ardent spirits, and other strong liquors. In all diseases of the eyes, especially those attended with inflamma- tion, the cold regimen ought to be observed. The patient must abstain from all spirituous liquors. The smoke of tobacco, smoky rooms, the vapours of onions and garlic, and all vivid lights and glaring colours> are carefully to bo avoided. The drink may be water, whey, or small beer ; and the aliment must be light and of easy digestion. For preventing disorders of the eyes, issues and setons are of prime use. Every person, whose eyes are tender, ought to have one or more of these in some part of the body. It will likewise be of use to keep the body gently open, and either to bleed or purge every spring and fall. All excess and night studies are to be avoided. Such as do not choose a seton or an issue, will reap benefit from wearing a small Burgundy- pitch plaster between their shoulders. A gutta serena, or amaurosis, is an abolition of the sight, without any apparent cause or fault in the eyes. When it is owing to a decay or wasting of the optic nerve, it does not admit of a cure; but when it proceeds from a compression of the nerves by redundant humours, these may in some measure be drained off, and the patient relieved. For this purpose the body must be kept open with the laxative mercurial pills. If the patient be young and of a sanguine habit, he may be bled. Cupping, with scarifications on the back part of the head, will likewise be of use. A running at the nose may be promoted by volatile salts, stimulating powders, &c. But the most likely means for relieving the patient are issues or blisters kept open for a long time on the back part of the head, behind the ears, or on the neck. I have known these restore sight, even after it had been for a considerable time lost. Should these fail, recourse must be had to mercurial salivation ; or, what will perhaps answer the purpose better, twelve grains of the cor- rosive sublimate of mercury may be dissolved in an English pint and a half of brandy, and a table-spoonful of it taken twice a-day, drinkin„ half a pint of the decoction of sarsaparilla after it. A cataract is an obstruction of the pupil, by the interposition of some opaque substance which either diminishes or totally extinguishes the sight. It is generally an opacity of the crystaline humour. In a recent OF THE EYE. 311 Or beginning cataract, the same medicines are to be used as in the gutta serena; and they will sometimes succeed. But when this does not happen, and the cataract becomes firm, it must be couched, or rather extracted. I have resolved a recent cataract by giving the patient frequent purges with calomel, keeping a poultice of fresh hem- lock constantly upon the eye, and a perpetual blister on the neck.* The myopia, or short-sightedness, and the presbyopia, or seeing only at too great a distance, are disorders which depend on the original structure or figure of the eye, therefore, admit of no cure. The incon- veniences arising from them may however be in some measure reme- died by the help of proper glasses. The former requires the aid of concave, and the latter of a convex glass. A strabismus or squinting, depends upon an irregular contraction of the muscles of the eye from a spasm, palsy, epilepsy, or an ill habit. Children often contract this disorder by having their eyes unequally ex- posed to the light. They may likewise acquire it by imitation from a squinting nurse, or play-fellow, &c. As this disorder can hardly be cured, patients ought to be careful to prevent it. Almost the only thing which can be done for it is to contrive a mask for the child to wear, which will only permit him to see in a straight direction. Spots or specks on the eyes are generally the effect of inflammation, and often appear after the small-pox ; the measles, or ophthalmias. They are very difficult to cure, and often occasion total blindness. If the specks are soft and thin, they may sometimes be taken off by gen- tle caustics and discutients: as vitriol, the juice of celandine, &c. When these do not succeed, a surgical operation may be tried ; the suc- cess of this, however, is always very doubtful. The blood-shot eye may be occasioned by a stroke, a fall, retching, vomiting, violent coughing, &c. I have frequently known it happen to children in the hooping-cough. It appears at first like a bit of scarlet, and is afterwards of a livid or blackish colour. This disorder generally goes off without medicine. Should it prove obstinate, the patient may be bled, and have his eyes fomented with a decoction of comphry roots and elder flowers. A soft poultice may be applied to the eyes ; and the body should be kept open by gentle purgatives. The watery or weeping eye, is generally occasioned by a relaxation or weakness of the glandular parts of that organ. These may be braced and strengthened by bathing the eye with brandy and water, Hungary- water rose-water, with white vitriol dissolvedin it, &c. Medicines which make a revulsion are likewise proper ; as mild purgatives, perpetual blisters on the neck, bathing the feet frequently in lukewarm water, &c. * In both these cases electricity merits a trial. 312 OF THE EAR. When this disease proceeds from an obstruction of the lachrymal duct, or natural passage of the tears, it is called a fistula lachrymalire unpardonable.—Those wretches who daily advertise their assistance to wom»a in this business, deserve, in my opinion, the most severe of all human punishment*, OV CHILD BIRTH. 359 calcined hartshorn prepared. If she be affected with vomiting, let her lake frequently two table spoonfuls of the saline mixture. In general, opiates are of service ; but they should always be given with caution. Sanguine robust women, who are liable to miscarry at a certain time of pregnancy, ought likewise to be bled a few days before that period arrives. By this means, and observing the regimen above pre- Bcribed, they might often escape that misfortune. Though we recommend due care for preventing abortion, we would not be understood as restraining pregnant women from their usual exercises. This would generally operate quite the contrary way. Want of exercise not only relaxes the body, but induces a plethora or too great a fulness of the vessels, which are the two principal causes of abortion. There are, however, some women of 60 delicate a texture, that it is necessary for them to avoid almost every kind of exercise during the whole period of pregnancy. OF CHILD-BIRTH. Many diseases proceed from the want of due care in child-bed ; and the more hardy part of the sex are most apt to despise the necessary precautions in this state. This is peculiarly the case with young wives. They think, when the labour pains are ended, the danger is over ; but in truth it may only then be said to be begun. Nature, if left to herself, will seldom fail to expel the foetus: but proper care and management are certainly necessary for the recovery of the mother. No doubt mischief may be done by too much as well as too little care. Hence females who have the greatest number of attendants in child-bed, gen- erally recover worst. But this is not peculiar to the state of child-bed. Excessive care always defeats its own intentions, and is generally mora dangerous than none at all.* During actual labour, nothing of a heating nature ought to be given. The woman may now and then take a little panado, and her drink ought to be toast and water, or thin goat gruel. Spirit*, wines, cordial waters, * Thoueh the management of women in child-hed has be^n practiced as an em- ' „ ^ Xlrt bed reouire to be manasted with skill and attention, and that they *°meo„i hur^bv the superstitious prejudices of ignorant and officious m.dwiyes. are often hurt by '"Viswav is much greater than is generally imagined; most of The mischief done in this way s nuc, g s^ ^ but h which might be Panted by alio ™S .{ fa , would not omv be tllt '"'e T^r'S Ikes, but would prevent the necessity of employing men in Kn^eH^anruUreeable branch of medicine, which... ou many accounts, more proper for the other sex. 360 CV CHILD-BIRTH. and other things which are given with a view to strengthen the mother and promote the birth, for the most part tend only to increase the fever, inflame the womb, and retard the labour. Besides, they endanger the woman afterwards, as they often occasion violent aud mortal liEemorr- hages, or dispose her to eruptive and other fevers. When the labour proves tedious and difficult, to prevent inflamma- tions, it will be proper to bleed. An emollient clyster ought likewise frequently to be administered, and the patient should sit over the steams of warm water. The passage ought to be gently rubbed with a little soft pomatum, or fresh butter, and cloths wrung out of warm water applied over the belly. If nature seems to sink, and the woman is greatly exhausted with fatigue, a draught of generous wine, or some other cordial, may be given, but not otherwise. These directions are sufficient in natural labours ; and in all preternatural cases, a skilful surgeon, or man-midwife, ought to be called as soon as possible. After delivery, the woman ought to be kept as quiet and easy a, bleeding will generally be proper at the beginning ; it ought, however, to be used with caution, and not to be repeated, unless where the signs of inflammation rise high ; in which case it will also be necessary to apply a blistering-plaster to the region of the womb. During the rigour, or cold fit, proper means should be used to abate its violence and shorten its duration. For this purpose, the patient may drink freely of warm diluting liquors, and if low, may take now and then a cup of wine-whey ; warm applications to the extremities, as heated bricks, bottles or bladders filled with warm water, and such like, may also be used with advantage. Emollient clysters of milk and water, or of chicken water, ought to be frequently administered through the course of the disease. These prove beneficial, by promoting a discharge from the intestines, and also by acting as a kindly fomentation to the womb and parts adjacent. Creatcare, however, is requisite in giving them, on account of the ten- derness of the parts in the pelvis at this time. To evacuate the offending bile from the stomach, a vomit is gener- ally given. But as this is apt to increase the irritability of the stomach, already too great, it will be safer to omit it, and to give in its stead a gentle laxative, which will both tend to cool the body, and to procure a free discharge of the bile.* The medicine which I have always found to succeed best in this dis- ease, is the saline draught. This, if frequently repeated, will often put a stop to the vomiting, and at the same time lessen the violence of the fever. If it runs off by stool, or if the patient be restless, a few drops of laudanum, or some syrup of poppies, may occasionally be added. If the stools should prove so frequent, as to weaken and exhaust the patient, a starch clyster, with thirty or forty drops of laudanum in it, may be administered as occasion Bhall require ; and the drink may be rice water, in every English pint of which half an ounce of gum-arabic has been dissolved. Should these fail, recourse must be had to Co- lumbo-root, or the powder of bole combined with opium. Though in general the food ought to be light, and the drink diluting, vet when the disease has been long protracted, and the patient is greatly spent by evacuations, it will be necesswy to support her with nourishing diet, and generous cordials. It was observed, that this fever, after continuing for some time, often acquires a putrid form. In this case the Peruvian bark must be given, * Midwives oueht to be very cautious in administering vomits or purges to women i/pmldbed Ihave knowna woman who was recovering extremely well thrown Into me most iLCSeot danger by a strong purge which was given her by an ofhc-ui midwife. 3G4 OP BARRENNESS. either by itself, or joined with cordials, as circumstances may require. As the bark in substance will be apt to purge, it«may be given in de- coction or infusion mixed with the tincture of roses, or other gentle astringents ; or a scruple of the extract of bark with half an ounce of spiritous cinnamon-water, two ounces of common water, and ten drops of laudanum may be made into a draught, and given every second, third, or fourth hour, as shall be found necessary. When the stomach will not hear any kind of nourishment, the patient may be supported for some time by clysters of beef-tea or chicken- broth. To avoid this fever, every woman in child-bed ought to be kept per- fectly easy ; her food should be light and simple, and her bed-chamber cool and properly ventilated. There is not any thing more hurtful to a woman in this situation than being kept too warm. She ought not to have her body bound too tight, nor to rise too soon from bed, after delivery ; catching cold is also to be avoided ; and a proper attention should be paid to cleanliness. To prevent the milk-fever, the breasts ought to be frequently drawn ; and if they are filled previous to the onset of the fever, they should, upon its first appearance, be drawn, to prevent the milk from becoming acrid, and its being absorbed in this state. Costiveness is likewise to be avoided. This will be best effected by the use of mild clysters and a laxative diet. We shall conclude our observations on child-bed women, by recom- mending it to them, above all things, to beware of cold. Poor women, whose circumstances oblige them to quit their bed too soon, often con- tract diseases from cold, of which they never recover. It is a pity the poor are not better taken care of in this situation. But the better sort of women run the greatest hazard from too much heat. They are generally kept in a sort of bagnio for the first eight or ten days, and then dressed out to see company. The danger of this conduct must be obvious to every one. The superstitious custom of obliging women to keep the house till they go to church, is likewise a very common cause of catching cold. All churches are damp, and most of them cold ; consequently they are the very worst places to which a woman can go to make her first visit, after having been confined in a warm room for a month. OF BARRENNESS. Barrenness may be very properly reckoned among the diseases of females, as few married women who have not children, enjoy a good state DISEASES OF CHILDREN. 3C3 of health. It may proceed from various causes, as high living, grief, relaxation, &c. ; but it is chiefly owing to an obstruction or irregularity of the menstrual flux. It is very certain that high living vitiates the humours, and prevents fecundity. We seldom find a barren woman among the labouring poor, while nothing is more common among the rich and affluent. The in- habitants of every country are prolific in proportion to their poverty ; and it would be an easy matter to adduce many instances of women who, by being reduced to live entirely upon milk and vegetable diet, have conceived and brought forth children, though they never had any before. Would the rich use the same sort of food and exercise as the better sort of peasants, they would seldom have cause to envy their poor vassals and dependants the blessing of a numerous and healthy offspring, while they pine in sorrow for want of even a single heir to their extensive domains. Affluence begets indolence, which not only vitiates the humours, but induces a general relaxation of the solids ; a state highly unfavourable to procreation. To remove this, we would recommend the following course: First, sufficient exercise in the open air ; secondly, a diet con- sisting chiefly of milk and vegetables :* thirdly, the use of astringent medicines, as steel, alum, dragon's blood, elixir of vitriol, the Spa or Tunbridge waters, Peruvian bark, &c. ; and, lastly, above all, the cold-bath. Barrenness is often the consequence of grief, sudden fear, anxiety, or any of the passions which tend to obstruct the menstrual flux. When-barrenness is suspected to proceed from affections of the mind, the person ought to be kept as easy and cheerful as possible ; all disa- greeable objects are to be avoided, and every method taken to amuse and entertain the fancy. CHAP. XLIX. DISEASES OF CHILDREN. Miserable indeed is the lot of man in the state of infancy ! he comes into the world more helpless than any other' animal, and stands much Ssth»^ lime, to'a milk and vegetable diet. SG6 DISEASES of children. longer in need of the protection and care of his parents; but alas ! this care is not always bestowed upon him ; and when it is, he often 6uffersas much from improper management as he would have done from neglect. Hence the officious care of parents, nurses, and midwives, becomes one of the most fruitful sources of the disorder of infants.* It must be obvious to every attentive person, that the first disease of infants arises chiefly from their bowels. Nor is this in the least to be wondered at, as they are in a manner poisoned with indigestible drugs and improper diet as soon as they come into the world. Every thing that the stomach cannot digest may be considered as a poison ; and unless it can be thrown up, or voided by stool, it must occasion sickness, gripes, spasmodic affections of the bowels, or what the good women call inward fits, and at last convulsions and death. As these symptoms evidently arise from somewhat that irritates the intestines, doubtless the proper method of cure must be to expel it as soon as possible. The most safe and effectual method of doing this is by gentle vomits. Five or six grains of the powder of ipecacuanha may be mixed into two table-spoonfuls of water, and sweetened with a little sugar. A tea-spoonful of this may be given to the infant every quarter of an hour till it operates ; or, what will more certainly answer the purpose, a grain of emetic tartar may be dissolved in three ounces of water, sweetened with a little syrup, and given as above. Those who are willing to use the emetic tartar, may give six or seven drops of the antimonial wine, in a tea-spoonful of water or thin gruel. Small doses of the ipecacuanha wine will be found more gentle than any of the above, and ought to be preferred. These medicines will not only cleanse the stomach, but will generally likewise open the body. Should this, however, not happen, and if the child be costive, some gentle purge will be necessary ; for this purpose some manna and pulp of cassia may be dissolved in boiling water, and given in small quantities till it operates ; or, what will answer rather better, a few grains of magnesia alba may be mixed in any kind of food that is given to the child, and continued till it has the desired effect. If these medicines be properly administered, and the child's belly and limbs be frequently rubbed with a warm hand before the fire, they will * Of the officious and ill-jndged care of midwives, we shall adduce only one in- stance, viz. the common practice of torturing infants, by squeezing their breasts, to draw off the milk, as they call it. Though a small quantity of moisture is generally found in the breasts of infants, yet as they are certainly not intended to give suck, this ought never to be drawn off 1 have seen this cruel operation bring on hard- ness, inflammation, and suppuration of the breasts ; but never knew any ill conse- quences from its being omitted. When the breasts are hard, the only application that we would recommend is a soft poultice, or a little of the diachylon plaster, spread thin upon a bit of soft leather, about the size of half a crown, and applied over each nipple. These may be suffered to continue till the hardness disappears. OF THE APHTHJJ, OR THRUSH. 3G7 seldom fail to relieve those affections of the stomach and bowels from which iuiants suffer so much. These general directions include most of what can be done for reliev- ing the internal disorders of infants. They will likewise go a consider- ble way in alleviating those which appear externally, as the rash, gum, ovfellon, &c. These, as was formerly observed, are principally owing to hot regimen, and consequently will be most effectually relieved by gentle evacuations. Indeed, evacuations of one kind or other constitute a principal part of the medicine of infants, and will seldom, if adminis- tered with prudence, in any of their diseases, fail to g'.ve relief. OF THE MECONIUM. The stomach and bowels of a new born infant are filled with a blackish coloured matter of the consistence of syrup, commonly called the meconium. This is generally passed soon after birth, by the mere effort of nature ; in which case it is not necessary to give the infant any kind of medicine. But if it should be retained, or not sufficiently carried off, a little manna or magnesia alba, may be given as mentioned above ; or, if these should not be at hand, a common spoonful of whey, sweetened with a little honey, or moist sugar, will answer the purpose. The most proper medicine for expelling the meconium is the mother's milk, which is always at first of a purgative quality. Were children allowed to suck as soon as they show an inclination for the breast, they would seldom have occasion for medicines to discharge the meconium ; but even where this is not allowed, they ought never to have daubs of syrup, oils, and other indigestible stuff, crammed down their throats. OF THE APHTHAE, OR THRUSH. The aphtha) are little whitish ulcers affecting the whole inside of the mouth, tongue, throat, and stomach of infants. Sometime* they reach through the intestinal canal; in which case they are very dangerou?, and often put an end to the infant's life. If the aphthse are of a pale colour, pellucid, few in number, soft, superficial, and fall easily off, they are not dangerous ; but if opaque, yellow, brown, black, thick, or running together, they ought to be dreaded. . . It is generally thought that the aphthae owe their origin to acid humours ; we have reason, however, to believe, they are more fre- quently owing to too hot a regimen both of mother and child. It >s a rare thing to find a child w>:<. is not dosed irih nine, punch, cnmanioi- 3G8 OF ACIDITIES. waters, or some other hot and inflaming liquors, almost as soon as it is born. It is well known that these will occasion inflammatory disorders even in adults ; is it any wonder then that they should heat and inflame the tender bodies of infants, aud set, as it were, the whole constitution on a blaze \ The most proper medicines for the aphthse are vomits, such as have been already recommended, and gentle laxatives. Five grains of rhu- barb, and half a dram of magnesia alba, may be rubbed together, and divided into six doses, one of which may be given to the infant every four or five hours till they operate. These powdets may either be given in the child's food, or a little of the syrup of pale roses, and may be re- peated as often as is found necessary to keep the body open. It is com- mon in this case to administer calomel; but as that medicine some- times occasions gripes, it ought always to be given to infants with caution. Many things have been recommended for gargling the mouth and throat in this disease ; but it is not easy to apply these in very youn" children ; we would therefore recommend it to the nurse to rub the child's mouth frequently with a little borax and honey; or u ith the following mixture: Take fine honey an ounce, borax a dram, burnt alum half a dram, rose-water, two drains ; mix them together. A very proper application in this case, is a solution of ten or twelve grains of white vitriol in eight ounces of barley-water. These may be applied with the finger, or by means of a bit of soft rag tied to the end of a probe. OF ACIDITIES. The food of children being for the most part of an acescent nature, it readily turns sour upon the stomach, especially if the body be any way disordered. Hence most diseases of children are accompanied with evident signs of acidity, as green stools, gripes, &c. These appearances have induced many to believe, that all the diseases of children were owing to an acid abounding in the stomach and bowels ; but whoever considers the matter attentively, will find that these symptoms of acidity are oftener the effect than the cause of their diseases. Nature evidently intended that the food of children should be acesent; and unless the body be disordered, or the digestion hurt, from some other cause, we will venture to say, that the acescent quality of their food is seldom injurious to them. Acidity, however, is often a symptom of disorder in children ; and, as it is sometimes a troublesome one, we shall point out the method of relieving it. When green stools, gripes/ purgings, sour smells, &c. show that the bowels abound with an acid, the child should have a little small broth, GALLING AND EXCOB.IATION. Sfi9 with light white bread in it; and should have sufficient exercise, in order to promote the digestion. It has been customary in this case to give the pearl-julep, chalk, crabs'-eyes, and other testaceous powders. These, indeed, by their absorbent quality, may correct the acidity ; but they are attended with this inconvenience, that they are apt to lodge in the bowels, and occasion costiveness, which may prove very hurtful to the infant. For this reason they should never be given unless mixed with purgative medicines ; as rhubarb, manna, or such like. The best medicine which we know in all cases of acidity, is that fine insipid powder, called magnesia alba. It purges, and at the same time corrects the acidity ; by which means it not only removes the disease, but carries off its cause. It may be given in any kind of food, or in a mixture as recommended in the Appendix.* When an infant is troubled with gripes, it ought not at first to be dosed with brandy, spiceries, and other hot things ; but should have its body opened with an emollient clyster, or the medicine mentioned above ; and, at the same, a little brandy may be rubbed on its belly with a warm hand before the fire. I have seldom seen this fail to ease the gripes of infants. If it should happen, however, not to succeed, a little brandy or other spirits may be mixed with thrice the quantity of warm-water, and a tea-spoonful of it given frequently, till the infant be easier. Sometimes a little peppermint-water will answer this purpose as well. GALLING AND EXCORIATION. These are very troublesome to children. They happen chiefly about the groin and wrinkles of the neck, under the arms, behind the ears, and other parts that are moistened with sweat or urine. As these complaints are, in a great measure, owing to want of clean- liness, the most effectual means of preventing them are, to wash the parts frequently with cold water, to change the linen often, and, in a word, to keep the child in all respects thoroughly clean. When this is not sufficient, the excoriated parts may be sprinkled with absorbent or drying powders; as burnt hartshorn, tutty, chalk, crabs'-claWs prepared, and the like. When the parts affected are very sore, and teud to real ulceration, it will be proper to add a little sugar of lead to the powders ; or to anoint the place with the camphorated ointment. If the parts be washed with spring water, in which a little white vitriol has been dis- solved, it will dry and heal them very powerfully. One of the be.c. Children who have had frequent returns of this disease, or whose constitutions seem to dispose them to it, ought to have their diet properly regulated.; all food that is viscid or hard of digestion, and all crude, raw, trashy fruits, are to be avoided. They ought likewise to have a drain constantly kept open in some part of their body, by means of a seton or issue. I have sometimes known a Burgundy-pitch plaster, worn continually between the shoulders for several years, have a very happy effect in preventing the return of this dreadful disorder. OF TEETHING. Dr. Arbuthnot observes, that above a tenth part of infants die in teething, by symptoms proceeding from the irritation of the tender nervous parts of the jaws, occasioning inflammations, fevers, convul- bions, gangrenes, &c. These symptoms are in a great measure owing to the great delicacy and exquisite sensibility of the nervous system at this time of life, which is too often increased by an effeminate education. Hence it comes to pass, that children who are delicately brought up, al- ways suffer most in teething, and often fall into convulsive disorders. About the sixth or seventh month the teeth generally begin to make their appearance ; first, the incisores, or fore-teeth ; next the canini, or do-teeth ; and, lastly, the molares, or grinders. About the seventh year, there conies a new set; and about the twentieth, the two inner grinders called denies sapientia, the teeth of wisdom. Children about the time of cutting their teeth, slaver much, and have eenerally a looseness. When the teething is difficult, especially when the do-teeth begin to make their way through the gums, the child has stagings in his sleep, tumours of the gums, watchings, gripes, green stools, the thrush, fever, difficult breathing, and convulsions. _ Difficult teething requires nearly the same treatment as an inflam- , . i / •,„,„.»,! with a letter from Dr. William TurnbuU in London, a phy- *I was lateyfavoured^«th» letter rr^u ^^ ^.^ |n tfc- tn.east sican of .^'"P^^v'opportunities of observing the symptoms and process coast of England had many opp gentimellts difftfr very little fro... ...y own ; of this d:lI18L'10U»diseas%„,,'^,,K"tBrilie 0f auy service; and recommends cataplasms he observes, that he never^^^fj'^ applied both to the throat and sole, o of garlic, camphor, and Vemce "e"L .,„.. of ,£,m0hor, castor, valerian root, sail of the lect. He likewise ^emmends bohase, of^camph^ca , ^ ^.^ hartshorn, and musk, adaptedi to the£*™*™o*-.-T:^ garlic *»<* bulled he advises two ^'"""/"^'^ter eight ounces; beat up the ingredients together vinegar each »\0U"f;.^Malaaddng three ounces of honey. Ul the *..-c o* ^S ov^geuU^'aud ancJS* —a for use. 376 OF TEETHING. matory disease. If the body be bound, it must be opened either by emollient clysters or gentle purgatives ; as manna, magnesia alba, rhu- barb, senna, or the like. The food should be light and in small quan- tity ; the drink plentiful, but weak and diluting, as infusions of balm, or of the lime-tree flowers ; to which about a third or fourth part of milk may be added. If the fever be high, bleeding will be necessary ; but this in very young children ought always to be sparingly performed. It is an eva- cuation which they bear the worst of any. Purging, vomiting, or sweat- ing, agree much better with them, and are generally more beneficial. Harris, however, observes, that when an inflammation appears, the physician will labour in vain, if the cure be not begun with applying a leech under each ear. If the child be seized with convulsion fits, a blistering-plaster may be applied between the shoulders, or one behind each ear. Sydenham says, that in fevers occasioned by teething he never found any remedy so effectual as two, three, or four drops of the spirits of hartshorn, in a spoonful of simple water, or other convenient vehicle, given every four hours. The number of doses may be four, five, or six. I have often prescribed this medicine with success, but always found a larger dose necessary. It may be given from five drops to fif- teen or twenty, according to the age of the child, and when costiveness does not forbid it, three or four drops of laudanum may be added to each dose. In Scotland, it is very common, when children are cutting their teeth, to put a small Burgundy-pitch plaster between their shoulders. This generally eases the tickling cough that attends teething, and is by no means an useless application. When the teeth are cut with diffi- culty, it ought to be kept on during the whole time of teething. It may be enlarged as occasion requires, and ought to be renewed at least once a fortnight. Several things have been recommended for rubbing the gums, as oils, mucilages, &c.; but from these much is not to be expected. If any thing of this kind is to be used, we would recommend a little fine honey, which may be rubbed on with the finger three or four times a-day. Children are generally at this time disposed to chew whatever they "et into their hands. For this reason they ought never to be without something that will yield to the pressure of their gums, as a crust of bread, a wax candle, a bit of liquorice-root, or such like. With regard to cutting the gums, we have seldom known it of any benefit. In obstinate cases, however, it ought to be tried. It may be performed by the finger nail, the edge of a sixpenny piece that is worn CF THE niCKET3. 377 thin, or any sharp body which can be with safety introduced into the mouth ; but the lancet, in a skilful hand, is certainly the most proper. In order to render the teething less difficult, parents ought to take care that their children's food be light and wholesome, and that their nerves be braced by sufficient exercise without doors, the use of the cold-bath, &c. Were these things duly regarded, they would have a much better effect than teething necklaces, or other nonsensical amulets, worn for that purpose. OF THE RICKETS. This disease generally attacks children between the age of nine months and two years. It appeared first in England about the time when manufactures began to flourish, and still prevails most in towns where the inhabitants follow sedentary employments, by which means they neglect either to take proper exercise themselves, or to give it to their children. Causks.—One cause of the rickets is diseased parents. Mothers of a weak relaxed habit, who neglect exercise, and live upon weak watery diet, can neither be expected to bring forth strong and healthy children, or to be able to nurse them, after they are brought forth. Accordingly we find that the children of such women generally die of the ricketi, the scrofula, consumptions, or such like diseases. Children begotten by men in the decline of life, who are subject to the gout, the gravel, or Other chronic diseases, or who have been often afflicted with the venereal disease in their youth, are likewise very liable to the rickets. Any disorder that weakens the constitution or relaxes the habit of children, as the small-pox, measles, teething, the hooping-cough, &o. disposes them to this disease. It may likewise be occasioned by impro- per diet, as food that is either too weak and watery, or so viscid that the stomach cannot digest it. But nursing is the chief cause of this disease. When the nurse is either diseased, or has not enough of milk to nourish the child, it can- not thrive. But children suffer oftener by want of care in nurses than want of food. Allowing an infant to lie or sit too much, or not keeping it thoroughly clean in its clothes, has the most pernicious effects. The want of free air is likewise very hurtful to children in this re- spect When a nurse lives in a close small house, where the air is damp and confined, and is too indolent to carry her child abroad into the open air, it will hardly escape this disease. A healthy child should always be in motion, unless when asleep; if it be suffered to he u. bit instead of being tossed and dandled about, it will not thrive. 578 or the 7ifO:c!:Ti. SrMPTOMS.— At the beginning of this disease the child's flesh grows soft and flabby ; its strength is diminished ; it loses its wonted cheer- fulness, looks more grave and composed than is natural for its age, and does not choose to be moved. The head and belly become too large in proportion to the other parts ; the face appears full, and the com- plexion florid. Afterwards the bones begin to be affected, especially in the more soft and spungy parts. Hence the wrists and ancles become thicker than usual; the spine or back-bone puts on an unnatural shape ; the breast is likewise often deformed ; and the bones of the arms and legs grow crooked. All these symptoms vary according to the violence of the disease. The pulse is generally quick, but feeble ; the appetite and digestion for the most part bad ; the teeth come slowly and with difficulty, and they often rot and fall out afterwards. Ricketty children have generally great acuteness of mind, and an understanding above their years. Whether this is owing to their being more in the company of adults than other children, or to the preternatural enlargement of the brain, is not material. Regimen.—As this disease is always attended with evident signs of weakness and relaxation, our chief aim in the cure must be to brace and strengthen the solids, and to promote digestion and the due prepa- ration of the fluids. These important ends will be best answered by wholesome and nourishing diet, suited to the age and strength of the patient, open dry air, and sufficient exercise. If the child has a bad nurse, who either neglects her duty, or does not understand it, she should be changed. If the season be cold, the child ought to be kept warm ; and when the weather is hot, it ought to be kept cool ; as sweat- ing is apt to weaken it, and too great a degree of cold has the same effect. The limbs should be rubbed frequently with a warm hand, and the child kept as cheerful as possible. The diet ought to be dry and nourishing, as good bread, roasted flesh, &c. Biscuit is generally reckoned the best bread ; and pigeons, pullets, veal, rabbits, or mutton roasted or minced, are the most pro- per meat. If the child be too young for animal food, he may have lice, millet, or pearl-barley, boiled with raisins, to which may be added a little wine and spice. His drink may be good claret, mixed with an equal quantity of water. Those who cannot afford claret, may give the child now and then a wine glass of mild ale, or good porter. Medicine.—Medicines are here of little avail. The disease may often be cured by the nurse, but seldom by the physician. In children of a gross habit, gentle vomits and repeated purges of rhubarb may sometimes be of use, but they will seldom carry off the disease ; that must depend chiefly upon such things as brace and strengthen the OF CONVULSIONS. Z~$ ByBtem : for which purpose, besides the regimen mentioned above, we would recommend the cold-bath, especially in the warm season. It must however be used with prudence, as some ricketty children cannot bear it. The best time for using the cold-bath is in the morning, and the child should be well rubbed with a dry cloth immediately after he comes out of it. If the child should be weakened by the cold-bath, it must be discontinued. Sometimes issues have been found beneficial in this disease. They are peculiarly necessary for children who abound with gross humours. An infusion of the Peruvian bark in wine or ale would be of service, •were it possible to bring children to take it. We might here mention many other medicines which have been recommended for the rickets ; but as there is far more danger in trusting to these than in neglecting them altogether, we choose ratlier to pass them over, and to recommend a proper regitneu as the thing chiefly to be depended on. OF CONVULSIONS. Though more children are said to die of convulsions than of any other disease, yet they are for the most part only a symptom of some other malady. Whatever greatly irritates or stimulates the nerves may occasion convulsions. Hence infants whose nerves are easily af- fected, are often thrown into convulsions by any thing that irritates the alimentary canal; likewise by teething, strait clothes, the approach of the small-pox, measles, or other eruptive diseases. When convulsions proceed from an irritation of. the stomach or bow- els, whatever clears them of their acrid contents, or renders these mild aud inoffensive, will generally perform a cure ; wherefore if the child be costive the best way will be to begin with a clyster, and afterwards to give a gentle vomit, which may be repeated occasionally, and the body in the mean time kept open by gentle doses of magnesia alba, or small quantities of rhubarb mixed with the powder of crab's claws. Convulsions which precede the eruption of the small-pox, or measles, generally go off upon these making their appearance. The principal danger in this case arises from the fear and apprehension of those who have the care of the patient. Convulsions are very alarming, and something must be done to appease the affrighted parents, nurses, &c. Hence the unhappy infant often uddergoes bleeding, blistering, and several other operations, to the great danger of its life, when a little time, bathing the feet in warm water, and throwing in a mild clyster, would have set all to rights. Wheu convulsion fits arise from the cutting of teeth, besides gentle 380 OF WATER TN THE HEAD. evacuations, we would recommend blistering, and the use of antispas- modic medicines, as the tincture of soot, asafoetida, or castor. A few drops of any of these may be mixed in a cup of white-wine-whey, and given occasionally. When convulsions proceed from any external cause, as the pressure occasioned by strait clothes or bandages, &c. these ought immediately to be removed, though in this case taking away the cause will not always remove the effect, yet it ought to be done. It is not likely that the patient will recover, as long as the cause which first gave rise to the dis- » order continues to act. When a child is seized with convulsions, without having any com- plaint in the bowels, or symptoms of teething; or any rash or other discharge which has been suddenly dried up ; we have reason to con- clude that it is a primary disease, and proceeds immediately from the brain. Cases of this kind, however, happen but seldom ; which is very fortunate, as little can be done to relieve the unhappy patient. When a disease proceeds from an original fault in the formation or structure of the brain itself, we cannot expect that it should yield to medicine. But as this is not always the cause, even of convulsions which proceed immediately from the brain, some attempts should be made to remove them. The chief intention to be pursued for this purpose, is to make some derivation from the head, by blistering, purging, and the like. Should these fail, issues or setons may be put in the neck, or between the shoulders. OF WATER IN THE HEAD. Though water in the head, or a dropsy of the brain, may affect adults as well as children, yet as the latter are more peculiarly liable to it, we thought it would be most proper to place it among the diseases of infants. Causes.—A dropsy of the brain may proceed from injuries done to the brain itself by falls, blows, or the like ; it may likewise proceed from an original laxity or weakness of the brain ; from schirrous tumours or ex- crescences within the skull; a thin watery state of the blood ; a dimi- nished secretion of urine ; a sudden check of the perspiration ; and, lastly, from tedious and lingering diseases, which waste and consume the patient. Symptoms.—This disease has at first the appearance of a slow fever • the patient complains of a pain in the crown of his head, or over his eyes ; he shuns the light; is sick, and sometimes vomits ; his pulse is irregular aud generally low, though he seems heavy and dull, yet he OF SUHGERT. 3«1 does not sleep; he id sometimes delirious, and frequently sees objects double; towards the end of this commonly fatal disease, the pulse be- comes more frequent, the pupils are generally dilated, the cheeks flushed, the patient becomes comatose, and convulsions ensue. Medicine.—No medicine has hitherto been found sufficient to carry off a dropsy of the brain. It is laudable, however, to make some at- tempts, as time or chance may bring many things to light of which, at present, we have no idea. The medicines generally used are, purges of rhubarb or jalap, with calomel, and blistering-plasters applied to the neck or back part of the head. To which we would beg leave to add diuretics, or medicines which promote the secretion of urine, such as are recommended in the common dropsy. A discharge from the nose ought likewise to be promoted by causing the patient to snuff the powder of asarum, white hellebore, or the like. Some practitioners have of late pretended to cure this disease by the use of mercury. I have not been so happy as to see any instance of a cure being performed in a confirmed dropsy of the brain ; but in so desperate a malady every thing deserves a trial.* CHAP. L. OF SURGERY. To describe all the operations of surgery, and to point out the different diseases in which these operations are necessary, would extend this article far beyond the limits alloted to it; we must therefore confine our observations to such cases as most generally occur, and in which proper assistance is either not asked, or not always to be obuuned Though an acquaintance with the structure of the human body is in- dispensably necessary to qualify a man for being an expert surgeon ; yet nrnny things may be done to save the lives of their fellow-men in emer- " nc es hv those who are no adepts in anatomy. It is amazing with what facility the peasants daily perform operations upon brute ammals, * One reason why this *-« <'^^^^ known till too far J^anced 'o »dm *°f ^' Alined to think that something might tou.s. and call a physician in durV'm?' Sufficiently known, and are often mistaken be done. But these symptoms are not >et ^™™ a ltriki instance in a patent. *ase for teething. 382 OF BLEEDING. which are not of a less difficult nature than many of those performed on the human species, yet they seldom fail of success. Indeed every man is in some measure a surgeon, whether he will or not. He feels an inclination to assist his fellow-men in distress, and accidents happen every hour which give occasion to exercise this feeling. The feelings of the heart, however, when not directed by the judgment, are apt to mislead. Thus one, by a rash attempt to save his friend, may sometimes destroy him ; while another, for fear of doing amiss, stands still and sees his bosom friend expire without so much as attempting to relieve him, even when the means are in his power. As every good man would wish to steer a course different from either of these, it will no doubt be agreeable to him to know what ought to be done upon such emergencies. OF BLEEDING. No operation of surgery is so frequently necessary as bleeding ; it ought therefore to be very generally understood. But though practised by midwives, gardeners, blacksmiths, &c. we have reason to believe that very few know when it is proper. Even physicians themselves have been so much the dupes of theory in this article as to render it the subject of ridicule. It is, however, an operation of great importance, and must, when seasonably and properly performed, be of singular service to those in distress. Bleeding is proper at the beginning of all inflammatory fevers, as pleurisies, peripneumonies, &c. It is likewise proper in all topical inflammations, as those of the intestines, womb, bladder, stomach, kid- neys, throat, eyes, &c. as also in the asthma, sciatic pains, coughs, head- aches, rheumatisms, the apoplexy, epilepsy, and bloody flux. After falls, blows, bruises, or any violent hurt received either externally or internally, bleeding is necessary. It is likewise necessary for persons who have had the misfortune to be strangled, drowned, suffocated with foul air, the fumes of metal, or the like. In a word, whenever the vital motions have been stopped from any cause whatever, except in swoon- ings occasioned by mere weakness, or hysteric affections, it is proper to open a vein. But in all disorders proceeding from a relaxation of the solids, and an impoverished state of the blood, as dropsies, cacochymies, &c. bleeding is improper. Bleeding for topical inflammations ought always to be performed as near the part affected as possible. When this can be done with a lancet it is to be preferred to any other method ; but when a vein cannot be found, recourse must be had to leeches or cupping. OF BLEEDING. 3S3 The quantity of blood to be let must always be regulated by tho strength, age, constitution, manner of life, and other circumstances re- lating to the patient. It would be ridiculous to suppose that a child could bear to lose as much blood as a grown person, or that a delicate lady should be bled to the same extent as a robust man. From whatever part of the body blood is to be let, a bandage must be applied between that part and the heart. As it is often necessary in order to raise the vein, to make the bandage pretty tight, it will be proper in such case3, as soon as the blood begins to flow, to slacken it a little. The bandage ought to be applied at least an inch, or an inch and a half from the place where the wound is intended to be made. Persons not skilled in anatomy ought never to bleed in a vein that lies over an artery or a tendon, if they can avoid it. The former may easily be known from its pulsation or beating, and the latter from its feeling hard or tight like a whipcord under the finger. It was formerly a rule, even among those who had the character of being regular practitioners, to bleed their patients in certain diseases till they fainted. Surely a more ridiculous rule could not be proposed. One person will faint at the very sight of a lancet, while another will lose almost the whole blood of his body before he faints. Swooning de- pends more upon the state of the mind than of the body ; besides, it may often be occasioned or prevented by the manner in which the operation is performed. Children are generally bled with leeches. This, though sometime* ne- cessary is a very troublesome and uncertain practice. It is impossible to know what quantity of blood is taken away by leeches ; besides, the bleeding is often very difficult to stop, and the wounds are not easily healed Would those who practice bleeding take a little more pains, and accustom themselves to bleed children, they would not find it such a dif- ficult operation as they imagine. Certain hurtful prejudices with regard to bleeding still prevail anion-; the country people. They talk, for instance, of head-veins, heart-veins, breast-veins, &c. and believe that bleeding in these will certainly cure all diseases of the parts from whence they are supposed to come, without considering that the blood-vessels arise from the heart, and return to it strain • for which reason, unless in topical inflammation, ,t signifies very iL from what part of the body blood is taken. But this, though a foolish prejudice, is not near so hurtful as the vulgar notion that the fir- teed >g will perform wonders. This belief makes them often post- Pne Urn operation when necessary, in order to reserve ,t forsomemore fZrtaut occasion, and, when they think themselves i„ extreme danger, ^fly toitforrehef. whether it beproper or not. Bleeding at ceru.u ' i •].«.. soimuis h»s likowi&e bad ettects. Stated periods or seasons m» 384 OF INFLAMMATIONS AND ABSCESSE9. It is a common notion that bleeding in the feet draws the humours downwards, and consequently cures diseases of the head and other superior parts ; but we have aleady observed, that, in all topical affec- tions, the blood ought to be drawn as near the part as possible. When it is necessary, however, to bleed in the foot or hands, as the veins are small, and the bleeding is apt to stop too soon, the parts ought to be immersed in warm water, and kept there till a sufficient quantity of blood be let. We will not spend time in describing the manner of performing this operation: that will be better learned by example than precept. Twenty pages of description would not convey so just an idea of the operation as seeing it once performed by an expert hand. Neither is it necessary to point out the different parts of the body from whence blood may he taken, as the arm, foot, forehead, temples, neck, &c. These will readily occur to every intelligent person, and the foregoing observations will be sufficient for determining which of them is most proper upon any particular occasion. In all cases where the intention is merely to lessen the general mass of blood, the arm is the most com- modious part of the body in which the operation can be performed. OF INFLAMMATIONS AND ABSCESSES. From whatever cause an inflammation proceeds, it must terminate either by dispersion, suppuration, or gangrene. Though it is impos- sible to foretel with certainty in which of these ways any particular inflammation will terminate, yet a probable conjecture may be formed with regard to the event, from a knowledge of the patient's age and constitution. Inflammations happening in a slight degree upon colds, and without any previous indisposition, will most probably be dispersed ; those which follow close upon a fever, or happen to persons of a gross habit of body, will generally suppurate ; and those which attack very old people, or persons of a dropsical habit, will have a strong tendency to gangrene. If the inflammation be slight, and the constitution sound, the dis- persion ought always to be attempted. This will be best promoted by a slender diluting diet, plentiful bleeding, and repeated purges. The part itself must be fomented, and, if the skin be very tense, it may be embrocated with a mixture of three-fourths of sweet oil, and one- fourth of vinegar, and afterwards covered with a piece of wax-plaster. If notwithstanding these applications, the symptomatic fever increases, and the tumour becomes larger, with violent pain and pulsation, it will be proper to promote the suppuration. The best application for this OF WOUNDS. 3?3 purposeis a soft poultice, which may be renewed twice a-day. If the suppuration proceeds but slowly, a raw onion cut small or bruised may be spread upon the poultice. When the abscess is ripe or fit for open- ing, which may easily be known from the thinness of the skin in the most prominent part of it, fluctuation of matter, which may be felt under the finger, and, generally speaking, an abatement of the pain, it may be opened either with a lancet, or by means of a caustic. The last way in which an inflammation terminates, is in a gangrene or mortification, the approach of which may be known by the following symptoms : the inflammation loses its redness, and becomes duskish or livid ; the tension of the skin goes off, and it feels flabby ; little blad- ders filled with ichor of different colours spread all over it; the tumour subsides, and from a duskish complexion becomes black; a thick low pulse, with cold clammy sweats, are the immediate forerunners of death. When these symptoms first appear, the part ought to be dressed with London treacle, or a cataplasm made of lixivium and bran. Should the symptoms become worse, the part must be scarified, and afterwards dressed with bascilicum softened with oil of turpentine. All the dres- sings must be applied warm. With regard to internal medicines, the patient must be supported with generous cordials, and the Peruvian bark exhibited in as large doses as the stomach will bear it. If the mortified parts should separate, the wound will become a common ulcer, and must be treated accordingly This article includes the treatment of all those diseases which in different parts of the country, go by the names of boils, imposthumes, uhitloes, &c. They are all abscesses in consequence of a previous in- flammation, which, if possible, ought to be discussed : but when this cannot be done, the suppuration should be promoted, and the matter discharged by an incision, if necessary ; afterwards the sore may be dressed with yellow basilicum, or some other digestive ointment OF WOUNDS. No part of medicine has been more mistaken than the treatment or cure of wounds. Mankind in general believe that certain herbs, oint- ments, and plasters, are possessed of wonderful healing powers, and imagine that no wound can be cured without the application of them. It is however, a fact, that no external application whatever contributes towards the cure of a wound, any other way than by keeping the parts soft clean, and defending them from the external a,r, winch may be as effectually done by dry lint, as by the most pompous anphcations, Time it is exempt from many of the bad consequences attending them. 2 c 336 OF WOUNDS. The same observation holds with x-espect to internal applications. These only promote the cure of wounds as far as they tend to prevent a fever, or to remove any cause that might obstruct or impede the operations of nature. It is nature alone that cures wounds. All that art can do is to remove obstacles, and to put the parts in such a con- dition as is the most favourable to nature's efforts. With this simple view we shall consider the treatment of wounds, and endeavour to point out such steps as ought to be taken to facilitate their cure. The first thing to be done when a person has received a wound, is to examime whether any foreign body be lodged in it, as wood, iron, lead, glass, dirt, bits of cloth, or the like. These, if possible, ought to be extracted, and the wound cleansed before any dressing be applied. When that cannot be effected with safety on account of the patient's weakness or loss of blood, they must be suffered to remain in the wound, and afterwards extracted when he is more able to bear it. When a wound penetrates into any of the cavities of the body, as the breast, the bowels, &c. or where any considerable blood-vessel is cut, a skilful surgeon ought immediately to be called, otherwise the patient may lose his life. But sometimes the discharge of blood is bo great, that if it be not stopped, the patient may die, even before a surgeon, though at no great distance, can arrive. In this case, some- thing must be done by those who are present. If the wound be in any of the limbs, the bleeding may generally be stopped by applying a tight ligature or bandage round the member a little above the wound. The best method of doing this is to put a strong broad garter round the part, but so slack as to admit a small piece of stick to be put under it, which must be twisted, in the same manner as a countryman does his cart-rope to secure his loading, till the bleeding stops. Whenever this is the case, he must take care to twist it no longer, as straining it too much might occasion an inflammation of the parts, and endanger a gangrene. In other parts where this bandage cannot be applied, various other methods may be tried to stop the bleeding, as the application 'of styptics, astringents, &c. Cloths dipped in a solution of blue vitriol in water, or the styptic water of the dispensatories, may be applied to the wound. When these cannot be obtained, strong spirits of wine may be used. Some recommend the agaric* of the oak as preferable to any of the * Dr. Tissot, in his Advice to the People, gives the following directions for gather- ing, preparing, and applying the agaric :—" Gather in autumn," says he, '' while the fine weather lasts, the agaric of the oak, which is a kind of functus or excrescence issuing from the wood of that tree. It consists at first of four parts which present Uwuueivcs succeslively: 1. "The outward rind or skin, which may be thrown away. OF WCUND3. 387 other styptics ; and indeed it deserves considerable eneoniums. It is easily obtained, and ought to be kept in every family in case of accidents. A piece of it must be laid upon the wound and covered with a good deal of lint, above which a bandage may be applied so tight as to keep it firmly on. Though spirits, tinctures, and hot balsams, may be used, in order to stop the bleeding, when it is excessive, they are improper at other times. They do not promote but retard the cure, and often change a simple wound into an ulcer. People imagine, because hot balsams con- geal the blood, and seem, as it were, to solder up the wound, that they therefore heal it; but this is only a deception. They may indeed stop the flowing blood, by searing the mouths of the vessels ; but, by ren- dering the parts callous, they obstruct the cure. In slight wounds, which do not penetrato much deeper than the skin, the best application is a bit of the common black sticking-plaster. This keeps the sides of the wound together, and prevents the air from getting into it, which is all that is necessary. When a wound penetrates deep it is not safe to keep its lips quite close ; this keeps in the matter, and is apt to make the wound fester. In this case the best way is to fill the wound with soft lint, commonly called caddice. It, however, must not be stuffed in too hard, otherwise it will do hurt. The lint may bo covered with a cloth dipped in oil, or spread with the common wax- plaster ; and the whole must be kept on by a proper bandage* We shall not spend time in describing the different bandages that may be proper for wounds in different parts of the body ; common sense will generally suggest the most commodious method of applying a bandage ; descriptions of this kind are not easily understood or re- membered. The first dressing ought to continue on for at least two days ; after which it may be removed, and fresh lint applied as before. If any part of the first dressing eticks so close as not to be removed with ease or safety to the patient, it may be allowed to continue, and fresh lmt dipped in sweet oil laid over it. This will soften it, so as to make it come off easily at next dressing. Afterwards the wound may be dressed twice a-day in the same manner till it be quite healed. Those who are fond " ,. The part '^^underthi.^ which i. the best sl^ M*?**" bursting open blood vessels. "^^X. 3. The third part adhering bleeding, aud generally fallsi off at »•£»*«££ t£,maUer vessels; and the fourth to the .econd, may ■a™'^""^%£ Effing to the same purpose." Where to, ^manner, and has nearly th. wme eflecia. * See Appendix, tt ax Plaster. 388 OF BURNS. of salves or ointments, may, after the wound has become very superficial, dress it with the yellow basilicum ;* and if fungus, or what is called proud flesh, should rise in the wound, it may be checked, by mixing with the ointment a little burnt alum or red precipitate of mercury. When a wound is greatly inflamed, the most proper application is a poultice of bread and milk, softened with a little sweet oil, or fresh butter. This must be applied instead of a plaster, and should be changed twice a day. If the wound be large, and there is great reason to fear an inflam- mation, the patient should be kept on a very low diet. He must ab- stain from flesh, strong liquors, aud every thing that is of a heating nature. If he be of a full habit, and has lost but little blood from the wound, he must be bled ; and, if the symptoms be urgent, the operation may be repeated. But when the patient has been greatly weakened by loss of blood from the wound, it will be dangerous to bleed him, even though a fever should ensue. Nature should never be too far ex- hausted. It is always more safe to allow her to struggle with the disease iu her own way, than to sink the patient's strength by excessive eva- cuations. Wounded persons ought to be kept perfectly quiet and easy. Every thing that ruffles the mind, or moves the passions, as love, anger, fear, excessive joy, &c. are very hurtful. They ought above all things to abstain from venery. The body should be kept gently open, either by laxative clysters, or by a cool vegetable diet, as roasted apples, stewed prunes, boiled spinage, and such like. OF BURNS. In slight burns, which do not break the skin, it is customary to hold the part near the fire for a competent time, to rub it with salt, or to lay a compress upon it, dipped in spirits of wine or brandy. But when the burn has penetrated so deep as to blister or break the skin, it must be dressed with some of the liniments for burns mentioned in the Ap- pendix, or with the emollient and gentle drying ointment, commonly called Turner's cerate.f This may be mixed with an equal quantity of fresh olive-oil, and spread upon a soft rag, and applied to the part affected. When this ointment cannot be had, an egg may be beat up with about an equal quantity of the sweetest salad-oil. This will serve very well, till a proper ointment can be prepared. When the burning * See Pppendix, Yellow Basilicum. t Si-e Appendix, Turner'* cerate. OF BRUISES. 399 Is very deep, after the first two or three days, it should be dressed with equal parts of yellow 6a«i/icuin and Turner's cerate, mixed together. When the burn is violent, or has occasioned a high degree of in- flammation, and there is reason to fear a gangrene or mortification, the same means must he used to prevent, as are recommended in other violent inflammations. The patient, in this case, must live low, and drink freely of low diluting liquors. He must likewise be bled, and have his body kept open. But if the burnt part should become livid or black, with other symptoms of mortification, it will be necessary to bathe them frequently with warm camphorated spirits of wine, tincture of myrrh, or other antiseptics, mixed with a decoction of the bark. In this case the bark must likewise be taken internally, and the patient's diet must be more generous, with wine, &c. As example teaches better than precept, I shall relate the treatment of the most dreadful case of this kind that has occurred in my practice. A middle-aged man, of a good constitution, fell into a large pan full of boiling water, and miserably scalded about one half of his body. As his clothes were on, the burning in some parts was very deep before they could be got off. For the first two days the scalded parts had been frequently anointed with a mixture of lime-water and oil, which is a very proper application for recent burnings. On the third day, when 1 first saw him, his fever was very high, and his body costive, for which he was bled, and had an emollient clyster administered. Poultices of Hread and milk, softened with fresh butter, were likewise applied to ;he affected parts, to abate the heal and inflammation. His fever still continuing high, ho was bled a second time, was kept strictly on the cooling regimen, took a saline mixture with small doses of nitre, and had an emollient clyster administered once a-day. When the inflam- mation began to abate, the parts were dressed with a digestive composed of brown cerate and yellow basilicum. Where any black spots ap- peared, they were slightly scarified and touched with the tincture of myrrh ; and to prevent their spreading, the Peruvian bark was admin- istered. By this course, the man was so well in three weeks as to be able to attend his business. OF BRUISES. Bruises are generally productive of worse consequences than wounds. The danger from them does not appear immediately, by which means it often happens that they are neglected. It is needless to give any definition of a disease so universally known ; we shall therefore proceed to point out the method of treating it. 390 OF BRUISES. In slight bruises it wiil be sufficient to bathe the part with warm vinegar, to which a little brandy or rum may be occasionally added, and to keep cloths wet with this mixture constantly applied to it. This is more proper than rubbing it with brandy, spirits of wine, or other ardent spirits, which are commonly used in such cases. In some parts of the country the peasants apply to a recent bruise a cataplasm of fresh cow-dung. I have often seen this cataplasm applied to violent contusions, occasioned by blows, falls, bruises, and such like, and never knew it fail to have a good effect. When a bruise is very violent, the patient ought immediatety to be bled, and put upon a proper regimen. His food should be light and cool, and his drink weak and of an opening nature ; as whey, sweetened with honey, decoctionsof tamarinds, barley, cream-tartar whey, and such like. The bruised part must he bathed with vinegar and water, as directed above ; and a poultice made by boiling crumb of bread, elder- flowers, and camomile flowers, in equal quantities of vinegar and wa- ter, applied to it. This poultice is peculiarly proper when a wound is joined to the bruise. It may be renewed two or three times a-day. As the structure of the vessels is totally destroyed by a violent bruise, there often ensues a great loss of substance, which produces an ulcer- ous sore very difficult to cure. If the bone be affected, the sore will not heal before an exfoliation takes place ; that is, before the diseased part of the bone separates and comes out through the wound. This is often a very slow operation, and may even require several years to be completed. Hence it happens that these sores are frequently mistaken for the king's evil, and treated as such, though in fact they proceed solely from the injury which the solid parts received from the blow. Patients in this situation are pestered with different advices. Every one who sees them proposes a new remedy, till the sore is so much irri- tated with various opposite applications, that it is often at length ren- dered absolutely incurable. The best method of managing such sores is, to take care that the patient's constitution does not suffer by confine- ment or improper medicine, and to apply nothing to them besides simple ointment spread upon soft lint, over which a poultice of bread and milk, with boiled camomile-flowers, or the like, may be put, to nourish the part, and keep it soft and warm. Nature, thus assisted, will generally in time operate a cure, by throwing off the diseased parts of the bone, after which the sore soon heals. 391 OF ULCERS. Ulcers may be the consequence of wounds, bruises, or imposthumei improperly treated ; they may likewise proceed from an ill state of the humours, or what may be called a bad habit of the body. In the latter case they ought not to be hastily dried up, otherwise it may prove fatal to the patient. Ulcers happen most commonly in the decline of life ; and persons who neglect exercise, and live grossly, are most liable to thein. They might often be prevented by retrenching some part of the solid food, or by opening artificial drains, as issues, eetons, or the like. An ulcer may be distinguished from a wound by its discharging a thin watery humour, which is often so acrid as to inflame and corrode the skin ; by the hardness and perpendicular situation of its sides or edges ; by the time of its duration, &c. It requires considerable skill to be able to judge whether or not an ulcer ought to be dried up. In general, all ulcers which proceed from a bad habit of body should be suffered to continue open, at least till the constitution has been so far changed by proper regimen, or the u»e of medicine, that they seem disposed to heal of their own accord. Ulcers which are the effect of malignant fevers, or other acute diseases, may generally be healed with safety after the health has been restored for some time. The cure ought not, however, to be attempted too soon, nor at any time without the use of purging medicines and a proper regimen. When wounds and bruises have, by wrong treatment, degenerated into ulcers, if the constitution be good, they may generally be healed with safety. When ulcers either accompany chronical diseases, or come in their stead, they must be cautiously healed. If an ulcer conduces to the patient's health from whatever cause it proceeds, it ought not to be healed ; but if, on the contrary, it wastes the strength and consumes the patient by a slow fever, it should be healed as soon as possible. We would earnestly recommend a strict attention to these particulars to all who have the misfortune to labour under this disorder, particu- larly persons in the decline of life; as we have frequently known people throw away their lives by the want of it, while they were extolling and generously rewarding those whom they ought to have looked upon as their executioners. The most proper regimen for promoting the cure of ulcers, >. to avoid all spices, salted and high-seasoned food, all strong liquors, and To cssen the usual quantity of flesh meat. The body ought to be kept peltry open by a diet consisting chiefly of cooling laxative vegetables, 392 OF ULCERS. and by drinkng butter-milk, whey sweetened with honey, or the l'ke. The patient ought to be kept cheerful, and should take as much exercise as he can easily bear. When the bottom and sides of an ulcer seem hard and callous, they may be sprinkled twice a-day with a little red precipitate of mercury, and afterwards dressed with the yellow basilicum ointment. Sometimes it will be necessary to have the edges of the ulcerscarified with the lancet. Lime-water has frequently been known to have very happy effects in the cure of obstinate ulcers. It may be used in the same manner as directed for the stone and gravel. My late learned and ingenious friend, Dr. Whyte, strongly recom- mends the use of the solution of corrosive sublimate of mercury in brandy, for the cure of obstinate, ill-conditioned ulcers. I have fre- quently found this medicine, when given according to the Doctor's di- rections, prove very successful. The dose is a table spoonful night and morning ; at the same time washing the sore twice or thrice a-day with it. In a letter which I had from the Doctor a little before his death, he informed me, ' That he observed washing the sore thrice a-day with the solution of a triple strength was very beneficial. '* A fistulous ulcer can seldom be cured without an operation ; it must either be laid open, so as to have its callous parts destroyed by some corrosive application, or they must be entirely cut away by the knife; but as this operation requires the hand of an expert surgeon, there is no occasion to describe it. Ulcers about the anus are most apt to become fistulous, and are veiy difficult to cure. Some indeed pretend to have found Ward's fistula-paste very successful in this complaint. It is not a dangerous medicine, and being easily procured, it may deserve a trial; but as these ulcers generally proceed from an ill habit of body, they will seldom yield to any thing except a long course of regi- men, assisted by medicines which are calculated to correct that parti- cular habit, and to induce an almost total change in the constitution. * In ulcers of the lower limbs great benefit is often received from tight rollers, or wearing a laced stocking, as this prevents the flux of humours to the sores, and dis- posed them to heal. 303 CHAP. LI. OF DISLOCATIONS. When a bone is moved out of its place or articulation, so as to impe li its proper functions, it is said to be luxated or dislocated. As this often happens to persons in situations where no medical assistance can be obtained, by which means limbs, and even lives, are frequently lost, we Bhall endeavour to point out tho method of reducing the most common luxations, and those which require immediate assistance. Any person of common sense and resolution, who is present when a dislocation happens, may often be of more service to the patient than the most expert surgeon can, after the swelling and inflammation have come on. When these are present, it is difficult to know the state of the joint, and dangerous to attempt a reduction ; and by waiting till they are gone off, the muscles become so relaxed, and the cavity filled up, that the bono can never afterwards be retained in its place. A recent dislocation may generally be reduced by extension alone, which must always be greater or less according to the strength of the muscles which move the joint, the age, robustness, and other circum- stances of the patient. When the bone has been out of its place for any considerable time, and a swelling or inflammation has come on, it will be necessary to bleed the patient, and, after fomenting the part, to apply soft poultices with vinegar to it for some time before the reduction is attempted. All that is necessary after the reduction, is to apply cloths dipt in vinegar or camphorated spirits of wine to the part, and to keep it per- fectly easy. Many bad consequences proceed from the neglect of this rule. A dislocation seldom happens without the tendons and ligaments of tiie joint being stretched, and sometimes torn. When these are kept easy till they recover their strength and tone, all goes on very well; but if the injury be increased by too frequent an exertion of the parts, no wonder if they be found weak and diseased ever after. DISLOCATION OF THE JAW. The lower jaw may be luxated by yawning, blows, falls, chewing hard substances, or the like. It is easily known from the patient's ben, > unable to shut his mouth, or to eat any thing, as the teeth of the under jaw do not correspond with those of the upper; besides, the chin 394 OF DISLOCATIONS- either hangs down or is thrown towards one side, and the patient is neither able to speak distinctly, nor to swallow without considerable difficulty. The usual method of reducing a dislocated jaw, is to set the patient npon a low stool, so that an assistant may hold the head firm by pressing it against his breast. The operator is then to thrust his thumbs, being first wrapt up with linen cloths that they may not slip, as far back mto the patient's mouth as he can, while his fingers are applied to the jaw externally. After he has got firm hold of the jaw, he is to press it strongly downwards and backwards, by which means the elapsed heads of the jaw may be easily pushed into their former cavities. DISLOCATION OF THE NECK. The neck may be dislocated by falls, violent blows, or .the like. In this case, if the patient receives no assistance, he soon dies, which makes people imagine the neck was broken : it is, however, for the most part only partially dislocated, and may be reduced by almost any person who has resolution enough to attempt it. A complete dislocation of the neck is instantaneous death. When the neck is dislocated, the patient is immediately deprived of all sense and motion ; his neck swells, his countenance appears bloated ; his chin lies upon his breast, and his face is generally turned towards one side. To reduce this dislocation, the unhappy person should immediately be laid upon his back on the ground, and the operator must place him- self behind him so as to be able to lay hold of his head with both hands, while he makes a resistance by placing his knees against the patient's shoulders. In this posture he must pull the head with considerable force, gently twisting at the same time, if the face be turned to one side, till he perceives that the joint is replaced, which may be known from the noise which the bones generally make when going in, the patient's beginning to breathe, and the head continning in its natural posture. This is one of those operations which it is more easy to perform than describe. I have known instances of it being happily performed even by women, and often by men of no medical education. After the neck is reduced, the patient ought to be bled, and should be suffered to rest fo* aome days, till the parts recover their proper tone. DISLOCATION OF THE RIBS. As the articulation of the ribs with the back-bone is very strong OF DISLOCATIONS. 395 they are not often dislocated. It does, however, sometimes happen, which is a sufficient reason for our taking notice of it. When a rib is dislocated either upwards or downwards, in order to replace it the pa- tient should be laid upon his belly on a table, and the operator must endeavour to push the head of the bone into its proper place. Should this method not succeed, the arm of the disordered side may be sus- pended over a gate or ladder, and while the ribs are thus stretched asunder, the heads of such as are out of place may be thrust into their former situation. Those dislocations wherein the heads of the ribs are forced inwards, are both more dangerous and the most difficult to reduce, as neither the hand nor any instrument can be applied internally to direct the luxated heads of the ribs. Almost the only thing that can be done is, to lay the patient upon his belly over a cask, or some gibbous body, and to move the fore-part of the rib inwards towards the back, sometimes shaking it; by this means the head of the luxated ribs may slip into their former place. DISLOCATION OF THE SHOULDER, The numerous or upper bone of the arm may be dislocated in various directions ; it happens, however, most frequently downwards, but very seldom upwards. From the nature of its articulation, as well as from its exposure to external injuries, this bone is the most subject to dislo- cation of any in the body. A dislocation of the humerous may be known by a depression or cavity on the top of the shoulder, and aa in- ability to move the arm. When the dislocation is downward or for- ward, the arm is elongated, and a ball or lump is perceived under the arm-pit; but when it is backward, there appears a protuberance behind the shoulder, and the arm is thrown forward towards the breast. The usual method of reducing dislocations of the shoulder is to seat the patient upon a low stool, and to cause an assistant to hold his body bo that it may not give way to the extension, while another lays hold of the arm a little above the elbow, and gradually extends it. The oper- ator then puts a napkin under the patient's arm, aud causes it to be tied behind his own neck: by this, while a sufficient extension is made, he lifts up the head of the bone, and with his hands directs it into its proper place. There are various machines invented for facilitating this operation, but the hand of an expert surgeon is always more safe. In young and delicate patients, I have generally found it a very easy mat- ter to reduce the shoulder, by extending the arm with one hand, and thrusting in the head of the bone with the other* In making the ex- tension, the arm ought always to be a little bent. 396 0» DISLOCATIONS. DISLOCATION OF THE ELBOW. The bones of the fore-arm may be dislocated in any direction. When this is the case, a protuberance may be observed on that side of the arm towards which the bone is pushed, from which, and the patient's inability to bend his arm, a dislocation of this joint may easily be known. Two assistants are generally necessary for reducing a dislocation of the elbow ; one of them must lay hold of the arm above, and the other below the joint, and make a pretty strong extension, while the operator returns the bones into their proper place. Afterwards the arm must be bent, and suspended for some time with a sling about the neck. Luxations of the wrist and fingers are to be reduced in the same manner as those of the elbow, viz. by making an extension in different directions, and thrusting the head of the bone into its place. DISLOCATION OF THE THIGH. When the thigh-bone is dislocated forward and downward, the knee and foot are turned out, and the leg is longer than the other; but when it is displaced backward, it is usually pushed upwards at the same time, by which means the limb is shortened, and the foot is turned inwards. When the thigh bone is displaced forward and downward, the patient, in order to have it reduced, must be laid upon his back, and made fa-.t by bandages, or held by assistants, while by others an extension is made by means of slings fixed about the bottom of the thigh, a little above the knee. While the extension is made the operator must push the head of the bone outward, till it gets into the socket. If the dis- location be outward, the patient must be laid upon his face, and dur- ing the extension the head of the bone must be pushed inwards. Dislocations of the knees, ancles, and toes, are reduced much in the same manner as those of the upper extremities, viz. by making an exten- sion in opposite directions, while the operator replaces the bones. In many cases, however, the extension alone is sufficient, and the bone will slip into its place merely by pulling the limb with sufficient force. It is not hereby meant that force alone is sufficient for the reduction of dislocation. Skill and address will often suceed better than force. I have known a dislocation of the thigh reduced by one man, after all the force that could be used by six had proved ineffectual. 397 CHAP. LII. OF BROKEN BONES, &c. There is, in most country villages, some person who pretends to the art of reducing fractures. Though in general such persons are very ignorant,yetsomeof them are very successful ; which evidently proves, that a small degree of learning, with a sufficient share of common sense and a mechanical head, will enable a man to be useful in this way. We would, however, advise people never to employ such operators, when an expert and skilful surgeon can be had ; but when that is impracticable, they must be employed ; we shall therefore recommend the following hints to their consideration : When a large bone is broken, the patient's diet ought in all respects to be the same as in an inflammatory fever. He should likewise be kept quiet and cool, and his body open by emollient clysters; or if these cannot be conveniently administered, by food that is of an opening quality ; as stewed prunes, apples boiled in milk, boiled spinage and the like. It ought, however, to be here remarked, that persons who have been accustomed to live high, are not all of a sudden to be reduced to a very low diet. This might have fatal effects. There is often a necessity for indulging even bad habits, in some measure, where the nature of the disease might require a different treatment. It will generally be necessary to bleed the patient immediately after a fracture, especially if he be young, of a full habit, or has at the same time received any bruise or contusion. This operation should not only be performed soon after the accident happens, but, if the patient be very feverish, it may be repeated next day. When several of the ribs are broken bleeding is peculiarly necessary. If any of the largo bones which support the body are broken, the patient must keep his bed for several weeks. It is by no means neces- sary, however, that he should lie all that time, as is customary, upon his back. This situation sinks the spirits, galls and frets the patient's Bkin, and renders him very uneasy. After the second week he may be gently raised up, and may sit several hours, supported by a bed-chair, or the like, which will greatly relieve him. Great care, however, must be taken in raising him up and laying him down, that he make no ex- ertions himself, otherwise the action of the muscles may pull the bone out of its place.* * Various pieces of machinery have been contrived for counteracting the force of themuscles, and retainingthe fragments of broken bones; butas descriptions of these 398 OF BROKEN BONES. It is of great importance to keep the patient dry and clean while in this situation. By neglecting this, he is often so galled and excoriated that he is forced to keep shifting places for ease. I have known a fractured thigh-bone, after it had been kept straight for above a fort- night, displaced by this means, and continue bent for life, in spite of all that could be done. It has been customary, when a bone was broken, to keep the limb for five or six weeks continually upon the stretch. But this is a bad posture. It is both uneasy to the patient, and unfavourable to the cure. The best situation is to keep the joint a little bent. This is the pos- ture into which every animal puts its limbs when it goes to rest, and in which fewest muscles are upon the stretch. It is easily effected, by either laying the patient upon his side, or making the bed so as to favour this position of the limb. Bone-setters ought carefully to examine whether the bone be not shattered or broken in several pieces. In this case it will sometimes be necessary to have the limb immediately taken off, otherwise a gangrene or mortification may ensue. The horror which "attends the very idea of an amputation often occasions its being delayed in such cases till too late. I have kuown this principle operate so strongly, that a limb, where the bones were shattered into more than twenty pieces, was not amputated before the third day after the accident, when the gangrene had proceeded so far as to render the operation useless. When a fracture is accompanied with a wound, it must be dressed in all respects as a wound. All that art can do towards the cure of a broken bone, is to lay it per- fectly straight, and to keep it quite easy. All tight bandages do hurt. They had much better be omitted altogether. A great many of the bad consequences which succeed to fractured bones, are owing to tight bandages. This is one of the ways in which the excess of art, or rather the abuse of it, does more mischief than would be occasioned by the want of it. Some of the most sudden cures of broken bones which were ever known, happened where no bandages were applied at all. Some method, however, fnust be taken to keep the member steady ; but this may be done many ways, without bracing it with a tight bandage. The best method of retention is by two or more splints made of leather or pasteboard. These, if moistened before they are applied, soon as- without drawings would be of little use, I shall refer the reader to a cheap and useful performance. On the Nature and Cnre of Fractures, lately published by my ingenious friend Mr. Aitken, surgeon in Edinburgh ; wherein that gentleman has not only given an account of the machines recommended in fractures by former authors, but has likewise added several improvements of his own, which are peculiarly useful in com- pound fractures, and incases where patients with broken bones are obliged to ueUuu. sported from oue place to another. OF STRAINS. 399 sume the shape of the included member, and are sufficient, by the as- sistance of a very slight bandage, for all the purposes of retention. The bandage which we would recommend is that made with twelve or eighteen tails. It is much easier applied and taken off than rollers, and answers all the purposes of retention equally well. The splints should always be as long as the limb, with holes cut for the ancles when the fracture is in the leg. In fractures of the ribs, where a bandage cannot be properly used, an adhesive plaster may be applied over the part. The patient in this case ought to keep himself quite easy, avoiding every thing that may occasion sneezing, laughing, coughing, or the like. He ought to keep his body in a straighf posture, and should take care that his stomach be constantly distended, by taking frequently some light food, and drinkiug frequently of weak watery liquors. The most proper external application for a fracture is oxycrate, or a mixture of vinegar and water. The bandages should be wet with this at every dressing. OF STRAINS. Strains are often attended with worse consequences than broken bones. The reason is obvious : they are generally neglected. When a bone is broken, the patient is obliged to keep the member easy, because he cannot make use of it; but when a joint is only strained, the person finding he can still make a shift to move it, is sorry to lose his time for so trifling an ailment. In this way he deceives himself, and converts into an incurable malady what might have been removed by only keeping the part easy for a few days. Country people generally immerse a strained limb in cold water. This is very proper, provided it be done immediately, and not kept in too lon°-. But the custom of keeping the part immersed in cold water for a long time is certainly dangerous. It relaxes instead of bracing the part, and is more likely to produce a disease than cure one. Wrapping a garter, or some other bandage, pretty tight about the strained part, is likewise of use. It helps to restore the proper tone of the vessels, and prevents the action of the parts from increasing the disease. It should not, however, be applied too tight. I have fre- quently known bleeding near the affected part have a very good effect; but what we would recommend above all, is ease. It is more to be de- pended on than any medicine, and seldom fails to remove the complaint.* * A itreat many external applications are recommended for strains, some of which do good, aud others hurt. The followiug are audi as may be used with the greater 400 OF RUPTURES. Children and old people are most liable to this disease. In the former it is generally occasioned by excessive crying, coughing, vomit- ing, or the like. In the latter, it is commonly the effect of blows or violent exertions of the strength, as leaping, carrying great weights, &c. In both a relaxed habit, indolence, and an oily or very moist diet, dispose the body to this disease. A rupture sometimes proves fatal before it is discovered. Whenever sickness, vomiting, and obstinate costiveness give.reason to suspect an obstruction of the bowels, all those places where ruptures usually hap- pen ought carefully to be examined. The protrusion of a very small part of the gut will occasion all these symptoms ; and if not returned in due time, will prove fatal. On the first appearance of a rupture in an infant, it ought to be laid upon its back, with its head very low. While in this posture, if the gut does not return of itself, it may easily be put up by gentle pressure. After it is returned, a piece of sticking- plaster may be applied over the part, and a proper truss or bandage must be constantly worn for a considerable time. The method of making and applying rupture bandages for children is pretty well known. The child must, as far as possible, be kept from crying, aud from all violent exertions, till the rupture is quite healed. In adults, when the gut has been forced down with great violence, or happens from any cause to be inflamed, there is often great difficulty in returning it, and sometimes the thing is quite impracticable without an operation; a description of which is foreign to our purpose. As I have been fortunate enough, however, always to succeed in my attempts to return the gut, without having recourse to any other means than what are in the power of every man, I shall briefly mention the method which I generally pursue. After the patient has been bled, he must be laid upon his back, with his head very low, and his breech raised high with pillows. In this situation flannel cloths wining out of a decoction of mallows and camo- mile flowers, or, if these are not at hand, of warm water, must be applied for a considerable time. A clyster made of this decoction, with a large spoonful of butter, and an ounce or two of salt, may afterwards be thrown up. If these should not prove successful, recourse must be had to pressure. If the tumour be very hard, considerable force will be safety, viz. poultices made of stale beer, or vinegar and oatmeal, camphorated spirits of wine, Mindererus's spirit, volatile liniment, volatile aromatic spirit diluted with a double quantity of water, and the common fomentation, with the addition of brandy or sp.rit of wine. OF CASUALTIES. 401 necessary ; but it is not force alone which succeeds here. The operator, at the same time that he makes a pressure with the palms of his hands, must with his finger artfully conduct the gut in by the same aperture through which it came out. The manner of doing this can be much easier conceived than described. Should these endeavours prove in- effectual, clysters of the smoke of tobacco may be tried. These have been often known to succeed where every other method failed. There is reasoii to believe that, by persisting in the use of these, and such other means as the circumstances of tho case may suggest, most hernias might be reduced without an operation. Cutting for the hernia is a nice and difficult matter. I would therefore advise surgeous to try every method of returning the gut before they have recourse to the knife. I have once and again succeeded by persevering in my en- deavours, after eminent surgeons had declared the reduction of the gut impracticable without an operation.* An adult, after the gut has been returned, must wear a steel bandage. It is needless to describe this, as it may always be had ready made from the artists. Such bandages are generally uneasy to the wearer for some time, but by custom they become quite easy. No person who has had a rupture after he arrived at man's estate, should ever be with- out one of these bandages. Persons who have a rupture ought carefully to avoid all violent ex- ercise, carrying great weights, leaping, running, and the like. They should likewise avoid windy aliment and strong liquors; and should carefully guard against catching cold. CHAP. LIII. OF CASUALTIES. It is certain that life, when to all appearance lost, may often, by due •care, be restored. Accideuts frequently prove fatal, merely because proper means are not used to counteract their effects. No person ought to be looked upon as killed by any accident, unless where the structure of the heart, brain, or some organ necessary for life, is evidently de- * I would here beg leave to recommend it to every practitioner, when his patient complains of pain in the belly with obstinate costiveness, to examine Hie groins and evervDlace where a rupture may happen, in order that it may ba immediately reduced. Hv ueelecting this, manv perish who were not suspected to have had rupture- till after they were dead. I'have known this happeu where half a dozen of the faculty Wciu lu attcndence. 2d *02 OF CASUALTIES. stroyed. The action of these organs may be so far impaired as even to be forsome time imperceptible, when life is by no means gone. In this case, however, if the fluids be suffered to grow cold, it will be impossible to put them again in motion, even though the solids should recover their power of ajting. Thus, when the motion of the lungs has been stopped by unwholesome vapour, the action of the heart by a stroke on the breast, or the functions of the brain by a blow on the head, if the person be suffered to grow cold, he will in all probability continue so ; but if the body be kept warm, as soon as the injured part has recovered its power of acting, the fluids will again begin to move, and all the vital functions will be restored. It is a horrid custom, immediately to consign over to death every person who has the misfortune, by a fall, a blow, or the like, to be de- prived of the appearance of life. The unhappy person, instead of being carried into a warm house, and laid by the fire or put to a warm bed, is generally hurried away to a church, or a barn, or some other cold damp house, where, after a fruitless attempt has been made to bleed him, perhaps by one who knew nothing of the matter, he is given over lor dead, and no farther notice takeu of him. This conduct seems to be the result of ignorance, supported by an ancient superstitious notion, which forbids the body of any person killed by accident to be laid in a house that is inhabited. What the ground of this superstition may be, we shall not pretend to inquire ; but surely the conduct formed upon it is contrary to all the principles of reason, humanity, and com- mon sense. When a person seems to be suddenly deprived of life, our first busi- ness is to inquire into the cause. We ought carefully to observe whether any substance be lodged in the windpipe or gullet; and if that is the case attempts must be made to remove it. When unwholesome air is the cause, the patient ought immediately to be removed out of it. If the circulation be suddenly stopped, from any cause whatever, except mere weakness, the patient should be bled. If the blood does not flow, he may be immersed in warm water, or rubbed with warm cloths, &c. to promote the circulation. When the cause cannot be suddenly re- moved, our great aim must be to keep up the vital warmth, by rubbing the patient with hot clotlis, or salt, and covering his body with warm sand, ashes, or the like. I should now proceed to treat more fully of these accidents, which, without immediate assistance, would often prove fatal, and to point out the most likely means for relieving the unhappy sufferers ; but as I have been happily anticipated in this part of my subject by the learned and humane Dr. Tissot, I shall content myself with collecting such of SUBSTANCES STOPT, ETC. 403 his observations as seem to be the most important, and adding such of my own as have occurred in the course of practice. OF SUBSTANCES STOPT BETWEEN THE MOUTH AND STOMACH. Tiiough accidents of this kind are very common and extremely dan- gerous, yet they are generally the effect of carelessness. Children should be taught to chew their food well, and to put nothing into their mouths which it would be dangerous for them to swallow. But children are not the only persons guilty of this piece of imprudence. I know many adults who put pins, nails, and other sharp-pointed substances in their mouths upon every occasion, and some who even sleep with the former there all night. This conduct is exceedingly injudicious, as a fit of coughing, or twenty other accidents, may force over the sub- stance, before the person is aware.* When any substance is detained in the gullet, there are two ways of removing it, viz. either by extracting it or pushing it down. The safest and more certain way is to extract it; but this is not always the easiest: it may therefore be more eligible sometimes to thrust it down, espe- cially when the obstructing body is of such a nature that there is no danger of its reception into the stomach. The substances which may be pushed down without danger are all common nourishing ones, as bread, flesh, fruits, and the like. All indigestible bodies, as cork, wood, bones, and pieces of metal, and such like, ought, if possible, to be extracted, especially if those bodies be sharp-pointed, as pins, needles, fish-bones, bits of glass, &c. When such substances have not passed in too deep, we should en- deavour to extract them with our fingers ; which method often succeeds. When they are lower, we must make use of nippers, or a small pair of forceps, such as surgeons use. But this attempt to extract rarely succeeds, if the substance be of a flexible nature, and has descended far into the gullet. If the fingers or pincers fail, or cannot be duly applied, crotchets, a kind of hooks, must be employed. These may be made at once, by bending a piece of pretty strong iron wire at one end. It must be intro- duced in the flat way ; and, for the better conducting it, there should likewise be a curve or bending at the end it is held by, to serve as a kind of handle to it; which has this farther use, that it may be secured by a string tied to it; a circumstance not to be omitted in any instru- * A woman in one of the hospitals of this city lately discharged a great number of pins, which »he had swallowed in the course of her business, through an ulcer in her ■ids. 404 SUBSTANCES STOPT BETWEEN ment employed on such occasions, to avoid such ill accidents as have Bometimes ensued from these instruments slipping out of the operator's hand. After the crotchet has passed below the substance that obstructs the passage, it is drawn up again, and hooks up the body along with it. The crotchet is also very convenient, when a substance somewhat flexible, as a pin, or fish-bone, sticks across the gullet, the hook, in such cases, seizing them about their middle part, crooks and thus dis- engages them, or, if they are very brittle substances, serves to break them. When the obstructing bodies are small, and only stop up a part of the passage, and which may either easily elude the hook, or straiten it by their resistance, a kind of rings, made either of wire, wool, or silk» may be used. A piece of fine wire of a proper length may be bent into a circle, about the middle, of about an inch diameter, and the long un- bent sides brought parallel, and near each other ; these are to be held in the hand, and the circular part or ring introduced into the gullet, in order to be conducted about the obstructing body, and so to extract it. More flexible rings may be made of wool, thread, silk, or small pack- thread, which may be waxed for their greater strength and consistence. One of these is to be tied fast to a handle of iron wire, whalebone, or any kind of flexible wood, and by this means introduced, in order to surround tthe obstructing substance and to draw it out. Several of these rings passed through one another may be used, the more certainly to lay hold of the obstructing body, which may be involved by one, if another should miss it. These rings have one advantage, which is, that when the substance to be extracted is once laid hold of, it may then, by turning the handle, be retained so strongly in the ring thus twisted, as to be moved every Way, which must in many cases be a considerable advantage. Another material employed on these unhappy occasions is the sponge. Its property of swelling considerably on being wet is the principal foun- dation of its usefulness here. If any substance is stopped in the gullet, but without filling up the whole passage, a bit of sponge^ may be intro- duced into that part which is unstopped, and beyond the substance. The sponge soon dilates, and grows larger in this moist situation ; and indeed the enlargement of it may be forwarded by making the patient swallow a few drops of water. Afterwards it is to be drawn back bv the handle to which it is fastened ; and as it is now too large to return through the small cavity by which it was conveyed in, it draws out the obstructing body along with it. The compressibility of sponge is another foundation of its usefulness in such cases. A pretty large piece of sponge may be compressed oi TIIE MOUTH ^ND THE STOMACH. 405 squeezed into a small size, by winding string of tape closely about it, which may be easily unwound and withdrawn, after the spongo has been introduced. A bit of sponge may likewise be compressed by a piece of whalebone split at one end ; but this can hardly be introduced in such a manner as not to hurt the patient. I have often known pins and other sharp bodies, which had stuck in the throat, brought up by causing the person to swallow a bit of tough meat tied to a thread, and drawing it quickly up again. This is safer than swallowing sponge, aud will often answer the purpose equally well. When all these methods prove unsuccessful, there remains one more, which is, to make the patient vomit; but this can scarcely be of any service, unless when such obstructing bodies are simply engaged in, and not hooked or stuck into the sides of the gullet, as in this case vomiting might sometimes occasion farther mischief. If the patient can swallow, vomiting may be excited, by taking half a dram or two scru- ples of ipecacuanha in powder made into a draught. If he is not able to swallow, an attempt may be made to excite vomiting, by tickling his throat with a feather ; and, if that should not succeed, a clyster of tobacco may be administered. It is made by boiling an ounce of tobacco in a sufficient quantity of water. This has often been found to succeed when other attempts to excite vomiting had failed. When the obstructing body is of such a nature that it may with safety be pushed downwards, this may be attempted by means of a wax candle oiled, and a little heated, so as to make it flexible ; or a piece of whale-bone, wire, or flexible wood, with a sponge fastened to the end. Should it be impossible to extract even those bodies which it is dan- gerous to admit into the stomach, we must then prefer the least of two evils, and rather run the hazard of pushing them down, than suffer the patient to perish in a few minutes; and we ought to scruple this resolution the less, as a great many instances have happened, where the swallowing of such hurtful and indigestible substances have been followed by no disorder. When it is manifest that all endeavours either to extract or push down the substance must prove ineffectual, they should be disconti- nued : because the inflammation occasioned by persisting in them, mi "lit he as dangerous as the obstruction itself. Some have died in consequence of the inflammation, even after the body which caused the obstruction had been entirely removed. While the means recommended above are made use of, the patient should swallow, or, if he cannot, he should frequently receive by in- jection, through a crooked tube or pipe that may reach down the gullet, 405 OF DROWNFD PERSONS. some emollient liquor, as warm milk and water, barley-water, or a de- coction of mallows. Injections of this kind not only soften and soothe the irritated parts, but when thrown in with force, are often more successful in loosening the obstruction, than all attempts with instru- ments. When after all our endeavours, we are obliged to leave the obstructing body in the part, the patient must be treated as if he had an inflam- matory disease. He should be bled, kept upon a low diet, and have his whole neck surrounded with emollient poultices. The like treatment must also be used, if there be any reason to suspect an inflammation of the passages, though the obstructing body be removed. A proper degree of agitation has sometimes loosened the inhering body more effectually than instruments. Thus a blow on the back has often forced up a substance which stuck in the gullet; but this is still more proper and efficacious when the substance gets into the wind- pipe. In this case, vomiting and sneezing are likewise to be excited. Pins, which stuck in the gullet, have been frequently discharged by riding on horseback, or in a carriage. When any indigestible substance has been forced down into the stomach, the patient should use a very mild and smooth diet, consisting chiefly of fruits and farinaceous substances, as puddings, pottage, and soups. He should avoid all heating and irritating things, as wine, punch, pepper, and such like ; and his drink should be milk and water, barley-water, or whey. When the gullet is so strongly and fully closed, that the patient can receive no food by the mouth, he must be nourished by clysters of soup, jelly, and the like. When the patient is in danger of being immediately suffocated, and allhopes of freeing the passage is vanished, so that death seems at hand} if respiration be not restored, the operation of bronchotomy, or open- ing the wind-pipe, must be directly performed. As this operation is neither difficult to an expert sugeon, nor very painful to the patient, and is often the only method which can be taken to preserve life in these emergencies, we thought proper to mention it, though it should only be attempted by persons skilled in surgery. OF DROWNED PERSONS. When a person has remained above a quarter of an hour under water, there can be no considerable hopes of his recovery. But as several circumstances may happen to have continued life, in such an unfortunate situation, beyond the ordinary term, we should never too OF DROWNED PERSONS. 407 soon resign the unhappy object to his fate, but try every method for h s relief, as there are many well-attested proofs of the recovery of per- sons to life and health who had been taken out of the water apparently dead, and who remained a considerable time without exhibiting any signs of life. The first thing to be done, after the body is taken out of the water, is to convey it as soon as possible to some convenient place where the necessary operations for its recovery may be performed. In doing this, care must be taken not to bruise or injure the body by carrying it in any unnatural posture with the head downwards, or the like. If an adult body, it ought to be laid on a bed, or on straw, with the head a little raised, and carried on a cart or on men's shoulders, and kept in as natural and easy a position as possible. A small body may be carried in the arms. In attempting to recover persons apparently drowned, the principal intention to be pursued is, to restore the natural warmth, upon which all the vital functions depend ; and to excite these functions by the application of stimulants, not only to the skin, but likewise to the lungs, iutestines, &c. Though cold was by no means the cause of the person's death, yet it will prove an effectual obstacle to his recovery. For this reason, after stripping him of his wet clothes, his body must be strongly rubbed for a considerable time with coarse linen cloths as warm as they can be made ; and, as soon as a well-heated bed can be got ready, he may bo laid in it, and the rubbing should be continued. Warm cloths ought likewise to be frequently applied to the stomach and bowels, and hot bricks, or bottles of warm water, to the soles of the feet, and to the palms of his hands. Strong volatile spirits should be frequently applied to the nose ; and the spine of the back and pit of the stomach may be rubbed with warm brandy or spirit of wine. The temples ought also to be chafed with volatile spirits ; and stimulating powders, as that of tobacco or marjo- ram, may be blown up the nostrils. To renew the breathing, a strong person may blow his own breath into the patient's mouth, with all the force he can, holding his nos- trils at the same time. When it can be perceived by the rising of the chest or belly that the lungs are filled with air, the person ought to de- sist from blowing, and should press the breast and belly so as to expel the air again ; and this operation may be repeated for some time, alternately inflating and depressing the lungs so as to imitate natural respiration. If the lungs cannot be inflatedin this manner, it may be attempted by » 4^3 OF DROWNED PKRSON9. blowing through one of the nostrils, and at the same time keeping tha other close. Dr. Monro, for this purpose, recommends a wooden pipn fitted at one end for filling the nostril, and at the other for being blown into by a person's mouth, or for receiving the pipe of a pair of bellows, to be employed for the purpose, if necessary. When air cannot be forced into the chest by the mouth or nose, it may be necessary to make an opening into the windpipe for this purpose. 11 is needless, however, to spend time in describing this operation, as it should not be attempted unless by persons skilled in surgery. To stimulate the intestines, the fumes of tobacco may be thrown up in form of a clyster. There are various pieces of apparatus contrived for this purpose, which may be used when at hand ; but where these cannot be obtained, the business may be done by a common tobacco-pipe. The bowl of the pipe must be filled with tobacco well kindled, and, after tiie small tube has been introduced into the fundament, the smoke may be forced up by blowing through a piece of paper full of holes, wrapped round the mouth of the pipe, or by blowing through an empty pipe, the mouth of which is applied close to that of the other. This may also be done in the following manner: A common clyster pipe, with a bag mounted upon it, may be introduced into the fundament, and the mouth of the bag may be applied round the small end of a tobacco-pipe, in the bowl of which, tobacco is to be kindled, and the smoke blown up as directed above. Should it be found impracticable to throw up the smoke of tobacco, clysters of warm water with the addition of a little salt, and some wine or spirits, may be frequently administered. This may be done by a common clyster-bag and pipe ; but as it ought to be thrown well up, a pretty large syringe will answer the purpose better. While these things are doing, some of the attendants ought to be pre- paring a warm bath, into which the person should be put, if the above endeavours prove ineffectual. Where there are no conveniences for using the warm bath, the body may be covered with warm salt, sand, ashes, grains, or such like. Tissot mentions an instance of a girl who was restored to life, after she had been taken out of the water, swelled, bloated, and to all appearance dead, by laying her naked body upon hot ashes, covering her with others equally hot, putting a bonnet round her head, and a stocking round her neck stuffed with the same, and heaping coverings over all. After she had remained half an hour in this situation, her pulse returned, she recovered speech, and cried out, I Jreeze, I freeze; a little cherry brandy was given her, and she remained buried, as it were, under the ashes for eight hours: afterwards she wa, taken out, without any other complaint, except that of lassitude or » weariness, which went off in a few days. The Doctor mentions Lke- OF DROWNED PERSONS. 4C9 wise an instance of a man who was restored to life, after he had re- mained six hours under water, by the heat of a dunghill. Till the patient shows some signs of life, and is able to swallow, it would be useless and even dangerous to pour liquors into his mouth. His lips, however, and tongue m;iy be frequently wet with a feather dipped in warm brandy or other strong spirits ; and, as soon as he has recovered the power of swallowing, a little warm wine, or some other cordial, ought every now and then to be administered. Some recommend a vomit after the patient is a little reanimated ; bnt if he can be made to puke without the sickening draught, it will be more safe; this may generally be done by tickling the throat and fauces with an oiled feather, or some other soft substance, which will not in- jure the parts. Tissot in this case, recommends the oxymel of squills, a table-spoonful of which diluted with water, may be given every quar- ter of an hour, till the patient has taken five or six doses. Where that medicine is not at hand, a strong infusion of sage, camomile flowers, or carduus benedictus, sweetened with honey, or some warm water, with the addition of a little salt, may, he says, supply its place. Tho Doctor does not intend that any of these things should be given in Buch quantity as to occasion vomiting. He thinks emetics in this situa- tion are not expedient, We are by no means to discontinue our assistance as soon as the pa- tients discover some tokens of life, since they sometimes expire after these first appearances of recovering. The warm and stimulating ap- plications are still to be continued, and small quantities of some cordial liquor ought frequently to be administered. Lastly, though the person should be manifestly re-animated, there sometimes remain an oppres- sion, a cough, and feverishness, which effectually constitute a disease. In this case it will be necessary to bleed the patient in the arm, and to cause him to drink plentifully of barley-water, elder-flower tea, or any other soft pectoral infusion. Such persons as have the misfortune to be deprived of the appearance of life, by a fall, a blow, suffocation, or the like, must be treated nearly in the same manner as those who have been for some time under water. I once attended a patient who was so stunned by a fall from a horse, that for above six hours he scarcely exhibited any signs of life ; yet this man, by being bled, and proper methods taken to keep up the vital warmth, recovered, and in a few days was perfectly well. Dr. Alexander gives an instance to the same purpose, in the Ediuburgh Physical and Literary Essays, of a man who was to all appearance killed by a blow on the breast, but recovered upon being immersed for some time in warm water. These, and other iustances of a similar nature, 4L1 OF NOXIOUS VAPOURS. which might be adduced, amount to a full proof of this fact, that many of these unhappy persons who lose their lives by falls, blows, and other accidents, might be saved by the use of proper means duly per- sisted in. OF NOXIOUS VAPOURS. Air may be many ways rendered noxious, or even destructive to ani- mals. This may either happen from its vivifying principle being de- stroyed, or from subtle exhalations with which it is impregnated. Thus air that has passed through burning fuel is neither capable of sup- porting fire nor the life of animals. Hence the danger of sleeping in close chambers with coal fires. Some indeed suppose the danger here proceeds from the sulphureous oil contained in the coal, which is set at liberty and diffused all over the chamber; while others imagine it is owing to the air of the room being charged with phlogiston. Be this as it may, it is a situation carefully to be avoided. Indeed, it is dangerous to sleep in a small apartment with a fire of any kind. I lately saw four persons who had been suffocated by sleeping in an apartment where a small fire of coal had been left burning. The vapour which exhales from wine, cyder, beer, or other liquors, in the state of fermentation, contains something poisonous, which kills in the same manner as the vapours of coal. Hence there is always1 danger in going into cellars where a large quantity of these liquors is in a state of fermentation, especially if they have been close shut up for some time. There have been many instances of persons struck dead on entering such places, and of others who have with difficulty escaped. When subterraneous caves, that have been very long shut, are opened, or when deep wells are cleaned, which have not been emptied for several years, the vapours arising from them produce the same effects as those mentioned above. For this reason, no person ought to venture into a well, pit, cellar, or any place thatis damp, and has been long shut up, till the air has been sufficiently purified, by burning gun-powder in it. It is easy to knowj as has been observed in a former part of this work, when the air of such places is unwholesome, by letting down a lighted candle, throwing in burning fuel, or the like. If these continue to burn, people may safely venture in ; but where they are suddenly extinguished, no one ought to enter till the air has been first purified by fire. The offensive smell of lamps and of candles, especially when their flames are extinguished, operate like other vapours, though with less violence, and less suddenly. There have, however, been instances of EFFECTS OF EXTREME COLD. 411 people killed by the fumes of lamps which had been extinguished in a close chamber: and persons of weak, delicate breasts, generally find themselves quickly oppressed in apartments illuminated with many caudles. Such as are sensible of their danger in these situations, and retreat seasonably from it, are generally relieved as soon as they get into the open air ; or, if they have any remaining uneasiness, a little water and vinegar, or lemonade, drank hot, affords them relief. But when they are so far poisoned, as to have lost their feeling and understanding, the following means must be used for their recovery :— The patient should be exposed to a very pure, fresh, and open air ; and volatile salts, or other stimulating substances, held to his nose. He should next be bled in the arm, or, if that does not succeed, in the neck. His legs ought to be put into warm water, and well rubbed. As soon as he can swallow, some lemonade, or water and vinegar, with the addition of a little nitre, may be given him. Nor are sharp clysters by any means to be neglected, these may be made, by adding to the common clyster, syrup of buckthorn and tinc- ture of senna, of each two ounces ; or, in their stead, half an ounce of Venice turpentine dissolved in the yolk of an egg. Should these things not be at hand, two or three large spoonfuls of common salt may be put into the clyster. The same means, if necessary, which were re- commended in the former part of this chapter, may be used to restore the circulation, warmth, &c. Mr. Tossach, surgeon at Alloa, relates the case of a man suffocated by the steam of burning coal, whom he recovered by blowing his breath into the patient's mouth, bleeding him in the arm, and causing him to be well rubbed and tossed about. And Dr. Frewen, of Sussex, men- tions the case of a young man who was stupified by the smoke of sea- coal, but was recovered by being plunged into cold water, and afterwards laid in a warm bed. The practice of plunging persons suffocated by noxious vapours in cold water, would seem to be supported by the common experiment of suffocating dogs in the grotto del cani, and afterwards recovering them by throwing them into the neighbouring lake. EFFECTS OF EXTREME COLD. When cold is extremely severe, and a person is exposed to it for a long time, it proves mortal, in consequence of its stopping the circula- tion in tho extremities, and forcing too great a proportion of blood to- wards the brain ; so that the panent dies of a kind of apoplexy, pre* 412 EFFECTS OF EXTREME COLD. ceded by great sleepiness. The traveller, in this situation, who finds himself begin to grow drowsy, should redouble his efforts to extricate himself from the imminent danger he is exposed to. This sleep which he might consider as some alleviation of his sufferings, would, if in- dulged, prove his last. Such violent effects of cold are happily not very common in this country ; it frequently happens, however, that the hands or feet of tra- vellers are so benumbed or frozen, as to be in danger of a mortification, if proper means are not used to prevent it. The chief danger in this si- tuation arises from the sudden application of heat. It is very common when the hands or feet are pinched with cold, to hold them to the fire ; yet reason and observation show that this is a most dangerous and im- prudent practice. Every peasant knows, if frozen meat, fruits, or roots of any kind, bo brought near the fire, or put into warm water, they will be destroyed by rottenness, or a kind of mortification ; and that the only way to re- cover them is to immerse them for some time in very cold water. The same observation holds with regard to animals in this condition. When the hands or feet are greatly benumbed with cold, they ought either to be immersed in cold water, or rubbed with snow, till they re- cover their natural warmth and sensibility : after which the person may hp removed into an apartment a little warmer, and may drink some cups of tea, or an infusion of elder-flowers sweetened with honey. Every person must have observed, when his hands were eveii but slightly affected with cold, that the best way to warm them was by washing them in cold water, and continuing to rub them well for some time. When a person has been so long exposed to the cold, that all appear- ances of life are gone, it will be necessary to rub him all over with snow or cold water ; or what will answer better, if it can be obtained, to im- merse him in a bath of the very coldest water. There is the greatest encouragement to persist in the use of these means, as we are assured that persons who had remained in the snow, or had been exposed to the freezing air during five or six successive days, and who had disco- vered no marks of life for several hours have nevertheless been revived. I have always thought, that the whitloes, kibes, chilblains, and other inflammations of the extremities, which are so common among the peasants in the cold season, were chiefly occasioned by their sudden transition from cold to heat. After they have been exposed to an ex- treme degree of cold, they immediately apply their hands and feet to the fire, or, if they have occasion, plunge them into warm water, by which means, if a mortification does not happen, an inflamiration sel- OF FAINTING FITS, ETC. 413 dora fails to ensue. Mo-t of the ill consequences from this quarter might easily be avoided, by only observing the precautions mentioned above. EFFECTS OF EXTREME HEAT. The effects of extreme heat, though not so common in this country, are no less fatal, and much more sudden than those of cold. In hot countries people frequently drop down dead in the streets, exhausted with heat and fatigue. In this case, if any warm cordial can be poured into the mouth it ought to be done. If this cannot be effected, they may be thrown up in form of a clyster. Volatile spirits, and other things of a stimulating nature, may be applied to the skin, which should be well rubbed with coarse cloths, whipped with nettles, or other stimu- lating things. Some of the ancient physicians are said to have restored to life persons apparently dead, by beating them with rods. Ilead-aches are often occasioned by exposure to intense heat; and in warm climates, where people are very liable to what they call coups de soleil, or strokes of the sun, it is a common custom to lay linen clotlis, several times doubled, on the head, aud to keep them moistened with very cold water for half an hour, or till the stupor is diminished. This they term drawing the fire out of the head. , CHAP. LIY. OF FAINTING FITS, AND OTHER CASES WHICH REQUIRE IMMEDIATE ASSISTANCE. Strong and healthy persons, who abound with blood, are often seized with sudden fainting fits, after violent exercise, drinking freely of warm or strong liquors, exposure to great heat, intense application to studyj or the like. I n such cases the patient should be made to smell to some vinegar. His temples, forehead, aud wrists, ought at the same time to be bathed with vinegar mixed with an equal quantity of warm water ; and two or three spoonfuls of vinegar, with four or five times as much water, may, if he can swallow, be poured into his mouth. If the fainting proves obstinate, or degenerates into a syncope, that is, 414 OF FAINTING FITS, ETC. an abolition of feeling and understanding, the patient must be bled. After the bleeding a clyster will be proper, and then he should be kept easy and quiet, only giving him every half hour a cup or two of an infusion of any mild vegetable, with the addition of a little sugar and vinegar. When swoonings, which arise from this cause, occur frequently in the same person, he should, in order to escape them, confine himself to a light diet, consisting chiefly of bread, fruits, and other vegetables. His drink ought to be water or small beer, aud he should sleep but moder- ately, and take much exercise. But fainting fits proceed much oftener from a defect than an excess of blood. Hence they are very ready to happen after great evacuations of any kind, obstinate watching, want of appetite, or such like. In these an almost directly opposite course to that mentioned above must be pursued. The patient should be laid in bed with his head low, and being co- vered, should have his legs, thighs, arms, and his whole body rubbed strongly with hot flannels. Hungary-water, volatile salts, or strong smelling herbs, as rue, mint, or rosemary, may be held to his nose. His mouth may be wet with a little rum or brandy ; and, if he can swallow, some hot wine, mixed with sugar and cinnamon, which is an excellent cordial, may be poured into his mouth. A compress of flannel dipt in hot wine or brandy must be applied to the pit of his stomach, and warm bricks, or bottles filled with hot water, laid to his feet. As soon as the patient is recovered a little, he should take some strong soup or broth, or a little bread or biscuit soaked in hot spiced wine. To prevent the return of the fits, he ought to take often, but in small quantities, some light yet strengthening nourishment, as panado made with soup instead of water, new-laid eggs lightly poached, cho- colate, light roast meats, jellies, and such like. Those fainting fits which are the effect of bleeding, or of the violent operation of purges, belong to this class. Such as happen after artificial bleeding are seldom dangerous, generally terminating as soon as the patient is laid upon the bed; indeed, persons subject to this kind, should always be bled lying, in order to prevent it. Should the fainting, however, continue longer than usual, volatile spirits may be held to the nose, and rubbed on the temples, &c. When fainting is the effect of too strong or acrid purges or vomits, the patient must be treated in all respects as if he had taken poison. He should be made to drink plentifully of milk, warm water, and oil, bar- ley-water, or such like ; emollient clysters will likewise be proper, and the patient's strength should afterwards be recruited, by giving hiui generous cordials, and anodyne medicines. OF FAINTING FITS, ETC. 415 Faintings are often caused by indigestion. This may either proceed from the quantity or quality of the food. When the former of these is the cause, the cure will be best performed by vomiting, which may be promoted by causing the patient to drink a weak infusion of camomile- flowers, carduus benedictus, or the like. When the disorder proceeds from the nature of the food, the patient, as in the case of weakness, must be revived by strong smells, &c ; after which he should be made to swallow a large quantity of light warm fluid, which may serve to drown, as it were, the offending matter, to soften its acrimony, and either to effect a discharge of it by vomiting, or force it down into the intestines. Even disagreeable smells will sometimes occasion swoonings, espe- cially in people of weak nerves. When this happens, the patient should be carried into the open air, have stimulating things held to his nose, and those substances which are disagreeble to him ought immediately to be removed. But we have already taken notice of swoonings which arise from nervous disorders, and shall therefore say 110 more upon that head. Fainting fits often happen in the progress of diseases. In the begin- ning of putrid diseases, they generally denote an oppression of tho stomach, or a mass of corrupted humours, and they cease after eva- cuations either by vomit or stool. When they occur at the beginning of malignant fevers, they indicate great danger. In each of these cases, vinegar, used both externally and internally is the best remedy during the paroxysm, and plenty of lemon-juice and water after it_ Swoouings which happen in diseases accompanied with great evacua. tions, must be treated like those which are owing to weakness, and the evacuations ought to be restrained. When they happen towards the end of a violent fit of an intermitting fever, or at that of each exacerbation of a continual fever, the patient must be supported by small draughts of wine and water. Delicate and hysteric women are very liable to swooning or fainting fits after delivery. These might be often prevented by generous cordials, and the admission of fresh air. When they are occasioned by excessive flooding it ought by all means to be restrained. They are generally the effect of mere weakness or exhaustion. Dr. Engleman relates the case of a woman in childbed, who after being happily delivered, sud- denly fainted, and lay upwards of a quarter of an hour apparently dead. A physician was sent for ; her own maid, in the mean while, being out of patience at his delay, attempted to assist her herself, and extending herself upon her mistress, applied her mouth to her's, blew in as much breath, as she possibly could, and in a very short time tiie exhausted 116 OF INTOXICATION. woman awaked as out of a profound sleep ; when proper things being given her, she soon recovered. The maid being asked how she came to think of this expedient, said, Bhe had seen it practiced at Alteuberg, by midwives upon children with the happiest effect. We mention this case chiefly that other midwives may be induced to follow so laudable an example. Many children are born without any signs of life, and others expire soon after the birth, who might, without all doubt, by proper care, be restored to life. From whatever cause fainting fits proceed, fresh air is always of the greatest importance to the patient. By not attending to this circum- stance, people often kill their friends while they are endeavouring to save them. Alarmed at the patient's situation, they call in a crowd of people to his assistance, or perhaps to witness his exit, whose breath" ing exhausts the air and increases the danger. There is not the least doubt but this practice, which is very common among the lower sort of people, often proves fatal, especially to the delicate, and such persons as fall into fainting fits from mere exhaustion, or the violence of some disease. No more persons ought ever to be admitted into the room where a patient lies in a swoon than are absolutely necessary fox* his assistance, and the windows of the apartment should always be opened, at least as far as to admit a stream of fresh air. Persons subject to frequent swoonings or fainting fits, should neglect no means to. remove the cause of them, as their consequences are always injurious to the constitution. Every fainting fit leaves the per- son in dejection and weakness ; the secretions are thereby suspended, the humours disposed to stagnation, coagulations and obstructions are formed, and, if the motion of the blood be totally intercepted, or very considerably checked, polypuses are sometimes formed in the heart or larger vessels. The only kind of swoonings not to be dreaded, are those which sometimes mark the crisis in fevers ; yet even these ought, as soon as possible, to be removed. OF INTOXICATION. The effects of intoxication are often fatal. No kind of poison kills more certainly than an over dose of ardent spirits. Sometimes, by destroying the nervous energy, they put an end to life at once ; but in general their effects are more slow, and in many respects similar to those of opium. Other kinds of intoxicating liquors may prove fatal when taken to excess, as well as ardent spirits ; but they may gener. ally be discharged by vomiting, which ought always to be excited when the stomach is overcharged with liquor. OF INTOXICATION. 417 More of those unhappy persons, who die intoxicated, lose tlvir lives from an inability to conduct themselves, than from the destructive quality of the liquor. Unable to walk they tumble down, and lie in Borne awkward posture, which obstructs the circulation or breathing, and often continue in this situation till they die. No person, when drunk, should be left by himself, till his clothes have been loosened, and his body laid in such a posture as is most favourable for continuing the vital motions, discharging the contents of the stomach, &c. The best posture for discharging the contents of the stomach is to lay the per- son upon his belly ; when asleep he may be laid on his side, with his head a little raised, and particular care must be taken that his neck be no way bent, twisted, or have any thing too tight about it. The excessive degree of thirst occasioned by drinking strong liquors, often induces people to quench it by taking what is hurtful. I have known fatal consequences even from drinking freely of milk after a debauch of wine or sour punch ; these acid liquors, together with the heat of tho stomach, having coagulated the milk in such a manner that it could never be digested. The safest drink is water with a toast, tea, infusion of balm, sage, barley-water, and such like. If the person wants to vomit, he may drink a weak infusion of camomile flowers, or lukewarm water and oil ; but in this condition, vomiting may generally be excited by only tickling the throat with the finger or a feather. Instead of giving a detail of all the different symptoms of intoxication which indicate danger, and proposing a general plan of treatment for persons in this situation, I shall briefly relate the history of a ca.^e which lately fell under my own observation, wherein most of these symptoms usually reckoned dangerous concurred, and where the treat- ment was successful. A young man, about fifteen years of age, had, for a hire, drank ten glasses of strong brandy. He soon after fell fast asleep, and continued in that situation for several hours, till at length his uneasy manner of breathing, the coldness of the extremities, and other threatening symp- toms alarmed his friends, and made them send for me. I found lira still sleeping, his countenance ghastly, and his skin covered with a cold clammy sweat. Almost the only signs of life remaining were, a deep laborious breathing, and a convulsive motion or agitation of his bowels. I tried to rouse him, but in vain, by pinching, shaking, applying vola- tile spirits, and other stimulating things to his nose. A few ounces of blood were likewise taken from his arm, and a mixture of vinegar and water was poured into his mouth ; but as he could nut swallow, \ery little of this got into the stomach. None of these thirgs having the lea^t effect, and the danger seeming to increase, I ordered his legs to be^ut 2 E 413 OF SUFFOCATION AND STRANGLING. into warm water, and a sharp clyster to be immediately administered. This gave him a stool, and was the first thing that relieved him. It was afterwards repeated with the same happy effect, and seemed to be the chief cause of his recovery. He then began to show some signs of life, took drink when it was offered him, and came gradually to his senses. He continued, for several days weak and feverish, and com- plained much of a soreness in his bowels which gradually went off, by means of a slender diet, and cool mucilaginous liquors. This young man would probably have been suffered to die, without any assistance being called, had not a neighbour, a few days before, who had been advised to drink a bottle of spirits to cure him of an a^ue, expired under very similar circumstances. OF SUFFOCATION AND STRANGLING. These may sometimes proceed from an infraction of the lungs, pro- duced by viscid clammy humours, or a spasmodic affection of the nerves of that organ. Persons who feed grossly, and abound in rich blood, are very liable to suffocating fits from the former of these causes. Such ought, as soon as they are attacked, to be bled, to receive an emollient clyster, and to take frequently a cup of diluting liquor with a little nitre in it. They should likewise receive the steams of hot vinegar into their lungs by breathing. Nervous and asthmatic persons are most subject to spasmodic affec- tions of the lungs. In this case the patient's legs should be immersed in warm water, and the steams of vinegar applied as above. Warm dilut- ing liquors should likewise be drunk ; to a cup of which a tea-spoonful of the paregoric elixir, may occasionally be added. Burnt paper, feathers, or leather, may be held to the patient's nose, and fresh air should be freely admitted to him. Infants are often suffocated by the carelessness or inattention of their nurses.* An infant when in bed should always be laid so that it cannot tumble down with its head under the bed-clothes ; and when in a cradle, ought never to be covered. A small degree of attention to these two simple rules would save the lives of many infants, and prevent others from being rendered weak and sickly all their days by the injuries done to their lungs. Instead of laying down a plan for the recovery of infants who are * These accidents are not always the effects of carelessness. I have known an in- fant overlaid by its mother being seized in the ni„ht by an hysteric fit. This ougnt to serve as a caution ayainst employing hysteric women as nurses ; and should lii. >. wi-o teach such women never to lav an inlant in the same bed with themselves, l^t lu a bina.i sdjis-nt out. OF SUFFOCATION AND STRANGLING. 419 suffocated, or overlaid, as it is termed, by their nurses, I shall give the history of a case related by Monsieur Janin, of the Royal College of surgery at Paris, as it was attended with success, and contains almost every thing that can be done on such occasions. A nurse having had the misfortune to overlay a child, he was called in, and found the infant without any signs of life ; no pulsation in the arteries, no respiration, the face livid, the eyes open, dull, and tarnished, the nose full of snivel, the mouth gaping, in short, it was almost cold. Whilst some linen cloths and a parcel of ashes were warming, he had the boy unswathed, and laid in a, warm bed, and on the right side. He then was rubbed all over with fine linen, for fear of fretting his tender and delicate skin. As soon as the ashes had received their due degree of heat, M. Janin buried him in them, except the face, placed him on the side opposite to that on which he had been at first laid, and covered him with a blanket. He had a bottle of iau de luce in his pocket, which he presented to his nose from time to ti^ie ; and between whiles some puffs of tobacco were blown up his nostrils ; to these succeeded the blow- ing into his mouth, and squeezing tiglit.his nose. Animal heat began thus to be excited gradually ; the pulsations of the temporal arteries were soon felt, the breathing became more frequent and free, and the eyes closed and opened alternately. At length the child fetched somo s'-ghs expressive of his want of the breast, which being applied to h'n mouth he catched it with avidity, and sucked as if nothing had happened to him. Though the pulsations of the arteries were by this time very well re-established, and it was hot weather, yet Mr. Janin thought ic advisable to leave his little patient three quarters of an hour longer under the'ashes. He was afterwards taken out, cleaned and dressed as usual ; to which a gentle sleep succeeded, and he continued per- fectly well. Mr. Janin mentions likewise an example of a young man who had hanged himself through despair, to whom he administered help as effec- tually as in the preceding case. Mr. Glover, surgeon in Doctors commons, London, relates the case of a person who was restored to life after twenty-nine minutes hanging, and continued in good health for many years after. The principal means used to restore this man to life were, opening the temporal artery and the external jugular ; rubbing the back, moutlu aud neck, with a quantity of volatile spirits and oil; administering the tobacco clyster by means of lighted pipes, and strong frictions of the 1c while it loads the stomach, imparts little or no nourishment ; at the same time it is one of the most expensive articles of food that can be used. Many of the working people in London expend one third more in bread and cheese and porter, than would procure them palatable and nutritious dishes.* Roots and fruits form a large class of the substitutes for bread. In warm climates, these in general preclude the use of bread altogether. The inhabitants of South America use the plaintain, banana, and yam, either boiled or roasted, almost exclusively. In like manner, the natives of the South Sea Islands use the bread-fruit, now introduced into our West India colonies. Potatoes in this country form the principal substitute for bread. Still, however, they are not cultivated and used to the extent they ought to be. In Ireland, and a great part of Scotland, they are a principal article of diet; they are not so hearty a food as corn, but no man will perish for hunger who has potatoes. As they thrive on every soil, and are less liable than grain to suffer from the inclemency of the season, we must blame ourselves if we suffer a famine to exist. Indeed, no such thing can ever happen, if due attention be paid to the culture of this valuable root. A far greater quantity of farinaceous food can be raised on an acre of ground, than if sown with any sort of corn. Some of the stout- est men are brought up on milk and potatoes ; and Dr. Pearson, who has bestowed much pains in analyising this root, says, that potatoes and water alone, with common salt, will be complete nutriment. To render them a good substitute for bread, nothing more is required than * A labouring man will be very poorly fed with half a pound of cheese in the day: this costs .......................................................... 5(k Bread........................................!"!!!!!'. '. 4 Porter..............................,...............!!!!!!!! 10 ■ Is. 7d. Whereas he would he amply satisfied with a soup or stew made of ball a pound of beef, coaling ............... 4,1 Vegetables............................................. 9 Bread................................"'.'.'.'.".'.'.!'."".".!"."" 2 Porier...........................I" " ............... r Is. Id. CF diet. 445 simple boiling or roasting ; but when intended to serve as a meal, they require the addition of milk, butter, or gravy. Stewed mutton and pota- toes, known by the name of Irish stew, is a cheap, nourishing, and palatable dish. The excess of fat in the mutton, which would be other- wise lost, is advantageously absorbed in the potatoes. It is, however, to be observed, when potatoes are used, in stews or broths, they ought previously to be boiled, and the water thrown away, as it contains Botnething deleterious. Indeed, botanists have classed this as a species of night-ahade, which it is well known is ah active poison. After the potatoe, the Jerusalem artichoke deserves to be mentioned, not only as being somewhat of the same nature, but as being still more productive, and easily raised ; yet it is a root hardly known by the generality of people, so little has it been cultivated. This plant grows six or seven feet high, and has a number of roots attached to it like potatoes. Their taste being somewhat similar to artichoke-bot- toms, it has been called an artichoke: but why it has obtained the epithet of Jerusalem is not so evident, as it is a native of Brazil. The parsnip is reckoned one of the most nourishing of our esculent roots, as containing the greatest quantity of saccharine matter, and being at the same time of easy digestion. Carrots are something of the same nature as parsnips, but more solid, and harder of digestion. When properly cultivated, they grow large, succulent, and palatable, particularly in soups and stews. The culture of this root much deserves attention. The farmer would find it ex- tremely profitable, as well as a useful crop, to alternate with grain, and it is well known to be an excellent food for horses. Much of the oats they consume might be saved by this much less expensive substitute. It is also an admirable food for cows, and greatly enriches their milk. The turnip possesses little or no saccharine matter, and is therefore not so nutritive as several other roots. It is, however, wholesome and emulcent, when properly cultivated, and forms the principal article of food for cattle in the winter. Sahafy, skirrets, and several sorts of beets, particularly that called the root of scarcity, are pleasant, nutritious, and digestible. Cabbage, and other sorts of kale, including cauliflowers and brocoli, are all likewise useful and wholesome vegetables, although ratlier inclined to create flatulency, but which is completely corrected by a proper ac- companiment of meat. Onions have long been considered a most valuable vegetable. In Egypt, they were a favourite article of food four thousand years ago. They are in that country more sweet aud less pungent than here. The onious of Portugal have a similar quality. They are best drest simply 448 of diet. boiled, and are thus rendered mild, of easy digestion, and go off without leaving any disagreeable heat on the stomach and bowels. They also form a savoury addition in soups, as do also their pungent species shal- lots and garlic. The strong smell these roots communicate to the breath, may be remedied by eating a few parsley-leaves immed:ate!y after. The leek is somewhat similar to the onion, only that the stock may be used as a pot-herb as well as the root. Indeed it is one of the best, most savoury, and wholesome, of herbs. The Welsh are fond of it to enthusiasm, aud the Scots make an admirable dish, by stewing au old cock, a piece of corned beef, or both, with plenty of leeks. There are many other roots and plants, valuable for culinary pur- poses ; what we have mentioned, however, are the principal. It may be proper to observe that, were they better boiled than they generally are in this country, it would extract a considerable quantity of the air contained in them, and thus diminish their flatulence. We cannot conclude this article without observing, that every rea- sonable attention should be paid to the constitution and habit; and that the choice of food, for the preservation of health, and the support of the human frame, will depend, very frequently, on these previous considerations. A tendency to flatulence and windy affections in the stomach or intestines, must convince any rational mind of the impro- priety of excessive indulgence in those vegetable substances which naturally produce it. A propensity to animal food, on the contrary, must be no less pernicious, in the most common intimation of reason, as well as by the corroboration of experience, to the habit and constitution of others. In one respect, an accumulation of bile will be created ; in the other, the most dangerous symptoms of inflammation must cer- tainly follow. We will not disturb the feelings of our readers by alarming them without an evident necessity ; but we feel it our duty to impress upon their minds the great expediency of making themselves acquainted with the nature and peculiarities of their own constitution. After all that can be said, the most eminent physician must, in all chronical cases, whensoever it may be deemed advisable to consult him, be compelled to grope his way in the dark, without such a communica- tion as this knowledge would always afford.* In most cases also, the necessity of that advice would be prevented ; for, although we are un- willing to repeat to our friends the words of an ancient adage, its perti- nency is so fully impressed on our minds, that we think it cannot be re- * NaL" w*wi11 add- that> in a<5ute cases, and such as leave no time for hesitation, we d.uld adduce instances where a reserve of communication of previous habits, and tms uses and operations of previous medicines, must have been productive of luUl OF DIET. 447 gardcd or considered, by any rational person, without the fullest con- viction of its importance. Although the place of bread may be occasionally supplied by farina- ceous roots and other vegetables, yet we would by no means wish to discourage the culture of grain. The culture of grain is the culture of men. While the husbandman is raising food for his fellow-crea- tures, he is laying the foundation of health and longevity to himself and his offspring. While the manufacturer or artificer is sitting in an awkward posture, breathing confined, and perhaps contaminated air, the peasant rises with the sun, eats his wholesome meal of milk and farinaceous food, hies him to the field, where he spends the day in useful labour, inhales the fresh breezes, and at eve returns home with a keen appetite, to enjoy his simple repast and sound repose. No manufacture enriches a nation so much as the culture of grain ; nor is it subject to the uncertainty of other manufactures, which often depend on the caprice of fashion, a3 the necessaries of life always find their value somewhere. Were pro, er encouragement given to agricul- ture, Britain would at all times, not only have a sufficiency of grain for home consumption, but a surplus for exportation. This would contri- bute more to her real wealth, the happines3 of her people, and the stability of her government, than the increase of her manufactures and trade, or* the extension of her territory. It is matter of regret that Britain, at a time when agriculture is cultivated as a science, should not raise grain for the supply of her own inhabitants, but be obliged to depend on foreign states for this essential necessary of life. Until an adequate remedy can be found for this evil, the free use of the various substitutes for bread must tend to ame- liorate the situation of the poor, and to lessen the price of labour. The great consumption of animal food, and the immense number of horses which are kept in this country, greatly increases the scarcity of grain. Their number has been computed at two millions, and every horse on an average, is supposed to consume the produce of three fertile acres, consequently, the produce of six millions of acres, is annually consumed by them ; this land would produce more grain than is suffi- cient to maintain half the inhabitants of Great Britain. Two hundred and sixty thousand of these animals are kept for pleasure. It may be said that they contribute to health ; but this we deny. Did our lad.es of fashion and fine gentlemen make use of their limbs instead of being dragged about in carriages, they would both benefit themselves and the public APPENDIX: CO*TA!l«ll«e A Litl of Simples, and of such Medical Preparations as are commonly used in Prac- tice, with their proper Doses. ALM The Method of preparing and compounding such Medicines as are recommended in a former part of the Book, with the addition of several others of a similar nature: AMD Eemarkt on the Doses, Uses, and Manner of applying the different Preparations. INTRODUCTION TO THE APPENDIX. Ignorance and superstition have attributed extraordinary medical virtues to almost every production of nature. That such virtues were often imaginary, time and ex- perience have sufficiently shown. Physicians, however, from a veneration for anti- quity, still retain, in their list of medicine, many things which owe their reputation entirely to the superstition and credulity of our ancestors. The instruments of medicine will always be multiplied in proportion to men's ignorance of the nature and cause of diseases; when these are sufficiently under- stood, the method of cure will ba simple and obvious. Ignorance of the real nature and permanent properties of those substances employed in the cure of diseases, is another reason why they have been so greatly multiplied. Physicians thought they could effect, by a number of ingredients, what could not bd done by any one of them. Hence arose those amazing farragos which have so Ions} disgraced the medical art, and which were esteemed powerful in proportion to the number of simples that entered their composition. The great variety of forms into which almost every article of medicine has been manufactured, affords another proof of the imperfection of the medical art. A drug which is perhaps most efficacious in the simplest form in which it can be nduiinis- t red, has been nevertheless served up in so many different shapes, that one would be induced to think the whole art of physic lay in exhibiting medicine under as many different modes as possible. Different forms of medicine, no doubt, have their use; but they ought never to be wantonly increased. They are by no means so necessary as is generally imagined. A few grains of powdered rhubarb, jalap, or ipecacuanha, wUl actually perform ad that can be done by the different preparations of these roots, and may also be exhi- bited in as safe and agreeable a manner The same observation holds with regard to the ftruvian bark, and of many other simples of which the preparations are very numerous. Multiplying the ingredients of a medicine not only renders it more expensive,but ■'.so less certain, both in its dose and operation. Nor is this all. The compouuj 8 o • <50 INTRODUCTION TO THE APPENDIX. when kept, is apt to spoil, or acquire qualities of a different nature. When a medicine is rendered more safe, efficacious, or agreeable, by the addition of another, they ought, no doubt, to be joined; in all other cases, they are better kept asun- der. The combination of medicines embarrasses the physician, and retards the pro- gress of medical knowledge. It is impossible to ascertain the precise effect of any one medicine, as long as it is* combined with others, either of a similar or dissimilar nature. In the exhibition of medicine, regard should not only be had to simplicity, but likewise to elegance. Patients seldom reap any benefit from things that are highly disagreeable to their senses. To taste or Bmell like a drug, is become a proverb; and, to say truth, there is too much ground for it. Indeed, no art can take away the disagreeable taste and flavour of some drugs, without entirely destroying their efficacy; it is possible, however, to render many medicines less disgustful, and others even agreeable; an object highly deserving the attention of all who administer medicine. The design of the following pages is, to exhibit such a list of drugs and medicines as may be necessary for private practice. They are considerably more numerous indeed than those recommended in the former part of the book, but are still greatly within the number contained in the most reformed dispensatories. The same medi- cine is seldom exhibited under different forms ; and where different medicines an- swer nearly the same intention, there is commonly no more than one of them re- tained. Multiplying forms of medicine for the same intention, tends rather to bewilder than assist the young practitioner, and the experienced physician can never be at a loss to vary his prescriptions as occasion requires. The chemical aud other difficult preparations are for the most part omitted. All of them that are used by any private practitioner are not worth preparing. He will buy them much cheaper than he can make them. Great care, however, is neces- sary to obtain them genuine. They are often adulterated, and ought never to be purchased unless from persons of known veracity. Such of them as are in common use are inserted in the list of drugs and medicines. Their proper doses and man- ner of application are mentioned in the practical part of the book, wherever they are prescribed. Such articles of medicine as are to be found in the house or garden of almost every peasant, as barley, eggs, onions, &c. are likewise for the most part omitted. It is needless to swell a list of medicines with such things as can be obtained when- ever they are wanted, and which spoil by being kept. The preparations made and sold by distillers and confectioners are also generally left out. These people, by operating upon a larger plan, generally make things better while it is in their power to afford them much cheaper than they can be prepared by any private hand. The quantity ordered of every medicine is as small as could well be prepared, both to prevent unneeesary expense, and that the medicine might spoil by keeping Almost every medicine suffers by being kept, and should be used as soon after it has been prepared as possible. Even simple drugs are apt to spoil, and should therefore be laid in in small quantities; they either rot, are consumed by insects, or evaporate so as to lose their peculiar taste or flavour, and often become quite insig- nificant. , • In the preparation of medicines, I have generally followed the most improved dis- pensatories; but have taken the liberty to differ from them wherever my own obser- vations, or those of other practical writers on whose judgment I could depend, sug- gested an improvement. INTRODUCTION TO THE APPENDIX. 43. In several compositions, the ingredient on which the efficacy of the medicines prin- cipally depends is Increased, while the auxiliaries, which are generally ordered in such trifling quantities as to be of no importance, are left out, or only such of them retained as are necessary to give the medicine a proper consistence, or the like. The colouring ingredients are likewise for the most part omitted. They increa=# the bulk and price of the medicine without adding any thing to Its value. It would be well if they were never used at all. Medicines are often adulterated for the sake of a colour. Acrid and even poisonous substances are, for this purpose, sometimes introduced into those medicines which ought to be most bland and emol- lient. Ointment of elder for example, is often mixed with verdegrise to give it a fine green colour, which entirely frustrates the intention of that mild ointment, Those who wish to obtain genuine medicines should pay no regard to their colour. Some regard is likewise paid to expense. Such ingredients as greatly increase the price of any composition, without adding considerably to its virtue, are gene- rally either omitted, or some- what less expensive substituted in their place. Medi- cines are by no means powerful in proportion to their price. The cheapest are often the best; besides, they are the least apt to be adulterated, and are always most rea- dily to be obtained. With regard to the method of compounding medicines, I have generally followed that which seemed to be the most simple and natural, mentioning the d.fferent steps of the process in the same order in which they ought to betaken, without paying an Implicit regard to the method of other dispensatories. For many of the remarks concerning the preparation, 4c. of medicine I have been obliged to the author of the New Dispensatory. The other ohservat.on. are either such as have occurred to myself in practice, or have been suggested » the lourse of reading, by authors whose names I am not able distinctly to recollect. I haveSowed the a.phapetical order, both with regard to the simples and prepa- rations A more scieni method would have been agreeable to some persons, bu r^fuuo the generality of ^J^^^Z^^ r,ddrrfl?stT la"9;:0fzt-z: riu-s o„ght to *~-. *. r \ZLT HZ ** advantages arising from thU — ■—£ d0 not appear equal to that ^^^i^SSi-,. book, to find out any article ; «hlch, by the' ^"*" ' nece9Sary. Whe„ Tha dose of every;-££—£ CS^ * - - —»»; S^ioned^ ^rnitit^rr of ^z^z^^, «*—— ness here is by no means necessary. proportional doses to the differ- Several attempts have ^^^^J^ ^ that can be said on this sub- ent ages and constitutions of patient . ^ ^ ^ ^^ ^q admin. jsct, a great deal must be left,t thsjud^ may be observed; but they Isters the medicine. ^Jf^JZ^ I i«ent between twenty and fourteen are by no mean, intended for exact nU J>> ^ ^^ ^ nine> one. may take t--tWrd90,^h;;.rd;r^Utofour. one-fourth ; from four to two. half; from nine to s«, «^^ "^ belo#one. a twelfth. one-sixth: from two to one . tenth^ ^ ^ mthm wh„ t9 452 INTRODUCTION TO THE APPENDIX. so grjat an attachment to that language, as first to write their recipes In It, and afterwards translate them; while others, to compromise the matter, write the one half in Latin, and the other in English. What peculiar charm a medical prescrip- tion, when written in Latin, may have, I shall not pretend to say; but have ven- tured to make use of the plainest English I could, and hope my prescriptions will succeed no worse for it. N. B. The Apothecary's weights, and the English wine measures are used throughout the whole book, the different denominations of which will appear from the following Table: A pound contains twelve ounces An ounce........eight drams A dram ........three scruples A scruple........twenty grains A gallon........eight pints A pint ........sixteen ounces An ounce........eight drams A spoonful is the measure of half an ounce. A LIST OP SIMPLES, 4I.TJ 01 SUCH MEDICAL PREPARATIONS AS OCGHT TO BB KEPI IV BBADIKES6 BOB PBIVATE PBACI1CB. AOARIO Alum Antimony, crude ' cinnabar of ■■ sulphur ot Balsam of Capivi - of Peru ■ of Tola Bark, cascarilla ■ cinnamon ■ Mezereon . Peruvian ------Winter's or canella alba Borax Calamine stone, levigated Castort Russian Caustic, common . lunar Earth, Fuller's . Japan .-----Armenian bole . French ditto Extracts of gentian . guaiacum ________— hellebore, blaok _-------— hemlook —---------jalap _ liquorice _______Peruvian bark —--------■ poppies __________wormwood Flowers of camomil* _ coltsfoot ._____--— elder _______— rosemary .___._____damask roses . rod ditto Fruits, almond _____. bitter apple ._____cassia flstularis ,_____Curasso oranges ______figs dried „ __—, Frenoh prunes ______Jamaica pepper . - Juniper berries Fruits, nutmegs ——— tamarinds Gum, aloes . ammoniac, in tears —— arabio ■ assafoetida » camphor . galbanum . gamboge —— guaiacum . kino ——- myrrh — opium Hartshorn, calcined ■ ■ shavings at Herbs, lessers centaury .. — — peppermint ——— spearmint . penny-royal ——— savin — trefoil ——— uva ursi . wormwood Load, litharge . ■ ■ white . sugar of Lemon-peel Mace Magnesia alba Manna Mercury, crude . calcined • JJthiop's mineral _,_____• oalomel .______. corrosive sublimate ._______red preeipitate ,______- white ditto * Musk Oil, essential, of ambor ___________» of anise -____. of cinnamon ,____________■ of Juniper _._____-___- of lemon-peel ____________of peppermint —. expressed, of almonds m APPENDIX. Oil expressed of linseed — of olives, of Florence oil — of palms — of turpentine Orange peel Oyster-shells, prepared Poppy-heads Resin, benzoin ■ ----flowers . Burgundy pitch . dragon's blood -----frankincense —— liquid storax ——— white, or resin ——— scammony Roots, birthwort ■ calamus aromaticus ------contrayerva ■ garlio —— gentian ------ginger —— hellebore, black, white ■-----jalap —— ipecacuanha —— lily, white —— liquorice ——— marshmallow —— mezereon ——— rhubarb ■ sarsaparilla -----■ seneka -----squills ■ tormentil ■■ turraerio ■ Virginian snake ——— wild Valerian • ' zedoary Saffron Sal ammoniac, crude -------------volatile Bait Epsom — of Olauber — of Hartshorn — nitre purified or prune! —— polychrest — Rochel —— of tartar Seeds, anise Seeds, caraway . cardamom . coriandor ------cummin ■ mustard ------sweet fennel ------wild carrot Senna Spanish flies Spermaceti Spirits, cethereal or sether -------of hartshorn i lavender,com pound • nitre ———— ditto dulcified ■ sal ammoniac ' sea salt ——— vinegar ————— vitriol -------■— wine rectified ----------volatile aromatio Steel, filings of -----rust of, prepared —— soluble salt of Sulphur vivum ——— balsam of —■—-- flowers of Tar —— Barbadoea Tartar, cream of —■ — emetio ——— soluble ■ vitriolated Tin prepared Tutty levigated Turpentine, Venice Verdegrise Vitriol, green ——— blue -------white Wax, white —— yellow Woods, guaiaenm ■ logwood ■ sassafras ——— sanders, red Zinc, flowers of GENERAL CATALOGUE OF MEDICINES IN COMMON USE; According to their English names; with their Dosrs. -------000------— N. B. The dozes here set down are the smallest and the largest usually given to adults, or full grown persons; for younger persons and infants, the dose munt be reduced in the proportions mentioned in the Appendix, pago 451, but must always be regulated by the strength as well as the age of tho patient. • iCr The New Names of Drugs are in Italics. Acid, the acetous ............................from 1 soruple to ------muriatic (spirit of salt) ...................... 10 drops ------uttrout diluted (aquafortis) .................. 10 drops ------vitriolio diluted ............................ 15 drops ^Sther vitriolic ....................................30 drops ■flSthiop's mineral. See Quicksilver with Sulphur Aloes ......................'...................... 6 grains . Alum.............................................. 0 grains ,-----burned ...................................... 3 grains . Amber prepared .................................. 4 dram Ammonia prepared (volatile salt of ammoniac)........ 1" grains Ammoniao gum.................................... 5 Kraina ----------milkof................................ 4 oz- Angelica powdered. ................................ J dram Anise, the seeds of...............................10 grains . Antimony........................................ 10 «rains _________. calcined (calx of antimony)................ 10 grains .__________glassof ............................•••• *6r,im ._________powder of, a succedaneum for Dr. James's ) 4 grams fever powders..................................' It often produces nausea and vomiting f i grain __________tartarised (tartaf emetic) ..............^ j gram . ,., ................ 6 grains Assafoetida ........................ , _________milkof ................................ »°"\ Asarum, powder of, to provoke sneezing............ ^ B«ins Balsam of capivi.................................'. "i senile ------Canadian ............................ _„ ___.— of Peru *.............................. * . . ....... 6 grains ______ofTolu ........................... . IJark, Peruvian, See Cinchona ..................... '"^ Uear's foot powder ......................'.'.'.'.'.'.'.'." 4 grains Benzoin, resin of .......................... I dram 40 drops 40 drops 49 drops . 2 dranrs .30 grains .^1) graius .12 grains . 1} dram . 1 scruple , .:>0 graius . 1 oz. . 1} dram . 1 dram .. 1 dram ..40 grains ,. H grains .. 15 grains , 4gr.emet. , J gr.alter. . i dram . 1 os. .CO drops . 1 dram .30 grains <30 grains . 2 drams ,.J0 grains ,.20 grains 156 MEDICINES TN COMMON USE, Benzoin, flowers of...........................from 5 grains to 15 grain* Bistort, powder of ................................ 1 scruple .. 1 dram BoleArmenian .................................... 10 grains .. 2 drama ____French...................................... 1 dram .. 2 drama Borax ............................-................ 10 grains ..10 grains Broom, ashes of the tops .......................... 1 scruple .. 1 dram Burdock, powder of the root ...................... 10 grains .. 1 dram c 1 grain .. 3 gr.alter. Calomel ...................•....................{ 3 grains ..lOgr.pur-. Camomile in powder .............................. 15 grains .. 2 scruples Camphor.......................................... 2 grains .. J dram Canellaalba ...................................... 1 scruple .. 2 drams Cantharides ...................................... i grain .. 3 grains Caraway seeds .................................;•• 5 grains ..20 grains Cardamoms....................................v 6 grains ..20 grains Casearilla bark powder ............................ 10 grains ..40 grains Cassia, the pulp................................... 2 drams .. 1 oz. Castor ........................................... 3 grains .. 1 scruple Catechu (Japan earth).............................. 20 grains .. 1 dram Ceruse acetated (sugar of lead) .................... £ grain .. 2 grains Chalk'.....•........................................20 grains .. 2 scruplsa Cinchona powder (Peruvian bark) .................. 2 scruples ..2 drama Cinnamon ........................................ 5 grains .. 1 dram Columbo powder .................................. 10 grains .. I dram Confection aromatic (cardiac confection .........' .. 15 grains .. 1 dram ■ opiate (London Philonium)................ 10 grains .. i dram Conserve of arum.................................. 1 scruple .. 1 dram ---------hips ...............................j ---------oranges ..............................> as much, as you please — roses ................................? ---------squills................................. 1 scruple .. 1 dram ■ wood sorrel ............................ $ oz. - .. 1 oz. Contrayerva..................................... 10 grains .. 1 dram Coriander seed.................................... 1 scruple .. 1 dram Cowhage, the spicnla contained in one pod, mixed) . . ... .^' r . >or5 grams ..10 grams with honey or molasses ......................) Crabs'claws, prepared ............................10 grains .. 1 dram Dandelion, expressed juice ........................ 1 oz. .. 2 oz. Decoction of hartshorn (white decoction.............. 1 oz. .. 6 OS. Decoction of broom tops: one ounce slightly boiled in a pint and a half of water to a pint: strain the li- quor.To be taken by tea-cupfuls at a time cinchona, decoction of Pe-rnvian bark...... 1 oa. .. 4 oz. ■ the inner bark of elm...................... 4 oz. . .16 oz. daily -------sarsaparilla.............................. 4.oz. .. 16oa.daily -------• of guaiacum, three drams to a pint of water.. 1 pint or more daily Electuary of cassia ................................. 1 dram* .. 1 oz. -----------scammony ............................20 grains .. I dram -----------»enna(lenitive electuary)................ £ dram .. 1 dram Elecampane, powder of the root....................20 grains .. 1 dram Extract of caacarilla ..............'................ 10 grains .. i dram WITH THEIR PROTER DO*E?. Extract of cinchona (extract of Peruvian bark ...from 10 grains ----------broom-tops ............................ 4 dram ■---------camomile .............................. 1 scruple ----------colocynthcompound (cathartic extract) .... 5 grains ——------gentian ................................ 10 grains ----------guaiacum .............................. 10 grains ----------black hellebore.......................... 2 grains ----------jalap .................................. 10 grains ----------liquorice................................ 1 dram — logwood ........ ....................... 10 grains ----------white poppies .......................... 1 grain ----------rue .................................... 10 grains ----------savin .................................. 10 grains ----------senna ................................. 10 grains Fouuol-secd........................................ 1 scruple Fern, powder of the root .........................• J dram Fox-glove, powder of tho leaves .................... i grain or a dram infused in a pint of boiling water, of which the dose is an ounce, once, twice, or thrice a-day. This should be used with great care and circum- spection. Gal bun ura.............................•...... Galls.............................. ...... Garlic, cloves of, stripped of tho exterior skin Gentian .................................... Germander........................................ 15 grains .......................... 6 grains ............................ 20 grains A 57 to i dram .. 1 dram .. 1 dram ..25 grains .. i dram .. 1 scruple ..10 grains .. I scruple .. 3 drama .. J dram .. 6 grains .. 1 scruple .. a dram .. I dram .. 1 dram .. | oz. .. 3 grains 10 grains 10 grains No. I. 10 grains Ginger............. Ginseng' ........... Guaiacum jjum-resin Gum arabio........< ----gamboge ..... Hartshorn, prepared 10 grains 15 grains 2 grains 1 scruple liquor volatile of, (spirits of hartshorn...... j dram salt of .................................. lOfwiiis Hellebore black 5 grains Hemlock, powdered leaves of ..................... 2 grains ________inspissated juice of ........................ 1 grain Begin these in small dosoa, and gradually increase as the constitution will bear. Honey of roses ..............................' __——. squills ............................. Jalap powder .......................""""'" Infusion of gentian compound (bitter infusion).. Infusion of roses, (tincture of roses) .......... ,--------senna ............................... Ipecacuanha ................................ Iron, rust of, prepared ...................... ____ammoniated, (martial flowers) ............ „__. tartarized........................... j_ vitriolated, (salt of Mara) ............. Kino, gum .................................. 1-dram 10 grains 10 grains 3 os. 9 os. 2 os. 10 grains 0 grains 4 grains 3 graius t grain lr grains ,.30 grains ,.20 grains .. No. V. .. 2 scruples ,. 1 dram ,.20 grains ..30 graius ..90 grains .. 1 dram ..10 grains .. 1 dram ,. 8 drums ..20 gruina ..10 (Trains ..15 grains .. 6 graius .. S drams .. 3 scruples ..30 grains .. 4 oz. .. 8 oz. .. 4 o>. ,. 30 grains ..25 (Tains .. 1 scrupie ..10 grains .. 5 grains .. J draiu 453 MrmciNrcs in common use, lOrraes, juice of ..............................from 1 dram Lichen, ash coloured, pround ...................... 8 graina ■ Icelandic,a strong decoction of................ 1 °z- Linseed, an infusion of one ounco to a quart of boil- ing water may be drank in cupfuls at pleasure Mace.............................................. 10 grains Madder, powder of ................................ i dram Magnesia, white.................................... i dram ---------calcined ................................ 1 scruple _________viIriolated, (bitter purging salt, or Epsom salt) 2 drams Manna ............................................ i oz- Mastich, gum...................................... J scruple Milk of Almonds (common emulsion)................ 1 oz. Millipedes ........................................ 20 grains Mixture camphorated (camphor jalap)................ £ oz. Musk.............................................. 2 grains -----mixture (musk jalap) ........................ J oz. Mustard seed...................................... 1 dram Myrrh gum........................................ 10 grains Natron prepared (soda salt) ........................ 10 grains Natron tartxrized (Rochcl salt.....->............... J oz. Natron vitriolated (Glauber's salt) .................. i oz. Nitre purified...................................... 10 grains Nutmeg .....................................;•••• 5grains Oil of almonds .................................... i oz. —— castor.........••.......................... 2 drams ------linseed...................................... i oz. Olibanum.......................................... 10 grains Opium purified (thebaic extract) .................... i grain, 1 In hydrophobia, frenzy, and some other desperate diseases, the dose may be augmented. Opoponax........................*................. 10 grains Oxymel of eolichicum.............................. A dram Petroleum ........................................ 10 drops Pills, aloetic compound ............................ 10 grains ----of the gums .................................. 10 grains ----quicksilver (mercurial pills) .................... 10 grains Pomegranate rind, powder of........................ 1 scruple Powder of aloes with canella (hiera picra) ............ £ scruple -------------with guaiacum ...................... A scruple ---------contrayerva compound .................. 15 grains ——— chalk compound .................... ... § dram ---------------with opium..................... 1 scruple ---------crabs' claws compound .................. 1 dram ---------ipecacuanha compound (Dover's powder).. £ scruple Quassia............................................ 5 graius Two drams to a pint of boiling water, and of cloves 1 one dram, for an infusion: dose..............f Quicksilver crude (mercury) ........................ £ oz. ———— calcined (calcined mercury).............. § grain with chalk............................. 10 graina to 3 drams ..40 grains .. 4 oz. .. 1 scruple .. 1 dram .. 2 drams .. 1 dram .. 1 oz. .. 2 oz. .. I dram .. 4 oz. .. 2 drams .. 2 oz. ..1 scruple .. 1] oz. .. 1 oz. .. 1 dram .. | dram .. I oz. .. 1 oz. .. J dram .. 1 scruple .. 1 oz. .. 1 oz. .. 1 oz. .. I'jrtram grain, 3 grains . £ dram . 1 dram .30 drops .25 grains .. £ dram ,. 1 scruple . 1 dram . 2 scruples . 1 scruple ,. £ dram .. 1 dram . a scruples . 2 drama .. £ dram ,.M grains .. 2 oz. .. 4 oz. .. 11 grains' .. J drain WITH THEIR PROPER DOSES. 4:3 Quicksilver, cinnabar of.......................from 6 grains ----------muriuted (corrosivesublimate).... ....... i grain *■ ■" with sulphur (Ethiop'smineral)............ 1 scrapie ----------vitriolated (yellow emetic mercury) ...... £ grain ----------vitriolated, as sternutatory................ 1 grain ----■----------------as emetio .................... 2 grains Quince-seeds, mucilage of, at pleasure; to obtund acrimony Rhubarb, powder of................................10 grains Resin yellow ...................................... 3 grains Rue powder........................................ 1 scruple fct. John's wort.................................. 20 grains Saffron............................................ 6 grains Sagapenum........................................ 10 grains Sal ammoniac..................................... 8 grains Baltof tartar ...................................... 10 grains Sarsaparilla, powder of ............................ 1 scruple Scammony ......................................*•• 6 grains Seneka............................................ 1 scruple Soap ............................................. £ dram Spirit of ammonia (sweet spirit of sal aminoniao) .... 1 dram ■ ammonia compound (volatile aromatio spirit) .. £ dram —— ammonia fostid (volatile foetid spirit).......... £ dram ------nitrous other (dulcified spirit of nitre)........ £ dram ______vitrioUo other (dulcified spirit of vitriol)...... £ dram Sponge, burnt......................■■............... 1 scruple Squillfresh........................................ 5 grains Sulphur, flowers of ................................20 grains ________precipitated (milk of sulphur)................ 1 dram ____________________of antimony .................. 1 grain Syrup of buckthorn ........ ....................... 1 dram --------ginger .................................... 1 dram --------poppies .................................. ldram .................... the same to 30 graina • • £ train .. 1 dram .. a jr. alter, .. 3 graina ..8 grains . 2 scruples . 1 scruple . 2 scruples . 1 dram .20 grains .30 grains . 1 scruplo . £ dram . 1 dram . 1 scruple . 2 scruples . \ oz. . 2 drama ,. 1 dram . 1 dram . 2 drams . 2 drama .. 1 dram ..12 graina .. 1 dram .. 2 drams ,. 5 grains .. 3 drums .. 2 drams .. 2 drains Syrups in general Tartar, cream of Tar water....... Tin, powder of... Turmeric 2 drams a pint daily 1 scruple £ scruple 1 os. Turpentine, spirit of................................ 0 drops Tincture of aloes .................................. ■ °z' ________________compound (elixir of aloes).......... i dram __________amafatida (foetid tinoture)............... £ dram __________benzoin compound (traumatio balsam)...... 10 drops __________cantharide............................... * soruPle __________cardamom* (oompound stomaohio tincture) ldram t„_ .................. £ dram __________castor ................................ __________catechu (Japan Earth) .............. ,__________cinchona (Tincture of Peruvian bark) ________— columba ....'........................ __________gentian compound (bitter tincture)........ 1 dram m_________ guaiacum ammoniated tincture guiaiacum I dram 1 dram 1 dram 1 dram .. 1 dram .. 1 dram ..15 drops .. 1 oz. .. 8 drams .. 2 drams ..40 drops .. 1 dram ..3 drams .. i£ drams .. 2 drams .. £ oz. .. 3 drams .. 3 drams .. i oz. ^CO MEDICINES IN COM.MON USE, ETC. Tincture of black hellebore ....................from 1 scruple to I dram ---------julap .................................. ldram .. £ oz. — ■ myrrh..................................30 drops ..2 drams --------- opium (thebaic tincture)..................10 drops . .40 drops ---------------camphorated (paregoric elixir)...... ldram .. £ oz. ---------rhubaxb ................................ * °*» .. 2 oz. ----------senna .................................. 2 drams .. 1 oz. __________snake-root .............................. ldram .. 2 drams ______—valerian...............................• ldram ..3 drams Valerian, powder of...............................• 1 scruple .. 2 drains Vinogar distilled.................................... ldram .. £ oz. ------of squills.................................... £ dram .. 1£ drams ---------------as an emetic..................... £ oz. .. 1 oz. Vitriol, blue, (vitriolated copper) .................. i grain .. 2 grains ------------violently emetio...................... 5 grains .. 1 scruple Uva ursi, in powder................................ 15 grains .. ldram Water, the simple distilled waters may generally be given £ oz. .. 2 oz. Wine of aloes (sacred tincturfi)...................... £ oz. .. 1 oz. --------antimony..................................20 drops .. 2 drar/.s --------ipecacuanha.............................. ldram .. 1£ oz. --------rhubarb (vinous tincture of rhubarb I........ £ oz. .. 2 oz. Winter's bark, or canella alba...................... 1 scruple ..2 drains Worm-seed........................................ £ dram ..ldram Zinc calcined (flowers of zinc)...................... 1 grain .. S graii:s ----vitriolated (white vitriol, orsalt of vitriol as a tonic) 1 grain .. 5 grains • ■■ as a quickly operating emetic incases ) ,. . „ . .. ... , : r „ , > 10 grams .. J dram of poison or the like being swallowed............> MEDICINAL PKEPAEATIONS. BALSAMS. Tub subject of this section Is not the natural balsams, but certain compositions, which, from their being supposed to possess balsamic qualtities, generally go by that name. This class of medicines was formerly very numerous, and held in great esteem. Modern practice, however, has justly reduced it to a very narrow compass. Anodyne Balsam.—Take of white Spanish soap, one ounce; opium unprepared, two drams; rectified spirit of wine, nine ounces. Digest them together in a gentle heat for three days ; and strain off the liquor, and add to it three drams of camphor. This balsam, as its title expresses it, is intended to heal pain. It is of service in violent strains and rheumatic complaints, when not attended with Inflammaiion. It must be rubbed with a warm hand on the part affected; or a linen rag, moistened with it, may be applied to the part and renewed every third or fourth hour till the pain abates. If the opium be left out, this will be the Saponaceous Balsam. Locatelli'* Balsam.—Take of olive oil, one pint; Strasburg turpentine and yellow wax, of each half a pound; red sanders, six drams. Melt the wax^with some part of the oil over a gentle fire; then, adding the remaining part of the oil of turpen. tine, afterwards mix them in the sanders, previously reduced to a powder, and keep stirring together till the balsam is cold. This balsam is recommended in erosions of the Intestines, the dysentery, haimorr- hages, internal bruises, and in some complaints of the breast Outwardly It is used for healing and cleansing wounds and ulcers. The dose, when taken internally, is from two scruples to two drams. The Vulnerary Balsam.—Take of benzoin powdered, three ounces ; balsam of Peru, two ounces; hepatic aloes, in powder, half an ounce ; rectified spiriu>f wine, two pints. Digest them in a gentle heat for three days, and then strain the balsam. This balsam, or rather tincture, is applied externally to heal rececent wounds and bruises. It is likewise employed internally to remove coughs, asthmas, and other complaints of the breast j it is said to ease the colic, cleanse the kidneys, and to heal internal ulcers, &c The dose is from twenty to sixty drops. This though a medicine of some value, does not deserve the extravagant encomi- ums which have been bestowed on it. It has been celebrated under the different names of the Commander's balsam, Persian Balsam, Balsam of Borne, We. Balsam, Friar's Balsam, Jesuit's Drops. Torlington's Drops, He. BOLUSES. A8 boluses are intended for Immediate use, volatile salts, aud ether ingredients toproper for being kept, are admitted into their composition. The, are genera ly imposed of powders, with a proper quantity of syrup, conserve, m-icilage. 1.* Ughterpowden are commonly made up with syrup, and the more ponderous, as prcurv &c with conserve ; but those of the lighter kind would be more convent. Ti made up with mucilage, as it increases their bulk less than the other additions, .nd'likewise occasions the medicine to pass down more easily, 4C2 BOLUSES AND CATAPLASMS. Astringent Bolus.—Take of alum, in powder, fifteen grains; gum kino, five grains ; syrup a sufficient quantity to make a bolus. In an excessive flow of the menses, and other violent discharges of blood pro- ceeding from relaxation, this bolus may be given every four or five hours, till the discharge abates. Diaphoretic Bolus.—Take of gum guaiacum in powder, ten grains; flowers of sulphur and cream of tartar, of each one scruple : simple syrup, a sufficient quantity. In rheumatic complaints, and disorders of the skin, this bolus may be taken twice a-day. It will also be of service in the inflammatory quinsey. Mercurial Bolus.—Take of calomel, six grains; conserve of roses half a dram. Make a bolus. Where mercury is necessary, this bolus may be taken twice or thrice a-week. It may be taken over night; and if it does not operate, a few grains of julap will be pro- per next day to carry it off. Bolus of Rhubarb and Mercury.—Take of the best rhubarb in powder, from a scruple to half a dram; of calomel from four to six grams; simple syrup, a suffi- cient quantity to make a bolus. This is a proper purge in hypochondriac constitu- tions ; but its principal intention is to expel worms. AVhere a stronger purge is necessary, julap may be used instead of the rhubarb. Pectoral Bolus.—Take of spermeceti, a scruple; gum ammoniac, ten grains: salt of hartshorn, six grains ; simple syrup, as much as will make them into a bolus. This bolus is given in colds and coughs of long standing, asthmas and beginning consumptions of the lungs. It is generally proper to bleed the patient before he begins to use it.* Purging Bolus.—Take of julap, in powder, a scruple; cream of tartar, two scruples. Let them be rubbed together, and formed into a bolus, with simple syrup. Where a mild purge is wanted, this will answer the purpose very well. If a stronger dose is necessary, the julap may be increased to half a dram or upwards. CATAPLASMS AND SINAPISMS. Cataplasms possess few or no virtues superior to a poultice, which may be so made as in most cases to supply their place. They are chiefly intended either to act as discutients, or to promote suppuration; and as they may be of service in some cases, we shall give a specimen of each kind. Discutient Cataplasm.—Take of barley meal six ounces; fresh hemlock leaves, bruised, two ounces; vinegar a sufficient quantity. Boil the meal and hemlock in the vinegar for a little time, and then add two drams of the sugar of lead. Ripening Cataplasm.—Take of white lily root, four ounces; fat figs and raw onions, bruised, of each one ounce; yellow basilicum ointment, two ounces; gum galbanum, half an ounce ; linseed as much as necessary. Boil the roots along with the figs in a sufficient quantity of water, then bruise and add to them the other ingredients, so as to form the whole into a soft cataplasm. The galbanum must be previously dissolved with the yolk of an egg. Where it is necessary to promote suppuration, this cataplasm may be used by those who choose to be at the trouble and expense of making it. For my part, I have never found any application more proper for this purpose than a poultice of bread and milk, with a sufficient quantity of either boiled or raw onion in it, and softened with oil or fresh butter. Sinapsismt.—Sinapsisms are employed to recall the blood and spirits to a weak part, as in the palsy or atrophy. They are also of serv.ce in deep seated pains, i* CLYSTERS. 4G3 the sciatica, iic. When the gout seizes the head or the stomach, they are applied to the feet to bring the disorder to these parts. They are likewise applied to the pa- tient's soles in the low state of fevers. They should not be suffered to lie on, how- ever, till they have raised blisters, but till the parts become red, and will continue so when pressed by the finger. The sinapsism is only a poultice made with vinegar instead of milk, and rendered warm and stimulating by the addition of mustard, horse-radish, or garlic. The common sinapsism is made by taking cram of bread and mustard seed in powder, of each equal quantities ; strong vinegar, as much as is sufficient, and mixing them so as to make a poultice. When slnapsisms of a more stimulating nature are wanted, a little bruised garlic may be added to the above. CLYSTERS. This class of medicines Is of more importance than is generally imagined. Clysters serve not only to evacuate the contents of the belly, but also to convey very active medicines into the system. Opium, for example, may be admiuisterered in this way when it will not sit on the stomach, and also In larger doses than at any time it can be taken by the mouth. The Peruvian bark may likewise be, with good effect, administered in the form of clyster to persons who cannot take it by the mouth. A simple clyster can seldom do hurt, and there aro many diseases where it may do good. A clyster even of warm water, by serving as a fomentation to the parts, . may be of considerable service in inflammations of the bladder and the lower inte3 tines, &c. Some substances, as the smpke of tobacco, may be thrown into the bowels In this way, which cannot be done by any other means whatever. This may be easUy effected by means of a pair of hand-beUows, with an apparatus fitted to them for that purpose. Nor is the use of clysters confined to medicines. Aliments may also be conveyed in this way. Persons unable to swallow, have been for a considerable time sup- ported by clysters. Emollient Clyster.-Take of linseed tea and new milk, each six ounces. Mix them. If fifty or sixty drops of laudanum be added to this, it will supply the place of the Anodyne Clyster. Laxativ, Clyster.-Take of milk and water, each six ounces; sweet oil or fresh butter, and brown sugar, of each two ounces. Mix them. If an ounce of Glauber s saltor two table-spoonfuls of common salt be added to this, it wul be a Purging C1CoZinaHve Cly.ter.-Take of camomile flowers, an ounco; aniseseeds, half an ounce Boil in a pint and a half of water to one pint In hysSric and hypochondriac complaints, this may be administered instead of the Foetid Clyster, the smell of which is so disagreeable to most patients. olciy.ter.-To four ounces of the infusion of camomile flowers, add an equal JaimenSry canal. When given to children, the quantity must be proportionably T.f^thfSroveVa gentle Are, and then mix in the oil. In the dysentery or ZSZTZ^ ■» «^™* «* ™>loow **•lu.....te 4G4 COLLYRIA, OR EYE-WATERS. ulcerated Intestines, .and blunt the sharpness of corroding humours. Forty or fKty drops of laudanum may be occasionally added; in which case it will generally supply the place of the Astringent Clyster. Turpentine Clyster.—Take of common decoction, ten ounces ; Venice turpentine, dissolved with the yolk of an egg, half an ounce; Florence oil one ounce. Mix them. This diuretic is proper In obstructions of the urinary passages, and in colicky com- plaints proceeding from gravel. Vinegar Clyster.—This clyster is made by mixing three ounces of vinegar with five of water-gruel. It answers all the purposes of a common clyster, with the peculiar advantage of being proper either in inflammatory or putrid fevers, especially in the latter. to- We think it unnecessary to give more examples of this class of medicines, si ingredients adapted to any particular intention may be occasionally added to one or other of the above forms. COLLYRIA, OR EYE-WATERS. Eye-waters have been multiplied without number, almost every person pretending to be possessed of some secret preparation for the cure of sore eyes. I have examined many of them, and find that they were very much alike, the basis of most of them being either alum, vitriol, or lead. Their effects evidently are, to brace and restora the tone of the parts; hence they are principally of service in slight inflammations, and in that relaxed state of the parts which is induced by obstinate ones. Camphor is commonly added to these compositions; but as it seldom incorporates • properly with water, it can be of little use. Boles and other earthy substances, aa they do not dissolve in water, are also unfit for this purpose. Collyrium of Alum.—Take of alum, half a dram ; agitate it well together with the white of an egg. This is the collyrium of Riverius. It is used in inflammations of the eyes, to allay heat, and restrain the flux of humours. It must be spread upon linen, and applied to the eyes; but should not be kept above two or three hours nt a time. Vitriolic Collyrium.—Take of white vitriol, half a dram ; rose-water, six ounces. Dissolve.the vitriol in the water, and filter the liquor. This, though simple, is perhaps equal in virtue to most of the celebrated collyria. It is an useful application in weak, watery, and inflamed eyes. Though the slighter' inflammations will generally yield to it, yet in those of a more obstinate nature the assistance of bleeding and blistering will be often necessary. When a strong astringent is judged proper, a double or triple quantity of the vitrjol may be used. I have seen a solution of four times the strength of the above used with manifest advantage. Collyrium of Lead.—Take sugar of lead, and crude sal ammoniac, of each four grains. Dissolve them in eight ounces of common water. Forty or fifty drops of laudanum may occasionally be added to this collyrium. Those who choose may substitute, instead of this, the collyria of lead, recom- mended by Goulard ; which is made by putting twenty-five drops of his Extract of Lead to eight ounces of water, and addjng a tea-spoonful of brandy. Indeed, common water and brandy, without any other addition, will in many cases answer very well as a collyrium. An ounce of the latter may be added to five or six ounces of the former; and the eyes, if weak, bathed with it night and morning. I have of late been troubled with a rheum in my eyes, for which I have found groat benefit, by washing them frequently with rose-water. Many experience t..a like good effect from anointing the eye-lids with Smelhom's salve. CONFECTIONS, CONSERVES, AND PRESERVES. Apothecary's shop was formerly so full of these preparations, that it might have passed for a confectioner's warehouse. They possess very few medicinal proper- ties, and may rather be classed among sweetmeats than medicines. They are some- times, however, of use, for reducing into boluses or pills some of the more ponder- ous powders, as the preparations of iron, mercury, and tin. Conserves are compositions of fresh vegetables and sugar beaten together into a uniform mass. In making these preparations, the leaves of vegetables must be freed from their stalks, the flowers from their cups, and the yellow part of orange-peel taken off with a rasp. They are then to be pounded in a marble mortar, with a wooden pestle, into a smooth mass; after which, thrice their weight of fine sugar is commonly added by degrees, and the beating continued till they are uniformly mixed ; but the conserve will be better if only thrice its weight of sugar be mixed. Those who prepare large quantities of conserves generally reduce the vegetables to a pulp by the means of a mill, and afterwards beat them up with sugar. Conserve of Red Rotes.—Take a pound of red rose-buds, cleared of their heels; btat them well in a mortar, and adding by degrees two pounds of double refined sugar, in powder, make a conserve. Alter the same manner are prepared the conserves of orange peel, rosemary flow- ers, sea-wormwood, the leaves of wood-sorrel, &c. The conserve of roses is one of the most agreeable and useful preparations belong. Ing to this class. A dram or two of it, dissolved in warm milk, is ordered to be given as a gentle restringent in weakness of the stomach, and likewise in phthi- sical coughs, and spitting of blood. To have any considerable effects, however, it must betaken in large quantities. Conserves of Sloes.—This may be made by boiling the sloes gently in water, being careful to take them out before they burst; afterwards expressing the juice, and beating it up with three times its weight of fine sugar. In relaxations of the uvula andglands of the throat, this makes an excellent gargle, end may be used at discretion. Pretervet are made by steeping or boiling fresh vegetables first in water, and after- wards in syrup, or a solution of sugar. The subject is either preserved moist in the syrup, or taken out aud dried, that the sugar may candy on it. The last is the most useful method. Candied Orange PeeU-Soak Sevile orange peel in several waters, till it lose* its bitterness ; then boil it in a solution of doubie-refiued sugar in water till it become tender and transparent. 100 DECOCTION'S. ' • Candied lemon-peel is prepared in the samesmanner. It is needless to add more of these preparations, as they belong rather to the art ot Hie confectioner than to the apothecary. DECOCTIONS. Water readily extracts the gummy and saline parts of vegetables, and, though its ection is chiefly confined to these, yet the resinous and oily being intimately blended wiih the gummy and saline, are in great part taken up along with them. Ilence watery decoctions and infusions of vegetables constitute a large and not unuseful class of medicines. Although most vegetables yield their virtues to water, as well by infusion as decoction, yet the latter is often necessary, as it saves time, and does in a few minutes what the other would require hours, and sometimes days, to effect The medicines of this class are all intended for immediate use. Decooction of Althaea.—Take of the roots of marsh-mallows, moderately dried, three ounces ; raisins of the sun, one ounce ; water three pints. Boil the ingredients in the water till one third of it is consumed; afterwasds strain the decoction and let it stand for some time to settle. If the roots be thoroughly dried, they must be boiled till one half of the water be consumed. In coughs, aud sharp defluxions upon the lungs, this decoction may be used for ordinary drink. The Common Decoction.—Take of camomile flowers, one ounce; elder flowers, and sweet fennel seeds, of each half an ounce; water, two quarts. Boil them for a little, and then strain the decoction. A medicine equally gocd may be prepared by infusing the ingredients for some hours in boiling water. This decoction is chiefly intended as the basis of clysters, to which other Ingredients may be occasionally added. It will likewise serve as a common fomentation, spirit of wine or other things being added in such quantity as the case may require. Decoction of Logwood.—Boil three ounces of the shavings, or chips, of logwood, in four pints of water, till one half of the liquor is wasted. Two or three ounces of simple cinnamon-water may be added to this decoction. In fluxes of the belly, where the stronger astringents are improper, a tea-cupful of this decoction may be taken with advantage three or four times a-day. Decoction of the Bark.—Boil an ounce of the Peruvian bark, grossly powdered in S pint and a half of water to one pint; then strain the decoction. If a tea-spoonful of the weak spirit of vitriol be added to this medicine, it will render it both more agreeable and efficacious. Compound Decoction of the Bark.—Take of Peruvian bark, and Virginian snake- root, grossly powdered, each three drams. Boil them in a pint of water to one-half. To the strained liquor add an ounce and a -half of aromatic water. Sir John Pringle recommends this as a proper medicine towards the decline of malignant fevers, when the pulse is low, the voice weak, and the head affected wiih a stupor, but with little delirium. The dose is four spoonfuls every fourth or sixth hour. Decoction of Sarsaparilla.—Take of fresh sarsaparilla root, sliced and bruised, two ounces; shavings of guaiacum wood, one ounce. Boil over a slow fire in three quarts of water, to one; adding towards the end half an ounce of sassafras wood, and three drams of liquorice. Strain the decoction. This may ejther be employed as an assistant to a course of mercurial alteratives, or taken after the mercury has been used for some time. It strengthens the stomach, DRAUGHTS. 4C7 snd restores flesh and vigour to habits emaciated by the venereal disease. It may also be taken in the rheumatism and cutaneous disorders proceeding from foulness of the blood and juices. For all these intentions it is greatly preferable to the De- coction of Woodt. This decoction may be taken, from a pint and a half to two quarts in the day. The following decoction is said to be similar to that used by Kennedy, in the cure of the venereal disease, and may supply the place of Lisbon diet-drink. Take of sarsaparilla, three ounces ; liquorice and mezereon root, of each half an ounce; shavings of guaiacum and sassafras wood, of each one ounce ; crude anti- mony, powdered, an ounce and a half. Infuse these ingredients in eight pints of boiling water for twenty-four'hours, then boil them till one half of the water is con- sumed ; afterward strain the decoction. This decoction may be used in the same manner as the preceding. Decoction of Seneka.—Take of seneka rattle-snake root, one ounce; water, a pint and a half. Boil to one pint, and strain. This decoction is recommended in the pleurisy, dropsy, rheumatism, and some obstinate disorders of the skin. The dose is two ounces, three or four times a-day. or oftener, if the stomach will bear it. White Decoction.—Take of the purest chalk, in powder, two ounces; gumarabic, half an ounce: water three pints. Boil to one quart, and strain the decoction. This is a proper drink in acute diseases, attended with or inclining to a looseness, and where acidities abound in the stomach and bowels. It is peculiarly proper for children when afflicted with sourness of the stomach, and for persons who are sub- ject to the heartburn. It may be sweetened with sugar, as it is used, and two or three ounces of simple cinnamon water added to it. An ounce of powdered chalk, mixed with two pints of water, will occasionally supply the place of this decoction, and also of the chalk julap. DRAUGHTS. This is a proper form for exhibiting such medicines as are intended to operate immediately, and which do not need to be frequently repeated; os purges, vomits, and a few others which are to be taken at one dose. Where a medicine requires to be used for any length of time, it is better to make up a large quantity of it at once, which saves both trouble and expense. .„„._„„ Anodyne Draught.-Tak* of liquid laudanum, twenty-five drops: simple cinnamon watr an ounce; common syrup, two drams. Mix them. In excessive pains where bleeding is necessary, and in great restlessness, this composing draught may be U n° 'tZTot^TTt** diuretic salt, two'scruples; syrup of poppies, twfd^^rplecin^amon water, and common water, of each an ounce. This draught is of service in an obtsruction or deficiency of urine. pZaing Draught*.-T>ke of manna, an ounce; soluble tartar, or Rochel salt from Selo four drams. Dissolve in three ounces of boiling water, to which barging salts, dissolved in four ounces of water, may be taken instead of tho JZ11.H_T£1S iJ-i "««** s—^dtoittheoth- ingredients. 468 ELECTUARIES. Sweating Draught.—Take spirit of Mindererus, two ounces; salt of hartshorn, five grains; simple cinnamon water, and syrup of poppies, of each half an ounce. Mix them into a draught. In recent colds and rheumatic complaints, this draught is of service. To promote its effects, however, the patient ought to drink freely of warm water gruel, or of some other weak diluting liquor. Vomiting Draughts.—Take of ipecacuanha, In powder, a scruple; water, an ounce: simple syrup, a dram. Mix them. Persons who require a stronger vomit may add to the above half a grain, or a grain, of emetic tartar. ■ Those who do not choose the powder, may take ten drops of the ipecacuanha wine; or half on ounce of the wine, and an equal quantity of the syrup of squills. ELECTUARIES. Electuaries are generally composed of the lighter powders, mixed with syrup, honey, conserve or mucilage, into such a consistence, that the powders may neither separate by keeping, nor the mass prove too stiff for swallowing. They receive chiefly the milder alterative medicines, and such as are not ungrateful to the palate. Astringent electuaries, and such as have pulps of fruit in them, should be prepared only in small quantities; as astringent medicines lose their virtue by being kept in this form, and the pulps of fruits are apt to ferment. For the extraction of pulps, it will be necessary to boil unripe fruits, and ripe ones, if they are dried, in a small quantity of water till they become soft. The pulp is then to be pressed out through a strong hair sieve, or thin cloth, and afterwards boiled to a due consistence, in an earthen vessel, over a gentle fire, taking care to prevent the matter from burning by continually stirring it The pulps of fruit that are both ripe and fresh may be pressed out without any previous boiling. Lenitive Electuary,—Take of senna, in fine powder, eight ounces ; coriander seed, also in powder, four ounces; pulp of tamarinds and of French prunes, each a pound; mix the pulp and powders together, and, with a sufficient quantity of simple syrup, reduce the whole into an electuary.—A t.-a-spoonful of this electuary taken two or three times a-day, generally proves an agreeable laxative. It likewise serves as a convenient vehicle for exhibiting more active medicines, as julap, scam- mony, and such like. This may supply the place of the electuary of Cassia, Electuary for the Dysentery.—Take of the Japonic confection, two ounces ; Loca- telli's balsam, one ounce; rhubarb in powder, half an ounce ; syrup of marshmallows enough to make an electuary. It is often dangerous in dysenteries to give opiates and astringents, without inter- posing purgatives. The purgative is here joined with these ingredients, which renders this a very safe and useful medicine for the purposes expressed in the title. About the bulk of a nutmeg should be taken twice or thrice a-day, as the symptoms and constitution may require. Electuary for the Epilepsy .—Take of Peruvian bark, in powder, an ounce; of powdered tin, and wild valerian root, each half an ounce ; simple syrup enough to make an electuary. Dr. Mead directs a dram of an electuary similar to this to be taken evening and morning in the epilepsy, for the space of three months. It will be proper, how- ever, to discontinue the use of it for the space of a few days every now and then. 1 have added the powdered tin, because the epilepsy often proceeds from worms EMULSIONS. 4G9 Electuary for the Gonorrhea.—Take of lenitive electuary, three ounces; julap and rhubarb, in powder, of each two drams; nitre, half an ounce; simple syrup enough to make an electuary. During the inflammation and tension of the urinary passages, which accompany a virulent gonorrhoea, this cooling laxative may be used with advantage. The dose is a dram, or about the size of a nutmeg, two or three times a-day, more or less as may be necessary to keep the body gently open. An electuary made of cream of tartar and simple syrup will occasionally supply the place of this. After the inflammation is gone off, the following electuary may be used: Take of lenitive electuary, two ounces; balsam of capivi, one ounce; gum guaiacum and rhubarb, in powder, of each two drams; simple syrup enough to make on electuary. The dose is the same as of the preceding. Electuary of the Bark.—Take of Peruvian bark, in powder, three ounces; casca- rilla, half an ounce; syrup of ginger, enough to make an electuary. In the cure of obstiuate intermitting fevers, the bark is assisted by the cascarilla. In hectic habits, however, it will be better to leave out the cascarilla, and put three drams of crude sal ammoniac in its stead. Electuary for the Piles.—Take flower of sulphur one ounce $ cream of tartar, half an ounce; treacle a sufficient quantity*to form an electuary. A tea-spoonful of this may be taken three or four times a-day. Electuary for the Palsy.—Take of powdered mustard-seed and conserve of roses, each an ounce; syrup of ginger, enough to make an electuary. A tea-spoonful of this may be taken three or four times a-day. Electuary for the Rheumatism.—Take of conserve of roses, two ounces ; cinna- bar of antimony, levigated, an ounce and a half; gum guaiacum, in powder, an ounce; syrup of ginger, a sufficient quantity to make an electuary. In obstinate rheumatisms, which are not accompanied with a fever, a tea-spoonful of the electuary may be taken twice a-day with considerable advantage. EMULSIONS. Emulsions, beside their use as medicines, are also proper vehicles for certain sub- stances, which could not otherwise be conveniently token in a liquid form. Thus camphor, triturated with almonds, readily unites with water into an emulsion. Pure oils, balsams, resins, and other similar substances, are likewise rendered miscibls with water by the intervention of mucilages. Common Emultion.-Ta.ke of sweet almonds, an ounce; bitter almonds, a dram; water two pints. Let the almonds be blanched, aud beat up in a mortar; adding the water by little and little, so as to make an emulsion : afterwards let it be strained. .. Arabic Emul*ion,-Tbis is made in the same manner as the above, adding to the almonds, while beating, two ounces and a half of the mucilage of gum argbic. Where soft cooling liquors are necessary, these emulsions may be used as ordinary ^Camphorated Emulsion.-Take of camphor, half a dram; sweet almeads. half a dozen. white sugar, half an ounce; mint water, eight ounces. Grind the camphor „d almonds well together in a stone mortar, and add by degrees the mint water; then strain the liquor, anddissolve It in sugar. Infevers, and other disorders which rehire the use pf camphor, a table-spoonful of this may be taken every two o, tiiree hours 470 EXTRACTS AND FOMENTATIONS. Emulsion of Gum Ammoniac—Take of gum ainmjmac, two drams; water, eight ounces. Grind the gum with the water poured upon it by little and little, till it is dissolved. This emulsion is used for attenuating tough viscid phlegm, and pro- moting expectoration. In obstinate coughs, two ounces of the syrup of poppies may be added to it. The dose is two table-spoonfuls three or four times a-day. Oily Emulsion.—Take of soft water, six ounces; volatile aromatic spirit two drams; Florence oil, an ounce; shake them well together, and add of simple syrup, half an ounce. In recent colds and coughs, this emulsion is generally of service; but if the cough proves obstinate, it will succeed better when made with the paregoric elixir of the Edinburgh Dispensatory, instead of the volatile aromatic spirit. A table-spoonful of it may be taken every two or three hours. EXTRACTS. Extracts are prepared by boiling the subject in water, and evaporating the strained decoction to a due consistence. By this process some of the more active parts of plants are freed from the useless, indissoluble earthy matter, which makes the larger share of their bulk. Water, however, is not (he only menstruum used in the prepa- ration of extracts ; sometimes it is joined with spirits, and at other times rectified spirits alone are used for that purpose. Extracts are prepared from a variety of different drugs, as the bark, gentian, julap, &c.; but, as they require a troublesome and tedious operation, it will be more convenient for a private practitioner to purchase what he needs of them from a professed druggist than to prepare them himself. Such of them as are generally used are inserted in our list of such medicines as are to be kept for private practice. FOMENTATION& Fomentations are generally intended either to ease pain, by taking off tension and spasm; or to brace and restore the tone and vigour of those parts to which they are applied. The first of these intentions may generally be answered by warm water, and the second by cold. Certain substances, however, are usually added to water with a view to heighten its effects, as anodynes, aromatics, and astringents, jcc. We shall therefore subjoin a few of the most useful medicated fomentations, that people may have it in their power to make use of them as they choose. Anodyne Fomentation.—Take of white poppy-heads, two ounces ; elder-flowers half an ounce; water three pints. Boil till one pint is evaporated, and strain out the ■ liquor.—This fomentation, as its title expresses, is used for relieving acute pain. Aromatic Fomentation.—Take of Jamaica pepper, half an ounce; red wine a pint Boil them for a little, and then strain the liquor. This is intended, not only as a topical application for external complaints, but also for relieving the internal parts. Pains of the bowels, which accompany dysenteries and diarrhoeas, flatulent colics, uneasiness of the stomach, and retchings to vomit, are frequently abated by fomenting the abdomen and region of the stomach with the warm liquor. Common Fomentation.—Take tops of wormwood and camomile flowers, dried, ol each two ounces ; water, two quarts. After a slight boiling, pour off the liquor.— Brandy or spirits of wine may be added to this fomentation, in such quantity as the particular circumstances of the case shall require; but these are not always necessary. Emollient Fomentation.—This is the same as the common decoction. GARGLES AND INVOSIONS. 471 Strengthening Fomentation.—Take of oak bark, one ounce; grnnate-peel, hail an ounce; alum, two drams; smith's forge water three pints. Boil the water with the bark and peel to the consumption of one third; then strain the remaining de- coction, and dissolve in it the alum.—This astringent liquor is employed as an ex- ternal fomentation to weak parts; it may also be used internally. GARGLES. However trifling this class of medicines may appear, they are by no means with- out their use. They seldom indeed cure diseases, but they often alleviate very dis- agreeable symptoms; as parchedness of the mouth, foulness of the tongue and fauces, &c. They are peculiarly useful in fevers and sore throats. In the latter a gargle will sometimes remove the disorder; and, in the former, few things are more re- freshing or agreeable to the patient, than to have his mouth washed with some soft detergent gargle. One advantage of these medicines is, that they are easily prepared. A little*ar- ley-water and honey, may be had anywhere; and if to these be added as much vine- gar as will give then an agreeable sharpness, they will make a very useful gargle for softening and cleansing the rr.jr.th. Gargles have the best effect when injected with a syringe. Attenuating Gargle.—Take of water, six ounces; honey, one ounce; nitre, a dram and a half. Mix them.—This cooling gargle may be used either in the inflam- matory quinsey, or in fevers, for cleansing the tongue and fauces. Common Gargle.—Take of rose-water, six ounces; syrup of clove July-flowers, half an ounce; spirit of vitriol a sufficient quantity to give it an agreeable sharpness. Mix them. This gargle, besides cleansing the tongue and fauces, acts as a gentle repellent, and will sometimes remove a slight quinsey. Detergent GargU.-Take of the emollient gargle, a pint; tincture of myrrh, an ounce ; honey, two ounces. Mix them.-When exulcerations require to be cleansed, or the excretion of tough viscid saliva promoted, this gargle will be of service. Emollient Gargle.—Take an ounce of marstoallow roots, and two or three figs; boil them in a quart of water tiU near one half of it be consumed, then strain out the liqnor. If an ounce of honey, and half an ounce of spirit of sal ammoniac, be added to the above, it will be an exceeding good attenuating gargle. This gargle is beneficial in fevers, where the tongue and fauces are rough and parched, to soften these parts and promote the discharge of saliva. The learned and accurate Sir John Pringle observes, that in the inflammatory quinsey or strangulation of the fauces, little benefit arises from the common gar- bles- that such as are of an acid nature do more harm than good, by contract.ng the emu'nctories of the saliva and mucus, and thickening those humours ; that a decoc- tion of figs in milk and water has a contrary effect, especially if some sal ammoniac be added ; by which the saliva is made thinner, and the glands are brought to secrets luove freely; a circumstance always conducive to the cure. INFUSIONS. Vegetables yield nearly the same properties to water by infusion as by decoction; and tliough they may require a longer time to give out their virtues in this way yet „___w- advances over the other ; .iuce boiling is found to dissipate the flue, 472 INFUSIONS. parts of many bitter and aromaiic substances, without more fully extracting tliefr medicinal principles. The author of the New Dispensatory observes, that even from those vegetables which are weak in virtue, rich infusions may be obtained, by returning the liquor upon fresh quantities of the subject, the water loading itself more and more with the active parts ; and that these loaded infusions are applicable to valuable purposes in medicine, as they contain inasmall compass the finer, more subtle, and active priua ciples of vegetables, in a form readily miscible with the fluids of the human body. Bitter Infusion.—Take tops of the lesser centaury and camomile flowers, of each half an ounce; yellow rind of lemon and orange-peel, carefully freed from the inner white part, of each two drams. Cut them in small pieces and infuse them in a quart of boiling water. For indigestion, weakness of the stomach, or a want of appetite, a tea-cupful of this infusion may be taken twice or thrice a-day. Infusion of the Bark.—To an ounce of the bark, in powder, add four or five table-spoonfnls of brandy and a pint of boiling water. Let them infuse for two or three days.—Th.s is one of the best preparations of the bark for weak stomachs. Iu disorders where the corroborating virtues of that medicine are required, a tea- cupful of it may be taken two or three times a-day. Infusion of Carduus.—Infuse an ounce of the dried leaves of carduus benedietus, or blessed thistle, in a pint of common water, for six hours, without heat; then filter the liquor through paper. This light infusion may be given with great benefit, in weakness of the stomach, where the common bitters do not agree. It may be flavoured at pleasure with cin- namon, or other aromatic materials. Infusion of Linseed.—Take of linseed, two spoonfuls; liquorice-root, sliced, half an ounce; boiling water, three pints. Let them staud to infuse by the fire for tome hours, and then strain off the liquor. If an ounce of the leaves of coltsfoot be added to these ingredients, it will then be the Pectoral Infusion. Both these are emollient mucilaginous liquor, and may be taken with advantage as ordinary drink in difficulty of making water; and in cou'lia and other complaints of the breast. 0 Infusion of Roses—Take of red roses, dried, half on ounce; boiling water, a quart; vitriolic acid, commonly called oil of vitriol, half a dram ; loaf sugar, an ounce. Infuse the roses in the water for four hours, in an unglazed earthen vessel; after- wards pour in the acid, and, having strained the liquor, add to it the sugar. In au excessive flow of the menses, vomiting of blood, aud otlier hsemorrhages, a tea-cupful of this gently astringent infusion may be taken every three or four hours. It likewise makes an exceeding good gargle. As the quantity of roses used here cau have little or no effect, an equally valuable medicine may be prepared by mixing tlieacid and water without infusion. Infusion of Tamarinds and Senna.—Take of tamarinds, one ounce; senna and crystals of tartar, each two drams. Let these ingredients be infused four or five hours in a pint of boiling water; afterwards let the liquor be strained, and an ounce 01 two of the aromatic tincture added to it Persons who are easily purged may leare out either the tamarinds or the crystals of tarter. This is an agreeable cooling purge. A tea-cupful may be given every half hour till it operates. This supplies the place of the Decoction of Tamarinds and Senna. Soanith Infusion—Take of Spanish juice, cut into small pieces, an ounce; salt of tartar, three drams. Infuse in a quart of boiling water for a night. To toe strained liquor add au ounce aud a half of the syiupof poppies—Iu receut colds, coughs, JULAPS. 473 snd obstructions of the breast, a tea-cupful of this Infusion may be taken wiih advantage three or four times a-day. Infusion for the Palsy.—Take of horse-radish root shaved, mustard seed bruised, each four ounces; outer rind of orange-peel, one ounce. Infuse them in two quarts of boiling water, in a close vessel, for twenty-four hours. In paralytic complaints, a tea-cupful of this warm stimulating medicine may be tajien three or four times a-day. It excites the action of the solids, proves diuretic end, if the patient be kept warm, promotes perspiration. If two or three ounces of the dried leaves of marsh trefoil be used instead of tiie mustard, it will make the Antiscorbutic Infusion. JULAI'S. The basis of Julaps Is generally common water, or some simple distilled water, with one-third or one-fourth its quantity of distilled spirituous water, and as much sugar or syrup as is sufficient to render the mixture agreeable. This is sharpened with vegetable or mineral acids, or impregnated with other medicines suitable to the intention. Camphorated Julap—Take of camphor, one dram ; rectified spirit of wine, ten drops ; double refined sugar, half an ounce; boiling distilled water, one pint. Hub the camphor first with the spirit of wine, then with the sugar; lastly, add the water, by degrees, and strain the liquor. In hysterical and other complaints, where camphor is proper, this julap may be taken in the dose of a spoonful or two as often as the stomach will bear it. Cordial Julap.—Take of simple cinnamon water, four ounces; Jamaica pepper- water, two ounces; volatile aromatic spirit, and compound spirit of lavender, of each two drams ; syrup of orange-peel, an ounce. Mis them.—This is given in the dose of two spoonfuls three or four times a-day, iu disorders accompanied with weakness nnd depression of spirits. Expectorating Julap.—Take of the emulsion of gura ammoniac, six ounces; syrup of squills, two ounces. Mix them. In coughs, asthmas, and obstructions of the breast, two table-spoonfuls of this julap may be taken every three or four hours. Mush Julap.—Rub half a dram of musk well together with half an ounce of Bugar, and add to it, gradually, of simple cinnamon and pepermmt-water, each two ounces ; ef the volatile aromatie spirit, two drams. In the low state of nervous fevers, diccuping, convulsions, and other spasmodic affections, two table-spoonfuls of this julap may be taken every two or three hours. Saline Julap.—Dissolve two drams of salt of tartar in three ounces of fresh lemon-juice, straiued ; when the effervescence is over, add, of mint-water and com- mon water, each two ounces ; of simple syrup one ounce.—This removes sickness at the stomach, relieves vomiting, promotes perspiration, and may be of some seruca in fevers, especially of the inflammatory kind. Vomiting Julap.—Dissolve four grains of emetic tartar in eight ounces of water, and add to it half an ounce of the syrup of clove July flowers.—In the beginning of fevers, where there is no topical inflammation, this julap may be given in the dose of one table-spoonful every quarter of an houi till it operates. Antimonial vomits serve not only to evacuate the contents of '.he stomach, but likewise to promote the different secretions. Hence they are Ivund iu fevers to ha e nearly the tw-a fcffects as Dr. James s Powder. ^74 MIXTURES, ETC MIXTURES. A mixture differs from a julap in this respect, that it receives into its composition not only salts, extracts, and other substances dissoluble in water, but also earths, powders, and such substances as cannot be dissolved. A mixture is seldom either an elegant or an agreeable medicine. It is nevertheless necesssry. Many persons can take a mixture, who are not able to swallow a bolus or an electuary ; besides, there are medicines which act better in this than in any other form. Astringent Mixture.—Take simple cinnamon-water, and common water, of each three ounces; spirituous cinnamon-water, an ounce and a half; Japonic confection, half an ounce. Mix them. In dysenteries which are not of long standing, after the necessary evacuations, a, spoonful or two of this mixture may be taken every fonr hours, interposing every second or third day a dose of rhubarb. The Astringent Mixture, which I have lately made use of with great success, is prepared thus: Take powder of bole with opium, two drams; cinnamon-water and penny-royal water of each three ounces; spirituous cinnamon-water six drams; simple syrup, one ounce. Mix them and take a table-spoonful four or five times a-day. Diuretic Mixture.—Take of mint-water, five ounces; vinegar of squills, six drams ; sweet spirit of nitre, half an ounce; syrup of ginger, an ounce and a half. Mix them. In obstructions of the urinary passages, two spoonfuls of this mixture may be taken twice or thrice a-day. Loxatice Absorbent Mixture.—Rub one dram of magnesia alba in a mortar with ten or twelve grains of the best Turkey rhubarb, and add to them three ounces of common water; simple cinnamon-water, and syrup of sugar, of each one ounce.— As most diseases of infants are accompanied with acidities, this mixture may either be given with a view to correct these or to open the body. A table-spoonful may be taken for a dose, and repeated three times a-day. To a very young child, half a spoonful will be sufficient. When the mixture is intended to purge, the dose may either be increased or the quantity of rhubarb doubled. This is one of the most generally useful medicines for children with which I am acquainted. Saline Mixture.—Dissolve a dram of the salt of tartar in four ounces of boiling water; and, when cold, drop into it spirit of vitriol till the effervescence ceases; then add, of peppermint-water, two ounces, simple syrup, one ounce. Where fresh lemons cannot be had, this mixture may occasionally supply the place of the saline julap. Squill Mixture.—Take of simple cinnamon-water, five ounces; vinegar of squills, one ounce; syrup of marchmallows, an ounce and a half. Mix them. This mixture, by promoting expectoration and the secretion of urine, proves serviceable in asthmatic aud dropsical habits. A table-spoonful of it may be taken frequently. OINTMENTS, LINIMENTS, AND CERATES. Notwithstanding the extravagent encomiums which have been bestowed on differ- ent preparations of this kind, with regard to their efficacy in the cure of wounds, eoras, &c. It is beyond a doubt that the most proper application to a green Wound is dry lint. But though ointments do not heal wounds and sores, yet thej OINTMENTS, LINIMENTS, AND CERATES. 475 serve to defend tli3m from the external air, and to retain such substances as may be necessary for drying, deterging, destroying proud flesh, and such like. For these purposes, however, it will be sufficient to mention only a few of the most simple forms, as ingredients of a more active nature can occasionally be added to them. Yellow Basilicum Ointment.—Take of yellow wax, white resin, and frankincense, each a quarter of a pound; melt them together over a gentle fire, then add, of hogs- lard prepared, one pound. Strain the ointment while warm.—This ointment is em- ployed for cleansing and healing wounds and ulcers. Ointment of Calamine. Take of olive oil, a pint and a half, white wax, and ca- lamine stone levigated, of each half a pound, Let the calamine stone, reduced into a fine powder, be rubbed with some part of the oil, and afterwards added to the rest of the oil and wax previously melted together, continually stirring them till quite cold. This ointment, which is commonly known by the name of Turner's Ce- rate, is an exceeding good application in bums and excoriations, from whatever cause. Emollient Ointment.—Take of palm oil, two pounds; olive oil, a pint and a half; yellow wax, half a pound; Venice turpentine, a quarter of a pound. Melt the wax in the oils over a gentle fire; then mix in the turpentine, and strain the ointment. This supplies the place'of Althoia Ointment. It may be used for anointing in- flamed parts, &c. Eye Ointment.— Take of hogslard prepared four ounces; white wax, two drams; tutty prepared, one ounce ; melt the wax with the lard over a gentle fire, and then sprinkle the tutty, continually stirring them till the ointment is cold.—This ointment will be more efficacious, and of a better consistence, if two or three drams of camphor be rubbed up with a little oil, and intimately mixed with it. Another.—Take of camphor and calamine stone levigated, each six drams; verde- Eiise, well prepared, two drams; hogslard and mutton suet, prepared, of each two ounces. Rub the camphor well with the powder ; afterwards mix in the lard and suet, continuing the triture till they be perfectly united—This ointment has been long in esteem for disease of the eyes. It ought, however, to be used with caution, when the eyes are inflamed or very tender. Issue Ointment.-Uix half an ounce of Spanish flies, finely powdered, m six ounces of yellow basilicum ointment. This ointment is chiefly intended for dressing blisters, in order to keep them open during pleasure. Ointment of Lead.-Take of olive oil half a pint; white wax, two ounces*, sugar of lead three drams. Let the sugar of lead, reduced into a fine powder, be rubbed up with some part of the oil, and afterwards continually stirring them till quite cold -This cooling and gently astringent ointment may be used in all cases where the intention is to dry and skin over the part, as in scalding, &c. Mercurial Ointment-Take of quicksilver, two ounces ; hogslard, three ounces ; mutton suet, one ounce. Rub the quicksilver with au ounce of the hogslard ,n a warm mortar, till the globules be perfectly extinguished; then rub it up with the rest of the lard and suet, previously melted together. The principal intention of this ointment is to convey mercury into the body b, Vipins rubbed upon the skin. WnZent ofSulphur.-Take of hogslard prepared, four ounces; flowers of sul- Jur an ounce and a half; crude sal ammoniac, two drams; essence of lemon, en or twelve drops. Make them into an ointment.-This ointment rubbed upon the piraiected will generally cure the itch. It is both the safest and best application for hat purpose, and, when made in this way. has no disagreeable smell. n- sJL for Disease, of the Skin.-Take of the ointment commonly called unguen- ScT^C^ -d a half; dower of brimstone and powder of hellebore, ol '470 PTILS. each an ounce; hogslard, three ounces; essence of lemon, or oil of thyme, fiem twenty to thirty drops, to correct the offenslveness of the smell. Make them Into an ointment.—I have not only known many ordinary affections of the skin cured by this ointment, buteven some of a very malignant nature, and approaching to leprosy. White Ointment.—Take of olive oil, one pint; white wax and spermaceti, of each three ounces. Melt them with a gentle heat, and keep them constantly and briskly stirring together, till quite cold. If two drams of camphor, previously rubbed with a small quantity of oil, be added to the above, it will make the White Camphorated Ointment. Liniment for Burnt.—Take equal parts of Florence oil, or fresh drawn Unseed oil, and lime-water; shake them well together in a wide mouthed bottle, so as to form a liniment.—This is found to be an exceeding proper application for recent scalds or burns. It may either be spread upon a cloth, or the parts affected may be anointed with it twice or thrice a-day. White Liniment.—This is made in the same manner as the white ointment, two-thirds of the wax being left out.—This liniment may be applied in cases of ex- coriation, where on account of the largeness of the surface, the ointments with lead or calamine might be improper. Liniment for the Piles.—Take of emollient ointment, two ounces; liquid laudanum, half an ounce. Mix these ingredients with the yolk of an egg, and work them well together. Volatile Liniment.—Take of Florence oil, an ounce; spirit of hartshorn, half on ounce. Shake them together.—This liniment, made with unequal parts of the spirit and oil, will be more efficacious where the patient's skin is able to bear it. Sir John Pringle observes, that, in the inflammatory quinsey, a piece of flannel moistened with this liniment, and applied to the throat, to be renewea every four or five hours, is one of the most efficacious remedies; and that it seldom fails, after bleeding, either to lessen or carry off the complaint. The truth of this observation I have often experienced. Camphorated Oil.—Rub an ounce of camphor, with two ounces of Florence oil, in a mortar, till the camphor be entirely dissolved. This antispasmodic liniment may be used in obstinate rheumatisms, and some other cases accompanied with extreme pain aud tension of the parts. PILLS. Medicines which operate in a small dose, and whose disagreeable taste or smell make it necessary that they should be concealed from the palate, are most commo- diously exhibited in this form. No medicine, however, that is intended to operate quickly, ought to be made into pills, as they often lie a considerable time on the stomach before they are dissolved, so as to produce any effect. As the ingredients which enter the composition of pills are generally so con- trived that one pill of an ordinary size may contain about five grains of the com- pound, in mentioning the dose we shall only specify the number of pills to be taken; as one, two, three, &c. Composing PUL-~Take of purified opium, ten grains ; Castile soap half a dram. Beat them together, and form the whole into twenty pills.—When a quieting draught will not sit upon the stomach, one, two, or three of these pills may be taken, as occasion requires. Deobstruent PM.—Take salt of steel; succotrine aloes; myrrh in powder; of each a uraui. Make into forty pills, of which two are to be takuu evening and wuriiiiig. PILL9. 4-r I have found these pills of excellent service in obstructions of the menses. The late Dr. Watkinson made it his dying request, that I would insert this prescription in the ' Domestic Medicine,' which he said would be immortal, and that ' his soul punted for immortality.' Foztid Pill.—Take of asafoetida, half an ounce; simple syrup, as much as is ne- cessary to form it into pills.—In hysteric complaints, four or five pills of an ordinary size may be taken twice or thrice a. day. They may likewise be of service to per- sons afflicted with the asthma. When it is necessary to keep the body open, a proper quantity of rhubarb, aloes, or julap, may occasionlly be added to the above mass. Hemlock Pill—Take any quantity of the extract of hemlock, and, adding to it about a fifth part its weight of the powder of the dried leaves, form it into pills of the ordinary size. The extract of hemlock may be taken from one grain to several drams In the day. The bestmethod, however, of using these pills, is to begin with one or two, and to increase the dose gradually, as far as the patient can bear them, without any remark- able degree of stupor or giddiness. Mercurial Fill— Take of purified quicksilver sfid honey, each half an ounce. RUb them together in a mortar, till the globules of mercury are perfectly extinguished ; then add, of Castile soap, two drams; powdered liquorice, or crum of bread, a sufficient quantity to give the mass a proper consistence for pills. When stronger mercurial pills are wanted, the quantity of quicksilver may be doubled. The dose of these piUs Is different according to the intention with which they are given. As an alterant, two or three may be taken daily. To raise a salivation, four or five will be necessary. Equal parts of the above pill and powdered rhubarb made into a mass, with a suffi- cient quantity of simple syrup, will make a Mercurial Purging Pill. Mercurial Sublimate PiU—Dissolve fifteen grains of the corrosive sublimate of mercury in two drams of the saturated solution of crude sal ammoniac, and make it into a paste, in a glass mortar, with a sufficient quantity of the crum of bread. This mass must be formed into one hundred and twenty pills. This pill which is the most agreeable form of exhibiting the sublimate, has been found efficacious, not only in curing the venereal disease, but also in killing aud ex- celling the worm*, after other powerful medicines had failed. For the venereal disease, four of these pills may be taken twice a-day, as an alter* ant three, and for worms two. Plumber'* P^.-Take of calomel, or sweet mercury, and precipitated sulphur of antimony, each three drams; extract of liquorice, two drams. Rub the sulphur and mercury well together; afterwards add the extract, and, with a sufficient quantity of the mucilage of gum arable, make them into puis. TWs.il! has been found a powerful, yet safe, alterative in obstinate cutaneous disorder • and has completed a cure after salivation had failed. In venereal cases it ■has liSse produced excellent effects. Two er three pills o an ordinary size may be taken night and morning, the patient keeping moderately warm, and dnnking Vtercach dosea draught of desertion of the woods, or of sarsaparilla PurZns Pitts-T*e of succotrlne aloes, and Castile soap, each two drams; of aimrile syrup, a sufficient quantity to make them into pills. Four or nve of these pills will generally prove a sufficient purge. For keeping the body gently open, one may betaken night and morning. They are reckoned loth deoostruent and stomachic, and will be found to answer all the purposes of Dr Anderson-spills, the principal ingredient of which is aloes. 473 PLASTBR3. Where aloetlc purges are improper, the following pills may be used : Take extract of julap, and vitriolated tartar, of each two drams ; syrup of ginger, as much as will make them of a proper consistence for pills. These pills may be taken in the same quantity as the above. PiUs for the Bile.—Take gum pill and colocynth pill, each a dram. Beat them together, and make the mass into thirty pills. In bilious and nervous patients, where it was necessary to keep the body gently open, I have found these pills answer the purpose extremely well. I generally give one over-night and another next morning once or twice a-week. But the dose must be regulated by the effect. Pill for the Jaundice.—Take of Castile soap, succotrine aloes, and rhubarb, of each one dram. Make them into pills, with a sufficient quantity of syrup or muci- lage.—These pills as their title expresses, are chiefly intended for the jaundice, which, with the assistance of proper diet, they will often cure. Five or six of them may be taken twice a-day, more or less as is necessary to keep the body open. It will be proper, however, during their use, to interpose now and then a vomit of ipecacu- anha or tartar emetic. Stomachic Pill—Take extract of gentian, two drams: powdered rhubarb, and vitriolated tartar, of each one dram; oil of mint, thirty drops; simple syrup a sufficient quantity. Three or four of these pills may be taken twice a-day, for invi- gorating the stomach and keeping the body gently open. Squill Pills.—Take powder of dried squills, a dram and a half; gum ammoniac, and cardamom seeds, in powder, of each three drams; syrup, a sufficient quantity. In dropsical and asthmatic complaints, two or three of these pills maybe taken twice a-day, or oftener if the stomach will bear them. Strengthening PHI*.—Take soft extract ot the bark, and salt of steel, each a dram- Make into pills. In disorders arising from excessive debility, or relaxation of the solids, as the chlorosis, or green sickness, two of these pills may be taken three times a-day. PLASTERS. Plasters ought to be of a different consistence, according to the purposes for which they are intended. Such as are to be applied to the breasts or stomach ought to be soft and yielding ; while those designed for the limbs should be firm and adhesive. It has been supposed, that plasters might be impregnated with the virtues of differ- ent vegetables, by boiling the recent vegetable with the oil employed for the compo- sition of the plaster; but this treatment does not communicate to the oils any valuable qualities. The calces ot lead boiled with oils unite with them into a plaster of a proper con- sistence, which makes tho basis of several other plasters. In boiling these composi- tions, a quantity of hot water must be added from time to time to prevent the plaster from burning or growing black. This, however, should be done with care, lest it cause the matter to explode. Common Plaster.—Take of common olive oil, six pints; litharge reduced to a fine powder, two pounds and a half. Boil the litharge and oil together over a gentle fire, continually stirring them, but keeping always about half a gallon of water In the vessel; after they have boiled about three hours, a little of the plaster maybe taken out aud put into cold water, to try if it be of a proper consistence; when that is the case, the whole may be suffered to cool, and the water well pressed out of it with the hands. PLASTERS. 479 This plaster is generally applied In slight wounds and excoriations of the skin. It kuops the part soft and warm, and defends it from the air, which is all that is neces- sary in such cases. Its principal use, however, is to serve as a basis for other piasters. Adhesive Plaster.—Take of common plaster, half a pound : of Burgundy pitch, a quarter of a pound. Melt them together. This plaster is principally used for keeping on other dressings. Anodyne Plaster.— Melt an ounce of adhesive plaster, and when it is cooling, mix with it a dram of powdered opium, and the same quantity of camphor, previously rubbed up with a little oil. This plaster generally gives ease in acute pains, especially of the nervous kind. Blistering Plaster.—Take of Venice turpentine, six ounces; yellow wax, two ounces ; Spanish flies, in fine powder, three ounces; powdered mustard, one ounce. Melt the wax, and when it is warm add to it the turpentine, taking care not to evaporate it by too much heat. After the turpentine and wax are sufficiently incor- porated, sprinkle in the powders, continually stirring the moss till it be cold. Though this plaster is made in a variety of ways, one seldom meets with it of a proper consistence. When compounded with oils and other greasy substances, its effects are blunted, and it Is apt to run; while pitch and resin render it too hard, and very inconvenient. When the blistering plaster is not at hand, its place may be supplied by mixing with any soft ointment a sufficient quantity of powdered flies; or by forming them into a paste with flour and vinegar. Blistering plasters prove highly disagreeable to many people, by occasioning stran- guary. I have therefore of late used a plaster in which a small quantity of blistering salve has been mixed with the Burgundy pitch plaster. I lay it over the part affect- ed, and suffer it to remain as long as it will stick. The blistering plaster loses its effVct in a few hours, whereas this will act for many days, or even weeks, and seldom fulls to remove pain or slight obstructions. Gum Plaster.—Take of the common plaster, four pounds; gum ammoniac and galbanum, strained, of each half a pound. Melt them together, and add of Venice turpentine, six ounces. This plaster is used as a digestive, and likewise for discussing indolent tumours. Mercurial Plaster.—Take of common plaster, one pound; of 'gum ammoniac, strained, half a pound. Melt them together, and, when cooling, add eight ounces of quicksilver, previously extinguished by triture, with three ounces of hogslard. This plaster is recommended in pains of the limbs arising from a venereal cause. Indurations of the glands, and other indolent tumours, are likewise found sometimes to yield to it. .....in Stomach Platter.—Take of gum plaster, half a pound; camphorated oil, an ounce and a half; black pepper, or capsicum, where it can be had, one ounce. Melt the plaster, and mix with it the oil; then sprinkle in the pepper, previously reduced to a fine powder. ,..,..,. An ounce or two of this plaster, spread upon soft leather and applied to the re- eion of the stomach, will be of service in flatulencies arising from hysteric and hy- pochondriac affections. A little of the expressed oil of mace, or a few drops of the essential oil of mint, may be rubbed upon it before it is applied. This may supply the place of the Antihysterio Platter. Warm Plaster.—Take of gum plaster, one ounce ; blistering plaster, two drams, Melt them together, over a gentle fire. This plaster is useful in the sciatica and other fixed pains of the rheumatic kmd j 4SQ POULTICES AND POWDERS. it ought, however, to be worn for some time, and to be renewed at least once a-week. If this be found to blister the part, which is sometimes the case, it must be made with a smaller proportion of the blistering. Wax Plaster— Take of yellow wax, one pound; white resin, half a pound; mutton suet, three quarters of a pound * Melt them together. This is generally used instead of the Melilot Plaster. It is a proper application after blisters, and in other cases where a gentle digestive is necessary. POULTICES. Through some oversight, this article was omitted in the earlier editions, though it relates to a class of medicines by no means unimportant. Poultices are often beneficial, even in the most simple form ; but more so, when employed to retain more active medicines, to keep them in contact with the skin, and to fit it for their absorption. Every nurse knows how to make a poultice. A poor woman, who had received a very dangerous wound in the tendons of her thumb from a rusty nail, called upon me some little time since. As her case properly belonged to the department of surgery, I advised her to apply to the hospital; but the official hirelings there refused to take her in, though I always understood that tliey were obliged to take in accidents. It seems, however, that some very confined meaning were annexed to this word by the surgeon on duty, and that he did not think the danger of a locked jaw, to be an accident as deserving of his pity and immediate assistance, as a broken arm or dislocated ancle. The poor woman came back to me; and as her situation became every moment more and more alarming, the pain and inflammation having reached as high as the arm-pit, I advised her to apply to the whole hand and arm a large poultice, with an ounce of laudanum sprinkled over it, and to renew the poultice twice a-day. This she did with so much success, that the thumb recovered in less than three weeks. POWDERS. This is one of the most simple forms in which medicine can be administered. Many medicinal substances, however, cannot be reduced into powder, and others are too disagreeable to be taken in this form. The lighter powders may be mixed in any agreeable thin liquor, as tea or water gruel. The more ponderous will require a more consistent vehicle, as syrup, con- serve, jelly, or honey. Gums, and other substances which are difficult to powder, should be pounded along with the drier ones; but those which are too dry, especially aromatics, ought to be sprinkled during their pulverization with a few drops of any proper water. Aromatic powders are to be prepared only in small quantities at a time, and kept iu glass bottles closely stopped. Indeed no powder ought to be exposed to the air, or kept too long, otherwise their virtues will be in a great measure destroyed. Astringent Powder.—Take of alum and Japan earth, each two drams. Pound them together, and divide the whole into ten or twelve doses. In an immoderate flow of the menses, and other haemorrhages, one of these pow- ders may be taken every hour, or every half hour, if the discharge be violent. Powder of Bole.—Take of bole armenic, or French bole, two ounces; cinnamon, one ounce; tormentil root and gum arabic, of each six drams; long pepper, one dram. Let all these ingredients be reduced into a powder. This warm, glutinous astringent powder, is given in fluxes and other disorders where medicines of that class are necessary, in the dose of a scruple, or half a liaia POWDERS. 431 If a dram of opium be added, it will make the Powder of Bole tcilh Opium, which Is a'medicineof considerable efficacy. It may be taken in the same quantity as the former, but not above twice or thrice a-day. Carminative Powder.—Take of coriander seed, half an ounce ; ginger, one dram ; nutmegs, half a dram; fine sugar, a dram and a half. Reduce them into powder for twelve doses. < This powder is employed for expelling flatulencies arising from indigestion, parti- cularly those to which hysteric and hypochondriac persons are so liable. It may likewise be given in small quantities to children in their food, when troubled with gripes. .Diuretic Powder.—Take of gum arable, four ounces; purified nitre one ounce. Pound them together, and divide the whole into twenty-four doses.—During the first stage of the venereal disease, one of these powders may be taken three tiiue3 a-day, with considerable advantage. Aromatic Opening Powder.—Take the best Turkey rhubarb, cinnamon, and fine s.igar, each two drams. Let the ingredients be pounded, and afterwards mixed well together. When flatulency is accompanied with costiveness, a tea-spoonful of this powder »iav be taken once or twice a-day, according to circumstances. Saline Laxative Powder.~Ta.ke of soluble tartar, and cream of tartar, each on» drain; purified nitre half a dram. Make them into a powder. In levers and other inliammatory disorders, where it is necessary to keep the body gently open, one of these cooling laxative powders may be taken in a little gruel, and repeated occasionlly. Steel Powder.—Take tilings of steel, and loaf sugar, of each two ounces; ginger, two drams. Pound them together. In obstructions of the menses, and other cases where steel is proper, a tea-spoon- ful of this powder may be taken twice a-day, and washed down with a little wine or w Venereal excrescences, Gummata. j Gymnastic.—Excercise taken with a view to preserve or restore health.—The an- cient physicians reckoned this an important branch of medicine. Hemorrhage.—Discharge of bloody Homorrhoidt.—The piles. Hectic Fever.—A. slow consuming fever, generally attending a bad habit of the body, or some incurable and deep-rooted disease. Hypochondriacism.—Low spirits. Hypochondriac viscera.-The liver, spleen, &c. so termed from their situation in the hypochondria or upper and lateral parts of the belly. Ichor.—Thin bad matter. Imposthume.—A collection of purulent matter. Infammation.-An increased vascular action in any particular part of the body. Ligature.—Bandage. M^Zry^Eruplions.-^tootion of small pustules resembling the seeds of millet. Morbific.—Causing disease. Mucut.-The matter discharged from the nose, lungs, &o. Mysentery.-A. double membrane which connects the intestines to the back-bone. Nervous.—Irritable. Nausea.—An inclination to vomit. Nodes -Enlargements of the bones generally produced by the venereal disease. PecforoZ.-Medicines adapted to cure diseases of the breast. PelZZ-The arch of bones at the lower part of the trunk; thus named from their resembling in some measure a basin. ■D^^ardium.—Membrane containing the heart. J^u«-A membrane lining the cavity of the belly and covering the », testines. 402 GLOSSARY. Perspiration.—The matter discharged from the pores of the skin in form of vapour or sweat. Phlegmatic.—Watery, relaxed. Phlogiston.—Is here used to signify somewhat rendering the air unfit for the pur- pose of respiration. Plethoric—Replete with blood. Polypus.—A diseased excrescence, or a substance formed of coagulable lymph, frequently found in the large blood-vessels. Put.—Matter contained in a boil. Regimen.—Regulation of diet. Rectum.—The straight gut, in which the fasces are contained. Respiration.—The act of breathing. Saliva.—The fluid secreted by the glands of the mouth. Sanies.— A thin bad matter, discharged from an ill-conditioned sore. Schirrous.—A state of diseased hardness. Slough.—A part separated and thrown off by suppuration. Spasm.—A diseased contraction. Spine.—The back bone. Styptic.—A medicine for stopping the discharge of blood. Syncope.—A fainting fit attended with a complete abolition of sensation and vo- luntary motion. Tabes.—A species of consumption. Temperament.—A peculiar habit of body, of which there are generally reckoned four, viz. the sanguine, the bilious, the melancholic, and the phlegmatic. Vertigo.—Giddiness. Ulcer.—An ill-conditioned sore. Ureters.—Two long and small canals which convey the urine from tne kidneys to the bladder. Urethra.—The canal which discharges the urine from the bladder. INDEX. Ablutions, Jewish and Mahometan, well adapted for the preservation of health, 71. Abortion, causes and symptoms of, 358. Means of prevention, ib. Proper treatment in the case of, ib. Abscesses, how to be treated, 209, 384. Accidents.—See Casualties. Acids, of peculiar service in consumptions, 127. In putrid fevers, 137. Not suit- able in the measles, 16G, Acidities in the bowels of infants, the origin of, 308. Method of cure, 3C9 Aciewobth, foundling hospital at, cause of the children there being afflicted with scabbed heads, and fatal consequences of their ill treatmen:, 873, note, Addison, his remarks on the luxury of the table, 45. .32™ er, very serviceable in removing fits of the athma, 270, note. Is excellent for flatulencios, 31)1, note. ^ihiop's mineral, strongly reoommended by Dr. Cheyne in inflammations of the eyes, 1:0. Africans, their treatment of children, 7, note Agaric of the oak, its merit as a styptic, 306. Method of gathering, preparing, and applying it, 386, 387, note. Agriculture, a healthful, constant, and profitable employment, 32. Is too much neglected in favour of manufactures, ib. Gardening the most useful amusement for sedentary persons, 86. Agub, a species of fever no person can mistake, and the proper medicine for generally known, 102. Causes of, ibid. Symptoms, ibid. Regimen for, 103. Under a proper regimen will often go off without medicine, ib. Medical treat- ment of, ib. Often degenerates into obstinate chronical diseases, if not radically cured 106 Peruvian bark, the only medicine to be relied on in, 107. Children how to be treated in, ib. Preventive medicine for those who live in marshy countries, 130. . AIR confined, poisonous to children, 20. A free open air will sometimes cure tho most obstinate disorders in children. 22. Occupations which injure the health by unwholesome air, 25, 26. The qualities of act more sensibly on the body than is imarined 61. The several noxious qualities of specified, ib. In large cities, polluted oy various circumstances, ib. The air in churches how rendered un- wholesome, 62. Houses ought to be ventilated daily, ibid. The danger at- tendine small apartments, 63. Persons whose business confines them to town ought to sleep in the country, ib. High walls obstruct tho free current of a,r, ib Trees should not be planted too near to houses, 54. Fresh au- peculiarly ' ssarv for the sick, ib. The sick in hospitals in more danger from the want of freCsh air than from their disorders, ib. Wh,lesomeness of the morning air, 67. Tho changeableness of one great cause of catching cold, 87. Those who keep lost within doors tho most sensible of those changes, ib. Of the night, to bo 494 INDEX. carefully guarded against, 88. Fresh air often of more efficacy In diseases than medicine, 90. Its importance in fevers, 100. States of liable to produoe putrid fevers, 135. Must be kept cool and fresh in sick chambers under this disorder, 137. Change of, one of the most effectual remedies for the hooping-cough, 194. The qualities of, a material consideration for asthmatio patients, 277. The vari- ous ways by which it may be rendered noxious, 410. Confined, how to try and purify, ib. Method of recovering persons poisoned by foul air, 411. Fresh, of the greatest importance in fainting fits, 416. Aitken, Mr., his treatise on the nature and cure of fractures, recommended, 397, 398, note. Alcali, caustic, recommended in the stone, 223. How to prepare it, ib. note. Aliment, is capable of changing the whole constitution of the body, 42. Will in many cases answer every intention in the cure of diseases, ib. The calls of hunger and thirst sufficient for regulating the due quantity of, ib. The quality of, how injured, 43. A due mixture of vegetables necessary with our animal food, 44. To what the bad effects of tea are principally owing, 45. Water, good and bad, distinguished, ib. Inquiry into the qualities of fermented liquors, with instructions for the due makiug of them, 46. The qualities of good bread, and why adulterated by bakers, 47. General rules for the choice of food, ib. Ought not to be too uniform, 48. Meals ought to be taken at regular times, ib. Long fasting injurious both to old and young, 49. Breakfasts and suppers, ib. Changes of diet ought to be gradually made, 50. General observations on, 437. Amaurosis.—See Gutta Serena. American Indians, their method of curing the venereal disease, 346. Amusements, sedentary, improper for sedentary persons, 40. Ought always to be of an active kind, 68. Anasarca.—See Dropsy. Anger, violent fits of, injurious to the constitution, 77. Tranquillity of mind es- sential to health, ib. Animal food, cautions in giving it to children, 12. Animals that die of themselves unfit for food, 43. Over-driven cattle rendered unwholesome, ib. The artifices of butchers exposed, 44. Too great a quantity of generates the scurvy, ibid. Injurious to many habits, 48. Animals and plants, tbe analogy in the nourishment of, stated, 65. Anthony's fire, St.—See Erysipelas. Aphtha.—See Thrush. Apoplexy, who most liable to this disorder, 279. Causes, ib. Symptoms and method of cure, 280. Cautions to persons of an apopletic make, 281. Apothecary's weights, a table of 452. Apparel.—See Clothing. Appetite, want of, causes and remedies for, 283. Arbuthnot, Dr. his advice in the inflammation of the lungs, 119. Arsenic, the effects of, on the stomach, 321. Medical treatment when the symptoms appear, ib. Arts.—See Manufactures, Ascites.—See Dropsy. Asses' milk, why it seldom does any good, 124. Instructions for taking it, ib. Asthma, the different kinds of this disorder distinguished, with its causes, 276. Symptoms, ib. Regimen, 277. Medical treatment, 378* Remedies proper in the moist asthma, ib. Atmosphere.—See Air. INDEX. 495 Ball's purging vermifuge powder, preparation of, 252. Balsams, how to prepare. Anodyne balsam, 461. Looatelli's balsam, ib. Vul- nerary balsam, ib. Bandages, tight, produce most of the bad consequences attending fractured bones, 398. Bark, Peruvian, the best antidote for sailors against disorders on a foreign coast, 32. How to be administered in the ague, 104. Distinction between the red bark and quill bark, ib. note, A decoction or infusion of may be taken by those who cannot swallow it in substance, 106. Is often adulterated, ib. note. Is the only medicine to be depended on in agues, 107. How it may be rendered more palatable, ib. May be administered by clysters, ib. Cold water the best menstruum for extrac'ing the virtues of this drug, 128. How to be administered in the putrid fever, 139; and in the erysipelas, IV 3, In an inflammation of the eyes, 180. Its efficacy in a malignant quinsey, 188. In the hooping-cough, \'.)7. A good medicine in vomiting, when it proceeds from weakness of the stomach, 216. Its efficacy in a diabetes, and how to take it, 219. Is good against the piles, 229; and worms, 251. Its uso dangerous for preventing a fit of the gout, 202. A good remedy in the King's-evil, 273: and in the Jluor alius, 356. Barley water, how made, 114 Barrenness in women, the general oauses of, 385. Course of relief, ib. Dr. Cheyne's observations on, ib. note. Bath waters good in the gout, &c. 430. Bath, cold, the good effects of on children, 19. Recommended to the studious, 41. Is peculiarly excellent for strengthening the nervous system, 289. There- fore should never bo omitted in gleets, 338. Is good for ricketty children, 379. Apoplexies frequently occasioned by the improper use of, 422. Absurd pre- judices against, ib. Nothing contributes moro to permanent health, ib. A single plunge or dip sufficient, continuing too long in it dangerous, ib. Morning tbe properest time for bathing, ib. Rules to be observed in the use of, 423. Is peculiarly salutary in scrofulous complaints, ib. Sea water preferable to river water, ib. Bath warm, of great servico in an inflammation of the stomach, 198. Bathing, a religious duty under the Judaio and Mahometan laws, 71. Is con- ducive to health, ib. Beab's-Foot, recommended as a powerful remedy against worms, 251. Beds, instead of being made up again as soon as persons arise from them, ought to de turned down and exposed to the air, 62. Bad effects of too great in- diligence in bed, 60. Damp the danger of, 89. Soft, are injurious to the kid BBER?the ul consequences of making it too weak, 46. Pernicious artifloes of ths dealers in, 47. Bells, parish, the tolling them for the dead a dangerous custom, 78. Biles, 385. Bilious colic, symptoms and treatment of, 203. ._____. fever.—See Fever. Bitb of a mad dog.—See Dog. .... ... Bitthbs warm and astringent, antidotes to agues, 108. Are serviceable in vomit- ine when it proceeds from weakness of the stomach, 216. Bladder, inflammation of, its general causes, 207. Medical treatment of. ib. _______, stone iu.—See Stone. JitASI.—-«■« ErysipeUi*. 496 INDEX. Bleeding, cautions for the operations of in fcver9, 100. In tho ague, 104. Its importance in the acute continual fever, 111. In the pleurisy, 115. When ne- cessary in the inflammation of the lungs, 119. Cautions against in a nervous fe- ver, 132. In the putrid fever, 139. In the miliary fever, 144. When necessary in the small-pox, 154. When useful in the measles, 166. When necessary in the bilious fever, 109. Under what circumstances proper in the erysipelas, 172. Mode of proper in an inflammation of the brain, 176. Is always necessary in an inflammation of the eyes, 178. When proper and improper in a cough, 191. When proper in the hooping-cough, 195. Is almost the only thing to be de- pended on in an inflammation of the stomach, 198. And in an inflammation of the intestines, 199. Is necessary in an inflammation of tho kidneys, POO. Its use in a suppression of urine, 2-20. Is proper in an asthma, 278, Is dangerous in fainting fits without due caution, 800. Cautions proper in a puerperal fever, 368. Is an operation generally performed by persons who do not understand when it is proper, 382. In what cases it ought to be had recourse to, ib. The quantity taken away, how to be regulated, 383. General rules for the operation, ib. Objections to bleeding by leeches, ib. Prevailing prejudices relative to bleeding, ib. The arm the most commodious part to take blood from, 384, Bleeding at the nose, spontaneous, is of more service where bleeding is neces- sary, than the operation of the lancet, 226. Ought not to be stopped without due consideration, ib. How to stop it when necessary, ib. Cautions to pre- vent frequent returns of, 227. Blind persons, when born so, might bo educated to employments suited to their capacity, 3U9, note. Blisters, peculiarly advantageous in the nervous "fever, 182. When only to be applied in the putrid fever, 139. When proper in the miliary fever, 144. Sel- dom fail to romovo tho most obstinate inflammation of the eye3, 179. A good remedy in the quinsey, 184. Proper for a violent hooping-cough, 196. Is one of the best remedies for au inflammation of the stomach, 198. Are efficacious in the tooth-ache, 224. Blood, involuntary discharges of often salutary, and ought not to be rashly stop- ped, 224. The several kinds of these discharges, with their usual causes, ib. Methods of cure, 225. ■-----, spitting of, who most subject to, and at what seasons, 231. Its causes, ib. Symptoms, ib. Proper regimen in 23i. Medical treatment, ib. Cautions for persons subject to, 233. ■-----, vomiting of, its causes and symptoms, 233. Medical treatment, ib. BLOOD-shot eye, how to cure, 311. Bloody-flux.—See Dysentery. Boerhaave, his observations on dress, 64, note. Mechanical expedients to relieve an inflammation of the brain, 175. Boluses, general rules for the preparing of, 461. The astringent bolns, 462. Diaphoretio bolus, ib. Mercurial bolus, ib. Bolus of rhubarb and mercury, ib. Pectoral bolus, ib. Purging bolus, ib. Bones, the exfoliation of a very slow operation, 390. Bones broken, often sue- cessl'ully undertaken by ignorant operators, 397. Regimen to be adopted after the accident, ib. Hints if the patient is confined to his bed, ib. Cleanliness to be regarded during his confinement, 898. The limb not to be kept on the stretch, ib. Cautions to bo observed in setting a bone, ib. Tight bandages con- demned, ib. How to keep tho limb steadv l>v »w nasy method, ib. Fracturos ot tho ribs, .91. INDEX. 49" Rowr.LS, inflammation of.—See Stomach. Boys, tho military exercise proper for them, 17. Brain, inflammation of, who most liable to it, with its causes and symptoms, 174. Regimen, 175. Medical treatment, ib. Dread, proper food for children as soon as they can chew it, il. A crust of the best gum-tick, 12. The best modes of preparing it in food for children, ib. Good, the qualities of and for what purpose adulterated by the bakers, 47. Toasted, a decoction of good to check the vomitings in a cholera morbus, 211. A surfeit of more dangerous than any other food, 441. The finest not always the best adapted for nutrition, ib. Household bread the most wholetome, ib. Wheat flour apt to occasion constipation, ib. Different kinds of grain mal:« tho best broad, ib. Consumption of bread increased by drinking tea, ib. Buck wheat highly nutritious, 443. Various substitutes for bread, 414. BaiMST0NE.--S<.'0 Sulphur. Broths, gelatinous recommended in the dysentery, how to make, 237. Broths and soups, various ingredients in the composition of, 439, 440. General observations on, ib. Tne most wholesome diet for the poor, ib. Bruises, why of worso consequences than wounds, 389. Proper treatment of, 320. The exfoliation of injured boucs a very slow operation, ib. How to cure sores occasioned by, ib. * Bubobs, two kinds distinguished, with their proper treatment, 310. Burdens heavy, injurious to the lungs, 27. Burgundy pitch, a plaster of between the shoulders an excellent remedy in a cough 19'. In a hooping-cough, 196. And for children in teething, 377- Burials' thedangers attending their being allowedin the midst of populous towns.52. Burns, slight, how to cure, 388. Treatment of when violent, 399. Extraordinary gase of, ib. Liniment for, 476. Butchers, their professional artifices explained and condemned, 43. Butter ought to bo very sparingly given to children, 14. Used in large quantities very injurious.to tho stomach, having a constant tendency to turn rancid, 443. Cabbaob leaves, topical application of in a pleurisy, 116. Camphor, why of little use in eye-waters, 464. Camporated oil, preparation of, 476. Camphorated spirit of wine, 485. Cancer its different stages described, with the producing causes 316. Symptoms, Z;. Regimen aud medical treatment, ib. Dr. Storck's method of treating this disorder, 318. Cautions for avoiding it, 320. f„r„i„.n CA^csn scroti, a disorder peculiar to cliimney-sweepers, owing to want of dean- CARR^G^'themdulgence of, a sacrifice of health to vanity, 68. Carrot, wild,' recommended in the stone, 223. .____- poultice for cancers, how to prepare, 319. ______oronerly manufactured, may supply the place of bread 445. cTs^alties, which apparently put an end to life, necessary cautions respecting, 401, _________. substances stopped in the gullet, 403. . drowning, 406. / ______ - noxious vapours, 410. _ extremity of cold, 411. ________extreme heat, 413. / ^pITms, their general intentions, 462. Preparation, of the dVuticut cat* plas.ii, ib. Keening catapluooi, 10. 2 k 498 INDEX. Cataract, the disorder and its proper treatment descrilod, 310. Cattle, stall fed, are unwholesome focfd, 43. Over-driven are killed in a high fever, ib.. The artifices of butchers exposed, ib. Cellars, long shut, ought to be cautiously opened, 53. And sunk stories, of houses unhealthy to live in, 90. Of liquors in a state of fermentation dangerous to enter, 410. How to purify the air iu, ib. Celsvs, his rules for the preservation of health, 92, Chancres, described, 341. Primary, how to treat, ib. Symptomatic, 342. Charcoal fibe, the danger of sleeping in the fume of, 410. Chekse, as a diet, injurious to health, 444. Chkyne, Dr., his persuasive to the use of exercise, 57. His judgment of the due quantity of urine not to be relied on, 86. Strongly recommends .ffithiop's mineral in inflammation of the eyes, 180. His observations on barrenness, 385, note. Chilblains, cause of, 373. How to cure, ib. Child-bkd women, how to be treated under a miliary fever, 3i;2. Child-bed fever.— See Fever. Child-birth, the season of, requires due care after the labour pains are over, 359. Medical advice to women iu labour, 360. How to guard against the miliary fever, 3(j2. Symptoms of the puerperal fever, ib. Proper treatment of this fever, ib.. General caution for women at this season, 363, 364. Children, their diseases generally acute, and delay dangerous, 4. Their disorders less complicated and easier cured than those of adults, ib. Are often the heirs of the diseases of their parents, 6. Those born of diseased parents require peculiar care in the nursing, ib. Are often lulled or deformed by injudicious clothing, 6. The usual causes of deformity in explained, 8. Their clothes ought to be fastened on with strings, 9. General rules for clothing them, ib. Cleanliness an important article in their dress, 10, The milk of the mother the most natural food fur, ib. Absurdity of giving them drugs as their first food, ib. The best method of expelling the meconium, 11. How they ought to be weaned from the breast, ib. A crust of bread the best gum-stick for them, 12. How to prepare bread in their food, ib. Errors in the quality of their food more frequent than in the quantity, ib. The food of adults improper tochildren, ib. Strong liquors expose them to inflammatory disorders, 13. Ill effects of unripe fruit, ib. Butter, 14. Honey a wholesome article of food for them, ib- The importance of exercise to promote their growth and strength, ib. Rules for their exercise, 15. Poverty of parents occasion their neglecting children, 17. The utility of exercise demonstrated from the organical structure of children, ib. Philosophical arguments showing the necessity of exercise, ib. Ought not to be sent to school too soon, 17. Nor be put too soon to labour, 92. Dancin" an excellent exercise for them, 19. The cold bath, Kb. Waut of wholesome air destructive to children, 20. To wrap them up close in cradles pernicious, 21. Are treated like plants in a hothouso, ib. The usual faulty conduct of nurses pointed out, 22. Are crammed with cordials by indolent*Durses, 28. Eruptions iguorautly treated by nurses, ib. Loose stools, the proper treatment of, 24. Every method ought to be taken, to make them strotig and hardy, ib. Indie*. tions of tho small-pox in, 148. Cm n cough.—See Cough. Cholera morbus, the disorder defined, with its causes and symptoms, 211 Medical treatment, ib. Churches, the severeal circumstances that render the air in unwholesome, 58. CtuixuiNG c.v wombs alter lying in, a dangerous custom, ai>i. INDEX. 499 Churohyards, the bad consequences of having them in large towns, 52. Cities, large, the air in contaminated by various means, 52. The bad effects of bury. ing the dead in, ib. Houses ought to be ventilated daily, ib. The danger at- tending small apartments, 53. AU who can, ought to sleep in the country, ib. Disorders that large towns are peculiarly liable to, 54. Cleanliness not sufficiently attended to in, 70. Should be supplied with plenty of water, 72, note. The best means to guard against infection in, 75. Clare, Mr., his method of applying saline preparations of mercury in venerevd cases, 345. Cleanliness, an important article of attention in the dress of children, 10; and to sedentary artists, 35, Finery in dress often covers dirt, 64. Is necessary to health, 69. Disorders originating from the want of. ib. Is not sufficiently attended to in large towns, 70. Nor by country peasants, ib. Great attention paid to by by the Romans, 70, note. Necessity of consulting cleanliness in camps, 71. Was the principal object of the whole system of the Jewish laws, ib. Is a great part of the religion of the Eastern countries, ib. Bathing and washing conducive to health, ib. Cleanliness peculiarly necessary on board of ships, 72, and to the sick, ib. General remarks on, ib. Many disorders may be cured by cleanliness alone, 96. The want of a very general cause of putrid fevers, 135. Is a great pre- servative against venereal infection, 348, and against galling in infants, 369. Clergy, exhorted to remove popular prejudices against inoculation, 160. Might do great good by undertaking the practice of it themselves, 162. Clothing, the only natural use of, 6. That of children has become a secret art, ib. Ought to be fastened on infants with strings instead of pins, 9. Pernicious conse- quences of stays, ib. Importance of cleanliness to children, 10. The due quantity of dictated by the climate, 61. Should be increased in the decline of life, 62, and adapted to the seasons, ib. Is often hurtful by being made subservient to the purposes of vanity, ib. Pernicious consequents of attempting to mend the shapo by dress, ib. Stays, ib. Shoes, 03. Garters, buckles, and other banda-es, ib. The perfectipn of to be easy and clean, ib. General remarks on, 64. Wet, tho danger of and how to guard against it, '88. Clysters, a proper form of for an inflammation of tho stomach, 198. And after an inflammation of the intestines, 200. Of tobaeco smoke, its efficacy in procurin- a stool, 204, note. Of chicken-broth, salutary in the cholera morbus, 211. Their use in suppression of urine, 220. Ought to be frequently administered in the pu- erperal fever, 363. Of tobacco, to excite a vomit, 405. Of tobacco fumes to sti- mulate the intestines, 408. The general intention of, 463. Preparation of the emollient clyster, ib. Laxative clyster, ib. Carminative clyster, ib. Oily clys- ter, ib. Starch clyster, ib. Turpentine clyster, 464. Vinegar clyster, ib. Cceliac passion, proper treatment for,#289. Coffee bkheies recommended in the stone, 233, Cold, extreme, its effects on the human frame, 411. The sudden app,cation of heat dangerous in such cases, 412. How to recover frozen or benumbed limbs, ib. Cold bath.—See Bath. Colds frequently occasioned by the itaprudent changes of .clothes at tue first ap- proaches of summer, 62, note. Various causes of specified, 90, 91. Tlieirgeneu.il causes, 189. Proper regimen on the symptoms appearing, ib. Danger of neglea- ing the disorder, 190. . Colics different species of, 201. Medical treatment of according to the species of 202 ' Bilious colic, 203. Hysteric colic, ib. Nervous colic, 204. Oautions ne- cess'uy to guard against the nervous colic, 205. General advice in colics, ib. 500 indix. Coi.lyiua.—See Eye-water*. Commerce imports often infectious disorders, 74. Confections, often very needlessly compounded, 465. Preparation of the Japonie confection, ib. Conserves and preserves, general remarks on and their composition, 465. Oi red roses, ib. Of sloes, ib. Candied orange peel, ib. Constitution, good or bad, the foundation of generally laid during infancy, 1. Consumptions, the increase of this disorder may be attributed to hard drinking, 67. Who most liable to, and its cause, 120. Symptoms, 122. Regimen, ib. Riding, 123. Much benefit to be expected from going a long voyage, ib. Tra- velling, ib. Diet, 150. Great efficacy of milk in, 124. Medical treatment, 126. ., nervous, defined, and the persons most liable to, 128. Proper treat. ment of, ib, .-------------Symptomatic, the treatment of must be directed to the producing rause, 129. Consumption, means of detecting and preventing, 129. Convulsions, why new born infants are liable to, 9. These preceding the erup- tion of small-pox, favourable symptoms, 148. The geneneral causes of, 379. Pro- par treatment of, ib. Extraordinary recovery of an infant seemingly killed by, 420. Farther instructions in like cases, 421. Cook, Captain, the circumnavigator, his means of preserving the health of his men, 31, note. Cookery, the arts of, render many things unwholesome that are not naturally so, 45. Roasting meat a wasteful mode of, 439. Cordials ought not to be given to infants, 11. Are the common refuge of nurses, who neglect their duty to children, 23. Are often fatal in an inflammation of the stomach, 198. When good in the gout, 261. Ought not to be given to a pregnant woman during labour, 359. Corn, damaged will produce the putrid fever, 135. Corns, in the feet are occasioned by wearing tight shoes, 63. Cortex. See Bark, Costivkness, a frequent recourse to medicines for the prevention of injurious to the constitution, 85. Is rather to be removed by diet than by drugs, lb. Its general causes and ill effects, 281. Reginen, 282. Remedies for, ib. Coughs, the proper remedies for, 191. A plaster of Burgundy-pitch laid between the shoulders an excellent remedy for, 492. The stomach cough and cough of the lungs distinguished, 193. Treatment for the nervous cough, ib. Cough, hooping, who most liable to, with its disposing causes. 194. Remedies, ib. Is infectious, ib. Vomits, their use, and how to administer them to children, 195. Garlic ointment a good remedy for, J96. Cough, phthisical, incident to sedentary artificers from their breathing confined air, 33. Cow-rox, remarks on 431. Is a complete preservation from the small-pox, 432. Mode of inoculation with, ib. Descriptions of the symptoms which accompany the genuine, 433. T/eatment, 436. Inoculation with when advisable, 437. Cradles, on many accounts hurtful to children, 21. Cramp, proper remedies for, 306. Cramp in the stomach, who most subject to, 297. Medical treatment of, ib. Crotchets, how to use for extracting substances detained in the gullet, 404. Croup in children described, 374. Its symptoms and proper treatment, ib. Cyder, the ill consequences of making it too weak, 46. INDEX. 501 Dancing, an excellent kind of exercise for young persons, 19. Daucus sylvkstris.—See Carrot. Deafness, when a favourable symptom in the putrid fever, 137, note. Methods of cure according to its causes, 312. A new operation for the cure of proposed, ib. note. Death , the evidences of sometimes fallacious, and ought not to be too soon credited, 402, 406, 409. The means to be used for the recovery of persons from, nearly the same in all cases, 421. Decoctions, general remarks on, 466. Preparation of the decoction of a!thee, ib. Common decoction, ib. Of logwood, ib. Of bark, ib. Compound decoction of bark, ib. Of Sarsaparilla, ib. Of seneka, 467. White decoction, ib. Deformity, often occasioned by the injudicious method of dressing children, 6. Is seldom found among savage nations, 7- The usual causes of explained, 8. Dews, night dangerous to health, 88. Diabetes, who most liable to this disorder, 217- Its causes and symptoms, ib. Regimen and medical treatment, 218. Distinguished from incontinency of urine, 219. Diarrhoea.—See Loesenest, Diet, will often answer all the Intentions of cure in diseases, 95. Illustrations, lb. General observations on, 486. Improper diet affects the mind as well as ths body, 488. Vegetable ought to preponderate over animal food, 439.—See Aliment. Dioestion, the powers of equally impaired by repletion or inanition, 48, Diseases, hereditary, cautions to persons afflicted with, 5. Peculiar disorders at- tending particular occupations, 26. Many of them infectious, 78. The knowledge of depends more upon experience and observations, than upon scientific principles, 93. Are to be distinguished by the most obvious and permanent symptoms, lb. The difference of age, sex, and constitution, to be considered, ib. Of the mind, to be distinguished from those of the body, 94. Climate, situation, and occupation, to be attended to, ib. Other collateral circumstances, ib. Many Indications of cure to be answered by diet, alone, ib. Cures often effected by fresh air, by ex- ercise, or by cleanliness, 96. Nervous diseases, of a complicated nature, and diffi- cult to cure, 235. Dislocation, should be reduced before the swelling and inflammation comes on, and how 393. Of the jaw, ib. Of the neck, 394. Of the ribs, ib. Of the shoulder, 395.' Of the elbow, 396. Of the thigh, ib. Of the knees, ancles, and toes, tb. Diuretic Infusion for the Dropsy, how to prepare, 2S8. Dog symptoms of madness in, 823. Ought to be carefully preserved, after biting to'ascertain whether he ismad or not, 824. Is often reputed mad when he is not so ib. Symptoms of a bite of a mad dog, ib. The poison cannot he many years dormant in the body, as is supposed, -325. Dr. Mead's receipt for the bite ,b. The famous East India specific for, ib. Other recipes, 326. Vinegar of considera- ble service in this disorder, ib. Medical course of treatment recommended 327- Beg .nT!b. Dipping in the sea not to be relied on, ib. Dr Tissot'., medical course for the cure of the hydrophobia, 328. Remarks on the Onnkirk medicine, 328, note. ,._ ... Dosfs of medicine, the relative proportions of for different ages, 451. Drams oughrHo be avoided by persons afflicted with nervous disorders 237. Sought, is the proper form for such medicines as are intended or immediate operation, 467. How to prepare the anodyne draught, ib. Diuretic draught, ib. Purging draught, ib. Sweating draught, 468. Vomiting draught, ib. riBEss — 5-ee Clothing. . ...,.,. Jkimuno, ^ons, who are seldom intoxicated may nevertheless injure Ukii 5C2 ixsr.x. constitutions; by, 6/. The habit of drinking 'frequently originates from mlsfor* tunes, ib. Frequently destroys the powers of the mind, ib. Leads to other vices, 68. Dftorsv, the several distinctions of with its causes, 255. Symptoms, 256. Regimen, 256. Medical treatment, ib. Tapping a safe and simple operation, 359. Dropsy op the brain.—See Water in the head. Drowned persons, ought not to be rashly given up for dead, 407. Proper trials for the recovery of, ib. Endeavours ought not to be suspended, upon the first re- turns of life, 409. Drunkenness.—See Intoxication. Dumb persons, may be taught to read, write, and discourse, 319, note. Dysentery, when and where most prevalent, 235. Its causes and symptoms, 236. Regimen, ib. Fruit, one of the best remedies for, 238. Proper drink for, ib. Medical treatment, ib. Cautions to prevent a relapse, 239. Ear, the several injuries it is liable to, 312. Deaftiess, medical treatment of accord. ing to its causes, ib. Ought not to be tampered with, 313. Ear-ache, its causes and proper treatment for, 245. How to drive insects out of, 246. Education op children, snould be begun at nome by the parents, 17, note. That of girls hurtful to the constitution, 18. Effluvia, putrid, will occasion the spotted fever, 135. Electricity, beneficial in the palsy, 293. Electuaries, general rules for making, 468. Preparation of lenitive electuary, ib. Electuary for the dysentery, ib. For the epilepsy, ib. For the gonorrhoea, 469. Of the bark, ib. For the piles, ib. For the palsy, ib. For the rheumatism, ib. Elixir, paregoric, how to prepare, 484. Sacred elixir, ib. Stomachic elixir, 485. Acid elixir of vitriol, ib. Emulsions, their use, 469. Preparations of the common emulsion, ib. Arabic emulsion, ib. Camphorated emulsion, ib. Emulsion of gum-ammoniac, 470. Oily emulsion, ib. Engleman, Dr. his account of the German method of recovering persons from faint- ing fits, 415. Entrails.—See Intestines. Epilepsy, the disorder defined, 294. Its causes and symptoms, ib. Due regimen, z95. Medical treatment, ib, Eruption sin children often free them from bad humours, but are mistaken, and ill-treated by nurses, 23. Ought never to be stopped without proper advice, ib. In fevers how to be treated, 139, 142, 143. In the small pox, 148. In children the causes of, 872. How to cure, 373. Erysipelas, a disorder incident to the laborious, 28. Its causes explained, and who most subject to it, 170. Its symptoms, ib. Regimen, 171. Medical treatment, 172. The scorbutic erysipelas, 173. Instructions for those who are subject to this dis- order, ib. Evacuations of the human body, the principal specified, 84. By stool, ib. Urine, 85. Perspiration, 87. Exercise, the importance of, to promote the growth and strength of children. 14. All young animals exert their organs of motion as seon as they are able, 15. The utility of proved from anatomical considerations, 16. And from philosophical de- ductions, ib. Military exercise recommended for boys, 17. Benefits of dancing, 19. Is better for sedentary persons under lowness of spirits than the tavern, 35. Gar« dening the best exercise for the sedentary, 36 Violent ought not to be taken aftel a full meal, 41. Is as necessary as food for the preservation of health, 55. Oui love of activity an evidence of its utility, 56. Indolence relaxes the solids, ib. JS3BX. f.r>3 Tiie Indulgence of carriages as absurb as pernicious, lb. Is almost the only c.i.« for glandular obstructions, ib. Will prevent and remove those disorders that me- dicine cannot cure, 57. Active sports better than sedentary amusements, 58, Exercise should not be extended to fatigue, ib. Is as necessary for the mind as for the body, 81. Is often of mbre efficacy than any medicine whatever, 96. The best mode of taking in a consumption, 123. Is of the greatest importance in a dropsy, 257. Ig necessary for the asthmatic, 277. Is superior to all medicine in nervous disorders, 238. And in the palsy, 294. Is proper for pregnant women, unless they are of a very delicate texture, 358. Want of, the occasion of rickets in children, 377. Extracts, general rules for making, but are more conveniently purchased ready made, 470. Eyes, inflammation of, its general causes, 177. Symptoms, lb. Medical treatment 178. How.to be treated when it proceeds from scrofulous habit, 180. Advice to those who are subject to this complaint ib. Are subject to many diseases which are difficult to cure, 309. The means by which they are frequently injured, ib. General means of prevention, 310. The several disorders of, with their medical treatment, 310, 311. Eyb-waters, general remarks on, and their principal intentions, 404. Collyrium ol alum, ib. Vitriolic collyrium. ib. Collyrium of lead, ib. Fainting-fits, how to cure, 30O» 413. Cautions to persons subject to them, 414 Bleeding dangerous in, ib. Falling-sickness.—See Epilepsy. Fasting, long, injurious to those who labour hard, 29. Is hurtful both to old and young, 49. Fathers culpably inattentive- to the management of their children, 8. Their irregular lives often injure the constitutions of their children, 5. Fear, the influence of very great in occasioning and aggravating diseases, 77. Its various operations, 78, 79. Feet, injured by wearing tight shoe?, 63. The washing of an agreeable article of cleanliness, 71. Wet, the danger of, 88. Bathing them in warm water, a 6 ,.,4 remedy in a cold, 190. And in the hooping cough, 196. Fermentation, the vapour of liquors in a state of, noxious, 410. Fevers of a bad kind often occasioned amon* labourers by poor living, 29. Fro. ouently attack sedentary persons after hard drinking, 35. Nervous, often the consequence of intense study, 38. Putrid and malignant often occasioned by want of cleanliness, 69. The most general causes of enumerated, 97. The distinguishing svmntoms of, ib. The several species of, 98. Is au effort of nature which ought to be assisted, ib. How this is to be done, ib. Cordials and sweetmeats improper in 100. Fresh air of great importance in, ib. The mind of the patient ought Lot to be alarmed with religious terrors, ib. Cautions as to bleeding and sweating Tn ib. Longings the callsof nature, and deserve attention, 101. Cautions to pre- vent a relapse ib. 109. Causes, ib. Symptoms, ib. F "_3-H. S«nt, 1,1. Symptoms favourable and unfavourable, 11, FK£ Sner^Si^pe^ 109. Proper treatment of accordin. to Its symptoms, ib. FtfVER, ln^tt!^"^t,?";.«. derived, and itsgeneralappearances, 141. Who tmo?UUbleTo'[t,ib. Causes, 142, Symptoms, ib. Regimen, 143. Prc,,,r _*_. 504 INDEX. cal treatment, 144. Cautions for avoiding this disorder, 145. How to prevent in child-bed women, 440. Fever, milk, how occasioned, 361, How to prevent, ib. Fevbb, nervous, why more common than formerly, and who most liable to it, 130. Its causes, ib. Symptoms and proper regimen, 131. Medical treatment, 132. Fever, puerperal or childbed, the time of its attack and symptoms, 362. Medical treatment of, 303. Cautions for the prevention of this fever, 364. Fevkr, putrid, is of a pestilential nature, and who most liable to It, 135. Its general causes, ib. Symptoms of, 136. Other fevers may be converted to this by improper treatment, ib. Favourable and unfavourable symptoms of, 137. Regi- men,ib. Medical treatment, 139. Cautions for the prevention of this disorder, 140. Fever, remitting, derivation of its name, 145. Its causes and symptoms, ib. 148. Proper regimen, ib. Medical treatment, 147. Cautions for avoiding this fever, ib Fever, scarlet, why so named, and its usual season of attack, 167. Proper treat- ment of, 168. Is sometimes attended with putrid and malignant symptoms, ib. Medicines adapted to this stage of the malady, ib. Feveii, secondary, in the small-pox, proper treatment of, 154. Flatulencies in the stomach, remedies against, 301. The several causes of, ib. Medical treatment of, 302. Flatulent colic, its causes and seat of the disorder, 202. Remedies for, ib. Flower-de-luce, the yellow water, the root of recommended for tbe tooth-ache 244. Fluor albus described, with its proper treatment, 956. Fomentations, how to make and apply, 470. General intentions of, ib. Anodyne fomentation, ib. Aromatic fomentation, ib. Common fomentation, ib. Emollient fomentation, ib. Strengthening fomentation, 471. Food.—See Aliment. Forgiveness up injuries ought to be practised from a regard to our own health, 77. Fractures.—See Bones, broken. Frozen limbs, how to recover, 412. Fruit, unripe, very hurtful to children, 13. Ripe, one of the best medicines both for the prevention and cure of a dysentery, 237. Fruits occasionally substitutes for bread, 444. The plantain tree used for that purpose in warm climates, ib. Funerals, the great number of visitors attending them dangerous to health, 74, Galling, in infants, the cause and cure of, 369. Gangrene, proper treatment of, 385. Gardening, a wholesome amusement for sedentary persons, 36. Gargles por the throat, how to make, 183, 186. General intentions of, 471. Method of making the attenuating gargle, ib. Common gargle, ib. Detergent gargle, ib. Emollient gargle, ib. Garlic ointment, a North British remedy for the hooping-cough, how to apply, 195. Gilders.—See Miners. Ginger, syrup of, how to prepare, 482. Girls, the common mode of education prejudicial to their constitution, 18. Means of rectifying it recommended, ib. Gleet, how occasioned and its symptoms, 337. Regimen, 338. Obstinate gleets cured by mercurial inunctions, 339. How to apply bougies, ib. Glover, Mr, his course of treatment for the recovery of a hanged man, 419. ■ Gonorrhoea, virulent, the nature of auditssymptoms, 332. Regimen, 333. Medical treatment, ib. Is often cured by astringent injections, 334. Cooling purges always proper in, ib. Mercufy seldom necessary in a gonorrhoea, 335. How to adminis- ter it when needful, ib. INDEX. 505 Goulard, Mr, his preparation of his celebrated extract of Saturn, 486. His vari- ous applications of it, ib. « Gout, the general causes of, 37. How to treat a looseness occasioned by repelling it from the extremities, 214. The sources of this disorder, and its symptoms, 251), 260. Regimen for) 201. Wool the best external application in, ib. Proper medicines after the fit, 262. Proper regimen in the intervals between the fits to keep off their returns, 263 How to remove it from tjie nobler parts of-the ex- trcmitles, 264. General cautions to prevent danger by mistaking it for other dis- orders, ib. Grain, various kinds of when boiled a good substitute for bread, '442. The culture of recommended, as it promotes health and longevity, 447. No manufacture equal to the manufacture of, 447. The scarcity of occasioned by the number of horses, ib. Gravel, how formed in the bladder, 86. How distinguished from the stone, 220. Causes and symptoms, 221. Re-jimen, ib. Medical treatment, 222. Green sickness, originates in indolence, 353. Grief, its effect, permanent, and often fatal, 80. Danger of the mind dwelling long upon one subject, especially If of a disagreeable nature, ib. The mind requires ex- ercise as well as the body, 81. Innocent amusements not to be neglected, ib. Is productive of nervous diseases, 286. Gripes in infants, proper treatment of, 868. Guaiacum, gum, a good remedy for the quinsey, 183. And rheumatism, 263. Gullet, how to remove substances detained in, 403. Cautions for the use of crotchets with this intention, 404. Other mechanical expedients, ib. Treatment If the obstructions cannot be removed, 405. Gums op children, application to during teething, and how to cut them, 376 Cuita serena, proper treatment of, 310. H.emoptob, spitting of blood.—See Blood. Hemorrhages.—See Blood. Harrogate wateb, an excellent medicine for expelling worms, 4?8. And for the jaundice, ib. In scurvy, ib. • Head-ache, the species of distinguished, 240. Causes, ib. Regimen, 242. Medical treatment, 243. Health o* the people in general, a proper object of attention for the ma- cistrates xi. Ought to be attended to in matrimonial contracts, 5. Is often laboured for after it is destroyed, 41. Rules given by Celsus for the preserva- HeabtVubn, the nature of this disorder, with its causes and remedies for, 284. Heat, extreme, how to recover persons overcome by, 413. Hemlock, a good remedy in the King's evil, 273. I. recommended, by Dr. ' Storck for the cure of cancers, 318. Hempseed, a decoction of good in the jaundice, and how to prepare it, 25,. Hiccup, its causes and method of treatment, 296. Hopfma^, his rules for guarding child-bed women against the miliary fever, 362. Honey, a wholesome article of food for children, 17. Is recommended in the stone, 223. HoBS^AmsTthTchewir^ofwai restore sensibility to the organs of taste when injured, 318. ^^ ^ ^^ ^ ^ ^^ dMgerons to thepatients than their Alters 53 Cleanliness peculiarly necessary in, 72. Often spread infection by being Vduated in the middle of populous towns, 75. How they might be reu- 50G INPKX, dored proper receptacles for the si«k, 70. Particularly in infectious disor- ders, ib. • Houses, instead of contrivances to make them close and warm, ought to be regu- larly ventilated, r>2. In marshy situations unwholesome, 54. Ought to be built in a dry situation, 90. Danger of inhabiting new-built houses before thoroughly dry, ib. Are often rendered damp by unseasonable cleanliness, ib. Are dan- gerous when kept too clcjpo and hot, 92. Husbandmen, the peculiar disorders they are exposed to from the vicissitudes of the weather, 27. Huxham, Dr., recommends the study of the dietetio part ef medicine, xi. Hydrocephalus —See Dropsy. Hydrophobia, Dr. Tissot's method of curing, 328. Hydrops Pectoris.—See Dropsy. Hypochondriac Affections, frequently produced by intense study, 38. Their causes, and who most subject to them, .306. The general intentions of cure, 307. Regimen, 308. Hysterics, a disorder produced by the habitual use of tea, 44. General causes of, 303. Symptoms, ib. Proper treatment of, 304. Regimen, ib. Medicines adapted to, 805. Hysteric Colic, symptoms and treatment of, 208. Jails, why malignant fevers are often generated in them, 52. Often spread an infection by being situated in the middle of populous towns, 71- Ought to be removed, 76. Janin, M., his relation of the recovery of an overlaid infant, 419. And of a man who had hanged himself, lb. Jaundice, the different stages of its appearance, with the causes of this dis- order, 253. Symptoms, ib. Regimen, 254. .Medical treatment, ib. Jesuit's Babk.—See Bark. Jews, the whole system of their laws tending to promote cleanliness, 71. Iliac Passion, a particular bind of inflammation in the intestines, 199. Imposthume in the brbast, in consumptions, how to make it break inwardly, when not to be discharged by other means, 128. Imposthumes after the small- pox, proper treatment of, 155. Incontinenoy o» uhine, distinguished from a diabetes, 219. Expedient for relief, ib. Indiqestion, is one of the consequences of intense study, 38. General causes and remedies for, 284. Indolence, its bad effects on the constitution, 56. Occasions glandular obstruc- tions, ib. HI consequences of too much indulgence in bed, 57. Is the parent of vice, 59. Is the general cause of most nervous disorders, 286. Infancy, the foundation of a good or bad constitution generally laid in this season of life, 1. Infants, nearly one half of those born in Great Britain die under twelve years of age, .1. Perish mostly by art, ib- Ought not to be suckled by delicate women, 2. Importance of their being nursed by their mothers, ib* Often lose their lives, or become deformed, by errors in clothing them, 6- How the art of bandaging them became the province of the midwife, 7* Philosophical ob- servations on their original structure, and on the causes of deformity, 8. Why they so frequently die of convulsions, 9. Why exposed to fevers, ib. And colds, ib- Rules for their dress, ib, Their food, 10. Reflections on the many evils they are exposed to, 365. Why their first disorders are in their bowels, ■ IXDEX. ."507 fb. lTow to cleanse their bowels, ib The meconium, 30?. Thrush, ib- Acidi- ties, 868. Gripes, ib- Galling and excoriation, 369- Stoppago of the nose, 370. Vomiting, ib. Looseness, 371. Eruptions, 372. Scabbed head, ib. Chil- blains, 373. Tho Croup, 374. Teething, 875- Rickets, 377- Convulsions, 37J, Water in the head, 380- How to recover infants seemingly dead, 418. Oought never to sleep in the samo bed with their mothers or nurses, 418, note. Casi of the recovery of an overlaid infant, 419, Case of an infant being seemins.y killed by a strong convulsion fit, and recovered, 420. See Children- Infection, the danger of, incurred by injudicious or unnecessary attendance on the sick, 73- And on funerals, 74- Is often communicated by clothes, ib Is frequently imported, ib. Is spread by hospitals and jails being situated in the middle of populous towns, 75- How to prevent infection in sick chambers, lb. In what respects the spreading of infection might be checked by the magistrate, 76. Bleeding and purging increase the danger of by debilitating the body, 141- Small-pox, 148. Inflammations, how the laborious part of mankind expose themselves to, 28. Proper treatment of, 884- Im-lammation of the bladder. —See Bladder, ■■■----------of the brain.—See Brain. -------—— of the eyes.—See Eyes. -------------. of the intestines.—See Intestines. ---------.„«». of the kidneys.—See Sidney* -------------of the liver.—See Liver. -------------of the lungs—See Lung*. _____________. of the stomach.—See Stomach. .-------------of the throat.—See Quinsey. -------------of the womb.—See Womb' Infusion, advantages over decoctions, 472. How to obtain rich infusions from weak vegetables, ib. Preparation of the bitter infusion, ib. Infusion of the bark, ib- Infusion of carduus, ib. Of linseed, ib- Of roses, ib. Of tamarinds, and senna, ib. Spanish infusion, ib. For the palsy, 473. Inns, the great danger of meeting with damp beds in them, 89- The sheets in, how treated to save washing, ib. Inoculation of the small pox, more favourably received here than in neighbour- ing countries, 156- Cannot prove of general utility while kept in the hands of a few, lb- No mystery in the process, ib- May safely be performed by parents or nurses 157- Various methods of doing it, ib. The clergy exhorted to remove the prejudices against theoperation, 158- Ought to be rendered universal, 160. Means of extending the practice, ib- Two obstacles to the progress stated, 161. Might be performed by clergymen, or by parents themselves, 162. The proper seasons and age for performing it, 163- Will often mend the habit of body, ib. Necessary prepaparation and regimen for, 168. Inoculation of the cow-pox, a prevention from mfeotion by the ■mall-pox, 164, 481 Manner of performing the operation, 432- When most advisable, 437. Insects, when they creep into the ear how to force them out, 246. Poisonous, the bites of how to be treatea, 329. Intemperance, one peat cause of the diseases of seamen, 30- The danger o< aTued bo* the construction of the human body, 65- The analogy _ the nourishment of plants and animals, ib. Is the abuse of natural passions, lb ,.; ib In Mquor and carnal pleasures, 66. The bad consequences of fcvulve 'whole families, ib. Effects of drunkenness on the constitution, ib. Per. 508 INDEX. sons who seldom get drnnk, may nevertheless injure their constitutions by drinking, ib- The habit of drinking frequently acquired under misfortunes, 67 Is peculiarly hurtful to young persons, 88- Leads to all other vices, ib. Intermitting Feveb.—See Ague. Intestines, inflammation of, general causes from whence it proceeds, 199- The Bymptoms, ib- Regimen and medical treatment, ib. Cautions to guard against it. 201' Intoxication produces a fever, 66. Fatal consequences of a daily repetition of this vice, ib. Persons who seldom get drunk, may nevertheless injure their constitutions by drinking, 67- Getting drunk a hazardous remedy for a cold, 190. Often produces fatal effects, 416- Proper cautions for treating persons in liquor, 417. The safest drink after a debauch, ib. Remarkable case, ib- Johnson, Dr., extraordinary cure of an infant seemingly killed by a strong convul- sion fit, related by, 429' Issues, how to make them take .the best effect, 292-. Itch, the nature and symptoms of the disease described, 374. Sulphur the best remedy against, ib- Great danger of the injudicios use of mercurial prepara- tions for, 273- Julaps, the form explained, 473. Preparation of the camphorated julap, ib. Cordial julap, ib- Expectorating julap, ib- Musk julap, ib. Saline julap,'ib Vomiting julap, ib- Kidneys, inflammation of, its general causes, 205- Its symptoms, and proper regimen, 205, 206. Medical treatment, ib. Where it proceeds from the stone and gravel, ib- Cautions for those subject to this disorder, 207—See Gravel. King's-evil —See Scrofula. Laborious employments, the peculiar disorders incident to, 27- The folly of men emulating each other in trials of strength, 28. Disadvantages attending their diet, ib. How they expose themselves to inflammations, ib. Danger of Bleeping in the sun, 29- Long fasting hurtful to them, ib. Injuries arising from poor living, ib- Many of the diseases of labourers not only occasioned, but aggravated, by poverty, ib- Labour should not be imposed too early on children, 13. Labour in child-bed, medical advice for, 359. Laudanum, how to be administered in a cholera morbus, 312. In a looseness, 213- In a diabetes, 219' When proper for a head-ache, 242- How to apply for the tooth-ache, 244. Will ease pain in the gout, 264. How to administer for the cramp in the stomach, 297. Is good for flatulencies, 301. Effects of an over- dose, 323. Medical treatment in this case, ib. Leading strings injurious to young children, 15. Leeches are proper to apply to children where inflammations appear in teething, 876. Objections to bleeding with them, 333. Lee ks, a proper ingredient for soups, 446- Lemons.—See Orange*. Leprosy, why less frequent in this country now than formerly, 371- Requires the same treatment as the scurvy, ib. Life may frequently be restored when the appearances of it are suspended by sudden casualties, 401, 403, 406, 420. Lime-water, recommended to prevent gravel in the kidneys from.degenoraring to the stone in the bladder, 222. Is a good remedy for worms, 251, Happy effects of in the cure of obstinate ulcers, 392- Limment for bums, preparations of, 476- White liniment, ib. For the piles, ib. \ oiutilv liuiuieut, ib. lWBttx. 509 Ltquops, strong, expose children to inflammatory disorders, 13. Fermented, the qualities of examined, 46- Tbe bad consequences of making them too weak, ib- Why all families ought to prepare their own liquors, ib- Cold, the danger of drinking when a person is hot, 91. Liver, schirrous, produced by sedentary employments, 37- Liveb, inflammation of, its causes and symptoms, 208. Regimen and medical treatment, 209- Abscess in, how to be treated, ib. Cautions in the event of a schirrous being formed, 210- Lobelia, an American plant used by the natives in the venereal disease, 846- Lochia, a suppression of, how to be treated, 861. Longings, in diseases, are the calls of nature, and often point out what may he of real use, 101. Looseness, habitual, general directions for persons subject to, 85. Its general causes, 212. A periodical looseness ought never to be stopped, 213. Medical treatment according to its various causes, ib. Means of checking it when neces- sary, 214. In children, proper treatment of, 371. Love, why perhaps the strongest of all passions, 82. Is not rapid in its progress, and may therefore be guarded against at its commencement, ib To pretend to it for amusement cruelty to the object, ib. Lues, confirmed, symptoms of, 344. Mercury thennly certain remedy known in Europe for this disease, 345. Saline preparations of mercury more efficacious than tho ointment, ib. How to administer corrosive sublimate, ib- American method of curing, 346. Mercury, properly administered, never fails to cure this diseise, 351. Lungs, injured by artists working in bending postures, 34. Studious persons liable to consumptions of, 37- Luxury, highly injurious to tho organs of taste and smell, 818- Mad dog.—See Dog. ,. . . ,. Magnesia Alba, a remedy for the heart-burn, 286- Is the best medicine in all eases of acidity, 368. Magnets, artificial, their reputed virtue in the tooth-ache, 245 Malt liquors, hurtful in the athma, 277—See Beer. Ma" why inferior to brutes in the management of his young, 1- Was never in- ^tltln^tCro,th of produced tbe rickets in children, .4- Morefavour- able to rT than to health! 19- Some, injurious to health by confining artisU n unwholesome air, 26- Cautions to the workmen, ib- <*^££°£ ture 32- Are injurious to health from artists .being ^l^^' ™ And from their working in confined postures, ib. Cautions ofcred to sedentary Matrimony', ought not to be contracted without a due attention to health and r^it u^r *gu£ t£mF££i~ «*—i SrAstX^eU a«nity wi the small-pox, 164- Cause and symptoms, ib, ProDer regimen and medicine, 166. Mechanics, ought to employ their leisure hours in gardening, 36. Meconium, the be*t mode of expelling ,ttl, W7- ^ ^ ^^ ^ ^ ^ Medicine, the W" ££p£fc„or.%. The study of neglected by gentle- iZtri^J^ZTZ 'open to pretenders, xvii. Ought to » 510 index. ptncrally understood, xviii- A diffusion of tho knowledge of, would destroy quackery, xx- Objections to the cultivation of medical knowledge answered, xxi- The theory of never can supply the want of experience and observation, 95. Medicines have more virtue attributed to them than they deserve, 95- Ought not to be administered by the ignorant nor without caution, 97- Want of per- severance in the use of one reason why chronie'diseases are so seldom cured, 200. Many retained which owe their reputation to credulity, 449- Are multiplied and compounded in proportion to ignorance of the causes and nature of dis- eases, ib. Disadvantages of compounded medicines. 450. Are often adulterated Ibr the' sake of colour, ib. The relative proportion of doses of for different ages', 451. A list of such medical preparations as ought to be kept for private, 453. Melancholy, religious, its effects, 82. Leads to suicide, 83. Defined with its causes, 289. Symptoms and regimen, 290. Medicinal treatment, 291. Menstrual discharge in women, the commencement and decline of, the most critical periods of their lives, 352. Confinement injurious to growing young women, ib.; and tight lacing for a fine shape, 353. Symptoms of the first appearance of this discharge, 354. Objects of attention in regimen at this time, ib. Ought to be restored whenever unnaturally obstructed, and how, ib. When an obstruction proceeds from another malady the first cause is to be removed, 355. Treatment under a redundancy of the discharge, 356. Regimen and medicine proper at the final declineof the menses, ib. Mercurv may be- given in desperate cases of an inflammation of the intestines, 201. Great caution necessary in using mercurial preparations for the itch, 275. Is seldom necessary in a gonorrhoea, 835. How to administer it when needful in that disorder, ib. Rubbing in the ointment the means of administering, 337. Preferable time for the performing that operation, ib. Is the only certain re- medy known in Europe for the cure of a confirmed lues, 345. Saline prepara- tions of more efficacious than the mercurial ointment, ib. How to administer cor- rosive sublimate in venereal cases, ib. Necessary cautions in the use of mercury, S47- Proper season for entering on a course of, ib. Preparations for, ib. Regi- men under a course of, 348. Mezereon root a powerful assistant in venereal cases, 346. Midwives, historical view of the profession, 7. How they became intrusted with the care of bandaging infants, with the ill effects of their attempt at dexterity in this office, ib. Miliary fever. See Fever. Military exercise recommended for boys to practice, 17. Mils, that of the mother, the most natural food for an infant,' 10. Cow's milk better unboiled, than boilea, 12. Is a good antidote against the scurvy, 44. Of more value in consumptions than the whole Materia Medica, 124 Its great effi- cacy in the scurvy, 270. A milk diet proper both for men and women in cases of barrenness, 365. Milk fever—See Fever\ Millipedes, how to administer for the hooping-cough, 196. Mind, diseases of, to be distinguished from those of the body, 94—See Passion*. Miners, exposed to injuries from unwholesome air and mineral particles, 26.- Cap- tions to, ib. Mineral Waters, the danger of drinking them in too large quantities, 217. Aro of considerable service in weakness of the stomach, 284- Tunbridge waters arc of service in bracing the syfctem, 426- Are an active purgative, ib. Pyrmont auu Spa waters serviceable in the gout, &c. 427- Purgiug Chalybeates, of Cud. index. 511 tenham nnd Scarborough, an excellent laxative, ib. Simple saline mineral waters of Bagnicge, Kilburn and Acton, ib- Harrogate waters of use in eruptions of the skin, ib. Bath waters afford relief in colics, 429. Directions for the use of, ib- Recommended in green sickness, palsy, gout, hypochondria, jaundice, 4c. 430. Buxton waters good in heartburn, nausea, diseases in the kidneys, &o" ib- Matlock tepid springs, ib. Bristol waters efficacious in relaxation of tbe sto- mach, &c- 431- Mixtures, general remarks on this form of medicines, 474. Composition of the ustringent mixture, ib- Diuretic mixture, ib. Laxative absorbent mixture, ib- Saline mixture, ib- Squill mixture, ib- Mothers, preposterous, when they think it below them to nurse their own children, 2- Under what circumstances they may be really unfit for this task, ib- Delicate mothers produce unhealthy 6hort-lived children, 5. Their milk the best food fbr children, 10. Ought to givo their childron proper exerc; = .', 13; and air, 21. Mouth, cautions against putting pins or other dangerous articles into, 403. Muscular exercise, a cure for the gout, 263. Mushrooms, a dangerous article of food, as-other funguses aro often gathered in- stead of them, 330- Music, the performance of recommended as a proper amusement for studious persons, 40- Musk, extraordinary effect prodnccd by, under particular circumstances, in ri ,i nervous fever, 134. Is a good remedy in the epilepsy, -JG ; and for the hiccup, 297- Deafness cured by, 313- Mustabd, white a good remedy in the rheumatism, 267- Natural history, tho study of nocossary to the improvement of agriculture, x» Nervous diseases, the most complicated and difficult to cure of all others, 285. General causes of, 286. Symptoms of, ib- Regimen, 287- Modioal treatment, 288- A cure only to be expeoted from regimen, 209. The several symptoms of, though difforontly namod, all modifications of the-samo disoaso, 307- Nervous disease, means of preventing, 308. Nervous colic, its causes and symptoms, 204. Medical treatment of, ib Nervous fever.—See Feccr. . Night-mare, its causes and symptoms described, 298. Proper treatment of, ib. Night-shade, au infusion of recommended in a cancer, 318. Nitre, purified, its good effects in a quinsey, 183. Is an efficacious remedy in the dropsy, 258. Promotes urine and perspiration, 291. Nose, ulcers in, how to cure, 814. Stoppage of in cliildren, how to cure, 370.—See Bleeding at. Nurses, their superstitious prejudices in bath.ng children, 20. The only certain evidence of a good one, 2-'. Their usual faults pointed out, 23. Administer cordials to remedy their neglect of duty towards children, in. Their mistaken treat- ment of eruptions, ib. And loose stools,' 24. Are apt to conceal the disorders of children that arise from their own negligence, ib. Ought to be punished for the misfortunes they thus occasion, ib. Sensible, often able to discover diseases sooner than persons bred to physic, 93. Are liable to catch the small-pox aga^u from those they nurse in that disorder, 150, note. Nursery, ought to be the largest and best aired room in a house, 21. Oatmeal, frequently made into bread, and peasants fed on it are healthy and ro- bust. 443. Erroneously supposed to occasion skin diseases, ib. Oil, aii antidote to the injuries arising hom working In mines or metals, 26. Sa*d at- INDEX. oil, the best application to the bite of a wasp or bee, 329. Camphorated, how to prepare, 476. Oils, essential, of vegetables, the proper menstruum for, 484. Ointment for the itch, 275. Use of ointments when applied to wounds and sorfs, 474. Preparation of yellow basillicum, 475. Emollient ointment, ib. Eye oint- ments, ib. Issue ointment, ib. Ointment of lead, ib. Mercurial ointment, ib. Ointment of sulphur, ib. Ointment for diseases of the skin, ib.—See Liniment. Opthalmia.—See Eye. Opiates, efficacious in a cholera morbus, 212. In a diabetes, 219. When proper for the head-ache, 222. Recommended for the tooth-ache, 244. Are delusive re- medies in nervous diseases, 269.—See Laudanum. Orange and lemon-peel, how to candy, 465. How to preserve .orange and lemon- juice in the form of syrup, 482. Oxvcratb, the most proper external medicine in a fracture, 399. Oystbrs of great service in consumptions, 126, note. Painters.—See Miners. Palsy, the nature of this disorder explained, with its causes, 292. Medical treatment 293. Paraphrenitis, its symptoms and treatment, 118. Parents, their interested views in the disposal of their children in marriage often a source of bitter repentance, 82, note. Parsnips, a nourishing food, 445. Passions, intemperance the abuse of, 65. Have great influence both in the cause and cure of diseases, 77. Anger, ib Pear, ib. Grief, 80. Love, 82. Religious melancholy, ib. The best method of counteracting the violence of the passions, 83- Peas, parched, good in cases of flatulency, 246. Peripneumony, who most subject to, 118. Its causes, symptoms, and proper regimen, 119,120. Perspiration, insensible, the obstruction of disorders the whole frame, 87. The various causes of its being checked, ib. Changes in the atmosphere, ib. Wet clothes, 88. Wet feet, ib. Night air, ib. Damp beds, 89. Damp houses, 90. Sudden transition from heat to cold, ib. Peruvian bark.—See Bark. . Philosophy, advantages resulting from the study of, XT. Phrenitis.—See Brain. Phymosis described, and how to treat, 343. Physicians, 111 consequence of their inattention to the management of children, 4. Their custom of prognosticating the fate of their patients a bad practice, 79. Are seldom called in until medicine can give no relief, 102. Pickles, provocatives injurious to the stomach, 45. Piles, bleeding and blind, the distinction between, 228. Who most subject to the disorder, ib. General causes, ib. Medical treatment of, 229. Periodical discharges of ought not to be stopped, ib. Proper treatment of the blind piles, ib. Exter- nal ointments of little use, 230. Pills, purging, proper form of for an inflammation of the intestines, 200. The ge- neral intention of this class of medicines, 476. Preparation of the composing pill, ib. Deobstruent pill, ib. Foetid pill, 477. Hemlock pill, ib. Mercurial pill, ib. Mercurial sublimate pill, ib. Plummer's pdl, ib. Purging pill, ib. Pill for the bile, 478. rill for the jaundice, ib. Stomachic pill, ib. Squill pills, ib. Strengthening pills, ib. Pins ought never to be used in the dressing of children, 9. INDEX. 513 Plasters, the general intentions of, and their usual basis, 478. Preparation of the common plaster, ib. Adhesive plaster, 47U. Anodyne plaster, ib. Blister, n ; plaster, ib. Gum plaster, ib. Mercurial plaster, ib. Stomach plaster, ib. ffuim plaster, ib. Wax plaster, 480 Pleurisy, the nature of the disorder explained, with its causes, 113. Symptoms 114. Regimen, ib. Medical treatment, 115. A decoction of seneka reckoned a specific in, 116. Basta-rd pleurisy, 117. Plumbers.—See Miners. Poisons, the nature and cure of a general concern and easily acquired, 820. Mineral poisons, 321. Vegetable poisons, 322- Bites of poisonous animals, 823. Bite of a mad dog, ib. Bite of a viper, 328. The practice of sucking poison out o' wounds recommended, ib. note. Poisonous plants ought to be destroyed in the neighbourhood of towns, 330. Negro remedy to cure the bite of a rattlesnake, ib. General rules for security against poisons, ib. Pooh living, the dangers of, 29. Porters subject to disorders of the lungs, 27. Postures confined, injurious to the health of sedentary artists, 33. Potatoes, the best substitute for bread, 444. Simply boiling or roasting the h-st method of cooking them, ib. Stewed mutton and potatoes a nourishing aud pala- table dish, 445. I'overty, occasions parents to neglect giving their children proper exercise, 18. Not only occasions, but agravates many of the diseases of labourers, 29. The poor suffer by bad air in large cities, 52. Poultices proper for inflamed wounds, 480. General intentions of, ib. Extraordi- nary case of the good effects of, ib. 1' iuders, general instruction for making and administering, 480. Astringent powder, preparations and doses of, ib. Powder of bole, ib. Carminative powder, 4U1- Diuretic powder, ib. Aromatic opening powder, ib. Saline laxative powder, ib. Steel powder, ib. Sudorific powder, ib. Worm powder, ib. Purging powder, ib. Powder for the tape worm, ib. Pax, small, who most liable to, and at what season, 148. Its causes and symp- toms, ib. Favourable and unfavourable symptoms in, 148, 149. Regimen, lb, How'the patient ought to be treated during the eruptive fever, ib. Children in this disorder ought not to lie together in the same bed, 150. Should be allowed clean linen 151 Patients under this disorder ought not to appear in public view, ih. Medical treatment, ib. The secondary fever, 154. When and how to open the nustules. 155. Of inoculation, 156. Pregnancy, how to treat vomiting when the effects of, 215. Rules of conduct for women under the disorders incident to, 357. Causes and symptom, of abor- tion, 358. How to guard against abortion, ib. Treatment in cases of abortion, ib. Pn^CBiP^s'^dical, patients exposed to danger by their being written in Latin, xx. Provisions unsound, the sale of a public injury, 43. s.t rcS^--™« - •.--» _- -— -mt:^—*--"-- * ■«■ Putrid kevsr.—See Ft cr. 514 INDEX. Quacks put out more eyes than they cure, 309. Quackery, how to destroy, xx. Quakers, their mode of dressing recommended, 64. Quinsey, a common and dangerous disorder, and to whom most fatal, 181. its causes, ib- Symptoms, ib- Regimen, 182- Medical applications, 183. Ho>» to promote suppuration, 183. How to nourish the patient when he cannot swallow, ib. Advice to persons subject to this disorder, 185. Quinsey, malignant, who most subject to, and its causes, 185. Its symptoms, 185. Regimen and medical treatment, 187. Ingenious invention in the cure of, 188- Rattle-snake, Negro remedy for the cure of its bite, 330. Regimen ought to co-operate with medicine to accomplish the cure of diseases, xi. Will often cure diseases without medicine. See Aliment- Religion, true, calculated to support the mind under every affliction, 83. The instructors in ought not to dwell too much on gloomy subjects, ib. Remitting fever,—See Fever. Repletion impairs the digestive power, 49. Diseases occasioned by, ib. How to treat a looseness produced by, 213. Resentment, the indulgence of injurious to the constitution, 77. Resins, and essential oils, the proper menstruum for, 489. Respiration, how to restore in a drowned person, 407. Rheumatism, acute and chronic distinguished, 264. Causes, 265. Symptoms, ib. Medical treatment, 266. Cautions to persons subject to this disorder, 267. Rice, a general article of diet, 442, Simple boiling of it renders a substitute for bread, ib. Rickets, the appearance of in Britain dated from the growth of manufactures and sedentary employments, 14. The causes of 377. Symptoms, 378, Regimen and medical treatment, ib. Rollers, pernicious tendency of applying them round the bodies of infants, 7. Romans, ancient, the r great attention to the cleanliness of their towns, 79, note. Roses, conserve of, its great virtue against haemorrhages, 229, 234. Rosemary, the external application of a popular remedy for the cramp, 306, note. Ruptures are chiefly incident to children and very old people, 400. The causes respectively, ib. Method of treatment, ib. Cutting should be avoided, if possible, 401, Cautions for persons afflicted with n rupture, ib. Sailors, their health injured by change of climate, hard weather, and bad provisions, SO. Many of their diseases spring from intemperance, ib. Ought to guard against wet clothes, 31. How the ill effects of salt provisions might be corrected, ib. Peruvian bark the best antidote to sailors on a foreign coast, 32. Cleanliness greatly conducive to their health, 72, Sal-prunella, its good effects in a quinsey, 183, Saline draughts, of good use for stopping a vomiting, 216. Preparation of for this purpose, ib. Peculiarly good in the puerperal fever, 345, Salivation not necessary in the cure of the venereal disease, 345. Sarsaparilla, a powerful assistant in venereal cases, 346, Scabbed head in children, difficult to cure, 372. Medical treatment, 373. Scarlet fever. See Fever. School, sending chileren there too young, its bad consequences, 17, Ought to be seated in a dry air, and not to be too much crowded, 22, Schirrus in the liver, proper regimen in the case of, 210. See Cancer. Scrofula, nature of this disease, aud its causes, 2/1. Symptoms and regimen, 272, Medical trjatin-ut, ib. iT^nnx. 515 Bcurvv, why prevalent among the English, 44. Where most prevalent, and the two distinctions of, 268. Causes of, ib. Symptoms and cure, ib. Instructions to seafaring men, ib. Extraordinary effects of milk, 270, Proper liquors, ib. Sea-bathiko, See Bathing. Ska-water, a good remedy in the king's evil, 273. Sbdentary life, Includes the greater part of the human species, 32, Few persons follow agriculture who are capable of other business, ib. Sedentary and active employments ought to be intermixed for the sake of health, 33. Artists suffer from unwholesome air, by being crowded together, ib. The postures artiste are con- fined to injurious to health, ib. Disorders produced by, ib, Cautions offered to the sedentary, 35. Sedentary amusements improper for sedentary persons, ib. Hints relating to improper food, ib. Exercise a surer relief for low spirits than drinking, ib. Gardening a wholesome amusement for the sedentary, 36. Disorders occasioned by intense study, 37, 88, Dietetical advice to the sedentary, 47. 48. Senses, disorders of, 309. Intemperance destroys the energy of, 315, Excess of eating produces the same effect, ib. Want of cleanliness highly injurious to the organs of sensation, ib, * Seton sometimes has extraordinary effects in an inflammation of the eyes, 179. I» of service for preventing apoplexies 381. The best method of making it, *.)i. Shoes, tight, the bad consequences resulting from, 03. The high heels of wo- men's shoes, ib. Sick., the mutual danger incurred by unnecessary visitors, 73- Persons in health to be kept at a distance from the sick, 74. Proper nurses ought to be employed about them, 75. Instructions for avoiding infection, ib. Tolling of bells- for the dead very dangerous to, 79. Their fears ought not to be alarmed, ib. Sight injured by studying by candle-light, 89. Sinapisms, the general intentions of, 46J. Directions for making of, ib. Sleep, the due proportion of not easy to fix, 59. Bow to make it refreshing, 60. Complaints of the want of chiefly made by the indolent, ib. Heavy .uppers cause uneasy nights, ib. Anxiety destructive of sleep, 61. That in the fore part of the night most refreshing, ib. Sleeping in the sun, the danger of, 29. Small-p ■*.—See Pox. ... ... Smell injuries to which the senseof is liable, with the remedies applicable to, 313,314. Soap, Alicant, recommended in the stone, 2>2. Soap-lees, how to take, lb. SoLmE^TxpTseT^taiy disorders from the hardships they undergo, 30 SP,NPES'"o2n bTnfby artists working in unfavourable postures, 34. Iran- re^Uea, the direct menstruum for r,,ins and essential oils of vegetables, 1 W wme camphorated how to prepare, 485. Spirit of Menu-em, ib. Spirits IZessoi, the general forerunner of a nervous fever, 30 The proper Spirits, lowne , n9 under tnis compla.nt, ib. remedies for, 303 Caut o P ^ ^ ^ ^ ^^ Srr8TomX^. thoufd be avoided by all persons afflicted with nervous u, orders, 287. Bmn-w B^;7^glbtanCes stopped in the gullet, 404. Spots in the eye", how to treat, »»• minting, how to con-t the habit of, JU. 516 ISDF.X. Stays, a ridiculous and psrniciou? article of female dress, 9, 62. The wearing tends to promote cancers in the breast, 316. Sternutatories, preparations of recommended for restoringlost smell, 314. Sticking-plaster is the best application for slight wounds, 787. Stomach, exercise the best cure for disorders of, 58. Inflammation of, a disorder that calls for immediate assistance, 197. Its causes, ib. Symptoms, ib. Regi- men, 198. Medical treatment, ib. Pain in, its causes, 246. Remedies for, 247. Instructions for persons subject to, 248. Stone, the formation of in the bladder explained, 86. This disorder how distin- guished from the gravel, 2-20.. Causes and symptoms, 221. Regimen, ib. Medi- cal treatment, 222. Alicant soap and lime-water, how to take for this disorder, ib. The uva ursi a remedy in present request for, 223. Stool, loose, the benefit of to children, 24. Proper treatment of when excessive, ib. The discharge by cannot be regular if the mode of living be irregular, 84. One iu a day generally sufficient ;for an adult, ib. How to produce a regularity ofj ib. Frequent recourse to medicine for costiveness injurious to the constitution, 85. SroucK, Dr. his method of treating cancers, 318. Strabismus.—See Squinting. Strains, proper method of treating, 399. The safest external application, ib, note. Strangulation, course of treatment for the recovery of persons from, 418. Strangury, from a blistering plaster, how to to guard against, 116. In the small pox, how to relieve, 152. From a venereal cause, described with its proper treat- ment, 342. Strasburgh, successful treatment of a miliary fever there, 143, 144, note. Strength, the folly of trials from emulation, 28, 30. Study, intense, injurious to health, 36. The disorders occasioned by, 38. Character of a mere student, 39. Hints, of advice to studious persons, ib. Danger of their having recourse to cordials, 40. Health often neglected while in possession, and la- boured for after it is destroyed, 41. No person ought to study immediately after a full meal, ib. Dietetical advice to the studious, ib. The general effects of on the constitution, 286.. Sublimate, corrosive, how to administer in venereal cases, 345. Suffocation, by the fumes of coal, liable to happen in close chambers, 410. Gene- ral causes of suffocation, 418. Overlaying infants, 419. Sugar, an improper article in the food of children, 12. Sulphub, a good remedy for expelling worms, 251. And for the itch, 275. Suppers, ought not to destroy the appetite for breakfast, 49. Heavy suppers sure to occasion uneasy nights, 60. Surgery, many of the operations of successfully performed by persons unskilled in anatomy, 361. Humanity induces every one more or less to be a surgeon, 302. Sweating generally excited in an improper mannerin fevers, 101, 110. Swoonings, the several causes of described, 299. Proper treatment of this disorder, ib. Cautions to persons subject to them, 300. Sydenham, Dr. his method of treating fevers in children from teething, 376. Symptoms, diseases better distinguished by, than by the systematical arrangement of, 93. The difference of sex, age, and constitution to be considered, ib. Disease.) of the mind to be distinguished from those of the body, 94., Syncope, proper treatment in, 413. Syrups, the general intention of, 482. How to make symple syrup, and to mo- dify it for particular purposes, ib. Tacitus, his remarks on the degeneracy of the Roman ladies, 3, note. INDEX. 517 Tallow-chandlers, ahd others working on putrid animal substances, cautious to, 27. Tapping for the dropsy a safe and simple operation, 259. Tar, Barbadoes, its efficacy in the m rvous coKc, 204. Tartar, soluble, a good remedy for the jaundice, 2J5. Cream of a good remedy in the dropsy, 258. And rheumatism, 266. Taste, how to restore the sense of when injured, 315. Tailors are exposed to injuries from breathing confined air, 34. Often loose the u'.e of their legs, ib. Hints of instruction offered to them in regard to their health, 3... Tea, the customary use of injurious to female constitutions. 5. Destroys their digestive powers and produce hysterics, 45. The bad qualities of principally owing to imprudence in the use of, ib. Green, chewing of a remedy for the heart-burn, 285. Is bad for persons troubled with flatulencies, 802. Occasions an unnecesiary consumption of bread, 412. Bad effects of an immoderate use of, ib. Teething, the disorders attending, 375. Regimen and medical treatment in, ib- Application to the gums, and howto cut them, 375. Temperance, the parent of health, 64. Testicles, swelled, the cause of, 339. Regimen and medicine in, 340. Treatment under a cancerous and scrofulous habit, rb. Thirst, how it may be quenched when a person is hot without danger, 01. Thought, intense, destructive of health, 36. Thhiwh, in infants, the disorder and its causes described, 367. Medical treatment of, 368. , . ,an v Tinctures and elixirs, the proper medicines to exhibit in the form of, 482. Pre- parations of the aromatic tincture, 483. Compound tincture of the bark, ib. Volatile foetid tincture, ib. Volatile tincture of gum guaiacum, ib. Tincture of black hellebore, ib. Astringent tincture, ib. Tincture of myrrh and aloe,, ib. Tincture of opium or liquid laudanum, ib. Tincture of hiera p.cra, ib. Com- pound tincture of senna, 484. Tincture of Spanish flies, ib. Tincture of the balsam of Tolu, ib. Tincture of rhubarb, ib. Tonic tincture, ib. Ti^oT, Dr. character of his Avis au Peuple, xii. His medical course for the cure of the hydrophobia, 328. Instances from of the recovery of drowned persons 4UJ. Tobacco a clyster of a decoction of useful to excite a vomit, 405 A clyster of the fumes of will stimulate the intestines, and produce a stool, 408. Toes the free motion of destroyed by wearing tight shoes, 03. Tooth achb the general causes of, 243. Medical t-tment oUb When recoup must be had to extraction, 245. Directions for cleaning the tee h, ib. To"ch injuries to which the sense of is liable, with the remedies »PP^b»et°'316>"* Touch, inJu"es destructive to the children'of the poor, 20. Chddren bred *°:Z^Z TTL sent too early into towns, ,2 Cleanliness not « LtW auended to, 69. The best means to guard against infection ,n ,., sufficiently at endeo »^J ^^ breathe unwholesome air, 26, 3o. Trades, some in ur.ous to hea y 8 ^ ^ ^^^ ^ T^eTrs, n^E- —nded * »■ ^» * ™> — - to sleep in damp beds, 89. Fevers why often fatal to, 99. Trees, Should not be planted too near to houses, 54 Trefoil, water, a good remedy in the rheumatism, 267- JSZ^SS?— wholesome nourishment, 44, turner's cerate, preparation of, 4,o. Vapour of feruu-ntiug liquors, noxious nature of, 41* ns tVt>KX. Vlgktables, wholesome corrections of the bad qualities of animal food, 44. Thell extraordinary effects in the scurvy, 268. Venerel disease, why omitted in the first edition of the work, 331. Unfavourable circumstances attending this disorder, ib. The virulent gonorrhoea, 332. Gleets, 337. Swelled testicles, 339. Buboes, 840. Chancres, 341. Strangury,ib. Phy- niosis, 343. A confirmed lues, S44. American method of curing this disease, 346. General observations, 347. Cleanliness a great preservative against, 348. The use of medicines ought not to be hastily dropped, 319. Is often too much disre- garded, 350. Ventilators, the most useful of all modern medical improvements, 53. Vertigo, often produced by intense study, 38. Vinegar, a great antidote against diseases, and ought to be used by all travellers, 31. Should be sprinkled in sick chambers, 75, 111, 137. Is of considerable service in the bite of a mad dog, 326. And in any kind of poisons, 329. Its medical pro- perties, 485. Is of use to extract the virtues of saveral medicinal substances ib. How to prepare vinegar of litharge, 486. Vinegar of roses, ib. Vinegar of squills, ib. Viper, the bite of, Xhe sufficiency of the grease for the cure of doubted, 329. Me- thod of treatment recommended, ib. Vitriol, elixir of, an excellent medicine in the weakness of the stomach, 283. And for windy complaints 289. Ulcers, proper treatment of according to their different natures, 391. Lime-water a good remedy, 392. Dr. White's method of treating them, ib. Fistulous ulcers, ib. Vomits, their use in agues, 103 ; and in the nervous fever, 132. Cautions for admi- nistering in the putrid fever, 139. Ought by no means to be administered in an in- flammation of the stomach, 198. Are useful in cases of repletion, 213. Are pow. erful remedies in thejaundice, 254. Are the first objects to be pursued when poison has been received into the stomach, 322. Their use in the hooping-cough, and how to administer them to children, 195. Form of a gentle one for infants dis- ordered in the bowels, 371. Vomiting, the several caus of, 218. Medical treatment of, ib. Saline draught for stopping of, 216. Causes of in children, 370. How to be treated ib. Of blood. See Blood. * Voyage, a long one frequently cures a consumption, 123. Voyages have an excellent effect on persons afflicted with nervous disorders, 289. Ureters and their use described, 206, note. Urine, the appearance and quality of, too uncertain to form any determined judg- ment from, 85. Dr. Cheyne's judgment as to the due quantity of, not to be re- lied on, 96. The secretion and discharges of, how obstructed, ib. Bad conse- quences of retaining it too long, ib. Too great a quantity of tends to a con- sumption, lb. Stoppage of, its general causes, 207- Caution as to the treatment of, 208. Diabetes, 264. Incontinency of, 219. Suppression of, medical treatment in, ib. Cautions to persons subject to this disorder, 220. Bloody causes of, 234. Medical treatment of, 235. Urine doctors, their impudence, and great success from the credulity of the popu- lace, 85, note. Uva ursi, a remedy in present request for the stone, 223. Walking, more conducive to health than riding, 447. Walls, high, unwholesome, by obstructing the frequent current of air, 53. Ward's essence, preparation of, 485. Wars occasion putrid fevers, by tainting the air with the effluvia of dead carcases, 135. INDEX. 519 Wasps, hornets, or bees, how the bite of ought to be treated, 326: Water, frequently unwholesome by mineral impregnations, 45. Cautions for the choice of, ib. Cold the danger of drinking, when a person is hot, 81. Water in the head is a disorder chiefly incident to children, 380. Its causes, symp- toms, and proper treatment, ib. The nature of the disorder seldom discovered in due time for cure, 381. Waters, by infusion how to prepare ; Lime-water, 486. Compound lime-water, ib. Sublimate-water, 487. Styptic-water, ib. Tar-water, ib. Watbb, simple-distilled, their medical uses, 487. Preparation of cinnamon-water, il>. Penijyroyal-water, ib. Peppermint-water, ib. Spearmint-water, ib. Hose-water, 488. Jamaica pepper water, ib. Waters, spjrituous-distilled, how to prepare, 488. Spirituous cinnamon water, ib. Spirituous Jamaica pepper-water, ib. Watery eye, how to cure, 311. Watkinson, Dr., his dying request, 477. Weaning of children from the breast, the proper mode of, 11, 15. Weather, states of which produce the putrid fever, 135. Wells, deep ought not to be entered till the air in them is purified, 410. Whey, an excelsent drink in a dysentery, 233 ; and the rheumatism, 306. Orange wheyhowtomake.llO. Alum whey, 488. Mustard whey, ib. Scorbutic whey, ib. Whyte, Dr, his remedies for flatulencies, 302. Wind. See Flatulencies. Windows, the danger of throwing them open on account of heat, and sitting near them, 91. Winb. good, almost the only medicine necessary in a nervous fever, 131. Wines, the medical properties of, 488. Their use in extracting the virtues of medi- cal substances, 489. Preparation of anthelmintic wine, ib. Antimonial wine, ib. Bitter wine, ib. Ipecacuanha wine, ib. Chalybeate or steel wine, ib. Stomachic wine, ib. Womb, inflammation of, its symptoms, 361. Medical treatment of, ib. Women, errors in their education pointed out, 3. Why subject U hysterics, 45. In child-bed, often die from their apprehension of death, 78. Their disorders ren- dered epidemical by the force of their imagination, ib. Every thing that can olarm them to be carefully guarded against, ib. Evil tendency of tolling bells for the dead, 79. How exposed to a miliary fever during pregnancy, 142. The* constitutions injured by living too much within doors, 351. Those who work in the open air almost as hardy as men, 352. Advice to with reference to the men- strual discharge, ib. At the commencement, ib. Fluor Alius, with its proper treatment described, 356. Advice to at the ceasing of the menses, 357. Rules of conduct during pregnancy, ib. Causes and symptoms of abortion, 358. How to euard against abortion, ib. Treatment of cases of abortion, ib. 1 Instructions at the time of child-birth, 360. Cause of the milk fever. 361. How to guard against thj miliary fever, 362. The puerperal fever, ib. General cautions for women in child-bed, 363. Causes of barrenness, 364. Wool, the best external application in the gout, 261. Workhouses poisonous to infants, 20. .,,*.,,*• .- Wobms. how to treat a looseness produced by, 214. Three principal kinds of d,stin. enisled 249. Causes, ib. Symptoms of, 260. Medical treatment for, ib. Re- dv for children 252. General cautions for preserving children from them, ib. Parents advised not to feed them with meat two or three times a,day, as the tk.H of animals iu a state of-"-refaction oft*, generates worms, lb. 52 0 INDEX. Wobt, recommended for the scurvy, and proper to drink at sea, 270. Is a powerful remedy in cancerous cases, 319. Wounds are not cured by external applications, 385. Are cured by nature, 38;1. Proper course of treatment, ib. How to stop the bleeding, ib. Caution against improper styptics, ib. Method of dressing them, 887. Poultices for inflamed wounds, 388. Regimen, ib. Writing, hints of advice to those who are much employed in, 33, 39. Young animals, all exert their organs of motion as soon as they are able, l_ EiiNC, the flowers of a popular remedy for the epilepsy, 298. THE FOLLOWING LETTERS OF REFERENCE SERVE FOR ALL THE SKELETONS. A Os Frontis, or Bone of the Forehead B Ossa Bregmatis C Os Temporum D Os Occipitis, or back part of the head a The Mastoide Process E Os Jugale F The Upjter Jaw G The Lower Jaw H The Clevicuia, or Collar Bone I The Sternum, or Breast Bone K The Seven Vertebra: of the Neck L The twelve Vertebrae of the Ribs M The five Vertebra of the Loins 1 to 7 the seven true Ribs 8 to 12 the five false Ribs N The Scapula, or Shoulder Blade b The Coracoide Process of the Scapula c The Acromium of the Scapula d The Spine of the Scapula e The Base of the Scapula O The Humerus, or Bone of the Arm f The Head of the Humerus e- A Sulcus, or Furrow, in which passes one of the heads of the Biceps n The outer Protuberance of the Humerus, from which arise the Muscles that extend the Wrist and Fingers . 1 The inner Protuberance, from which arise the Muscles that bend the Wrist and Fingers p The Radius and Q the Ulna, Bones of the Fore-arm k the Olecranon, or Tip of the Elbow r The Bones of the Carpus, or Wrist S Tiie Bones of the Metacarpus, or Hand T The Bones of the Thumb • U The Bones of the Fingers W Os Sacrum X Os Coccygis y Os Ilium 1 The Spine of the Ilium Z Os Ischium m The Obtuse Process of the Ischium ""* LETTERS OF REFERENCE. A Os Pubis * B The Femur, or Thigh Bone n The Head of the Femur o The great Trochanter p The lesser Trochanter q The Linea Aspera, or Spine of the Femur r The inner Protuberance of the Femur s The outer Protuberance of the Femur C The Patella, or Knee Pan D The Tibia, the largest Bone of the Leg E The Fibula t The lower Appendix of the Fibula, or inner Ankle u The lower Appendix of the Fibula, or outer Ankle F The Os Calcis, or Bone of the Heel G The Tassus, or Instep, composed of six Bones, besides the Os Caldi H Bones of the Metatarsus, or Foot I Bones of the Toes COMPENDIUM OP ANATOMY. In order to distinguish the different layers of Muscles in this Work, the following method is adopted:—the external Muscles are referred to with figures; and the Ninth Plate, which is the Front View of the next Layer of Muscles, is referred to with tbe Italic Alphabet. Plate X. the Back of the same Figure, with the Roman Alphabet, which is continued in Plate XI. representing the inner Layer of Muscles ; and the Front View of the' inner Layer, Plate XII. is distinguished by Figures and a *. NAME, ORIGIN, INSERTION, AND USK OP TIIE MUSCLES. 1. Sternohyodccu* arises from the sternum and clavicula, and Is Inserted Into the base of the hyoides.l 2. Sterno-Mastoidaius arises from the sternum, and part of the clavicula, and Is inserted into the outer part of the mastoid process. 3 Trapezius arises from the hinder part of the head, from the spines of the vertebrae of the neck, and the eight upper ones of the back, Is inserted into the spine and acromium of the scapula and the clavicula. 4 Pectoralis arises from part of the clavicula, the sternum and the ata upper ribs'; and is inserted by a strong tendon into the humerus, four fingers breadth below its head. , .__.__ 6 Deltoides arising from part of the clavicula, from the acromium and spine of the scapula: it is composed of several lobes or parcels of flesh, which all Join in one tendon, and are inserted into the humerus, four fingers breadth "t^hath two heads, one arisingfrom the upper edge of the head of the scapula, tho other from the processes coracoides of the scapula, botti chs- linctlv seen with their union about the middle of the arm, m Fig. IX. and rakTonebelly. which Is inserted by a strong round tendon into the tuberocity at the upper end of the radius. l Draw, the head downw»TJ» and .l.l«w»y«. ,,„„.„„.„„,,. Thi, m,:vole, p.«-i, g over Um *Z0™£b™?"%u^» S£-k» -......- -*h we - m ttot "i,ru \ ££. a: a\r:,fand'£ut< I, .»xv motion, excep, that of dc^.ng U. £ J, and 8, bend* the fore-arm. 524 COMPENDIUM OF ANATOMY. 7. Brachialisinternus is partly covered by the biceps, and is marked with two figures. It arises from the middle and internal part of the humerus j and is inserted into the upper and fore part of the ulna. 8. Triceps Extensor Cubiti is composed of the brachiseus externus, the mus- eums longus, and the musculus brevls. These three joined make one tendon, which covers the elbow, and is inserted into the hind part of the olecranon. 9. Anconeus ariseth from the back part of the outer protuberance of the humerus, and is inserted into the ulna, four fingers breadth below the ole- cranon. 10. Pronator rotundus rises from the inner protuberance of the humerus, where those bending the wrist and fingers arise, and descends obliquely to its insertion, a little above the middle of the radius. II. Supinator Radii longus ariseth a little above the outer protuberance of the humerus, and is inserted into the loweripart of the radius. 12. Flexor Carpi radialis hath its rise from the inner protuberance of the humerus, and upper part of the ulna, and is inserted into the first bone of the metacarpus, that sustains the fore finger. 13. Flexor Carpi ulnaris ariseth from the inner protuberance of the humerus, and is inserted into the inner little bone of the wrist. 14. Pulmaris rises with the former, and passing by a slender tendon to the palm of the hand, expands itself and is inserted into the bones of the meta- carpus, and the first bones of the fingers. 15. Perforatus and Ferforans. The first rises from the inner protuberance of the humerus and the radius, and is divided into four tendons, which are in- serted into the second bone of the fingers. Just above their insertion they are perforated, to give passage to the tendons of the perforans, which arises from the upper part of the ulna, and is divided into four tendons, that pass through the former, and are inserted into the third bones of the fingers. 16. Extensor Carpi radialis ariseth from the outer protuberance, of the hu- merus and is inserted into the bones of the metacarpus, which sustain the fore and middle fingers. 17. Extensor Carpi ulnaris, rises from the same place with the former, and is inserted into the bones of the metacarpus, which sustain the little finger. 18. Extensor Pollicis rises from behind the middle part of the radius and ulna, and passes over the tendon of the extensor radialis, and is inserted by two or three tendons into the bones of the thumb. 19. Extensor Digetorum ariseth from the outer protuberance of the humerus, and from the hinder part of the radius and ulna. At the wrist it is divided into three tendons, which are inserted into the bones of the three first fingers. 20. Extensor minimi Digiti, ariseth from the outer protuberances of the D, Helps to extend the arm, 10. Turns the piilin of the hand downwards. 11. Turns the palm upward. fl 12. Bends the wrist. 13. Bends the wrist and little finper. 14. Helps the hand to gr.vp any ilitni. thir 1 •The mu8Cles of t'": fure-aJm UK never marked strong, but when the hand grasps some. IS. They bend the flnecr«. 16 and 17. Extends the wrist. 18. Extends the Ihumli. 19. Extends the flufnr . SO. Extends the little finger. COMPENDIUM OF ANATOIIT. 525 humerus, and from the upper part of the ulna, and is inserted into the third bone of the little finger. 21. Serralus major anticus, ariseth from the six lower true ribF, and from the first, and sometimes second false ribs, by so many distinct portions, resem- bling the teeth of a saw, and is inserted into the base of the scapula. A part of this muscle is only seen, the rest being covered by the pectoralis. 22. Obliques descendens, ariseth from the two last true ribs, and the five false, by five or six digitations, the four uppermost lie between the teeth of the serratus. It descends obliquely by a broad and thin tendon; and passing under the rectus, is inserted all along the linea alba, to the upper and fore part of the spine of the ilium, and to the fore part of the'os pubis. • 23. Rectus, rises from the sternum, and two last true ribs, and is inserted Into the os pubis. 24. Lafi«simug Dorsi, arises from the hind part of the spine of the ilium, the upper spine of the os sacrum, from all the spines of the vertebrae of the loins, and from the seven lower ones of the back. It passes by the lower angle of the scapula, to which some of its fibres are fixed, and joining with the teres major, is inserted into the humerus, three fingers below Its head. 25. Teres major, ariseth from the lower angle of the scapula, and is Inserted with the former 26. Infraspinatus, rises from the cavity below the spine of the scapula, and filling that cavity, is inserted into the humerus, a little below its head. 27. Splenius, ariseth from the three lower vertebras of the neck, and five upper ones of the back, and is inserted above the mastoid process. 28. Sacralumbalis, arises from the upper part of the os sacrum.^nd back part cf the spine of the ilium, and is inserted into the back part ot the ribs, near their root. 29. Longissimus Dorsi, rises from the same origin as the former, and is Inserted partly into the processes of the vertebras of the back, and partly into the ribs. . . .. 30 Gluteus major, arises from the external surface of the ihum and ischium. from the os coccygis and os sacrum, and is inserted into the thigh bone, a hand's breadth below the great trochanter. 31. Gluteus medius, rises from the external surface of the ilium and ischium, and is inserted into the great trochanter. 32. Triceps, hath three heads, two of them arise from near the articulation being »o flxed, raises the ribs. S3. Assists in expiration. .ustalni It when bent back. It has three S3 Ri.scthe body when >'■"? °" ™ ,"*' *"r like several muscl s. Th.y are not always or lour ba.Ms which divide It and ™™J^£" /th Cthe navel, and in some bodiesbelow ,t. "«".*'- ^•'iT.rSw-W.5£«W---. Ui. .0 thin at iu origin, that the , VaJ?1, m»v be seen, butat IU Insertion is fle-hy. ^8 Dnws the arm downwards and backwards. -„. Draw, the head tackward^andridewaya^ ,t D„ckwIirdl, and sustain it when bent M, and »• These mu-ole. k~P »» X.lde, they draw the body sideways. forward. .- and *h';" '.^^VnJoned musde. are entirely covered by the tr.Pe.ms and the all*. ,l„«.ld5$! theVsh»P. and acuon may be plainly seen m ~o»n in the small fioUre, °> the .u.e of Fmure VII. 30. Ext. nds the thlah. 31 Helps to extend the thigh, U. Pulls the thigli inwari. 526 ecMrFN'TnFM or avatomy. of the os pubis, the other from the tubercle of the ischium, and are inserted all along the spine of the femur. 33. Membranosus, ariseth from the upper and fore part of the spine of the ilium: its fleshy part terminates at the great trochanter, where its membranous begins, and spreading over the muscles of the thigh, passes to its insertion on the upper part of the tibia. 34. Sartorius, rises with the former, and descending obliquely over the thigh, is inserted into the inner and upper part of the tibia. 35. Gracilis, rises near the articulation of the os pubis, and is inserted into the upper and inner part of the tibia. 36. Biceps Femoris has two heads; one rising from the tuberosity of the ischium, the other from the linea aspera of the thigh bone: they both join, and are inserted by one tendon into the upper part of the fibula. 37. Seminervosus ariseth from the hinder protuberance of the ischium, and is inserted into the inner part of the tibia, below its articulation with the fibula. 38. Semimembranosus rises from the upper protuberance of the ischium, and is inserted into the upper and back part of the tibia. 39. Rectus Femoris ariseth from the lower part of the spine of the ilium, and is inserted with the two following muscles. 40. Vastus Externus ariseth from the great trochanter and external part of the femur, and is Inserted with the 41. Vastus Internui, which ariseth from the lesser trochanter, and internal part of the femur. These three muscles make one strong tendon, just above the knee, and passes over the patelia, to which it adheres, and is inserted into the upper part of the tibia. 42. Tabialis anticus, ariseth from the upper and outer part of the tibia, and is inserted into the os cuneform and os metatarsi. 43. Gastrocnemius has two distinct fleshy originations from the hind part of the protuberance of the thigh bone. In its descent they are Mated into two fleshy bellies, the innermost is thickest and largest; they, joining together, make a broad strong tendon, which joins with the tendon of the solaeus, and is inserted with it. 44. Soleus, arises from the upper and back part of the tibia and fibula, and increases to a fleshy belly, which lies under the former muscle, and terminating in a very strong tendon (by some called the cord of Achilles), and is inserted into the hinder part of the os calcis. 45. Peroneus, arises from the upper and outer part of the fibula, and passing under the channel of the outer ankle, is inserted into the outer bone of the metatarsus. 83. Draws the legend thigh outwards. 34. Crosses the legs in the manner that tailors Bit; from whence Its name. 35. Helps to bend the leg, and assist in bringing It and the thigh inwards. 36. Helps to bend the leg, and is employed in turning the leg and foot outward, when we stt down. 37- Helps to bend the leg. 38. Helps to bend the leg. These four last muscles generally act together, and make but one mass, which appear like onemuFCle, especially about the middle of the thigh. » 89, 40, 41. These muscbs extend the leg. When a figure stands on one leg, there appear above the knee certain swellings, which are made by the tendon of these three muscles, and the skin As soon as the knee bends, they disappear, 42. Bends the foot, 43 and 44. These extend the foot. The action of these muscles is very necessary In walking running, leaping, and standing on tip-toe; and those who walk or run much, or earrv heave burdens, have their muscles larger than others. ' * 45. Draws the foot outwards. COMPENDIUM OF ANATOMY. 527 46. Extensor Dijeforum Pedis ariseth from the upper part of the tibia, and is niserted into the bones of the toes. Fig. IX. a. Corrupter SuperctlU arises fleshy from the internal angular process of the os frontis, above the joining of the os nasi and nasal process of the superior maxillary bone ; from thence it runs outwards, and a little upwards. Inserted into the inner and Inferior fleshy part of the occipito-frontalis muscle, where it joins with the orbicularis palpebrarum, and extends outwards as far as the middle of the superciliary ridge. 6. Temporali* arises fleshy from a semicircular ridge of the lower and lateral part of the parietal bone, from all the pars squamosa of the temporal bone, from theexternal angular process of the os frontis, from the temporal process of the sphenoid bone and from an aponcuriosis which covers it. From these different origins the fibres descend like radii .towards the jugum, under which they pass, and are Inserted by a strong tendon into the upper part of the coronoid process of the lower jaw, in the duplicature of which tendon this process Is enclosed as in a sheath, being continued down all its fore part to near the last dens molaris. e. Masseter arises by strong tendinous and fleshy fibres, which ruas in different directions from the superior maxillary bone, where it joins the os mala?, and from the interior part of the zygoma, its whole length, as far bade as the tubercle before the socket for the condyle of the lower jaw, the exter- nal fibres slanting backwards and the internal forwards. e Inserted into the angle of the lower jaw, and from that upwards near to the top of its coronoid process. d. Levatur Anguli Orit, arises thin and fleshy, from the hollow of the superior maxillary bone, between the root of the socket of the first dens molaris, and the foramen infra-orbitarium. Inserted into the angle of the mouth and under lip where it joins with its antagonist. e. Buccinator, arises tendinous and fleshy, from the lower jaw, as far back as the last dens molaris, and fore part of the root of the coronoid process : fleshy from the upper jaw, between the last dens molaris and pterygoid pro- cess of the sphenoid bone, from the extremity of which it arises tendinous being continued between both jaws to the constrictor pharyngis superior, with which it joins: from thence proceeding with straight fibres, and adhering close to the membrane that lines the mouth, it is Inserted iuto the angle of the mouth within the orbicularis oris. /. Depressor Labii Ivferioris, arises broad and fleshy, intermixed with fat from the"inferior partlof the lower jaw, next the chin, runs obliquely upwards and is • 46. Extends the tow. #«_._«!. th« other and mnVe It project OTer the Inner c^hu."of tTh°eeye* ^SttZ 2ft*Z^£tt£***^U^*~«»>. P"V,To*puVlutTwe?%ewuVw,a,rds,«.dPre.3 It against the upper, at the same time drawing U '' fMrfhtlower to the upper jaw. and by means of IU oblique deeusaat.on, alltU. forward, ■'I'ltadA-*. corner of the mouth upwards, and make that part of the cheek, opposite* "T To" d^the^e ofTh.'nfcu.h backward, and outwards and contract l,s cavity, by ■».», S-3 COMPENDIUM 01' ANATOMY. Inserted into the edge of the under lip, extends along one half of the Hp, and is lost in its red part. g. Levator Scapula, arises tendinous and fleshv from the transverse pro- cesses of the five superior vertebrae of the neck, by as many distinct slips, which soon unite to form a muscle that runs downwards and outwards. . Inserted fleshy into the superior angle of the scapula. h. Subclavius, arises tendinous from the cartilage that joins the first rib to the sternum. Inserted, after becoming fleshy, into the inferior part of the clavicle, which it occupies from within an inch or so of the sternum, as far outwards as to its connection by ligament with the corocoid process of the scapula. t. Pectoralis Minor, arises tendinous and fleshy from the upper edge of tho third, fourth, and fifth ribs, near where they join with the cartilages. Inserted, tendinous, into the corocoid process of the scapula, but soon grows fleshy and broad. k. Obliquus Ascendent, arises from the spine of the ilium, the whole length between the posterior and superior anterior spinous process; from the os sa- crum and the three undermost lumber vertebrae, by a tendon common to it, and to the serratus posticus inferior muscle, from Poupart's ligament, at the middle of which it sends off the beginning of the cremaster muscle, and the spermatic chord in the male, or round ligament of the womb , passes under its thin edge, except a few detached fibres. Inserted into the cartilage ensiformis, into the cartilage of the seventh, and those of all the false ribs; but at the upper part it is extremely thin, resem- bling a cellular membrane, and only fleshy at the cartilage of the tenth rib. Here its tendon divides into two layers j the anterior layer, with a great por- tion of the inferior part of the posterior layer, joins the tendon of the external oblique, and runs over the rectus, to be inserted into the whole length of linea alba. The posterior layer joins the tendon of the transversalis muscle, as low as half way between the umbicilius and os pubis : but below this place, only a few fibres of the posterior layer are seen, and the rest of it passes before the rectus muscle, and is inserted into the linea alba, so that the whole tendon of the external oblique passes before the rectus muscle, with the anterior layer of the internal oblique muscle, and is inserted into the linea alba. I. Pyramidalis arises along with the rectus, and running upwards within the same sheath is Inserted with an acute termination near half way between the os pubis and umbilicus, into the linea alba and inner edge of the rectus muscle. It is fre- quently wanting on both sides, without any inconvenience. m. Flexor Perforatus, arises tendinous and fleshy from the internal condyle of the os humeri; tendinous from the coronoid process of the ulna, near the edge of the cavity that receives the head of the radius : fleshy from the tubercle of the radius, and membranous and fleshy from the middle of the fore part of the radius, where the flexor pollicis lonus arises. Its fleshy belly sends off fou; round tendons before it passes under the ligament of the wrist. ft. To pull the scapula upwards, and a little forwards. A. To pull the cuvicle downwards and forwards. i. To "bring the scapula forwards and downwards, or to raise the ribs upwards. k. To assist the obliquus descen.tens externu9. l. A !ils the inferior part of the rectus. • m. To Lend the second joint or phalanx of the Augers, COMPENDIUM OF ANATOMY. 520 Inserted into the anterior and upper part of the second bone of each finger, being near the extremity of the first bone, divided for the passage of the perforans. Ligamentum Annulare. n. Iliacus Interims arises fleshy from the transverse process of the last ver- tebra? of the loins, from all the inner lip of the spine of the os ilium, from the edge of that between its anterior superior spinous process and the acetabulum, and from most of the hollow parts of the ilium.—It joins with the psoas ma;,'. nus (a muscle seated within the loins), where it begins to become tendinous; and is Inserted along with it. o. Cruralis, arises fleshy from between the two trochanters of the os femnris; but nearer the minor, and firmly adhering to -most of the fore part of the os femoris, and connected to both vasti muscles. Inserted, tendinous, into the upper part of the patella, behind the rectus. FIG. X. a. Complexut, arises from the transverse processes of the seven superior vertebras of the back, and four inferior of the neck, by as many distinct ten- dinous origins, In its ascent it gets a fleshy slip from the spinous process of the first-vertebrae of the back. From these different origins'it runs upwards, and is every where intermixed with tendinous fibres; it is Inserted, tendinous and fleshy, into the inferior edge of the protuberance in the middle of the os occipitis, and into a part of the curved line that runs forward from the protuberance. b. Splenius Capitis, arises tendinous from the four superior spinous processes of the vertebrae of the back; tendinous and fleshy, from the five inferior of the neck • and adheres firmly to the ligamentum nucha?. At the third vertebrae of the neck, the splenii recede from each other, so that part of the complexus muscle is seen. ___ Inserted by as many tendons into the five superior transverse processes of the vertebrae of the neck, and tendinous and fleshy into the posterior part of the mastoid process, and into the os occipitis, where it joins with the root of "'ct RhomZdeus, 1. Ehomboideus major arises tendinous from the spinous processes of the Ave superior vertebrae of the back. Inserted into all the basis of the scapula below its spine. rRhomboideus minor arises tendinous from the spinous processes of t_) three inferior vertebrae of the neck, and from the ligamentum nucha?. Inserted into the base of the scapula, opposite to its spine. TTpraXinatus arises fleshy from aU that part of the base of the scapula tht is aoove'ts spine: also from the spine and superior costa, passes under !£ acCum. and adheres to the capsular ligament of the os humeri. „ To ..*t the psoas In bending the thigh, and to bring I. directly forward* "•' TodVaw Ihe'ne^Ewa^.?.^ on. side, and when both act, to draw the be* dlrcetl, ^ChrV the head and upper v.rtebr. of ,h. neeK toward, laterally: _d when both act, ,TT!,dr.w"h.^ufaobtqrry,upward...nd directly Inw^. * t" B.U.t|tne'af?m,up»nrds and at the same time to pall the capsular Hgaraent from between U.o"h,uc»* that it may not be pinched. 5S0 COMPi-.NDirM OF ANATOMY. Inserted tendinous into that part of the large protuberance on the head of the os humeri that is next the groove for lodging the tendon of the long head of the biceps. e. Serratus Posticus Inferior arises by a broad thin tendon, in common with that of the latissimus dorsi, from the spinal processes of the inferior vertebra? of the back, and from the three superior of the loins. Inserted into the lower edges of the four inferior ribs, at a little distance from their cartilages, by as many distinct fleshy lips. f. Triceps Extensor Cubiti, arises by three two heads, the first longus, pretty broad and tendinous, from the inferior costa of the scapula, near its cervix, the second head, called brevis, arises by an acute, tendinous, and fleshy beginning, from the back part of the os humeri, a little below its head, out- wardly. The third called brachialis externus, arises by an acute beginning from the back part of the os humeri. These three heads unite lower than the insertion of the teres major, and cover the whole posterior part of the humerus, from which they receive addition in their descent. Inserted into the upper and external part of the process of the ulna, called olecranon, and partly into the condyles of the os humeri, adhering firmly to the ligament. g. Gemini arises by two distinct origins, the superior from the spinous pro- cess, and the inferior from the tuberosity of the os ischium : also, from the posterior sacroischiatic ligament. They are both united by a tendinous and fleshy membrane and form a purse for the tendon of the obdurator internus, muscle. Inserted, tendinous, and fleshy, Into the cavity at the inner side of the root of the trochanter major, on each side of the tendon of the obdurator internus, to which they firmly adhere. h. Quadratus Femoris arises tendinous and fleshy, from the outside of the tuberosity of the os ischium, and running transversely, is Inserted, fleshy, into a round ridge, continued from the root of the large tro- chanter to the root of the small one. FIG. XI. i. Trachelo-Mastoidams arises from the transverse processes of the three uppermost vertebrae of the back, and from the five lowermost of the neck, where it is connected with the transveralis cervicis, by as many thin tendons, which unite into a belly, and run up under the splenitis. Inserted into the middle of the posterior side of the mastoid process, by a thin tendon. k. Coraco Brachialis, arises tendinous and fleshy from the coracoid process of the scapula, adhering in its descent to the short head of the biceps. Inserted, tendinous, and fleshy, about the middle of the internal part of the os humeri, near the origin of the third head of the triceps, called brachialis e. To depress the ribs Into which It Is inserted. f. To extend the fore-arm. g. To roll the thigh outward., and to preserve the tendon of the obturator Internus from being Burt by the hardness of that part of the Ischium over which It passes; also, to hinder it from starting out of its place while the muscle Is in action, h. To roll the thigh outwards. I. To as-isi the complexus; but it pulls the head more to the side. To raise the arm upwards and forwards. COMPENDIUM OP ANATOMY. 5"1 extcrnus, where it sends down a thin tendinous expansion to the internal con- dyle of the os humeri. I. Extensor Radialis Brevier, arises tendinous, from the external condyle of the os humeri, and from the ligament that connects the radius to it, and runs along the outside of the radius. Inserted by a round tendon into the upper and back part of the metacarpal bone that sustains the middle finger. m. Supinator Radii Brevis, arises tendinous, from the external condyle of the os humeri, tendinous and fleshy, from the external and upper part of the ulna, and adheres firmly to the ligament that joins these two bones. Inserted into the head, neck, and tubercle of the radius, near the insertion of the biceps, and ridge, running from that downwards and outwards. n. Spinalis Dorsi arises from the spinous processes of the two uppermost ver- tcbric of the loins, and the three inferior of the back, by as many tendons. Inserted into the spinous processes of the nine uppermost vertebrae of the back, except the first, by as many tendons o. Gluteus Minimus arises fleshy from a ridge that Is continued from the superior anterior spinous process of the osilium, and from the middle of the dor- sum of that bone, as far back as its great niche.-Inserted by a strong tendon into the fore and upper part of the trochanter major. p. Obdurator Internus arises from more than one half of the internal circum- ference of the foramen thyroideum, formed by the os pubis and ischium; its inside is covered by a portion of the levator ani, and appears to be divided mto a number of fasciculi, which unite and form a roundish tendon, that passes out of the pelvis, betweenthe posterior sacro-ischiatic ligament and tuberosity of the os ischium, where it passes over the capsular Ugament of the thigh bone; it is enclosed as in a sheath, by the gemini muscles.-Inserted by a round tendon in the large pit at the root of the trochanter major. _ , «,„ q. PoplUeus, arises by a round tendon from the lower and back part of the externalcondyle of the os femoris, then rims over the Ugament that involve L joint, firmly adhering to it, and part of the semilunar carriage. As It runs ove the joint, it becomes fleshy, and the fibres run obliquely .nwards,be.,, covered with a thin tendinous membrane.-Inserted, broad, thin, and fleshy, 'nto a ridle at the upper andinternal edge, of the tibia, a litUe below its head t TMaltpostic*arises by a narrow fleshy beginning from the fore and tZrt of the tibia just under the process which joins it to the fibula, then ZSZ^^SL** in the upper part of the interrosseus flgnment. it passmg tnrougn a p ^ ^ ^ from ^ ca^Tt*^^^^'mA bone; -a,so fa»fl-T "u^amelt S fibres running towards a middle tendon, which sets off a seus lament. Wnd tne maiec.lus internus. roUnd one «^J« £_■ * ^ mner part of the os navicular*, being co^dC^^ t To assist the last mentioned ™;f'«;bri th, nand .opine. m To roll the rn.llus outwards, ana.t° D"'f. " r8isin» the spue. E iSVrect and tU the «««g£*X££* backus, and in rolling It °p. To ^n^rfefrl. obliquely outward..^ ^ ^^ r^mtm (nm Wlig plnphed- Af(„ a. To assist In bendiiut the leg, an . ,„„,,, 532 COMPENDIUM O? AN ATOM?. tendinous filaments to the os caleip, os cuboides, and to the root of the meta- tarsal bone that sustains the middle too. s. Flexor Longus Dig. Pedie, arises by an acute tendon, which soon becomes fleshy, from the back part of the tibia, some way below its head, near the entry of the medullary artery; which beginning, is continued down the inner edge of this bone, by short fleshy fibres, ending in its tendon: also, by tendinous and fleshy fibres, from the outer edge of the tibia; and between this double order of fibres the tibialis posticus muscle lies enclosed.—Having passed under two an- nular ligaments, it then passes through a sinuosity at the inside of the os calcis, and about the middle of the sole of the foot divides it into four tendons, which pass through the slits of the perforatus, and just before its division, it receives a considerable tendon from that of the flexor pollicis longus. Inserted into the extremity of the last joint of the four lesser toes. t. Flexor Pollicis Longus, arises by an acute, tendinous and fleshy beginning from the posterior part of the fibula, some way below its head, being continued down the same bone, almost to its inferior extremity, by a double order of oblique fleshy fibres, its tendon passes under an annular ligament at the inner ankle. Inserted into the last joint of the great toe, and generally sends a small tendon to the os calcis. FIG. XII. 1 * Depressor Labii Sup Aleq. Nasi, arises thin and fleshy from the os max- illare superius, immediately above the joining of the gums with the two dentes incisivi, and the dens caninus, from thence it runs up under part of the levator labii superioris alaeque nasi.—Inserted into the upper lip and root of the ala nasi. 2* Orbicularis Oris. This muscle is in a great measure formed by the muscles that move the lips , the fibres of the superior descending, those of the inferior ascending, and discussating each other about the corner of the mouth, run Hlong the lip to join those of the opposite side, so that the fleshy fibres appear to surround them like a mouth sphincter. 3 * Sterno Thyredeus, arises fleshy from the whole edge of the uppermost bone of the sternum internally, opposite to the cartilage of the first rib, from which it receives a small part of its origin.—Inserted into the surface of the rough line, at the external part of the inferior edge of the thyroid cartilage. 4* Scalenus Anticus, arises from the fourth, fifth, and sixth transverse pro- cesses of the first vertebra? of the neck by as many tendons. Inserted, tendi. nous and fleshy, into the upper side of the first rib near its cartilage. 5* Subscapularis arises fleshy from all the base of the scapulare internally, and from its superior and inferior costa: being composed of a number of tendi- nous and fleshy fasciculi, which make prints on the bone, they all join together, s. To bend the last joint of this toe. t. To bend the last joint of the toes. 1 * To draw the upper lip and ala nasi downwards and bnckwar Is. 2 « To shut the mouth, by contracting and drawing both lips together, and to counteract all the mu-clos that assist In forming tt. il * To draw the larynx downwards. 4. • To bend the neck to one side ; or, when the neck is fixed, to elevate the ribs, and to dilate the thorax. 5 • To roll the humerus Inward', and to draw It to the side of the body : and to prevent the Oiio.uUr ligament front being pinched. Comp'.>d:vm or anatomy. G33' TV. np the hollow of the scapula, and pass over the joint, adhering to the capsular Ugament.—Inserted, tendinous, into the upper part of the internal pro- tuberance at the head of the os humeri. 6* Intercostales ext. $ int. arise from the inferior acute edge of each superior rib and run obliquely forwards, the whole length from the spine to near the joining of the ribs with their cartdages; from winch, to the sternum, there Is only a thin membrane covering the internal intercostals, which arise in the same manner as the externals but they begin at the sternum, and run ob- liquely backwards, as far as the angle of the rib, and from that to the spine they are wanting.—Inserted into the upper obtuse edge of each inferior rib, as far back as the spine, into which the posterior portion is fixed. /*■ Tendinous Expansions. 8* Transversalis Abdominis, arises tendinous, but soon becoming fleshy from the inner or back part of the cartilages of the seven lower ribs, where some of its fibres are continued with those of the diaphragm and the intercostal muscle, by a broad thin tendon, connected to the transverse processes of the last ver- tebra? of the back and the four superior vertebrae of the loins, fleshy from the whole spine of the os ilium internally, and from the tendon of the external oblique muscle, where it intermixes with some fibres of the internal oblique.— Inserted into the cartilago ensiformis, and into the whole length of the linea alba, excepting its lowermost part. 9* Obdurator Externus arises fleshy from the lower part of the os pubis, and fore part of the inner crust of the ischium, surrounds the foramen thyroideum, a number of its fibres, arising from the membrane which fills up that fora- men, are collected like rays towards a centre, and pass outwards around the root of the back part of the cervix of the os femoris.-Inserted by a strong tendon, into the cavity at the inner and back part of the root of the trochanter major, adhering in its course to the capsular ligament of the thigh bone. 10* Adductores Femoris. Under this appellation are comprehended three dis- tinct muscles. ,. , _ .. 1 Adductor Longus Femoris, arises by a pretty strong roundish tendon, from the'upper and interior part of the os pubis, and ligament of its sy^ioiulrosis. or the inner side of the pectinalis.-Inserted, tendinous, near the middle of the nosterior part of the linea aspen, being continued for some way down il Adductor Brevis Femoris, arises tendinous from theospubis, near its joining withthe opposite os pubis, below and behind the former.-Inserted, tendmous L d fltshy into the L* and upper part of the linea aspera, from aTittle below 1 trochanter minor, to the beginning of the insertion of the abductor longus 8 AdduJol Magnn Femori,, arises a little lower down than the former, near T'.n/tlie ossa pubis, tendinous and fleshy, from the tuberosity TZT^Tt^Z run outwards and downwards.-Inserted into muscles or triceps bring[the thigh 1 rZWSS-"h^l^ PJTiS^".^-- 534 COMPENDIUM OF ANATOMY. almost the whole length of the linea aspera, into a ridge above the internal con- dyle of the os femoris, and by a roundish long tendon, into the upper part of that condyle, a little above which the femoral artery takes a spinal turn towards the ham, passing between this muscle and the bone. 11* Biceps Flexor Cruris arises by two distinct heads, the first, called lon- gus, arises in common with the semitendinosus, from the upper and posterior part of the tuberosity of the os ischium. The second called brevis, arises from the linea aspera, a little below the termination of the glutoeus maximus, by a fleshy acute beginning, which soon grows broader as it descends to join with the first head, a little above the external condyle of the os femoris.—In- serted by a strong tendon into the upper part of the head of the fibula. 12* Extensor Brevis Dig. Pedis, arises fleshy and tendinous from the fore and upper part of the os calcis, aud soon forms a fleshy belly, divisible into four portions, which sends off an equal number of tendons, that pass over the upper part of the foot, under the tendons of the former.—Inserted by four slender tendons into the tendinous expansion from the extensor longus, which covers the small toes, except the little one, also into the tendinous expansion from the extensor pollicis that covers the upper part of the great toe. 13* Tendo Tibialis Fostici. The tibialis posticus arises by a narrow fleshy beginning, from the fore and upper part of the tibia, just under the process which joins it to the fibula, then passing through a perforation in the upper part of the interrosseous ligament, it continues its origin from the back part of the fibula, next the tibia, and from near one half of the upper part oi the last-named bone, as also from the interrosseous ligament the fibres running towards a middle tendon, which sends off a round one that passes in a groove behind the maleolus internus.—Inserted tendinous, into the upper and inner part of the os naviculate, being further continued to the os cuneiforme internum and medium; besides, it gives some tendinous filaments to the os calcis, os cuboides, and to the root of the metatarsal bone that sustains the middle toe. 11 * To bend the leg. N. B. This muscle forms what Is called the outer hamtring. Beiwuea It and the inner, the poplitical nerve, artery, and vein, are situated. 12 * To extend the toes. 13 * To extend the foot, and to turn the toes inwards MILNER AND SOW15RBY, PRINTERS, HALIFAX- I 1 ^1