Sfellf \848 X-^kK:. ;; ir-: ^ I r~--f!-5'-t---*L«iKr Ltl t|t BfS*& tiiW \ZTZ sJEfflBaR I'- 'F'S^f", =-- ^nsffftj^ritrif&iJt..*! »?5 i^U^feifal rv^&Mg Pi« m$?$rfeJ 11 :U->*&§riHWfcf :Mf$. X'^jcXv lH^v" rfS't 'y-h-- '-' !.-.■ : ^\?a=;'i.;?tf ^r -••f;:: t-*V*A»rK ---i: ■^fc**** - :...'■■ K J>. &f :-. ;,»fTi f. if ¥ ——-r-.---.'V. ■■■■■. 'UO^- Q Surgeon General's Office mm ANNEX N< ' C?Z.'y3iOQXj-2C;aCj ZOC/J ^^GQTIQ Ji Thdzs skoairuj where Blisters, Poutb'res. ljL'rr/irs.J'l/islrr.\ S-r. nrr lo be ;nit wuLthe Organs ot'tlLeliaman.System.inftieir resprchi.e p horn. Dose: SdP" This preparation is not often used, and is not equal to the Aqua Ammonia, or Hartshorn HARTSHORN. Dose:|30 to 40 drops. | 6 to 8 drops. |Once or twice aday.|In water. Good fbr low spirits, fainting, and nervousness. CHALK (crab's eyes), or the prepared. Dose: 8 to 10 grains. 3 to 4 grains Once or twice a day. 8 to 10 grains. Good for acid stomach and loose bowels. LIME-Water. Dose:|3to4tablespoonfuls|3 to 4 teaspoonfuls.|Once during the day| Good for acid stomach and heaitbum. MAGNESIA (Calcin- 20 to 30 and 40 grs. 8 to 12 grains, 30 to 40 grains. 10 to 12 grains. Good for acid stomach, heartburn, and a gentle purge. SUBCARBONATE of] Potash, or prepared Kali, or Salt of Tartar. Good for acid stomach, heartburn, and a gentle purge. In little mint-water. ed). Dose Of the carbonate, Once or twice a day. Once or twice a day. In common or mint-water. 18 ABSORBENTS.—■Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. CARBONATE OF POTASH. Dose: Solution of Subcarbon- ate of Potash, or Ley of Tartar. Dose: Good for acid stomach and heartburn. CARBONATE OF SODA.—Subcarbon- ate of Soda, or pre- pared Natron : 6 to 8 grains. supercarbon: ATE of SODA : 1 teaspoonful. Good for acid and weak stomach, and 3 to 4 grains. 4 to 5 grains. 2 or 3 times a day. 3 or 4 times a day. In mint-water. In water. bladder. Also, good in gonorrhoea or clap difficulty of making water, irritability of the stomach and burnt hartshorn burnt sponge, SHELLS (Prepared), RHUBARB ROOT Not often used. Good for acid stomach and heartburn. Chew a small piece. Good for acid stomach, and opens the bowels. Now and then du- ring the day. 19 ALTERATIVES, or such Medicines as alter, increase, or improve, the Secretions of the Body, when irregular, obstructed, or bad. ^P3 Note.—I have taken the liberty of making these a distinct class, to suit the purposes of the work. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ANTIMONY. Of the precipitated Sulphuret or Kermes Mineral, 1 or 2 grains. One half a grain. The Golden Sulphuret, 1 or 2 grains. One half a grain. Good for impure secretions of the skin and blood. ^THIOPS. Mineral :[10 to 20 grains. | 8 to 10 grains Good for sores on the skin, and scaldhead in children. IODINE. Of the tine 15 to 20 drops Once or twice a day Once or twice a day, ) With a little su- \ gar, or in pills. 12 or 3 times a day. |In syrup. ture—dose 2 or 3 times a day. In mucilage or tea. 5 or 6 drops. Good for scrofula and enlargement of the glands. THE WHITE PRECIPITATE.—Used only, mixed with lard, to destroy vermin in the head. THE RED PRECIPITATE.—Used to burn and purify foul ulcers on the limbs or body. MERCURIAL OINTMENT.—Rubbed under the arms, or in the groin, produces salivation. Also, rubbed on to destroy ci"abs. THE ACETATE OF MERCURY.—Cures ugly pimples on the face. Take a camel's-hair brush, dip it in, and touch the pimple. I^3 These last four are never given internally. 20 ALTERATIVES.—Continued. FOR A GROWN PER- FOR A CHILD FROM 5 HOW MANY TIMES IN WHAT TO .BE SON, - TO 7 YEARS OF AGE. A PAY. TAKEN. MERCURY. Of the blue pill. Dose : 5 or 6 grains. ' 2 or 3 grains. At night—bedtime. Rolled into a pill. Of the chloride or calomel, 3 to 4 grains. 2 or 3 grains. 2 or 3 times a dav, or In sugar or pills. •Bichloride, or corro- From tV to i of a night and morning. sive sublimate, grain. Dangerous. Once a day enough. In a wineglass of syr- IrtT * This is a poison, and should be bandied with great care. |up or sugar & water Good for biliousness, costive'n'ess, indigestion, dysentery, when the liver is sluggish, and for venereal diseases, scrofula, and pox, and when in larger quantifies, mixed with water, rubbed on to destroy crabs. !ty The first two preparations are used in several diseases to restore or increase the mucous and salivary secretions, when dried up or checked. MURIATIC ACID : |15 to 20 drops. | 3 to 5 drops. |2 or 3 times a day. |In water, 1, tumbler. Good for liver complaints, eruptions of the skin, and scrofula. SARSAPARILLA— (root). Compound decoction. Dose: Syrup, 4 or 5 times a day. 4 or 5 times a day. 1 wineglassful. 1 tablespoonful. 1 wineglassful. 1 tablespoonful. Good for impurity of the blood, scrofula, and venereal diseases BURNT SPONGE : [10 to 15 grains- | 5 to 6 grains. |2 or 3 tames a day. Good for scrofula and enlargement of the glands. In water. In simple-syrup. 21 ALTERA TIVES.—Continued. ' FOR A GROWN PER-SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. SODA—the subcarbon-ate or prepared na-tron. Dose : 6 to 8 grains. 3 to 4 grains. Good for scrofula and sourness of the stomach. SULPHUR—the flow-ers of. Dose : i to 1 teaspoonful. 10 to 15 grains. 2 or 3 times a day. 2 or 3 times a day. In mint-water. « Molasses or honey. i\](\ rmrcre. Good for the itch, and eruptions of the skin of a scabby nature. This is also a mild purge. MILKof SULPHUR :|Half a teaspoonful. [ 8 to 10 grains. |Once or twice aday.|In any syrup. Good for diseases of the skin, sores, &c. 22 ANTISEPTICS, or such Medicines as given internally, or applied externally, prevent a tendency to Putrefactions of the Body, or any parts of it, and are used in sw.h Diseases as malignant Typhus Fever, putrid Sore Throat, and Mortification of the Limbs and Extremities. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ABSINTHIUM — or common Wormwood steeped in spirits 1 tablespoonful. A wineglass. Good for weakness after childbirth, and after typhus fever varioloid, and such diseases. ■VCETIC ACID —or distilled Vinegar: Haifa wineglass, 2 or 3 times a day. In water or plain. It may be used, also, after small-pox, 2 or 3 times a day. In water. 1 tablespoonful. Good for foul ulcers about the body and extremities, and for liver complaints. This is an excellent remedy, also, for dropsy, difficulty of'passing water, and in clap or gleet. C1IRIC ACID — of the crystals: 30 to 40 grains. 15 to 20 grains. 3 or 4 times a day. Good in putrid sore throat, varioloid, and small-pox. Very pleasant to the patient CAMPHOR—of the In water. gum 3 to 4 grains. Good for typhus fever and putrid sore throat CAMOMILE (flow 2 to 3 grains. 2 or 3 times a day. In powder or pills. Dose Steep a handful of the flowers in a pint of boiling water, let it cool, and give a wineglassful every 3 hours. Good for weakness after illness. AW, a tonic. 23 ANT1SEP TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. CINCHONA, or com- mon pale Peruvian Bark. Of the powder, Of the quill bark, Yellow Peruvian Bark, Red Peruvian Bark, 6 to 3 or 8 grains. 4 quills. 3'or 4 times a day. In hot water, cooled 3 to 4 grains. 1 quill put into boiling water, and al- lowed to cool. A wineglassful every 3 or 4 hours. Good in mortification from gunshot wounds, and injuries, hospital gangrene, and in all putrefactive diseases. It is also a tonic, and strengthens in weakness from long illness. LEMON. MYRRH—of the tinc- ture, Good in scurvy and sore mouth. MURIATIC ACID. Dose: 15 to 20 drops. 8 to 10 drops. Good for diseases of the skin, scrofula, and foul ulcers. NITRIC ACID : 110 to 15 or 20 drops.|6 to 8 or 10 drops. |2 or 3 times a day. |In water. Good for diseases of the skin, scrofula, and foul ulcers. I^3 Nitric and muriatic acid mixed together, one half a wineglass of each, and thrown into a bath, is very strengthening in illness from fevers, &c. -. 1 teaspoonful. Half a teaspoonful. In a wineglass of water, held in the mouth but not swallowed. Twice a day. Ill water. 24 ANTISEP TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ^ of a grain. OPIUM (in pills): | 1 to 1 grain. Good for scurvy and foul ulcers. SULPHURIC ACID:| 5 to 10 drops. | 3 to 6 drops. Good, for diseases of the skin, scrofula, and foul ulcers. I^3 Among these, I must mention COLD WATER, applied to the body with a sponge or towel, frequently useful in many of these diseases. |Once or twice aday.| In a pill. 12 or 3 times a day. jln water. 25 ANTHELMINTICS, or such Medicines as are given to destroy and remove Worms from the Bowels— same as Vermifuges. ,, FOR A CROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ALLIUM, or Garlick ASAF03TIDA. CAMPHOR. Dose: CALOMEL. Dose: co Good for all kinds of worms. GAMBOGE —of the gum and powder: See page 14 (Antispasmodics) for the dose. 4 to 5 grains. | 2 or 3 grains. |^ or 3 times a day. | In sugar or honey. 1 grain. Twice a day. In honey. 3 grains. Good for worms (generally combined with the same quantity of calomel). IRON FILINGS: | 8 to 10 or 20 grs. | 3 to 4 grains. ) Twice a day. | In syrup. Good for worms^ scurvy, rickets, epilepsy, and indigestion. Excellent for the tapeworm. JALAP—of the pow- 4 to 5 grains. 1 teaspoonful. The powder, good for all kinds of worms ; the tincture, for worms and disordered stomach; also, a tonic. MURIATE of SODA, der. Dose Of the tincture, 8 to 10 grains. 1 to 2 teaspoonfuls, 2 or 3 times a day. 2 or 3 times a day. In honey. In water. or common table-salt, OLIVE OIL: 1 tablespoonful. 1 teaspoonful. Good for worms and costiveness. This is excellent in dyspepsia 5 or 6 times a day. Alone. 26 ANTHELMINTICS.—Continued. FOR A GROWN PER- SON. FOR ACHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. SCAMMONY—of the powder: 6 to 8 grains. 4 times a day. In syrup. 3 or 4 times a day. In honey or syrup. 3 to 5 grains. Good for worms and costiveness. It is generally used with calomel. Mix three or four grains of calomel with each powder. If the scammony is used alone, you must increase the dose. SPIGELIA, or PINKI ROOT : , I 5 or 6 grains. 3 or 4 grains. Good for worms of all kinds. It is better to give a dose of castor oil and turpentine first. It is bet- ter, also, to put three grains of calomel, and three or four grains of rhubarb, in each powder of the pink root for worms. STEEL.—See Iron. TANACETUM, or TANSY.—Not often used. TIN—of the powder: 115 to 20 grains. | 8 to 1Q grains. [Night and morning. | In honey or syrup. Good for worms and epileptic fits. TOBACCO.—Not often used. There are several kinds of bark used on plantations; but I prefer the castor oil and turpentine, followed by powders of calomel, pink root, and rhubarb, in the proportions directed for worms, further on in the book. (See Worms.) ] 27 ASTRINGENTS, or such Medicines as are used to stop or restrain immoderate Discharges from any of the natural outlets of the Body, particularly the Bowels. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. 2 or 3 times a day. In pills or honey. ALUM—of the pow- I der • '4 to 8 grains. | 2 to 3 grains. Good for bloody flux, great looseness of the bowels, and flowing from the womb. This medicine should only be used when the discharge is great and dangerous. Milder astringents ought to be tried first, or small doses of calomel and quinine. AROMATIC CON- 6 to 8 grains tincture: FECTION. Dose : 15 to 20 grains Good for cramps in the stomach and bowels, and for purging CATECHU—of the 1 teaspoonful 2 or 3 times a day. 3 or 4 times a day. In water, with 1 or 2 drops of peppermint Mint or plain water. 8 to 10 or 15 drops Good for looseness of the bowels, and flooding of long standing. Also, good to check the courses when they are too free CHALK, prepared, or Crab's Eyes 6 to 8 grains. 3 to 4 grains. 3 or 4 times a day. Mint-water, or wa- ter with paregoric. Good for looseness of the bowels from acid stomach, and for bowel complaints in general. This 13 good for infants when they are griped. Take three or four grains of the chalk, and rub it in a mortar; then mix it with half a pint of water, and put in twenty drops of paregoric; strain it through a cloth, and give a teaspoonful three or four times a day. 28 ASTRINGENTS.—Continued. FOR A GROWN PER- SON. roll A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. 3 or 4 times a day. CHALK, powder, with I opium : j 10 grains. Good for dysentery, and bowel complaints of long standing. KINO—tincture of the gum: 1 teaspoonful. 15 to 20 drops. Good for obstinate looseness of the bowels, and bloody flux LEAD (sugar of lead). Apply to a physician for the dose. OAK & GALL NUTS Good for weak and irritable stomach and bowels, diarrhoea, and looseness. LOG WOOD—of the 1 winegflassful. In mint-water. 4 or 5 times a day. | In water with sugar. decoction : Good for looseness of the bowels OPIUM—the different prepar'ons of opium. ZINC—the sulphate or white vitriol. TONICS (generally). I tablespoonful. 3 or 4 times a day. In water. Most of the tonics are astringents. 29 ANODYNES, or such Medicines as are used to relieve Restlessness, Nervousness, Pain, and to produce Sleep and quiet. They are mild Narcotics, and are used frequently, in large doses, as Narcotics. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. OPIUM (purified gum Of the tincture, or * laudanum, to 1 grain, in pill, 20 to 30 drops, oi a grain. Once or twice a day Once or twice a day. Rolled in the fingers In water. 8 to 10 drops Good to relieve pain,,restlessness, to produce sleep, for asthma, hooping-cough, and spasms PAREGORIC—elixir,| 1 teaspoonful. |20 to 30 drops. |Once or twice a day.| Water or warm tea. Good for hooping-cough, asthma, weak stomach, cramp, and restlessness. POPPIES—syrup of 1 teaspoonful. the white 1 to 2 teaspoonfuls. 2 oi*)3 times a day. | In water or by itself. Good for coughs, restlessness, nervous irritation, soreness and weakness of the chest. TINCTURE of HY- OSCIAMUS, or Henbane: 6 to 8 drops. 3 or 4 times a day. 20 to 40 drops. Good for shortness of breath, consumption, weakness and soreness of the chest. kidneys, producing a flow of urine. TOBACCO —of the 30 to 60 drops. wine : Of the extract (not often used): 2 to 3 grains 10 to 15 drops. \ a grain 2 or 3 times a day. Once or twice a day, In sugar and water. It acts also on the In water. In a pill. Good for bronchitis, violent, spasmodic coughs, cramp and spasmodic closure of the windpipe, asthma, 30 APERIENTS, or such Medicines as open the Bowels gently—same as mild Purges. FOR A GROWN PER- SON. FOR A CHILD I-'ROM 5 TO 7 YEARS OF \OE. HOW MANY TIMES A 1) \Y. IN WHAT TO BE TAKEN. |Once or twice aday.jln sugar and water. The plain tincture, Compound tincture, Of the wine, 1 teaspoonful. 1 teaspoonful, 2 teaspoonfuls. ^ a teaspoonful. This 4 or 5 times a day. 4 or 5 times a day. 3 times a day. With a little su- gar and water. In sugar and water. CREAM of TARTAR.jl to 2 teaspoonfuls |30 to 40 grain. Good for eruptions and sores of the skin, and erisipelas. RHUBARB—root. 2 to 3 teaspoonfuls. 2 to 3 teaspoonfuls. 3 to 4 teaspoonfuls. Good for cramps, wind in the bowels, and stomach-ache SAL POLYCREST : | 1 teaspoonful. Cooling purge, and keeps the bowels gently ope sulphur water of the Virginia springs. ROCHELLE SALT :|2 to 3 teaspoonfuls.| 1 teaspoonful. |Once or twice a day;| In water Opens the bowels ; cooling. SULPHATE of POT-I ASH, or Vitriolated Tartar: I 1 teaspoonful. *-a teaspoonful. |2 or 3 times a day. |In water, \ tumbler. mixture is an excellent substitute for the Cooling purge TAMARINDS- served : Once or twice a day. In water. Good for eruptions of the skin. •pre- Pour a pint of boiling water over a tablespoonful of the tamarinds. Put in a little white sugar. Good to assist other medicines ; given to open the b owe small-pox, scarlet fever, and eruptive diseases, as rashes, Is. Very pleasant and cooling in fevers, &c. 31 CATHARTICS, or active Purges—such Medicines as purge out the Bowels briskly. FOR A GROWN PER- SON. FOR A CHILD FROM 0 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ALOES—of the extract of Spiked, Of I he powder, Of the tincture, 8. to 10 grains. G to '8 grains. I to 4 teaspoonfuls 15 to 20 grains. 10 to 15 grains. 5 to 6 grains. to 8 grains. to 6 jrrains. 3 3 2 Good for costiveness and worms. Aloes are in eacli powder, given three or four times COMMON ALOES- (Barbadoes Aloes): Of the powder, Of the extract, Good for obstinate costiyeness GAMBOGE. CALOMEL: Good for costiveness, biliousness, and a more generally useful than this CASSIA (pulp). COLOCYNTH—pow- der: 8 to 10 grains. 4 to 5 grains. Good for costiveness (habitual). to 4 grains. Once or twice a day. In pills. to 4 grains. 2 or 3 times a day. Pills, or With sugar. teaspoonfuls. 3 or 4 times a day. In sugar and water. used, also, with calomel and rliubarb, three to four grains a day, to force the courses when stopped. Once or twice a day. Once or twice a day. Pills, or with sugar. In pills. to 4 grains. Twice a day. In sugar or syrup. fieat many complaints. There is, perhaps, no medicine Every 3 hours, until it acts freely on the bowels. In sugar. \ 32 CA THAR TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. Once or twice a day. In pills. COLOCYNTH, of the % compound extract: 8 to 10 grains. 5 or 6 grains. Good for habitual costiveness. CREAM of TARTAR|lto2tablespoonfuls|l to 2 teaspoonfuls. 12 or 3 times a day. |In sugar andwater. Cooling purge. EPSOM SALTS: 1 to2tablespoonfuls or more. Cooling purge in hot weather. JALAP—powder: |15 to 20 grains. Purge in fevers and costiveness. MANNA: 12 or 3 tablespoonfuls Good to keep the bowels open. MAGNESIA—of the calcined: 2 to 3 teaspoonfuls, 2 or 3 times a day. 2 or 3 teaspoonfuls, 8 to 10 grains. | Twice a day. Half the quantity. |Until it operates. 1 teaspoonful. Every 2 hours, until it purges freely. In water. |In syrup or honey. Good for costiveness and acid secretions in the stomach and bowels MAGNESIA (carbon- ate) : 4 to 5 teaspoonfuls In plain water. or mint- 2 or 3 times a day. Mint or plain water. 2 to 3 teaspoonfuls. Good to open the bowels, and to carry off acid secretions from the stomach and bowels. MERCtJRY, or QUICKSILVER.—This is not often used. It passes quickly through the bowels, and is used to force obstructions of the bowels in invagination of a gut, &c. 33 CA THARTICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. OIL—CASTOR OIL: Of the pure oil, cold- pressed, The common Plantation Castor Oil (inferior). 1 wineglassful, mod- erate size. 2 tablespoonfuls, or less. Once or twice a day With a few drops of brandy or mint- water. Give less, as it is apt to gripe. Good for costiveness, indigestion, diarrhoea, dysentery, colic, and cholera morbus. • Castor oil ought to be kept'in all houses, and on all plantations, and is one of the safest and best purges. CROTON OIL : POTASH—Nitrate of, or soluble tartar. Supertartrate, or Cream of Tartar: RHUBARB—powder: One drop on the tongue. Very severe. Use with caution. Increase the doses directed under Aperients, page 30. 20 to 30 grains, or less. 10 to 15 grains, or less. 2 or 3 times a day. In mint-water. Purge for costiveness when the bowels are weak. Rhubarb, in small doses, acts beneficially on en« larged spleens, and in fever and ague. This is not generally known SCAMMONY, powder 10 to 15 grains, orj less. Active purge in costiveness.' 6 to 8 grains, or less. 3 or 4 times a day. In mint-water, 34 CA THAR TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. SENNA—leaves: 2or3tablespoonfuls 2 to 3 teaspoonfuls.| | Pour boiling water over them—say a pint. Give a cupful every two hours during the day, until it operates freely. Good to open the bowels in colds and fevers. \ SULPHATE of Soda, or Glauber Salts 2 teaspoonfuls. |2 or 3 times a day. In water. 2 tablespoonfuls, or less. Purge in costiveness, fevers, &c. SULPHUR—flowers : |2 or 3 teaspoonfuls.| 1 teaspoonful. |2 or 3 times a day. |In water. Purge in eruptive complaints of the skin, as itch, sores, &c. SALT WATER.—This is used by sailors at sea ; it purges actively. Give it by the tumblerful, in the absence of better medicine. 35 DIAPHORETICS—or Sweats, or such Medicines as produce Perspiration and Sweating. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ANTIMONY—the ox- 1 ide, or Antimonial powder: 4 grains. 3 or 4 times a day. In sugar. 2 gram. Good in fevers and chest"complaints, as pleurisy, pneumonia, &c This powder may be given either by itself or in warm snake-root tea. It is excellent in small-pox, scarlet fever, and measles. ANTIMONIAL Wine|1 teaspoonful orless| 20 drops. |3 or 4 times a day. Jin water. Good in fevers and chest complaints; also, in erysipelas, or St. Anthony's fire. AMMONI A—C arbon- ate, or Salt of Harts- horn. SOLUTION, or Aqua Ammonia : 8 to 10 drops. ' 20 drops Good for typhus fever, and other fevers, where there is great LIQUOR of the ACE TATE of AMMO- NIA, or Spirit of Mindererus l to 3 teaspoonfuls. 3 or 4 times a day. debility. 3 or 4 times a day. In water. In water. 1 teaspoonful. Good in fevers where there is weakness, pleurisy, typhoid, and pneumonia. CAMPHOR—Gum : . I 3 to 4 grains. | 1 to 3 grains. |3 or 4 times a day. | In a julep or pilL Good in fevers and illness, where there is great weakness. s : .-^. 36 DIAPHORETICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. DOVER'S POWDER 5 to 6 grains. 3 to 4 grains. Good in pleurisy, pneumonia, colds, and winter fevers. GUAIACUM—Gum: | 5 to 10 grains. | 3 to 4 grains. Good in rheumatism and gout of long standing. 2 or 3 times a day. I By itself, with sugar, I or in warm tea. |2 or 3 times a day. | In a pill. AMMONIATED tinc- ture of GUAIACUM 1 to 3 teaspoonfuls, or less. ^ to 1 teaspoonful. 2 or 3 times a day. This preparation is In syrup. useful in puerperal Good for rheumatism and winter complaints from exposure. fever, or great weakness after childbirth. For sailors and seafaring people, who are exposed, tako it at night, and keep your bed. 2 grains. 1 grain. IPECACUANHA, or HIPPO—powder Good in fevers. If it produces vomiting, make the dose smaller NITRE—NITRATE Every 3 hours. of POTASH, or SALTPETRE: 3 to 5 grains. 2 or 3 times a day. 6 to 12 grains. Good for fevers, difficulty of making water, and in pleurisy and pneumonia. SWEET SPIRITS of 1 teaspoonful. In warm water, syr- up, or sugar. In water. NITRE 30 dr ops. Good for fevers, irritation of the bladder from clap, and in colds 3 or 4 times a day. In water. 37^ DIAPHORE TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. MUSTARD WHEY. SENEKA, or LARGE SNAKE-ROOT (de- ■> coction). 2 tablespoonfuls of the root. 1 tablespoonful of the root. Put it in a pint of water, and boil it down to half a pint. Give a wine- glassful, hot, every hour. Good in pleurisy, pneumonia, typhoid pneumonia, and typhus fever; also, in weakness after any of these complaints. It is excellent in coughs, with a grain of tartar emetic in it, and with four grains of camphor, sometimes. SERPENTARIA, or Small Snake-Root Take a small handful of the root, pour on it, when washed clean, a pint of boil- infusion), ing water, and let it draw like tea. Give a wineglassful of this, hot, every hour. Good in colds, pleurisy, chest complaints, and check of perspiration. OXYMEL.orACETA. 1 teaspoonful. 2 or 3 teaspoonfuls. TED HONEY: Good for colds, sore throats, and influenza LIFE-EVERLAST- ING-herb (dry) 3 or 4 times a day. By itself or in water. Give a Take a handful, pour on it a pint of boiling water, and draw to a tea cupful every hour, hot. Good for colds in the winter. This is an excellent medicine to use on plantations. It grows in the old fields, and is known by almost every old woman. It is needless to mention the botanical name. It is generally known by the name of life-everlasting, or catpaw. 38 i DIAPHORE TICS.—Continued FOR A GROWN PER-SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. VAPOR, or STEAM BATH. WARM WATER. SAGE TEA. BALM TEA. WINE WHEY. In a bath, or given to drink. Very gentle and pleasant. Very gentle and pleasant. Take 1 wineglass of Madeira or Sherry wine, half a pint of milk, hot, 1 wine-glass of hot water; throw the water into the milk, with a little white sugar; then put in the wine, strain it, and drink the whey hot, without the curd. Taken generally in bed. 39 DTLUENTS or such Medicines as are given in large quantities in Fevers, Bilious Disorders, Disor- ders of the Chest from Colds or Consumptions, Diarrhoea and Dysentery, Gravel and Stone m the Bladder, and Difficulty of passing Urine. They are generally given warm. 1 FOR A GROWN PER- 1 J SON. . | FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. BARLEY-WATER. 1 BALM TEA. BEEF TEA. CHICKEN WATER. COMMON TEA (hy-son, weak), or sugar and water. GRUEL. TOAST-WATER. WHEY. Good in fevers, &c i. ' « - ' ' ' > 40 DEMULCENTS, or such Medicines as are used in the above Complaints, and many others, and to sheathe and protect the Membranes of the Boiocls, Bladder, and Urethra, when inflamed and tender, m Fevers and Winter Complaints, when the Bowels are weak, aud^the Patient wants Nourishment. FOR A GROWN PER- SON. FOR A CHILD FROM 5 HOW MANY TIMES TO 7 YEARS OF AGE. , A DAY. IN WHAT TO BE TAKEN. ARROW-ROOT (Bermuda).—Take a teaspoonful, pour on it a very little cold water till dissolved, and add one or two lumps white sugar; pour on them one pint boiling water. This may be made thicker by using more arrow-root. Give a little, warm, every now and then. GUM ARABIC (best).—Take a teaspoonful of the powder, one teaspoonful of powdered white sugar; pour on them a pint of hot or cold water, and stir it welk Give a little every now and then. ALTHEA, or MARSH-MALLOW.—This must be boiled. Ask a physician or apothecary for direc- tions. Give a little, warm, every now and then. 1 wineglassful,small size. 2 to 3 tablespoonfuls 3 or 4 times a day. 13 or 4 times a day. | In syrup. ALMONDS (sweet). Of the emulsion: Good for coughs and stoppage of urine. OIL OF ALMONDS :|1 teaspoonful orless| 30 drops. Good for coughs, clap, and difficulty of making water. BARLEY (pearl).—Boil it with a plenty of water. CARRAGEEN, or IRISH MOSS.—Prepared same as litchen. FLAXSEED. LITCHEN, or ICELAND MOSS.—Take a tablespoonful, pour on it a pint of water, boil down to half a pint; sweeten with white sugar. 41 DEMUL CENTS.—0 ontinued. FOR A GROWN PER- IfOR A CHILD FROM 5 SON. | TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. T-rrrr.----ttt-t—--------1 IN WHAT TO BE TAKEN. MALLOWS. LIQUORICE (extract).—Dissolve in hot water. Give a tablespoonful every half hour. Good for •^ colds, check of perspiration, and soreness of the chest. LIVE OIL (Lucca.)\ 1 wineglassful. | 2 tablespoonfuls. |Once ortwice aday.|Plain orwarmwat'r Good for dyspepsia and costiveness. Dyspeptics should use a plenty of good oil with their food. 42 DIURETICS, or such Medicines as promote and increase the flow of Urine, and force it when checked or stopped. They are used in Dropsy and Strangury; also in Clap, Gravel, and stoppage of the Kidneys from cold. FOR A GROWN PER- SON. FOR A CHILD FROM 0 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. COLCHICUM, or Meadow Saffron (ex- tract) : Of the wine or tinct., GLOVE (powder): Of the tincture, -£ a gram. 30 drops. i a grain. 2 or 3 times a day. 2 or 3 times a day. In water. From J to 1 grain 1 teaspoonful. Good for rheumatism, and painful affections^ of the body and limbs from cold DIGITALIS, or FOX i to 1 grain 15 to 20 drops In pills. 2 or 3 times a day. 3 or 4 times a day. In water. In syrup. 8 to 10 drops. Good for dropsy of the chdst, and general dropsy, andwater about the heart, palpitation of the heart, and shortness of breath. LM. Boil a handful of the berries, and give a wineglass of the fluid every 3 hours. Good for dropsy, clap, and stoppage of the urine. JUNIPER (berries) LYTTA, or CAN- THARIDES. Of the tincture, PINE GEM and TAR Good in clap and gleet 5 to 6 drops. 2 to 3 drops. 2 or 3 times a da^ In water. , 43 DIURE TICS.—Continued. FOR A GROWN PER- iFOR A CHILD FROM 5| HOW MANY TIMES SON. TO 7 YEARS OF AGE. A DAY. IN WHAT TO BE TAKEN. POTASH—Supertar trate of Potash. (Crystals of tartar.) Good for clap, gleet, and acid stomach. CARBONATE of POTASH. SUB-CARBONATE of POTASH, or pre pared Kali. 5 to 6 grains. 2 to 3 tablespoonfuls or less. 3 to 4 grains. 1 tablespoonful, or less. Good in stoppage of urine. A mild alkali. ACETATE of POT ASH, or diuretic salt \ to 1 wineglassful, or less 2 or 3 times, a day. 2 or 3 times a day. 2 or 3 times a day. In water. In water. In water. 2 tablespoonfuls, or less. Good for dropsy, stoppage of urine, clap, and gleet. To prepare this on a plantation, take peariash and vinegar, and mix them together slowly, until the effervescence ceases; then use the liquor. NITRATE of POT- 3 to 5 grains. ASH, or Saltpetre 10 to 15 grains Good for fevers, strangury, burning, and difficulty of making water Liquor of CITRATE of POTASH, or Sa- line Mixture. 2 or 3 times a day. In water. 44 DIURE TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILI) FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. SWEET SPIRITS of NITRE : 1 to 2 teaspoonfuls. 1 teaspoonful. Good in clap, fevei's, and difficulty of making water. CARBONATE of SO- DA. 15 to 20 grains. SUB-CARBONATE of SODA, or pre- pared Natron 8 to 10 grains. 3 to 4 grains. 3 or 4 times a day. 2 or 3 times a day. 2 or 3 times a day. In water. In water. In water. 6 to 8 grains. Good for strangury and fever, where the urine is scanty and red. SARSAPARILLA : I Drink freely of the decoction. Purifies the blood. SENEKA, or LARGE 2 tablespoonfuls of 1 tablespoonful, boiled in a pint of water to half a pint. SNAKE-ROOT: | the root's. v /-, Good for stoppage of urine, clap and gleet, and winter complaints. SQUILLS (powder OXYMEL of Squills 1 to 2 grains. ^ a grain. 1 to 2 tablespoonfuls 1 teaspoonful. or less. Good for coughs, chest complaints, colds, and check of perspiration. Twice a day. 2 or 3 times a day. In pills. / 45 DIURE TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. 3 or 4 pills. TURPENTINE—so- lidified gum. Good for clap, gleet, and scanty urine. SPIRITS OF TUR- PENTINE: " 30 to 40 drops 1 pill. 8 to 10 drops; 3 or 4 times a day. Good for gravel, gleet, worms, epilepsy, rheumatism, and neuralgia In syrup. 2 or 3 times a day. | In syrup. 46 JBMET1CS, or such Medicines as produce Vomiting or Puking. They also produce Perspiration and act on the Chest, producing spitting, and on the Bowels, producing purging, and relieve Spasms Coughs, and assist in producing the Courses in Women, when stopped. FOR A GROWN PER- SON. FOR A CHILI) FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ANTIMONY—the an- timonial powder in larnje doses : , ANTIMONIAL Wine 8 to 10 grains. 1 teaspoonful. 5 to 6 or more grs. \ a teaspoonful. Good in fever and ague, chest complaints, &c. TARTRATE of AN- Until they vomit. Every half-hour, till it vomits well. Warm flaxseed tea. In a little water. TIMONYandPOT ASH, or TARTAR EMETIC. grain. f a gram. Pat into a tumbler of water, and given every now and then until the patient vomits. Sometimes give all at once. Good in measles struck in, biliousness, and in fevers to throw off bile. SULPHATE of COP- PER, or BLUE VITRIOL: HIPPO,orIpecacuanha Of wine of Hippo 1 teaspoonful 1 teaspoonful 2 to 4 tablespoonfuls In water, until it vomits. In warm water. |Given till it vomits. Not often used. 6 or 8 grs. or more. In warm water—half for a child. Good to throw off sour or indigestible food from the stomach, and in dysentery. Hippo is excellent in small-pox, measles, and eruptive diseases, to throw the eruption out on the skin. 47 EME TICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. TINCT.ofLOBELIA,| 1 teaspoonful. Good for severe asthma. SQUILLS—powder: Of Oxymel of Squills, Syrup of Squills, Tincture of Squills, 2 to 3 grains. 3 or 4 tablespoonfuls do. do. or less. 1 tablespoonful 1 teaspoonful. grain. 1 tablespoonful. 30 drops. Good for chest complaints, asthma, and bad coughs. Once or twice a day. Once,or twice a day. Once or twice a day. 3 or 4 times a day. | In water. In syrup or warm »'. water. In water. do. " do. TOBACCO SULPHATEofZINC or White Vitriol. Very severe. Seldom used but in strangulated hernia and severe asthma. 25 to 30 grains. Good in sore throat and asthma 8 to 10 grains. Until it vomits. In warm water. 48 EMMENAGOGUES, or such Medicines as produce the Monthly Courses in Females, when checked or stopped. They ought not to be used when there are symptoms of inflammation, or a plethora, or fullness of the system. They are good in Chlorosis, or Green-sickness. FOR A GROWN PER- IFOR A CHILD FROM 5 SON. TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. . ALOES—different I I | | preparations. | See Cathartics, page 31, for dose, Sfc. Good for monthly courses, when they are checked, and the patient is weak, pale, and thin. ANTISPASMODICS (generally). See Antispasmodics, page 13, for doses, 8fc. Good when the courses are checked, and there is pain and'fullness. EMETICS. | See Emetics, page 46, for doses, fyd. Good when the courses are checked, and there is pain and fullness. GALBANUM. HELLEBORE (black) MERCURY-different preparations. MYRRH. IRON—different prep- arations. RUBIA, or MADDER powdered root See Calomel, page 31, for dose, Sfc. See Tonics, for dose, fyc. 30 grains. Good for courses when checked with weakness 2 or 3 times a day. Not often used. In water. 49 EMMENAGOG UES.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. SAV1NE—dried. Leaves powdered Twice a day. 5 or 6 grains. BATHING THE FEET up to the knees in warm water, with mustard. TONICS—generally. | See Tonics. See directions for stoppage of the monthly courses. In syrup. 50 EXPECTORANTS, or such Medicines as are employed in disorders of the Lungs and Chest, to cause spitting up of Mucus or matter from the Windpipe or trachea, and the Tubes which branch into the Lungs. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. GUM AMMONIAC- powder: 8 to 10 grains. 3 to 5 grains. Good for coughs and asthma. ASAEQ^TIDA—tine-130 drops to a tea-15 to 20 drops. ture of Asafoetida : spoonful. Good for nervous weakness, fainting, and hooping-cough. VOLATILE SPIRIT 20 to 30 drops. 6 to 8 grains. of ASAFCETIDA Gum—in powder, Good for nervous complaints. ALLIUM, or GAR- LICK. ANTIMONY—differ- ent preparations. BALSAM of TOLU: TINCT'REof TOLU, 8 to 10 drops. 4 to 5 grains. 2 or 3 times a day. 3 or 4 times a day. 3 or 4 times a day. 3 times a day. In syrup. In water. In water. In pills. See Diaphoretics, page 35, for doses, fyc. \ to 1 teaspoonful. 30 to 40 drops. 2 or 3 times a day. Twice a day. In water. In syrup. \ a teaspoonful. 15 to 20 drops. Good for coughs of long standing, and for weakness and soreness of the chest. BALSAM COPAIVA.|20 to 30 drops. | 6 to 8 drops. , |3 or 4 times a day. |On a lump of sugar. Good for coughs and colds, clap and stoppage of urine. 51 EXPECTORANTS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE'. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. generally See Emetics, page 46. In small doses. See Alteratives, page 19. EMETICS HIPPO: MYRRH. Good for asthma and coughs. MERCURY—some preparations of Mei cury, Good for consumption in the early stages SQUILLS—different preparations. See Emetics, page 46, and make the doses smaller, Good for water on the chest, coughs, and asthma. SENEKA, or LARGE SNAKE-ROOT. See Diuretics, page 42. Good in pleurisy and pneumonia. TOBACCO. ( Good in severe asthma. SULPHATE of ZINC or White Vitriol. See Emetics, page i6,for doses, SfG, Good for sore throat and asthma. VAPOR OF SULPHURIC ^HER (inhaled). 52 EXPECTORANTS.-Contmued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. VAPOR of WATER or Steam (inhaled). Good for sore throat and asthma. Some of the DEMUL- CENTS, as Oil of Almonds, Barley, Li- quorice, &c. See Demulcents, page 40. Good for coughs and soreness of the chest. Some of the DIURET- ICS, as Colchicum, as Digitalis, &c. See Diuretics, page 42. Good for dropsy of the chest, asthma, and weak lungs. 53 NARCOTICS, or such Medicines as relieve Pain and Irritability, and produce Sleep. They are also called Anodynes, although I have used the term Anodynes to signify the milder Narcotics, and in this sense they are commonly used.—(See Anodynes, page 29.) FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ACONITE, or Monks- hood : Of the tincture, Good in rheumatism. BELLADONNA, or Deadly Nightshade. BELLADONNA— Extract. CAMPHOR—of the powdered gum. to 1 teaspoonful. Once or twice a day. In syrup. This medicine is used in neuralgia with considerable success, but is sometimes very severe, and should be used with caution. See Antispasmodics, page 13, for dose, fyc. Good in painful rheumatism and neuralgia, and in colic pains of the bowels. CONIUM, or HEM- 1 to 2 grains. Good for scrofula, schirrus, &c. LOCK: Not often used DIGITALIS, or FOX- GLOVE. Once—at night. In a pill. See Diuretics, page 42, for dose, fyc. Good for rheumatism, palpitation of the heart, and nervous complaints. 1 54 NAR COTICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 .YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. H70SC\rAMUS, or HENBANE. See Anodynes, page 29, for dose, Sfc. Good for consumption of the lungs, violent coughs, and difficulty of passing urine. OPIUM—its prepara- I See Anodynes, page.29. tions. | Good to relieve pain, colic, spasms, cholera morbus, and all painful disorders, as rheumatism o-out <£:e STRAMONIUM, or i to i grain, increased by degrees to 1 grain: given in epilepsy, gout, neural- gia, and obstinate rheumatism. THORN-APPLE. Of th<- extract. POWD'Rof BURNT HARTSHORN- with Opium 3 to 4 grains. 5 to 8 grains Good in fevers from colds, &c, and for restlessness POWD'R of CHALKU to 2 scruples, oi AND OPIUM. less, more often. Good in dysentery and purging of the bowels, with straining. COMPOUND POW Once ortwice a day, 20 to 30 grains, oil Once a day. less, more often. DER of HIPPO, or Dover's Powder. 8 to 10 grains. Good in typhoid pneumonia, rheumatism, &c. 3 to 5 grains. At a dose. In syrup. In syrup. In syrup. 55 REFRIGERANTS, or such Medicines as are used to reduce the Heat of the Body, in Fevers and Inflammatory Disorders. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. ACETIC ACID, or Distilled Vinegar. See Antiseptics, page 22, for dose, fyc. Divide the doses, and give them oftener. Good in fevers, erysipelas, and scarlet fever. The dose of these medicines should be divided, and given oftener, as they are apt, when used in this way, to become uneasy and injurious to the stomach. ACETATE of POT- ASH, or acetate^l kali See Diuretics, page 42, for dose, Sfc. Good in fevers, irritation of the bladder, and eruptive diseases of the skin. AMMONIA(Muriateof Ammonia), or SAL AMMONIAC. ALUM (Sulphate of Alumina). CATHARTICS (gen- erally). See Cathartics, page 31, for dose, <$j-c. Good in fevers ^and inflammatory complaints. LIQUOR of the CI- TRATE of POTASH or Saline Mixture. See Diuretics, page 42, for dose, Sfc. Good in fevers and inflammatory complaints 56 REFRIGERANTS—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. NITRATE of POT- ASH,, or Saltpetre. See Diuretics, page 42, for dose, Sfc. Good in fevers and inflammatory complaints. SUPERTARTRATE of POTASH, or Crystals of Tartar. See Diuretics, page 42,, for dose, fyc. Good for fevers and inflammatory complaints. SPIRITS of NITRIC .ETHER, or Sweet Spirits of Nitre. 1 teaspoonful. Good for fevers and inflammatory complaints DILUTE SOLUT'N 30 drops. of ACETATE OF LEAD, or Goulard Water: 8 to 10 drops. SUPERACETATE of LEAD, or Suffar 3 to 4 drops. 3 or 4 times a day. of Lead.—Dangerous. 4 or 5 times a day. In water. In water. Good in irritability of the stomach, with retching, fevers, and inflammatory complaints. SULPHATE of ZINC or White Vitriol. 10 grains or less. Good in inflammatory sore throat, &c 3 to 4 grains. 2 or 3 times a day. In water. 57 SIALAGOGUES, or such Medicines as increase the Secretion of Saliva. They are sometimes useful in Dyspepsia and sub-acute Inflammation of the Stomach and Bowels, when their Secretions are dried up. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. GINGER. MERCURY, or Quick silver (the principa preparations). Good for dyspepsia and costiveness MASTICK—gum. NITRIC ACID. PYRE THRUM, or PELLITORY of SPAIN. TOBACCO: See Alteratives, pxge 19, for doses, fyc. See Antiseptics, page 23, for dose, Sfc. | See Anodynes, page 29. Good for asthma and strangulated hernia. 58 STIMULANTS, or CORDIALS—such Medicines as rouse and support the Powers of the System, when' weakened by Disease. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. AETHER (Sulphuric JEther). See Antispasmodicsj page 13, for dose, Sfc Good for fainting, nervous weakness, and low spirits. ALCOHOL, and the different Spirits, &c. Dose according to circumstances. Good in mania-a-potu, sinking in typhus fever, &c. ALLIUM, or Garlick. I ANISE-SEED (oil). |30 to 40 drops. Not often used as a stimulant. ARNICA MONTA- NA, Mountain Ash, or Leopard's Bane. ARMOR AC I A, or Horse-radish. Generally given in combination with other medicines 3 to 5 drops. |2 or 3 times a day. In water. Good ford ASAFCETIDA BALSAM OF PERU. ropsy. See Antispasmodics, page 13, for dose, Sfc. 6 to 8 drops. | 3 to 5 drops. |3 or 4 times a day. Good in coughs of long standing, weakness of the chest, and asthma. In syrup or water. 59 S TIMULANTS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF. AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. BALSAM OF TOLU.| 6 to 8 drops. | 3 to 5 drops. , Good in coughs of long standing, weakness of the chest, |3 or 4 times a day. |In syrup or water. and asthma. CAJEPUT (oil). CAN ELLA (Alba). Of the powder, Of the tincture, Not often used as a stimulant. 3 or 4 times a day. 3 or 4 rimes a day. 5 to 6 grains. 2 to 3 grains. 1 teaspoonful. 30 drops. Good for indigestion and weakness of the bowels, with wind CAMPHOR. | See Antispasmodics, page 13, for dose, Sfc. Good in typhus fever, pneumonia typhoides, and great debility in illness CARDAMOM (seeds) 1 to 2 teaspoonfuls Of the tincture, Of the compound tincture, \ to 1 teaspoonful. \ to 1 teaspoonful. 1 to 3 teaspoonfuls. Good in weakness, and swelling of the ankles after illness wind in the bowels, and colic pains. CAPSICUM, or CAY- 20 to 30 grains. In water. In water. In water. 3 or 4 times a day. 3 or 4 times a day. Good, also, in cramps, indigestion, and In .water. ENNE PEPPER. 10 to 15 grains. Good in colds and fevers in the winter-time, from exposure year. When you use red pepper in fever and ague, you must give it just as the fever is corning on. Give a wineglass of the snake-root tea with it, every half-hour, hot, until the sweat comes out. In hot snake-root tea, or with white sugar powdered. r also, in fever and ague, in the fall of the 60 STIMULANTS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. CARRAWAY (seeds). Of the tincture. CINNAMON. Of the tincture, Of the compound tincture, 1 to 2 teaspoonfuls. 1 teaspoonful. 1 teaspoonful. 2 or 3 times a day. 2 or 3 times a day. In syrup and water. In syrup and water. 1 to 2 teaspoonfuls. Good for wind in the bowels, cramps, and colds. BALSAM COPAIVA.| See Expectorants, page 50, for dose, fyc. This is used rather to stimulate the bowels, the bladder, and the kidneys, than the body generally. It is liven in gleet, weakness of the kidneys, to excite the bladder, and sometimes for tapeworm. CORIANDER (seeds). Tincture. GALBANUM—Com- pound plaster. GINGER —different preparations. GUAIACUM (gum): 3 to 5 grains. 1 to 2 grains. Of the Ammoniated tincture, 1 to 1 teaspoonful. 15 drops. Good for dyspepsia, rheumatism, and gleet. 2 or 3 times a day. 2 or 3 times a day. In a pill. In water. 61 S TIMULANTS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. MUSTARD. | Used on the body in a plaster or poultice. Good for rheumatism and dryness of the skin, in winter colds. 5 to 6 drops. 3 to 4 drops. MINT —Tincture of PEPPERMINT. Good for pain in the stomach, and wind in the bowels. GREEN MINT—or Mint-Water. MYRISTICA—or NUTMEGS—of the tincture : i- to 1 teaspoonful. 30 drops. 2 or 3 times a day. 2 or 3 times a day. In water, or on lump of sugar. In water. \ to 1 teaspoonful. Good for cramps of the stomach, wind in the bowels, &c. It is also used in large doses of the pow- der, from 1 to 2 drachms, in epilepsy. . OPIUM -^different preparations. See Anodynes, page 29, for dose, Sfc. Good in putrid fevers, and fevers of a congestive nature. . N ICP* Note.—It may seem strange that Narcotics should be also stimulants, but such is the fact. Frequently, when they act as Narcotics on the brain, they rouse the bowels, and vice versa. BLACK PEPPER— 30 to 40 grains. | 8 to 10 grains. powder. Good in intermittent fevers and fever and ague. 5 or 6 times a day. In a pill. 62 STIMULANTS.—Continued. FOR A GROWN PER- FOR A CHILD FROM 5 HOW MANY TIMES IN WHAT TO BE SON. TO 7 YEARS OF AGE. A DAY. TAKEN. WHITE PEPPER. SERPENTARIA, or Small Snake-root. SULPHURIC vETHER. BALSAM OF CAN-ADA, or Canada See Diaphoretics, page 36, for dose, fy 20 drops to 1 tea- 8 to 10 drops. spoonful. 3 or 4 times a day. In water. Rubbed'on the skin, Turpentine. Common TURPEN-TINE SPIRITS. 8 to 10 drops or more 5 to 6 drops. 3 or 4 times a day. in rheumatism. In sugar. 1 to 1 teaspoonful. |3 or 4 tfmes a day. Good in rheumatism, worms, gleet, and epilepsy. VALERIAN (root)— Of the tincture, 1 to 2 teaspoonfuls Good in headache from indigestion and disordered stomach, low spirits, &c Different PREPA- RATIONS of IRON DIAPHORETICS— in general. TONICS—in general. In water. 63 STIMULANTS.—Continued. i—-----! ' ------■---------■------ FOR A GROWN PER- FOR A CHILD FROM 5 HOW MANY TIMES ------------------1 IN WHAT TO BE SON. TO 7 YEARS OF AGE. A DAY. TAKEN. LINIMENT of AM- ' MONIA. To be rubbed on the skin. LINIMENT of CAM- PHOR. To be rubbed on the skin. COMPOUND LINI- MENT of Camphor, or OPODELDOC. To be rubbed on the skin. Good for rheumatism, sprains of long standing, and swelled joints, from cold and exposure TINCT'RE of SOAP. Rubbed on the skin. ' COMPOUND SOAP LINIMENT. Rubbed on the skin. Good in rheumatism, erysipelas of long standing, chilblains, &c. ' ( PLASTER OF ASA- FGETIDA. Put over the stomach, for irritable and weak stomach. COMPOU'D PITCH PLASTER. PLASTER of SPAN- Put over the chest, and other parts of the body, to relieve pain and inflammation, ISH FLIES, or as in pneumonia, pleurisy, &c. The fly-blister is used to relieve inflammations FLY BLISTER. of the body or inward parts generally. When used to relieve inflammations of the skin, the blister should be placed near the inflamed place, but not so near as to inflame it more. 64 TONICS, or such Medicines as are used to strengthen and give tone to the Body and System, when weakened by Disease. They are generally used when the Patient has recovered from a fit of Illness, and is weak. FOR A GROWN PER-SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. MURIATIC ACID. NITRIC ACID. SULPHURIC ACID. ABSINTHIUM, or WORMWOOD. ANTHEMIS, or Cam-omile Flowers. ARNICA Montana, or Leopard's Bane. ARSENIC—different preparations. Fowler's Solution. n .....l :„ c~......_ j See Alteratives, page 19, for dose, fyc. See Antiseptics, page 22, for dose, fyc. See Antiseptics, page 22, for dose, Sfc. Take a little handful of the green leaves, and pour a pint of boiling water on it; give a wineglassful, after it has drawn (cold), three or four times a day; or pour a pint of good whiskey on the leaves, in a bottle, and a wineglass twice a day. Good in weakness after country fever and confinement, and restores appetite. Take a small handful of the flowers, put them into a pitcher, and pour a pint of boiling water on them; when cold, give a wineglassful three or four times a day. Good for weakness and want of appetite after sickness. \ a teaspoonful. 20 drops. 3 or 4 times a day. In water. Good in fever and ague, paralysis, and rheumatism of long standing. BISMUTH, or Oxyde of Bismuth. 65 TONICS.—Continued. 1---------__--------------------------- FOR A GROWN PER- FOR A CHILD FROM 5 HOW MANY TIMES IN WHAT TO BE • SON. TO 7 YEARS OF AGE. A DAY. TAKEN. CASCARILLA Bark. Of the powder, ctj Of the tincture, Of the volatile tinc-ture, 8 to 10 grains. 1 to 1 teaspoonful. ^- to 1 teaspoonful. 3 to 5 grains. 20 to 30 drops. 20 to 30 drops. 3 or 4 times a day. 3 or 4 times a day. 3 or 4 times a day. i In syrup. In water. In water. Good for weakness of the stomach after fevers; gout and rheumatism, and sour stomach. CINCHONA, or PE- RUVIAN BARK.— Different kinds. See Antiseptics, page 22, for dose, fyc. Good for fever and ague, and weakness after fevers, and illness in general COLUMBO ROOT.— 8 to 10 or 20 grains 1 to 2 teaspoonfuls. Of the powder, Of the tincture, 3 or 4 times a day. 3 or 4 times a day. In syrup and water. In syrup and water. 3 to 5 grains 30 drops. Good for weakness of the stomach and bowels, from indigestion and acidity, or from long illness. COPPER —(sulphate of copper), BLUE VITRIOL. AMMONIATED Cop- per. Good for gout, neuralgia, and rheumatism. 66 TONICS.—Continued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO HE TAKEN. CUSP ARIA, or, AN- GUSTURA BARK. Different prepar'ns. GENTIAN. — (com- pound tincture,) 1 to 2 teaspoonfub 30 dr Good in want of appetite, and weak stomach. HOPS. ops. 2 or 3 times a day. In wine or water. ICELAND MOSS. See Demulcents, page 40. Good in illness where nourishment is required MANUBIUM,orhore- hound (tea.) MYRRH (powder and tincture). SULPHATE of QUI- NINE. QUASSIA. Of the tincture. Take a small handful of the leaves, pour on them a pint of boiling water, sweeten with sugar or molasses. Good in colds, coughs, and hoarseness. 30 drops. to 1 teaspoonful. Good for weak stomach from indigestion and acidity. RED PORT WINE. I I 3 or 4 times a day. In syrup and water. 67 TONICS.—Con tinued. FOR A GROWN PER- SON. FOR A CHILD FROM 5 TO 7 YEARS OF AGE. HOW MANY TIMES A DAY. IN WHAT TO BE TAKEN. PREPARATIONS of IRON (rust of iron). 3 to 4 grains. 2 or 3 times a day. 8 to 10 grains Good for dyspepsia, weakness of the stomach, and indigestion MURIATED TINC-I TURE OF IRON. |l0 to 30 drops. "* 6 to 8 drops. Good in weakness of the kidneys and bladder, worms, rickets, and epilepsy SULPHATE of ZINC, 15 to 20 grains. 2 or 3 times a day. Or, White Vitriol. 4 or 5 times a day. In syrup. In water. In water. 6 to 10 grains. Good in fever and ague. White vitriol is not generally used in fever and ague, or as a tonic, but it is recommended by several writers. OXIDE of ZINC, or, Flowers of Zinc. Not often used, but recommended by writers for fever and ague, and epilepsy. DIRECTIONS FOR MAKING PLASTERS, BLISTERS, POULTICES, OINTMENTS, &c. ' How to make a cold Mustard Plaster, or Cataplasm.—Take one spoonful of mustard, three spoonfuls of wheat or corn flour; mix them together with a little vinegar or water, and spread on a cloth. If too stiong, mix more flour; put thin muslin over the plaster. How to make a warm Mustard Poultice.—Take a half-pint of corn meal, boil it, and mix with it a tablespoonful of mus- tard, put into a thin bag, hot, and lay on the part. How to make a Mustard Pediluvium, or bath for the feet.— Take two kettlefuls of warm water, put into a tub, and throw in two tablespoonfuls of mustard ; stir round, and bathe the feet. How to make a Mustard Bath for the body.—Take a bathing tub, put in warm water, say half full, then put in four table- spoonfuls of mustard, arid stir round ; then bathe the body. If it is not strong enough, throw in more mustard. How to make the Nitro-Muriatic Bath.—Take a bathing- tub,half fill it with blood-warm water; then throw in a wine- glass of nitric and one of muriatic acid—put in your hand, and if you feel your fingers tingle, or your skin smart a little, it is strong enough ; if not, throw in more oftthe acids, stir the water well and bathe. How to make a warm Anodyne Poultice.—Take a ha'lf-pint of cornmeal, boil it, and stir well into it, while warm, a tea- spoonful of powdered.opium, more, if necessary ; put it into a thin bag, and apply it. How to make an Opium Plaster.—Take a teaspoonful, or tablespoonful, according to the size of the plaster, of powdered opium, pour on it enough boiling water to make a paste ; then spread it on a rag, and apply it. POULTICES--BLISTERS. 69 How to make a Bread Poultice.—Take the crumb of wheat bread, mash it up with warm water or milk. You may some- times put in a little piece of soft soap, or Castile soap, and beat it up to make it light; How to make a Carrot or Turnip Poultice.—Take three or four turnips or carrots—boil them until they are soft, mash them and apply them warm. How to make a common Corn-flour, or Hominy Poultice.— Take a half-pint of corn-flour, or corn grist, boil it, put in a little milk, or a teaspoonful of sweet oil, or hog's lard, to keep it from getting hard—put it on warm. You may, sometimes, put in the soap as in the bread poultice.—(See Bread Poultice.) How to make a Flaxseed Poultice.—Take a teacupful of flaxseed, put it into a small pot,. and pour on it a tea- cupful of boiling water. Then put the pot on the fire and let it boil up twice, or three times, until it is ropy enough to spread on a cloth. The ground flaxseed is sometimes preferred. There are several other kinds of plasters, but you must send to an apothecary's shop, if you wish to use them ; such as, strengthening plaster, pitch plaster, compound galbanum plaster, adhesive plaster, or strap, Sfc. Poultices may also be made of any vegetable or herb which will boil and mash soft, provided they do not inflame the place, such as, potatoes, salsify, spinach, cabbage, tansy, Indian potato, hops, camomile, the soft pulp of the artichoke, squashes, &c, &c. How to put on a Blister (Fly-Blister).—Take the blister- plaster in roll, scrape off some with a. knife, and spread on a cloth or piece of brown paper; if it is hard, hold it to the fire. If you wish to do it neatly, take a piece of adhesive plaster (sticking plaster or strap), and spread the blister on the yellow or sticking side, leaving about an inch of the strap all round (not covered by the blister). This prevents the blister from slipping. How to dress a Blister.—When it is taken off, spread some of the simple ointment on a rag, and cover the place—taking care to cut the bladders as they rise. How to make Simple Ointment, or Healing Salve, in a Jiurry.—Take equal quantities of beeswax and sweet oil, and melt them together. 70 CLYSTERS—GARGLES. How to make a Clyster or Injection.—Common Clyster.— Take a little common soap (ley soap) and warm water, mix them well together, and put them into the pipe or bladder, draw it up and squirt it out of the pipe, until all the air is out of it; then oil the end of the pipe with "sweet oil or hog's lard, and when you put the. pipe into the fundament, be care- ful to push the point up toward the back-bone, if the patient is lying on his belly, but if he is lying on his back, you must , push it down, always pushing it toward the back-bone. Purgative Clyster.—Take a small wineglass of castor oil, a half wineglass of turpentine (spirits) a tumbler full of warm flaxseed tea, and two teaspoonfuls of castile-soap, scraped fine ; mix them well together. Anodyne Clyster.—Take a wineglassful of sweet oil (olive oil) two teaspoonfuls of laudanum, half pint of warm water; mix well together. This is very slightly anodyne. Another is made with the oil and laudanum, without the water, and a half wineglass of laudanum, instead of two teaspoonfuls. Also this : two tablespoonfuls tincture of asafcetida, and half-pint warm water. Flaxseed Clyster.—Boil the flaxseed, not too thick—or, only pour boiling water.on it, and strain. A piece of common soap, cut sharp, and pushed backward and forward in the fundament, will frequently answer all the purposes of a clyster in costiveness. Starch Clyster.—Mix the starch and warm water, not too thick, and use. Rice gruel, rice water, barley water, gum arabic, and many other substances may be used, and, in fact, any warm oil, or slimy fluid.' Injections of tobacco, and other plants, and drugs, are used in particular cases, but as these set down are in common use, they will prove generally sufficient, and a physician must direct others, if necessary. How to make Gargles for sore throat.—Honey Gargle.—• Take two tablespoonfuls of honey, throw them into a teapot of boiling water; put the end of the spout in your mouth, and draw the steam into your throat. Vinegar Gargle.—Take a tablespoonful of vinegar, a half teaspoonful of salt, throw them into a half pint of water, and mix. GARGLES--PILLS AND POWDERS. 71 Port Wine Gargle.—Take a tablespoonful of red port wine, a wineglassful of water. Peruvian Bark Gargle.—Take two quills of common Pe- ruvian bark, pour on them a half-pint of boiling water; let it cool, and use. Kreosote Gargle.—Take a wineglassful of water, put in four or five drops of kreosote ; if this is not strong enough, • put in more of the kreosote, according to the tender state of the throat. There are several other gargles. How to make the Calomel and Opium Pills.—Take twen- ty-four grains of calomel, three grains of powdered or lump opium ; rub them together well in a mortar with a pinch of powdered gum arabic, then put in three or four drops of brandy or other spirit ; roll the mass in a plate, and cut into twelve equal parts and roll twelve pills in your fingers, using a little liquorice root powder, or magnesia, or rhubarb, to keep the pills from sticking. Every family ought to keep a box of these pills in their houses, and every planter should keep them on his plantation. See Cbolera-Morbus. Most pills are made in this way. How to mix a dose of Castor Oil and Laudanum.—Take a wineglassful of castor oil, put in fifteen or twenty drops of laudanum. How to mix a dose of Calomel and Rhubarb.—Take five grains of calomel, from five to ten grains of rhubarb (best), make into one powder. How to mix a dose of Calomel and Jalap.—Take five or eight grains of calomel, ten or fifteen grains of Jalap, make into one powder. How to mix a dose of Calomel and Dover's powder.—Take five grains of calomel, five grains of Dover's powder, make them into one powder. A dose of Castor Oil and Turpentine.—Take a wine- glassful of castor oil, fifteen to twenty or thirty drops of spirits of turpentine. A dose of blue pill.—Take five or eight grains of blue pill mass, make it into a pill. These doses are for grown persons, lessen them for children according to their age. 72 BILIOUS REMITTING, OR COUNTRY FEVER. BILIOUS REMITTING, OR COUNTRY FEVER. This is the fever which is so fatal to those who live on the swamps, marshes, and plantations, in the summer and fall of the year. It is common in the low country of South Caroli- na, Florida, Georgia, Alabama, Louisiana, Mississippi, and many of the middle and western states. Symptoms.—Slight chills, immediately followed by flushes of heat, which disappear and return every quarter of an hour, or so, the chills becoming shorter, and the heat increasing, until a fever comes on. At the same time, the patient feels weary and sleepy, but also restless and uneasy, and frequently low-spirited. Frequently, too, he has pains in his head, ba.ek, and limbs, and when the fever shows itself clearly, these pains increase, especially those of the back and legs. Soon after- ward, the whites of his eyes becomes tinged with yellow, his tongue is covered with a brownish fur, be becomes sick at his stomach, and now and then throws up bile. He feels a fulness and weight in his right side, just about the short rib, where the liver is, and in the left side, also, and about the pit of the stomach. He breathes heavily, and seems distressed. He passes very little water, and that is very deeply colored with bile. His pulse is full and quick, but not strong or hard.jand in general, his skin is dry and hot. The patient lies in this state for some hours, when a gentle sweat comes out.over the upper parts of his body, and some- times over his whole body. The fever has now cooled, but it does not leave entirely, and the pulse is still quick, and the skin warmer than natural. This is what is called a remission, but it lasts only from one to two hours, when the fever again rises as high or higher than it was before. After some time, the fever cools again, as it did before, and goes on, rising and cool- ing, day after day, until it comes to what is called a crisis, and the patient suddenly gets better, or the fever continues,' and becomes more obstinate, fixed, and steady. BILIOUS REMITTING, OR COUNTRY FEVER. 73 This is the general course of these fevers, but they are some- times very severe and fatal, and there is no disease which shows a greater variety of symptoms. There is one thing, also, which must be noticed particularly. There are two forms of the disease; one in which the fever rises about nine or ten o'clock in the morning; the other, in which it rises not until twelve or two o'clock. Again, in the first form, the patient has a good and a bad day, which are very evident and distinct,more so than in the last form. For instance; although the fever rises regularly every day, yet it is much higher, and the patient is much more ill every other day. If his fever is not so high to-day as it was yesterday, and he is better, to-Tnorrow his fever will be as high, or higher, and he as ill, or more ill to-morrow, than he was yesterday. This, as I have said, is the general course of these fevers, but they are sometimes so severe, that they have scarcely any remission, and the fever seems to keep at its height the whole time. Another thing must be noticed too. The fever does not al ways come on in the day, but sometimes in the evening, and during the night. When the first attack takes place, look at your watch,, and you will find that the fever will be pretty regular to the hour, in its attacks from day to day, though this is not always the case. Notice this also; in very severe attacks, the chills are generally very - slight, and last a very little while, and the fever rises rapidly to its height, which is intense. The patient has a tormenting thirst, very severe pains in his loins and legs, great distress and difficulty of breathing, excruciating headache, sick stomach, and a very distressing feeling of fullness and weight in the stomach. After these symptoms have continued about twenty-four hours, or a day and a night, they disappear almost entirely, and the patient becomes calm and quiet. This calm, however, is like the calms which occur in a hurricane. It is very short: the fever returns with fury; the whites of the eyes become yellow, the eyes themselves red and watery, a deadly sickness comes o"n, and the patient is tormented with a constant vomiting, raging thirst, and a distressing feeling of weight in the stomach. After some time, the fever cools, the distressing symptoms abate, and a clammy sweat comes out over the body. All this while, the bowels are generally costive. The fever rises and cools, and the symptoms, which I have described, are 7 74 BILIOUS REMITTING, OR COUNTRY FEVER. more or less violent, changing with the fever as it rises or cools, and the disease keeps this course until it either comes to a crisis, and the patient suddenly gets better, or dies. This change for the better or worse, generally occurs in the third paroxysm; that is to say, after the fever has made two of these violent attacks, and.cooled off, and during the third attack.— But if the disease continues beyond the fifth or sixth attack of the fever, the patient becomes very weak, and sinks, the remis- sions, or intervals of calmness between the attacks, are not dis- tinct, the patient becomes delirious, that is, gets out of his head, the skin feels either stinging hot when you touch it, or cool and clammy, like that of a dead person. The pulse generally be- comes quick and irregular, though sometimes it is natural, or nearly so. When the disease has advanced as far as this, the lips become of a purple color and swollen, the tongue dark brown, or black, clammy, and offensive to the smell, the eyes dry, or red and watery, the urine either very small in quantity, or entirely stopped, or of a dark brown color, and has a bad smell. The passages are either black, bloody, and in great quantity, or reddish and watery. The belly feels soft and' as if it was filled with air, in which state it is said to. be tym- panitic, and sometimes, just before the patient dies, blood will be discharged from his bowels, or nose, or mouth. When the disease^appears in this form, as I have just de- scribed, it is said to be malignant, and it will be generally found that the more sudden and violent the attack is at its commencement, the more violent and dangerous will the disease itself be, and the chills occur only before the first paroxysm, or attack, afterward they do not appear. But when the attack is gradual and approaches, comparatively slowly, the disease itself will be proportionately slow in its course. Notice this. Between these two varieties of the disease, Which 1^have just described, there are several others, which only differ in their degree of violenoe, and the symptoms which they exhibit, being complicated, either at an early or late pe- riod of their course, with inflammations of different organs, as the brain, the liver, the bowels and blood-vessels. The symptoms which appear in these varieties are so various and numerous, as frequently to puzzle the most experienced physi- cians, and this is the reason, perhaps, why we see physicians resorting to such contradictory practice in different cases. You will find, however, that the two most important organs affected BILIOUS REMITTING, OR COUNTRY FEVER. 75 and most frequently affected, are the liver, and the alimentary canal, that is, the stomach and bowels, and the symptoms and violence of the disease will depend upon the organ which is affected. For instance, if the stomach and bowels are the organs chiefly affected, there will be a great quantity of un- wholesome bile in them, a thick, yellowish layer of mucus, or slime, on the tongue, which, as the disease advances, be- comes dry, cracked, and of a dark brown or black color. The patient has a bitter taste in his mouth, loses his appetite, and frequently has a disgust for every kind of food; his urine becomes muddy and yellowish, he feels a great weight about his chest, his belly is tender when you touch it, and filled with wind, and he has great pain in his head, and pains in his loins and knees. The remissions or intervals between the attacks of fever, are distinct; his tongue is fiery red at the tip and edges, and when the brown or black crust scales off, is smooth, shining, and red; his passages are watery and reddish, like the washings of flesh ; he can not pass his wa- ter, apd has a,craving for cool and acid drinks; and, lastly, when his disease is in its last stage, he has great difficulty in swallowing. This which I have just described, is called the Gastro- Enteric form of the disease. Treatment of the Gastro-Enteric form.—When you have satisfied yourself that your patient has this form of the disease, which I have last described, give him this:— 12 grains of Calomel, 12 grains of Jalap (powder), in syrup, at one dose, or divided into two, if he is a grown person—if a child, -give half. Or this :— 10 grains of Calomel, 12 grains of the compound extract of Colocynth, made into 4 pills, and to be taken at one or two doses; or, 10 grains of Calomel, and 2 tablespoonfuls of Glauber Salts, in water, in three hours after the Caknnel. Remember, you can give these doses only at the commencement of the disease, and when the patient is not troubled with throwing up. After the bowels have been well purged out once or twice, you can give this :— 12 grains of Calomel, 12 grains of James' powder (best English), 76 BILIOUS REMITTING, OR COUNTRY FEVER. made into four powders, one powder to be given every three Or four hours ; but if they purge too much, or produce vomiting, stop with them for a while, and give this:— A wineglassful of Castor Oil, A wineglassful of Lemon, or any syrup, and A teaspoonful of Carbonate of Magnesia, well rubbed up in a mortar. Give a teaspoonful every hour. Remember the patient ought to have two or three passages every twenty-four hours, during the course of the disease. If the skin is very dry and not, you may Dut the patient into a bath of water, just cold enough to be comfortable, or sponge his body with water, and let it dry off. Give the patient, also, cool drinks of Lemon juice, sugar and water, or of Citric acid, in place of the Lemon; or you may use the Lemon acid. Or, you may give him drinks made of hot water poured on sliced apples, with a little sugar, or fresh orange juice, with water, taking care to let him drink a very little at a time, for if he drinks too much at once, he will vomit. If he calls for cold water, let him have it in small quantities at a time ; it will not be improper while he is taking the Calomel, as many people think. A useful drink is, Flaxseed tea, al- lowed to become cold, with a little Lemon or Orange juice and sugar in it. Notice this. As soon as the patient is taken with the fever, lose no time, but give him the medicines which I have direct- ed, and if they purge too much, stop them for a while, and give injections to keep the bowels open.—(See Injections, page 70.) Remember, also, that in this disease, Calomel is your main dependence, but do not give it so as to produce salivation, unless you find the patient sinking, and the fever runs over the ninth day, then use the Calomel and Opium pills directed in page 71. (See page 71.) Give one of these pills every two or three hours, until the mouth is sore. You. will find, however, that if you keep up the use of the Calomel and James' Powder (as directed in pages 75 and 76), they will answer every purpose, unless the patient's stomach becomes too weak and irritable to keep them down; then give the Calomel and Opium pills, or these powders :— 12 grains of Calomel, "12 grains of Dover's Powder, rubbed together and made into six powders. Give one every two hours, until you see mucus, or slime, on the tongue • then BILIOUS REMITTING, OR COUNTRY FEVER. 77 stop and see if you have broken the fever. If not, go. on ; but if the patient's stomach is now strong enough, go back to the Calomel and James' powder. As a general rule, whenever in these fevers, or any other, you can produce a mucus or sliriie on the tongue," you have gone far .enough with the Cal- omel. But if the disease is not checked, go on till the mouth is a little sore. • As soon as you find that you have broken the fever, begin with the Quinine, in small doses. I do not like the modern practice of giving large doses; they generally leave the stomach in a bad state, although they stop the fever sooner than small ones. .This is a good mixture:— 4 grains of Quinine,, to half a pint of water, with 2 or 3 drops of Sulphuric Acid, or Elixir of Vitriol. Give a wine- glassful 4 times a day. When your patient is getting well, be careful not to let him over-eat himself, or eat unwholesome food, as cholera-morbus or indigestion is very apt to be produced, either of which will bring back the fever. Treatment of the Hepatic form of the disease.—This isthe most severe, and is generally attended with great irritability of the stomach, but not always. See pages 73 and 74, for a description of'the symptoms. Read from, " notice this, also," to " bowels, or nose, or riiouth," in page 74. When you notice these symptoms or many of them, you may conclude that the patient has the hep.atic'form of the disease, that is to say that his liver is the chief organ.affected, and is engorged with vi^ated and dark bile. You must now lose no time, but try to get Calomel to act upon the patient as soon as possible. If his stomach is very irritable, and he can not keep down the medicines which I have recommended in page 75, you must bleed him, only at the commencement of the disease; afterward, bleeding is dangerous. If this does not quiet the stomach, give 10 grains of Calomel at a dose, mixed with half a grain of Opium powder, and give 2 or 3 grains of Dover's powder, every hour. You must, at the same time, keep giving the Calomel, if the- patient throws it up, as it is of the utmost importance to get the Calomel to act upon the liver, and open the bowels, to carry off the unwholesome stuff which is in there. If the bowels are not opened quickly by the Calomel, give injections until they are.—(See page 70, for Clysters.) , , . Cover the patient's bowels with a warm mustard poultice. 7# 78 BILIOUS REMITTING, OR COUNTRY FEVER. (See page-68.) Put blisters to the calves of his legs, and if he seems to be getting weak, put a large strong blister over the liver, on the right side, just over the short ribs. (See page 69, for directions for Blisters.) If his stomach becomes quiet, use the Calomel and James' powder, as directed in pages 75 and 76. I have found the Calomel and James' powders the best powders in Country fever, of whatever kind it may be. If you find the patient begin to get worse, and sink, put mustard plasters on every part of the body where you can find .room. Pot hot bricks, or bottles of hot water, wrapped in flannel, to the feet, and in fact,' around the body, to keep up an artificial heat; and give wine, good Madeira or Port Wine, by the glassful; if you have not wine, give brandy and water, warm and strong, and give one of the Calomel and Opium pills, directed in page 71, every hour, or every half hour, until you find by the slime on the tongue, that the calomel is be- ginning to take effect-. If this is slow, give between the pills 4 grains of Calomel, with a quarter of a grain of Sulphate of Morphine, or 2 grains of Dover's powder at a dose. Again, if you find that the patient's bowels begin to purge very vio- lently, which is often the case in these fevers, give 4 grains of Dover's powder at a dose, and if this does not stop them quickly, use this mixture:— A tablespoonful of the Tincture of Kino, A tablespoonful of Paregoric, 30 grains of Crab's eyes, or prepared chalk, well mixed up arid shaken together with a half-pint of water. Give a tablespoonful of this every half hour, until they are checked, then stop. While you are giving this, keep on with the Calomel in doses of 4 grains, every "hour or half hour.__ Don't quit your patient because he seems to be dying.- I have had cases to sink until I could scarcely feel the.puls°e for sev- eral hours, and they could scarcely swallow, and yet they re- covered. Last of all do not let your patient die for want of Calomel. There are many persons who will not use Calomel because, they say, that so many people have been killed by it; and I am aware that ignorant physicians have salivated very often when there was no occasion ; but we must not condemn the tools because the carpenter does not know how to use them. When your patient begins to get better, use the Quinine, as I have directed. - INTERMITTING FEVER, OR FEVER AND AGUE. 79 INTERMITTING FEVER, OR FEVER AND AGUE. A fever and ague may be known by the following symp- toms ; the cold stage, the hot. stage, and the sweating stage. The Cold Sta.o'e.—Before describing the cold stage, I will give the symptoms which show themselves, just before it comes on. A feeling of great weariness, a desire to yawn and stretch frequently, slight pains in the loins and legs, and sometimes pain in the back, and melancholy feelings. After thesefeel-, ings have lasted for some time, the patient begins to feel cold along his back, as if cold air was blowing on hirn; his fingers and feet become cold, and sometimes shrivelled and pale, and the finger-nails look blue ; he feels restless and uneasy, and is generally cross and fretful, or dull and gloomy. This feel- ing of cold on the back, soon extends until the whole body has the same feeling to the patient. His skin becomes pale, shrivelled, and rough, his pulse becomes small, but quick and hard, and at the same time weak. And now a shivering and trembling of his jaws come on, which soon extend to his whole frame. The rigors are now said to have come on, and they are'sometimes so severe, that the patient seems to be in convulsions. Several other symptoms now make their ap- pearance, which vary according to the age and constitution of the patient, but it is not important to mention them. After these chills and rigors have lasted some little time, flushes of heat pass over the body and face, which soon in- crease, while the chills disappear, and the body soon becomes hot. This is the hot stage. The Hot Stage.—As soon as this stage comes on, the coun- tenance becomes flushed and full, the skin hot and dry, the mouth dry, and the patient has a great thirst. His pulse is strong, full, and quick ; his breathing is more free and regu- lar than in the cold stage, but still more hurried than natural. He has frequently pain in his forehead, and in his back, and legs, and sometimes he is out of his head. The hot stage is generally much longer than the cold stage, but the length of SO INTERMITTING FEVER, OR FEVER AND AGUE. time which it lasts, is different in different cases. After this stage comes the Sweating Stage.—As soon as the sweat comes out about the head and the breast, the fever begins to cool, the pulse falls, but is .still full; the breathing becomes free and natural, and as soon as the sweat comes out all over the body, the fever leaves entirely, but the patient feels languid arrti weary, and has no appetite, and can not bear cold air to blow on him ;— sometimes the patient feels very well, but not often. This which I have described, is an Intermittent Fever, as it usually occurs ; but they are very various in their symptoms, appearances, and character in general, according to the age and constitution of the patient whom they attack. We frequently see them of an inflammatory character (that is. showing inflammation of some organs of the body), some- times of a congestive character (or where the blood is dis- posed to become stagnant in the blood-vessels). Sometimes they appear of a bilious character, and show symptoms of irritation of the stomach and bowels, and sometimes of a malignant character, though not often. Again. They are of various types, as we say ; for instance, when the fever comes on every-day (that is every 24 hours), at a regular hour, we call it a regular quotidian fever; when it comes-on every other day, at a regular hour, we call it a regular tertian ; when it comes on every fourth day, we call it a quartan ; and", when it comes on every fifth day, a quin- tan. When the fever does not come on at^ie same hour, or near it, we say it is irregular. I shall describe, first, the treat- ment of Fever and Ague, as it usually appears. Treatment.—When you see that the disease is a simple and regular or irregular Fever and Ague, as I have described, ex- amine the patient's tongue; if it is foul, and he is sick at his stomach, vomits bile, has a bitter taste in his mouth, pajn in his stomach and bowels, or some of these symptoms, you may be sure that his stomach and bowels have unwholesome stuff in them, which ought to be brought away. . Give him one or two grains of Tartar emetic in a tumbler of water, just before the cold stage comes on, until he vomits freely. As soon as his stomach is settled, give him eight or ten grains of Calomel, and when this has purged him freely, begin with the Calomel and James' Powder, as directed in pages 75 and 76. Follow the directions in page 75, also. INTERMITTING FEVERK OR FEVER AND AGUE. 81 While the patient has the fever on him, let him drink freely of cool, acidulated drinks, as lemon juice, or any of the drinks described in page 76, in small draughts at a time, and during the intermission, or while the patient seems to be compara- tively well, this mixture I have found excellent. ~ Take a little handful of small Snake Root, pour a pint of boiling water on it in a teapot; then put in 12 grains of Dover's Powders, 1 teaspoonful of Saltpetre, 1 teaspoonful of Epsom or Glauber Salts, 1 teaspoonful of Spirits of Nitre, 1 teaspoonful of Paregoric, 1 teaspoonful of Antimonial Wine. Keep this warm by the fire, and give a wineglassful every hour, during the intermission. If the stomach becomes irri- table, you must give a Calomel and Opium pill every 3 hours, until it is settled.—(See page 71.) In this fever, as in Remitting fever, you will find Calomel the best medicine which you can use, only give it in smaller doses. When you succeed in breaking the fever, give the Quinine, as directed in page 77.,. Remember, also, what I have said about the tongue being slimy. When this takes place, the fever generally leaves or decreases. In cases where there are symptoms of inflammation, with a strong, full pulse, bleeding is good, and I like bleeding in the cold stage. A few ounces of blood will generally be suf- ficient. In these cases you will have to use your own judg- ment and notice the symptoms. As a general rule, although warm drinks are good before the cold stage comes on, never give stimulating drinks unless the patient is very weak, and the cold stage lasts a long time. The stimulating drinks in- crease the fever when it comes on. When the patient is getting better, let him change the air if he can, and notice the directions in page 77. With regard to the other forms of the disease, which I have mentioned, I will only say, use your judgment and follow this general rule. Rule.—Purge out the bowels regularly, but mildly, until all the vitiated stuff comes away, and use Calomel and James' powder, or the other combinations which I have set down, reg- ularly, but with proper caution, until you see the tongue look good, the passages have a yellow and healthy look, and the Fever breaks. As long as the tongue is dry and harsn, and 82 YELLOW FEVER. the passages are dark or clay-colored, or ash-colored, keep on giving the Calomel. The patient, should have one or two good passages a day, and you should examine them. When you find the Calomel gripes, stop it for a while, and use the mixture of Castor Oil and Magnesia, in page 76, You must also increase the quan- tity of Quinine every day, giving one fourth more. YELLOW FEVER. Symptoms.—A feeling of sudden giddiness at the com- mencement of the disease, weakness, pain in the back, loins, and legs, sickness at the stomach, and chills creeping all over the body. After some time, say from 6 to 12 hours, the pulse rises and beats violently, the skin becomes very hot and dry, the eyes -red, the face flushed ; the patient has great thirst, severe headache, pains in the srnall of the back and legs, feels a great weight and tightness about the stomach, and can not bear the light. His tongue looks white and sometimes clean, and in about twenty-four hours-from the time he was taken, the patient begins to throw up often, particularly after drink- ing anything. At first he throws up only such fluids as he has drank, but after these have come away, he brings up a quantity of bile, either of a pale yellow or dark green color, and this is frequently so acid as to make the throat and lips sore. And nOw he feels great heat and tenderness about the pit of the stomach, he looks very much distressed, and quite hopeless ; he sighs frequently, and is very restless, and fre- quently is delirious. . Sometimes he has a difficulty of swal- lowing, and he suffers from hunger, while he is unable to move his legs. This paroxysm lasts, that is to say, the patient lies in this state from 24 to 36 hours, and sometimes longer,- when all the "distressing symptoms,except the sickness at the stomach and throwing up, arerelieved ; the pulse becomes natural and the skin becomes cool and moist. The patient, sometimes, now seems so much better, that he is inclined to think -that he has got over the attack ; but more frequently he seems to be in a state of stupor, and notices or cares about nothing. This calm, YELLOW FEVER. 83 hewever, like that mentioned in remittent fever (page 73), is ominous ; for after a few hours, the pain and burning in the stomach increase and become very distressing ; he throws up often and very violently ; the stuff which comes from his stom- ach now has no bile in it, but looks like the grounds of Port wine in a fluid. His thirst is great, but everything which he swallows is thrown up immediately, with great violence. His eyes and the skin about his neck and breast now become yellow. This second paroxysm lasts, that is to say, the patient lies in this second state just described, from 12 to 36 hours, when new symptoms make their appearance, and the third and last stage of the disease comes on. His pulse now becomes very weak, his tongue dark brown or black ; he throws up every moment, and with violence, and the stuff which comes up, is a black, ropy fluid, like coffee grounds mixed with a glairy, shining fluid. His hands and feet become cold and clammy, and the pain and burning at the pit of the stomach are excruciating. At this time, too, he generally has green or black passages, and feels unable to pass his stools from weakness of the muscles of the belly. And now the whole body is of a dirty yellow color, and the patient soon dies with hiccough, bleeding from different parts, delirium, stupor, or convulsions. This is the usual course of this disease, but it is frequently much more severe, and, as in many other diseases, has various other symptoms, and assumes various degrees of violence. Sometimes the patient becomes raving mad, or falls down sud- denly, as if struck with a blow, and goes off into convulsions, and sometimes the patient sinks and dies before any one thinks that anything is the matter with him, his only symptoms being melancholy looks, and a great"change in his temper. Treatment.—Bleed at the commencement of the disease, but only at the commencement. Take blood until the pa- tient seems fainty. The blood ought to be drawn during the first twelve hours. Give, also, 10 grains of Calomel, 10 grains of Jalap, at a dose, in syrup, if the patient is a grown person ; if a child, less. As soon as the medicine begins to operate on the bow- els, help it, by giving injections. 30 drops of the acet. tincture of opium, ^ wineglass of lemon-syrup, 1 teaspoonful of gum-Arabic (powdered), to one half pint of water. Give a tablespoonful of this mix- ture in the morning, and one in the evening. You may give two or three grains also of Dover's powder every night, when the patient is in bed. Lastly, keep the bowels open well by giving a clyster once or twice a day.—(See page 70.) - But it is dangerous to give medicine by the mouth. AOUTE INFLAMMATION OF THE BOWELS. Symptoms.—An uneasy feeling in some part of the belly, and, after some time, a burning pain, generally about the navel; bowels almost always obstinately costive—sometimes, but very seldom, dysentery and straining ; generally sickness at the stomach, and violent puking, and the patient some- times throws up dung ; tongue dry, and generally with a white fur, or with a streak of brown fur along the middle, and pale- red edges; great thirst, urine highly colored and small quan- tity, and pain and difficulty in making water; forehead and palms of the hands generally moist, the rest of the body hot and dry. He breathes short, and raises his chest up and down ; pulse small, feels tight and quick. The patient lies on his back, with his knees drawn up and his shoulders raised, so as not to stretch the muscles of his belly. Some- times the disease begins with these symptoms: a slight chill, followed by a fever or excitement, then a sinking of the whole body ; the feet and hands cold, and lastly damp ; great weakness, face as pale as death, hands and fingers mottled, belly tight and swelled, and the pulse weak, soft, and Undu- ACUTE INFLAMMATION OF THE BOWELS. 107 lating; lastly, the bowels puffed with a great quantity of wind. Be careful not to,confound this disease with colic, as the patient lies quiet, instead of Tolling and tossing about as in colic. Treatment.—Bleed immediately, until the patient feels sick, and take a little blood every now and then, when the pulse indicates it, until the violence of the inflammation is subdued. Then apply leeches or cups over the stomach. Keep the bowels open with mild cathartics or laxatives. At the commencement of the disease, use injections of this kind, to open the bowels, before you give the purgative medi- cines :— One pint of boiling water poured on a wineglassful of flax- seed ; pour off the water, and give injections with it. When you have reduced the inflammation by bleeding, leeching, and injections, as directed, give this :—- 5 or 8 grains of calomel, 2 grains of opium (powdered), made into one powder, and given every two hours, until the pain in the belly is relievedtand the skin becomes soft; then give a wineglassful of castor-oil, and if this does not purge out the bowels well, give a half-wineglassful of the same ev- ery two hours, until it does. If, again, you can not produce purging in this way, give this injection :— 1 pint of flaxseed-tea (warm), A wineglassful of the oil of turpentine, With the whites of two eggs. Throw this injection up the bowels, and then give two grains of powdered, opium, in one dose, and let the patient go to sleep. If the patient is not decidedly better now, put a blis- ter over the belly, or warm poultices of cornmeal, boiled, with a teaspoonful of powdered opium in each poultice. When all these have been resorted to without effect, try this : A teaspoonful of snuff, To 1 pint of water. Give this in two injections. This disease sometimes termi- nates in mortification of the bowels. When this is about to take place, you will notice these symptoms : the pain gener- ally ceases, the pulse becomes very small and weak, the hands and feet are very cold, and great weakness of the whole body. You must not, however, give up when you observe these symptoms, but stimulate with good wine, and give freely 108 ACUTE "INFLAMMATION OF THE LINING MEMBRANE. of the mucilaginous drinks, if the stomach can bear them.— (See Demulcents, page 40.) When the patient is recovering, give nothing but the mild- est food, so as not to irritate the bowels; and when the bow- els (as they are apt to be) are filled with wind, rub the belly with a flesh-brush, or use injections, with a little mint-water or asafcetida in them. ACUTE INFLAMMATION OF THE LINING MEMBRANE OF THE BOWELS. This disease is of two forms. First, where the inflamma- tion is seated in the large bowels, or rather in what is called the duodenum. When this is the case, you will observe the following— Symptoms.—The whole surface of the body frequently jaundiced, appetite bad, bitter taste in the mouth, tongue covered generally with a whitish fur; water of a high color, and small in quantity ; not much pain in the bowels; head- ache, bowels sluggish, but may be moved by gentle purges and clysters. The pulse feels like a cord, and generally fuller than in inflammation of the stomach. The second form is where the disease is confined to the small intestines, and may be known by the following— Symptoms.—The bowels sometimes loose, or easily moved, and the passages slimy ; the belly hard and tender; the tongue has a white or light-brown fur along the middle, and its edges and tip are of a bright color; irritable stomach generally, and a slight burning pain, and a feeling of weight about the navel. The treatment of these two forms of disease which I have just described does not differ materially from that of acute inflammation of the bowels (page 107). DYSENTERY. 109 DYSENTERY. This disease is the same as that just described, only located in two of the lower large bowels, namely, the colon and the rectum. Symptoms.—Wandering pains in the bowels and occasion- ally looseness, but usually costiveness, loss of appetite, bad taste in the mouth, sick stomach, chills, with flushes of heat every now and then, thirst and dry skin, low pulse. Some- times sudden griping comes on, with slimy and bloody pas- sages, attended with great straining. Frequently, also, there is pain and difficulty in passing water. In advanced stages of the disease, the passages often have a very disagreeable smell. The tongue is at first generally covered with a white fur, which, as the diseases advances, becomes brown, rough, and dry, with the edges red and moist. When the disease lasts a long time, or the inflammation is notof an acute char- acter, the edges and tip of the tongue are usually clean,smooth, and red, and sometimes the whole tongue is smooth, clean, and red, like raw flesh. The passages, generally, contain no bile. In aggravated forms of this disease, many other symp- toms may appear, and the disease may deviate from the course which I have described ; but you will find no difficulty in de- tecting it, if you pay attention to them. Treatment.—Attention to the disease at its commencement, is of the utmost importance. As a general rule, whenever the pulse is firm and quick, or hard and frequent, bleed. If, however, the fever is not high, but of a low, or typhoid char- acter, do not bleed. Give an emetic of hippo at the com- mencement of the disease.—(See page 46.) This is not al- ways necessary ; but if the tongue has a brown fur along the middle, or there is sick stomach and puking of bile, give it. Next, about two hours after the emetic, give this:—10 or 12 grains of calomel, made irfto two powders. Give one pow- der two hours after the other (for a grown person), and three or four hours after the last powder, give a dose of, castor oil and laudanum.—(See page 71.) If the medicine does not produce good passages, but griping and straining, give a dose of opium (gum).---(See page 29.) When the disease is, in a measure subdued, give this:— 6 grains of calomel, 24 grains of Dover's powder, 10 110 CHRONIC DYSENTERY. made into six or eight powders. Give one powder every three hours, until the griping is checked. Or this:—■ 2 grains of calomel, 2 grains James' powder (best), 1 grain powdered opium, made into eight powders ; give one every two or three hours. CHRONIC DYSENTERY. When the symptoms of inflammation have disappeared* and the discharge from the bowels is still obstinate, showing that the discharge has become chronic dysentery, you must give calomel until you see a slime on the tongue, and the passages look good. Use this:— 12 grains calomel, 2 grains of powdered opium, made into six pills; give one pill every three hours. Give also this:— 1 pint of flaxseed tea (warm), \ grain of sulphate of "morphine. Give a wineglassful of this every hour; Let the patient take free also, for nourishment, chicken water, and such medicines as are mentioned in page 39 (Diluents). You must also use anodyne clysters (see page 70), and emollient clysters, such as flaxseed and starch (see page 70). If, after all these, the disease is still-obstinately continued, give this:— 1 teaspoonful of powdered gum arabic, \ wineglassful balsam copaiva, 2 teaspoonfuls'of white sugar, , 1 teaspoonful of laudanum, In a half-pint of water. Give a tablespoonful of this mixture every-two or three hours. Or, you may try this :— 3 grains of Dover's powders, 10 grains crab's-eyes, made into one powder. Give a powder every three or four hours. CHRONIC INFLAMMATION OF MUCOUS MEMBRANE, &C. Ill As a last resort, when all these have failed, salivate the patient with this :— 6 grains of calomel, 1 grain of sulph. morphine, made into three pills or powders ; give one every three hours. Or this :— 12 grains blue pill, 2 grains morphine, 5 grains compound extract of colocynth, made into four pills ; give one pill every three hours. When the patient is getting better, he must take no solid food, but such things g.s are mentioned, page 39 (Diluents). As a drink, give this—a wineglassful of the bark of slippery-elm (powder) pour on it a pint of boiling water, and give a wine- glassful every hour,'when cool. *--- CHRONIC INFLAMMATION OF THE MUCOUS MEM- BRANE OF THE BOWELS. Whenever you hear people talking of marasmus, liver complaint, dyspepsia, &c, you may conclude that they mean this disease; as its symptoms are rather obscure, and it is apt to be mistaken for other complaints. You may know it, however, by the following Symptoms.—Pain and a soreness about the bowels when- ever the patient coughs and sneezes ; or pressure is made on his bowels : languor and weakness of the body; generally cold hands and feet, flushed cheeks, slight fever in the even- ing, a burning in the palms of the hands and soles of the feet; a small, weak, sharp or corded pulse ; usually a pain, like colic, in the bowels after eating; sometimes diarrhoea, and sometimes costiveness ; appetite very variable. When the disease has lasted a long time, the patient feels uneasy, after eating, until he obtains a passage, and the food which comes away, looks half digested. The patient wastes away rapidly now. In children, as the limbs shrivel, the belly becomes large. Considerable straining, and the discharges from the bowels are sometimes slimy and small in quantity, mixed with 112 ACUTE INFLAMMATION OF THE LIVER. the natural passes, sometimes like bloody matter; sometimes watery and in quantity, and sometimes dark, or whitish, hav- ing pieces of food undigested in them. Skin dry, sallow or dingy, tongue generally smooth and red at the edges, with a brown streak along the middle. Treatment.—You must pay great attention to the patient's food ; he must not eat any solid food, but such as these; arrow-root, prepared barley, rice boiled soft with boiled milk; he may occasionally take a soft boiled egg. Keep the bowels gently open with a dose of castor oil and ten drops of laudanum, but do not give active purges. If the disease remains obstinate, leech and cup, and even blister the belly, and when the place has healed, put on-a tight flannel bandage around the belly. You may give these powders, also, occa- sionally 25 grains of Dover's powder, 1 grain of calomel, ✓ made into 8 powders; give one powder every five or six hours, during the day. Or this :— i wineglassful of the spirits of turpentine, 1 teaspoonful of laudanum, 1 tablespoonful of white sugar, rubbed up with the white of an egg, to 3 wineglasses of water; mix them together and give a teaspoonful three or four times during the day. You may try five or six drops of balsam copaiva every day, if these fail. ACUTE INFLAMMATION OF THE LIVER. ' Symptoms.—Slight febrile symptoms, a feeling of tightness in the right side and the pit of the stomach. There is very often, too, pain in the chest,-shoulder, or collar-bone. Pain in the right side, on pressure. Generally a dry cough, and difficulty of breathing, sometimes sick stomach and puking of bile. The whites of the eyes, and skin about the breast, face and neck, somewhat yellow. Urine deep yellowish brown; with bile in it; great thirst, hot and dry skin; full, active and firm pulse; bowels generally costive. These are the usual symptoms, when the inflammation is seated in the ACUTE INFLAMMATION OF THE LIVER. 113 substance of the liver, but when it is merely on the surface, the pulse is small, tight, and quick; tongue covered with a white or thick yellowish fur, or smooth and glossy, having fissures or furrows, and appears raised in some places. The bowels are sometimes, but not often,loose, and much griping, as in dysentery. This disease, when it continues beyond the sixth or seventh day, is apt to produce abscess of the liver. When this has occurred, the pain in the side is lessened, and instead, there is a sensation of weight and throbbing, with chills at times, sweats at night, a feeling or sinking or oppression in the chest, and a crawling of the skin, skin clammy. . Sometimes the abscess opens outward, and you may let out the matter with a lancet or knife. Sometimes it points internally, and the matter is discharged through the bowels or lungs. Be careful not to confound- this disease with inflammation of the stomach. Treatment.—Bleed until the pulse is evidently affected, then give 15 or 20 grains of calomel, in one dose, and about two hours afterward, a wineglass.of castor oil. If one bleeding does not succeed, repeat it several times in the course of the first few days, then apply leeches over the stomach and liver. Keep the bowels well open, by" giving 8 or 10 grains of calo- mel, twice or three times a day, and if the bowels are not opened by this, give a small dose of Epsom or glauber salts, two hours after each dose, until they are (see pages 32 and 34, for doses, &c), or castor oil. After you have, in a meas- ure, reduced the inflammation by bleeding, and opened the bowels well, as directed, put blisters over the liver (that is, over the short ribs on the right side), and keep the bowels open by giving these powders :— 3 grains of calomel, 3 grains of antimonial powder, 1 grain of powdered opium, made into one powder, and given every five hours, until the gums are a little sore. If these powders do not keep the bowels well open, you' must give a dose of castor oil or Epsom salts between them every now and then. Remember that blisters must be kept constantly over the^ liver—as fast as one heals sufficiently, put on another. Give this, also:— 2 grains of antimonial powder, 2 grains of saltp'etre (powdered), 10* 114 CHRONIC INFLAMMATION OF THE LIVER. every'four hours, and let the patient drink warm flaxseed lea, or gum'water; if these powders irritate the "Stomach, stop them. - When an abscess has formed in the liver, keep the bowels well open by 5 or 6 grains of calomel every.now and then, followed in four hours by a dose of castor-oil or Epsom salts, and bathe the patient's feet and hands in this mixture: one half a wineglass of nitric and muriatic acid, mixed in one gallon of warm water. And let the patient take this : a teaspoonful of these acids to a tumbler of water. Give a wineglassful (sucked through a quill), every three hours during the day. CHRONIC INFLAMMATION OF THE LIVER. Symptoms.—This disease frequently remains as a conse- quence of the acute form, but sometimes it comes like any other disease. When it comes on, from whatever cause, you will observe these Symptoms.—Acid, and sometimes sick stomach and puking; bad appetite, iudigestion, wind, and sometimes slight pains in the bowels, and a feeling of fullness about the stomach.— Sometimes the patient feels a slight dull pain and weight in the right side, abouj; the short ribs ; and frequently a pain in the right shoulder. The pain in the right side, however, is frequently not felt, unless the part is pressed upon, when the patient feels an uneasiness and tightness there. The face looks thin and sickly. The whites of the eyes, skin of the face, neck, and heart yellowish. Bowels generally costive, but sometimes loose, and the passages, are disagreeable, small, dark, slimy, and greenish, or muddy and watery. Water colored with bile, and burns high upthe bladder when it is passed. Tongue generally dry and white, a bitter and disagreeable taste in the mouth ; dry, harsh skin. Some- times a-dry cough and difficulty of breathing. This disease is very common among those who live in swamps and un- healthy parts. Treatment.—Put leeches or cups over the liver, and when CHRONIC INFLAMMATION OF THE LIVER. 115 these are removed, put on, from time to time, warm, soft poul- tices.—(See pages 68 and 69.) Open the bowels gently with castor oil, or with this :— * 6 grains of calomel, 10 grains of rhubarb, 2 grains of James'powders, given at one dose, in syrup or honey. Then use this :— 4 grains of blue pill, 1 grain of the comp. extract of colocynth, or of the extract of conium, or hyosciamus, if you can get them, made into one pill. Give a pill three times a day, from day to day, until you find the gums a little sore, then stop until the gums are well, and go on again as before, until the disease is cured, but be careful not to salivate. While you are giving these pills, you must keep the bowels gently open, by giving, every now and then, a small dose of Epsom or glauber salts, or rhubarb (powder).—{See pages 32, 34, and 33.) In Connexion with the other remedies, you may use this; to give tone to the stomach, and keep the bowels in a good state :— 2 teaspoonfuls of the tincture gentian, 1 teaspoonful of the carbonate of soda, 30 drops of nitric acid, mixed with a half-pint of the decoction of sarsaparilla, which last is made thus. Take as much of the root of the sarsapa- rilla (broken Up),' aswill get into a very small tumbler, put this into a pan and pour a pint of water on it; boil this down to a half-pint, and mix it. Give a tablespoonful-of this mix- ture every morning, noon, and evening.- Bathe the feet as directed in page 68. If the disease remains obstinate, rub the part over the liver with this,:— 1 teaspoonful of white precipitate, rubbed up with a tablespoonful of lard. Rub this over the liver two or three times a day, until pustules come out. The patient must be kept in a dry atmosphei'e and a com- fortable room—wear warm clothirig, .avoid taking cold, and eat nothing but the most wholesome food. 116 ACUTE AND CHRONIC INFLAMMATION OF THE SPLEEN. ACUTE INFLAMMATION OF THE SPLEEN. This disease is not very common, but the symptoms are, a heavy pain under the false ribs of the left side, which is much increased when pressed upon ; sometimes a pain under the right shoulder-blade, arid the place looks a little swollen. Frequently, also a burning in the stomach, sickness and gid- diness, and other bad feelings, particularly when the patient 6its up in bed; skin and eyes yellowish, and water colored with bile. Notice these symptoms, as you are apt to mistake this disease for inflammation of the liver. Treatment.—Bleed until the pulse is reduced, then purge out the bowels in the same manner as in acute inflammation of the bowels (page 107). After the bowels have been well purged out, put the patient into a warm bath, and attend to the directions, generally, in pages 107 and 108. CHRONIC INFLAMMATION OF THE SPLEEN. Symptoms.—A sickly and gloomy countenance, fretful tem- per, uneasy and painful feelings at times, and the patient can not lie on the left side ; sometimes the patient throws up blood. Treatment.—Leech or cup the part over the spleen, which is on the left side, under the short ribs ; and when this is done, rub the place with tartar emetic ointment, until pustules come out; and put the patient into a warm bath every now and then. Keep the bowels constantly open by giving these pills; 4 grains of blue pill, 1 grain of extract of hyosciamus, made into one pill; give a pill every morning and evening, until the gums are sore, then stoj> and go on again, until the disease is cured. You may give this also ; 1 grain of James' powder, 3 grains of saltpetre. Give this every night and morning, or very small doses of tartar emetic, say one fourth of a grain, at a dose. You may use, also, every now and then, some of the medicines in pages 35 to 38 (Diaphoretics). ENLARGEMENT AND INDURATION OF THE SPLEEN. 117 ENLARGEMENT AND INDURATION OF THE SPLEEN. This is very apt to occur from intermitting fever, and is common among those who live on swamps, marshes, and in unhealthy parts of the country. Symptoms.—This disease may be known by a large swel- ling on the left side, about the short ribs, which sometimes rises and falls. Very often, too, the skin is discolored in this place, and you will see what is well known as the fever cake. Treatment.—Give^this; 1 tablespoonful of Peruvian bark (powdered), 1 teaspoonful of rhubarb (powder), T teaspoonful of sal-ammoniac (powdered), rubbed together, and made into four powders. Give one powder every two hours during the day. Give this, also, as a drink; 1 grain of tartar emetic, 2 quarts of warm flaxseed tea. Give a wineglassful every two or three hours during the day, for eight days or so. Keep the bowels constantly open with this; 2 grains of blue pill, 1 grain of antimonial powder, made into one pill. Give a pill every night and morning, arid if they do not keep the bowels open sufficiently, give a dose of some mild purge,-as Epsom salts', rhubarb, or castor oil, every now and then. Put the patient into a warm bath every night, and rub the spleen frequently with a brush, and put a tight flannel bandage around his belly, and let him wear it If the disease is obstinate, you may give this; 8 or 10 drops of the tincture of iodime, three times a day, or rub the part over the spleen frequently with the iodine ointment. - ACUTE INFLAMMATION OF THE MEMBRANE WHICH SURROUNDS ALL THE BOWELS OF THE ABDOMEN —CALLED THE PERITONEUM. Symptoms.—Creeping chills, with flushes of heat every now and then, weariness of the body, and pain in the limbs. Frequently sharp pain in some part of the belly,, which, after 118 ACUTE INFLAMMATION OF THE PERITONEUM. remaining in one spot for a short time, spreads over the whole or most of the belly. This is not always the case, for some- times, in the most severe cases, there is no pain, but only a little uneasiness about the bowels ; and sometimes the pain flies about from one place to another in the bowels. There is always much pain when you press on the belly ; and the patient will lie on his back, with his knees and shoulders raised to prevent the covering from pressing on his bowels. Weight and uneasiness about the stomach, and headache. Pulse frequent, and somewhat hard and small, and sometimes, but very seldom, full. Face generally pale, sharp, and anx- ious; bowels costive; tongue moist, arid at first covered with a thin white fur, and the edges red, as the disease advances. Urine small in quantity, and sometimes none at all. Bestless- ness, short, quick, painful, and difficult breathing. Gener- ally the belly swells, and becomes'tight in about twenty-four haurs after the disease hag commenced. When this disease occurs in females, just after their confinement, it is called puerperal fever, and the patient sinks much sooner than when it occurs in other patients. This disease is generally very'rapid in its course, and may end in death in a few days, or even hours ; or sometimes, but not often, in mortification ; or the patient may get better, or, lastly, it may end in chronic peritonitis. When it ends in mortification, the pain in the--bowels suddenly ceases, the patient becomes very weak, his pulse very small and quick, and frequently stops every now and then ; the hands and feet become cold and clammy, &c. When you see these symptoms the case is hopeless. Treatment.—Bleed immediately until the patient is sick, and if the pain and fever come on again, bleed„a second, or even a third time, if necessary ; but remember, never bleed after the first twenty-four hours, as it is dangerous. When you find that the fever and inflammation have been subdued, in a measure, by the bleeding, put leeches, if you can get them, all over the Kelly; if not, cup the belly in sev- eral places, and after the leeches or cups come off, keep flan- nels, wrung out in warm water, constantly applied all over the belly. As soon as you find the pain and tenderness in the bowels relieved in a measure, give this (if a'grown person) • 10 grains of calomel, 20 grains of jalap, CHRONIC INFLAMMATION OF THE PERITONEUM. 119 rubbed up and made into two powders. Give one powder an hour after the other, and in two hours after the last pow- der, if the bowels are not open', give this ; A large wineglass of castor oil, A tablespoonful of spirits of turpentine; mix them, and divide them into two doses. Give one dose, and if it does not purge in two' hours,. give the other. If, after you have bled and purged out the patient well, the belly is still tender and painful when you press it, put a blister over it, and instead of using oil and wax, use mercurial oint- ment to dress the blister with. When the violence of the inflammation appears to have been subdued, give this; 3 grains of calomel, 1 grain of powdered opium, . made into one powder. Give a powder every three or four hours during the day, until the patient is decidedly better, then use this ;—one grain of powdered digitalis, in a little honey or syrup, every two or three hours, until the pulse becomes soft and natural. Sometimes when the-patient ap- pears to be doing well, particularly a female, just after child- birth, they will suddenly'sink and become very weak, and all, or- most, of the symptoms of mortification, as I have de- scribed, will suddenly, appear, When you see this, give wine immediately, a glass four or five times a day, and if it does not quickly rouse the patient, give this ; - 3 grains of gum camphor/ 1 grain of powdered opium, rubbed together with a little white sugar, and made into one powder. Give a powder every three or four hours' during the day, and night, at intervals of three hours, and continue this until the patient is restored. When the patient is get- ting better, take great care that he eats nothing but thin race gruel or barley, and that he does not take cold. This disease is very insidious in its attack, and frequently becomes dangerous before it is suspected. It generally occurs as a consequence of the acute form, and may be known by these 120 INFLAMMATION OF THE KIDNEYS. Symptoms.—The belly feels-tight, rather than painful, par- ticularly when the bowels are costive 'y aud the patient some- times complaihs of a feeling, as if a ball was rolling about in his bowels. There is sometimes a slight pain in the belly, which leaves and returns. But most frequently there is a soreness and uneasiness about the navel, when the belly is pressed upon, or the patient coughs aud sneezes, and some- times a pricking sensation about the lower part of the belly, after exercise or exertion. But the belly never feels tight to the hand, when pressed upon, as in the acute form ; but the skin feels loose, while you can feel as if thei'e was a tight bandage underneath. Pulse not much altered, except about evening, or when the disease is far advanced, and then it is quick and small. Face and skin generally pale and sickly. After this disease has lasted sometime, water is apt to be formed on the bowels. You must be very careful to notice the symptoms of this disease, as they are apt to escape no- tice, or puzzle even physicians. Treatment.—-Put leeches or cups over the whole belly, and when these are removed, dress the place with nrercui'ial oint- ment Open the bowels and keep them constantly open by castor oil, cream of tartar, or mild purges, and give one of these powders every night and morning ; 3 grains of calomel, •: 2 grains of Dover's powders. But the food which the patient uses, is of more importance in the cure of this disease than medicine. The patient must positively take only as much nourishment as is absolutely necessaiy for sustenance, and that of the lightest kind, aa soft boiled rice, gruel, &c. INFLAMMATION OF THE KIDNEYS. This disease may be produced by cold or by blows, strains gravel, and irritating substances, rheumatism, or some disease settling on the kidneys. When it comes on iri females, the symptoms are like those of other complaints caused by cold, eu h as chills, with flushes of heat every now and then, and INFLAMMATION OF THE KIDNEYS. 121 when the fever comes on, there is pain in the loins. But when it proceeds from the other causes which I have men- tioned, these are the Symptoms.—A deep-seated, severe pain in the loin, on one or both sides, which is not much increased by pressure, but is by any sudden jerk or jar of the body. Sometimes the pain darts down to one testicle, and a numbness is felt in the thigh of that side. There is very little water passed, and that high colored, and, sometimes, tinged with blood, and great desire to pass it. Bowels costive, frequently sick stomach, and puking, and severe wind pains in the bowels. Sometimes a dull pain begins low down, and moves slowly up to the back. The skin generally hot and dry, the pulse hard, full, and quick, in the beginning, afterward small and quick. This disease does not last longer than the seventh day, without an abscess in the kidney, or the inflammation subsiding. When an abscess is forming, there will be frequent shivering and chills, dull, heavy, throbbing pain, and a feeling of numbness in the loin, and the fever cools. Sometimes the abscess bursts inside, and the matter comes away with the urine; this may be known by examining the water, and you will see a thick stuff, which settles down to the bottom of the pot by itself; but if it mixes up with the water, you may conclude that it is not matter from an abscess, but o'nly a sediment caused by inflammation of the kidneys or bladder. When the patient is about to get better, without an abscess, these will be the symptoms: the pain and fever abate, the skin all over the body becomes moist, the sickness and puking are checked, the water flows freel^is muddy, or mixed with slime, called mucus. An abscesTin the kidneys is always to be avoided, if possible. Treatment.—Bleed immediately, and then cup the loins. When the cups are removed, put a large, soft, warm poul- tice to the loins, and purge out the bowels with this; 12 grains of calomel, or blue pill, 40 grains comp. extract colocynth, made into six pills ; give one pill every hour, until the bow- els are well opened—and if they do not purge well, give a dose of castor-oil two hours after the last pill. About even- in o-, give two or three injections of this (warm); 1 quart of flaxseed tea, I wineglass of laudanum, mixed. 11 122 INFLAMMATION OF THE BLADDER. The patient must drink freely of flaxseed-tea, say a cupful, having in it one grain of Dover's powder, every two or three hours, day and night. You must also surround the patient's body with hot bricks, wrapped in flannels which have been wet with vinegar and water, and put under the bed-cOvering. After you have continued this treatment from twelve to twen- ty-four hours, if the pain in the loins is not relieved, and the urine does not flow freely, you must put a blister over the place which was cupped, and when the blister has been on four or five hours, take it off, and put on the place a large warm mustard-poultice (see page 68), and put on another when this gets hard. Keep the bowels open from dayto day with mild purges, as Epsom salts, &c. After the inflamma- tion and severe pain in the loin have been subdued, there is apt to be a soreness in the loin, in one or both sides. When this is the case, give this :— 25 grains of uva ursi, 3 grains Dover's powder, made into one powder. Give a powder every three or four hours during the day; give very light food Tor nourishment. INFLAMMATION OF THE BLADDER. Symptoms.—A severe burning, shooting, or throbbing pain over the privates, which sometimes shoots down to the testi- cles, fundament, and thigh*^ The place near the fundament feels sore when you touch it, and that over the privates more painful when you press on it. The patient tries often to pass water, and strains, without being able to pass but a very small quantity, and that deep red and often bloody. Some- times the water comes away constantly, in drops. Very of- ten, sick stomach and puking; oppression of the chest; bow- els costive, and sometimes a straining; pulse quick, hard, and full; great thirst, hot and dry skin, restlessness and melan- choly. These symptoms vary at times, according as one or another part of the bladder is principally inflamed This disease generally lasts for about six or seven days and ends in mortification of the bladder, or the patient gets better • and sometimes, but rarely, matter is found in the bladder When CHRONIC INFLAMMATION OF THE BLADDER. 123 mortification is about to take place, the pain ceases suddenly, the hands and feet become cold, a clammy sweat comes over the body, the patient becomes very weak, his face very pale, his mind somewhat composed, pulse weak and quick, &c. When the patient; is about to get better, the pain ceases or lessens; a warm sweat comes over the whole body; the water comes away plentifully, and with no pain, but looks muddy ; and he can bear pressure over the privates. Treatment.—Bleed immediately until the pulse is reduced, and put leeches about the fundament and over the privates, and as soon as the leeches come away, put warm poultices over the leech-bites. Give a dose of castor oil, and two or three injections of flaxseed-tea, until the bowels have been well emptied. Then give an anodyne clyster (see page 70). Next, sweat the patient with bricks, in the manner directed in page 122; and let him use, as a drink, the mixture of flaxseed-tea, with Dover's powder, recommended in the same page. If there is now a stoppage of water, you must intro- duce a silver catheter : get directions from a physician. Let the patient sit down in a tub of warm water several times during the day. If the disease still remains obstinate, use this :— 2 grains of calomel, Or 3 of blue pill, 1 grain of opium, or 4 of Dover's powder, made into one powder. Give a powder every four hours un- til the patient is relieved. Last of all, when these remedies fail, put a blister over the privates, and do after as recom- mended for the kidneys, page 121. CHRONIC INFLAMMATION OF THE BLADDER. This disease sometimes arises from the same cause which produces the disease just described, or it may remain as a consequence of it. Symptoms.—A. feeling of weight and tenderness near the fundament; a heat or burning, and slight shooting pains, over the privates ; a desire to pass water continually, and fre- quent spasm of the bladder and water-passage. The water is filled with a thick and sometimes ropy slime or mucus. 124 INFLAMMATION OF THE WOMB. Weakness, slow fever, and thirst. The digestion, too, is generally bad ; sometimes sickness and puking; bowels cos- tive, skin harsh and dry, tongue covered with a white or brown fur. Some other symptoms appear, more or less nu- merous, according to the severity of the case. Treatment.—If the pulse is full and active, and much pain about the privates, bleed moderately; then cup the loins, and put leeches now and then about the fundament. Keep the bowels constantly loose by giving a dose of castor-oil or mag- nesia every now and then.—(See pages 32 and 33.) If the disease remains obstinate, rub the loins with tartar-emetic ointment. The patient must drink constantly of flaxseed- tea, or slippery-elm tea, made by pouring a pint of boiling water on a teaspoonful of the elm-bark. He may take one of these pills every night and morning also:— 15 grains of uva ursi, ^ grain of the extract of hyosciamus, made into one pill. If these remedies do not succeed (as the disease is sometimes very obstinate), try the balsam-Copaiva capsules. Give one three times a day. Remember, the pa- tient must take only the simplest food, and no spirituous liquors, but use such drinks as flaxseed-tea, barley-water, &c.; must not ride on horseback, or take hard exercise. Some- times two or three grains of super-carbonate of soda, mixed with the drinks, gives relief. INFLAMMATION OF THE WOMB. This generally occurs in females just after child-birth. Symptoms.—A fixed, dull, aching, or shooting pain be- tween the hips,-with a feeling of weight or bearing down near the fundament, generally increased by motion, or when pressed upon. Urine stopped, or passed with much pain and difficulty. The pain may be more or less severe, and differently located, according to the pait of the womb to which the inflammation is principally confined. Sometimes the pains are in paroxysms, like after-pains, but may be dis- tinguished from them with little difficulty. Frequently the after-discharge is stopped, but not always; severe headache INFLAMMATION OF THE WOMB. 125 and delirium toward evening; sick stomach, and pukiug now and then. Pulse full, strong, and hard—sometimes small, quick, and contracted ; bowels generally slow ; urine small in quantity, of a deep-red color, and passed with pain and difficulty. This disease is apt to end in suppuration or mor- tification of the womb if the patient does not get better in four or five days, though these results are not very common. These are the symptoms when the womb alone is inflamed; but when it involves the peritoneum, it is called puerperal fever, and these are the Symptoms.—The pulse becomes quicker, the lower part of the stomach swells and becomes very tender; great weak- ness ; the patient lies on her back, with the knees and shoul- ders raised; tongue dry and covered with a brown coat, and sometimes looseness of the bowels, particularly toward the termination of the disease. When the patient is about to get better, the pain and tenderness of the womb decrease; the pulse becomes soft and slower, the tongue clean and moist, the skin soft and moist; the urine flows more freely, and the other symptoms become better. When mortification (which seldom occurs) is about to take place, you will'no- tice the usual symptoms of mortification, which I have de- scribed. Suppuration, or the formation of matter in the womb, is very dangerous, particularly if the matter is discharged in the cavity of the belly. When it is about to happen, you will notice these symptoms: slight chills and heat passing irregularly over the body; a weight in the womb, and a les- sening of the pain after five or six days ; great weakness; dry, red tongue ; a flush in one or both cheeks; cool sweats in different parts of the body, and the discharge from the privates increased and offensive. Treatment.—Bleed immediately, and if the pulse does not become soft and the pain abate, bleed again, and again, until they do. Put leeches, if they can be had, over the privates and about the privates, and as soon as the leeches come off, put warm poultices to the leech-bites, apply them from time to time as fast as they get hard. Then give this : 8 or 10 grains of calomel, and four hours afterward a dose ol fcpsom salts—(See table.) Put blisters to the inner part of the thighs, high up, and give clysters of warm flaxseed-tea, or warm milk and water, frequently. When the bowels have 11* 12f> CHRONIC INFLAMMATION OF THE WOMB. been well purged out with the calomel and the salts, give this:— 36 grains of Dover's powder, 12 grains of Calomel, made into six powders. Give one powder every three or four hours during the day. The patient must drink freely of flaxseed-tea. Two grains of James' powder, mixed with two grains of saltpetre (powdered), every night and morn- ing, will do much good when there is not much irritability of the stomach. If these remedies do no good, give this :— 1 grain of powdered opium, 2 grains of calomel, made into one powder, and given every three hours ; and put a large blister over the womb, above the privates. CHRONIC INFLAMMATION OF THE WOMB. This disease is very common, and very apt to be mistaken or neglected. The inflammation in most cases is seated principally in the neck and mouth of the womb. Symptoms.—Sometimes only a heat low down in the womb, or dull, shooting pains, which go and come. Some times a weight and pain in the upper parts of the privates. The patient generally has the whites, which often looks like matter. This disease may last for many years, and at last cause an incurable disease of the womb. Females, there- fore, should never neglect attending to the whites. Treatment.—The treatment in this disease does not differ materially from that of inflammation of the womb, only you need not give such large doses. When you have bled, the necessity for which must be determined by the pulse, and purged out the bowels, &c, if the whites still remain, see the directions for the whites, and follow them. If the disease is obstinate, you may put blisters, about the size of your hand, to the back, just above the fundament, and if there is not much-inflammation, you may give a few drops of balsam copaiva twice or three times a day. PLEURISY. 127 PLEURISY. Symptoms.—A severe sticking pain in the chest, on one side or the other, which is increased when the patient draws a deep breath, or coughs. Breathing short and quick. Short and dry cough, with a colorless spittle. Sometimes there is blQod in the spittle, and then you may know that the lungs are inflamed also. Hot and dry skin ; urine Small in quantity and deep red ; tongue covered with a thick white fur; faco flushed, pulse very hard, full and quick. The patient tries to keep his ribs from moving, and uses the muscles of his belly to breathe with. Notice this—these symptoms do not always appear as there is sometimes very little pain and cough, and yet much inflammation. Treatment.—Bleed from a large orifice, until the pain is lessened, and the pulse falls, and if it rise again, you must bleed again, and again, with judgment, until it is removed. Put a good blister over the place where the pain is, and give this:— 12 grains of calomel, 12 grains of Dover's powder, made into two or three powders, and give one every two or three hours, until they operate; four or five hours afterward, give a moderate dose of castor-oil, or Epsom salts. -The patient must drink, every two or three hours during the day, some of the senega, or senpentaria.—(See page 37.) Or, if the skin is not very dry, flaxseed tea. If you find the skin obstinately dry, put about two grains of the antimonial pow- der or six drops of the antimonial wine, or six grains of salt- petre, to every cup of the snake-root, Which must be given hot. Keep the bowels open from day to day, with one or two moderate doses of some mild purge, or the calomel and Dover's powder as directed. You will find the life-everlasting tea, an excellent thing to use as a sweat, particularly if you have not the snake-root. This is not a dangerous disease in strong healthy persons, but sometimes in weak constitutions, it is dangerous, as it may bring on consumption. ^ The bad symptoms are these:—Bloody spittle, a wheezing in the throat, loose bowels, convulsions, while the patient is con- stantly trying tQ sit up. When these symptoms appear, you must treat it like the following disease. 128 INFLAMMATION OF THE LUNGS. PERIPNEUMONY, OR INFLAMMATION OF THE LUNGS. In this disease, the substance of the lungs is principally inflamed, and these are the • Symptoms.—Difficulty of breathing when the patient is lying down ; dull pain in the chest, generally about the breast bone ; sometimes about the pit of the stomach, and sometimes about the shoulder-blade. Cough, and spitting up a quantity of clear glairy stuff, sometimes mixed with blood. Pulse quick, full, and laboring, but not generally hard, weak and irregular when the disease is advanced. When the disease is very violent, and the inflamed portion of the lungs is about to be disorganized, or water to form on the lungs, you will observe these symptoms:—The spittle white, yellowish, or greenish, with bubbles in it, and sticks close to the vessel. Sometimes, however, the disease becomes dangerous, and a considerable portion of the lungs disorganized, without any conspicuous symptoms. Treatment.—As this disease is nearly allied to plenrisy, the treatment is not materially different. It is not necessary to take so much blood, and, in fact, blood, in many cases, must be taken with much caution, as wheri the pulse is weak, instead of bleeding, give this: a wineglassful of the root of poligala, or senega; pour a pint of boiling water on this, and let it boil about half an hour. Then put in one grain of tar- tar emetic, and give a wineglassful of the mixture, warm, every hour. As a general rule, keep the bowels open by giving this:— 2 grains of calomel, 1 grain of hippo, or antimonial powder, every two hours during the day, and four or five hours after the last dose, give a dose of castor-oil or Epsom salts.—(See Table.) The patient may drink freely, from time to time, of flaxseed tea, and if the pain in the chest is obstinate, put a blister between the shoulders, and to the calves of the legs, if necessary. Lastly, if the patient begins to sink, give this:__ 1 grain of camphor* 1 grain of powdered opium, rubbed up with a little white sugar, and taken every hour and to produce perspiration, when the skin is obstinatelv dry'. 1 grain of tartar emetic, 4 grains of saltpetre (powdered), made into eight powders." Give-one powder every hour. BILIOUS PLEURISY. 129 BILIOUS PLEURISY. This disease is a modification of pneumonia, or inflamma- tion of the lungs. Symptoms.^-White tongue, with a yellowish streak along the middle, at the commencement of the disease; afterward, dark, brown, and dry. Pulse generally small and quick, and somewhat tight, like a cord. Frequently, the patient feels, when the disease is coming on, considerable pain in the back and legs ; sometimes a fulness arid tightness in the right side ; and sometimes the bowels are loose, just before the fever comes on. The skin and the whites of the eyes generally tinged with bile ; face flushed and yellowish. Sharp pain in the forehead. Pain in the chest, sometimes very severe and burning, but more commonly dull, with weight and oppression in the breast. Sometimes the fever lasts for several days be- fore the pain in the breast comes,on. Thejpatient does not spit much, and what he spits is yellowish and frothy, and marked frequently with streaks of blood. The fever generally rises in the evening, and cools in the morning. There is gen- erally puking of bilious matter, but sometimes what comes up, has no bile in it, but only the mucus, and contents of the stomach. Urine always yellow arid bilious. When the patient is about to get better, you will see a gentle perspiration, the cough will become less troublesome, and the pain and op- pression of the chest will abate ; the urine flow more freely, and have a sediment in it; and he will spit up a quantity of thick yellowish matter. But if what he spits up becomes dark, or red and watery, the cough becomes dry, the pain and oppression spread through the whole chest, with a feeling of suffocation, the face and lips blue, the pulse soft, laboring, and irregular, if the inside of the body feels cold, while the outside is stifl very warm, and other bad symptoms appear, the patient is in great dan- ger. This, however, is a very treacherous disease, and some- times the patient may get better, when the worst symptoms appear, and die, when very few ba.d symptoms are seen. Treatment.—Bleed immediately, but be careful to keep your finger on the pulse, while the blood is running. If you find the pulse rise, let the blood run until it falls again ; then tie up the arm. Next give an emetic of hippo (see page 46), and when the patient has thrown up once or twice, so as to 130 INFLAMMATION OF THE LARYNX. remove everything in his stomach, put a large blister between his shoulders, which must be dressed with warm poultices, when it comes off, for a day or two, and give this; 12 grains of calomel, 8 grains of antimonial powder, 4 grains of camphor, rubbed up, and made into six powders. Give one powder every hour, until they produce two or three good large bil- ious passages ; then, four or five hours after the last powder, give a dose of castor-oil. Remember, both in this disease and peripneumony, all the bleeding must be done in the first twenty-four hours, for afterward bleeding is dangerous unless practised with great caution and judgment. With regard to the rest of the treatment in this disease, follow the directions for peripneumony. After the inflammation and pain in the chest have been relieved in a measure, give the senega and tartar emetic, as directed for peripneumony (see page 128). Some physicians speak highly of the muriate and carbonate of ammonia, in this and peripneumony, but, as I have never used them much, I can not recommend them. You may give an emetic of hippo, every now and then, during this dis- ease (but not in peripneumony), if the pain in the chest is obstinate, and the skin is^very dry and hot. INFLAMMATION OF THE LARYNX. This disease is apt to be mistaken for croup, but by atten- tion to the symptoms, you will distinguish it. Soreness in the throat, uneasiness in swallowing, and tenderness when the throat is pressed upon. The voice changed to a thick, hoarse whisper, and when the breath is drawn in, it sounds hoarse, dull, and hollow, as if passing through a narrow open- ing. If you look into the throat, you will find it pale, red, swollen, and dropsical.' The patient does not spit much but what he spits is ropy. Pulse generally quick, small/and tight; tongue white, with red points and covered with a lay- er of clear mucus, &c. The patient is unable to cough out. This is a dangerous disease and requires the most prompt treatment. * ACUTE BRONCHITIS. 131 Treatment.—Bleed immediately until the patient faints; then put several leeches to the throat, and a good-sized blis- ter to the back of the neck. When the leeches . Breath offensive; headache, ringing noise in the ears, giddiness, and the patient not inclined to exert herself, and often fretful and ill-tempered. Several other symptoms appear at times. jaundice. 151 This disease is apt to be complicated with the whites, and is often produced by it, or excessive flow of the courses ; or it may arise from indolent habits, unwholesome food and air, the courses not appearing at the proper time, neglected cos- tiveness, and chronic irritation of the -bowels.J In this dis- ease, when long continued, the patient is apt to have a cra- ving for such things as chalk, ashes, clay, &c. Treatment.—If the bowels are costive, and the belly swol- len and tight, as they are apt to be, keep them open with this : 4 grains of rhubarb, 2 grains of aloes, rubbed together, and given at one dose at night. Give one of these powders every third night, until the bowels are well emptied and loose. Give this, also, once or twice a week: 5 grains of blue pill, 1 grain of the extract of hyosciamus, made into one pill. Nourishing and light food, as brrtths, game; change of air, gentle exercise, and sea-bathing in warm weather. When the disease has lasted some time, try this :— - 30 grains of green vitriol, A teaspoonful of white sugar, rubbed up and made into six powders; give one powder ev- ery morning and evening ; or this :— 24 grains of the black sulphuret of iron, A teaspoonful of white sugar, made into three'powders; give one powder three times a day. The citrate of iron is a beautiful preparation, but I have never tried it. I have used the following pills with much benefit:— 6 grains of calomel, 6 grains of Kermes' mineral, 18 grains of gum-guaiacum, made into six pills; give one pill every morning and night JAUNDICE. Sometimes this disease comes on slowly, and with distinct symptoms, such as a general feeling of weariness, and an aversion to move about; peevishness and melancholy, cos- 152 JAUNDICE. tiveness, bad appetite, belching of acid stuff, slight wind-pains in the bowels, fullness and tightness at the pit of the stom- ach, oppression of the chest, restlessness at night, chills every now and then, with flushes of heat, sick stomach, and the urine is muddy, and deposites a thick stuff like pitch. ^ After a few days, the skin begins to itch all over, the taste in the mouth is bitter, the urine of a deep-yellow color, the passages whitish or clay-colored. The whites of the eyes and skin about the lips, neck, and forehead, next become yellow, and afterward the whole body. Or the eyes and skin may be- come yellow without any particular symptoms. Again, it may come on in this way: a severe pain all at once, just be- low and to the right of the pit of the stomach. This soon increases, becomes very painful, and extends to the left shoul- der, the loins, and all about the stomach ; sickness at the stomach, and violent puking. The color of the skin in jaundice is not always the same* but sometimes it is yellow, like gold, sometimes a greenish yellow, and sometimes dark or almost black. When it is greenish or dark, the liver is generally diseased, and it is called black jaundice ; when yellow, yellow jaundice. This disease may disappear in a short time, or become chronic and last for some time, and waste the patient away, or kill him. The black jaundice is the most dangerous. Gall-stones are apt to be formed in the gall-bladder, and when they are coming away they give excruciating pain,'butthe patient is generally better afterward. Treatment.—If there is great pain about the stomach, bleed immediately, if the patient can bear it. Then put him into a warm bath, arid when you take him out, put leeches to the place where the pain is, and when they drop off, put-warm poultices to the leech-bites.—r(See page 69.) Then give this, if a grown person :—■ 4 grains of powdered opium, 15 grains of calomel, rubbed together, and given at one dose. If this does not purge out the bowels quickly, give clysters until they are (see page 70). Put the patient several times into a warm bath. When the bowels are well emptied, feel'the pulse; if you find it slow, full, and rather active, give an emetic of hippo, or two or three of them, until the patient throws-up freely, when gall-stones are very apt to come away. But if FLATULENT or wind colic. 153 the pulse is small, quick, and tight, like a cord, and the skin warm and dry, you may know that one of the guts, called the duodenum, is inflamed, and you must then put blisters to the pit of the stomach, ancf when the blister comes off, put warm poultices to the raw place (see page 69). Give this:— 3 grains of Dover's powder, every two hours;- keep the bowels open with clysters, and the patient must take cool acid drinks, as lemonade, and gruel or boiled milk for nourishment. Emetics or purges here would be wrong. Lastly, when the disease.is not very violent, but obstinate, and lasts for some time, keep the bow- els open with a dose of blue pill or calomel every now and then, followed by some mild purge (see page 20), and pay particular attention to the patient's food and clothing. FLATULENT OR WIND COLIC This may arise from two causes : indigestible food eaten in too great quantity, or a chronic irritation of the coats of the stomach and some of the bowels. When it arises from the first cause, the symptoms are these : a feeling of disten- tion and uneasiness in the pit of the stomach, or a little be- low, on the left side. This feeling of distention of the stom- ach and bowels soon increases very much, with a dull, sick- ening pain. All these pains soon become very severe, and particularly about the navel. The patient generally tosses, rolls, or moves about quickly, with his body bent forward, and both hands pressed against his belly. If the colic is con- fined principally to the stomach, the patient will belch up a great quantity of wind ; but if it is in one of the large guts, called the colon, the wind passes downward, but with much more difficulty, and frequently not-until the .patient has been relieved by medicine, &c. To distinguish colic from inflam- mation of the bowels, notice this : the patient is relieved by pressure on his belly (see Inflammation of the Stomach,-page 104, and Inflammation of the Bowels, page 106), so that you may not mistake one disease for the other. You must not confound it with bilious colic, neither, for in bilious colic there is a puking of bile, and the .eyes are yellowish, head- ache, and bitter taste in the mouth, which is not the case in 154 FLATULENT OR WIND COLIC. flatulent colic. And you can easily distinguish it from paint- er's colic, for painter's colic comes on slowly, but this very quickly and violently. It is not generally a dangerous corn- plaint, but requires immediate relief, as it may produce in- flammation of the bowels. Treatment.— When it comes on just after the patient lias eaten heartily, give a teaspoonful of hippo in warm water, with twenty drops of the essence of peppermint in it, for a grown person. If this does not puke, give another dose. About a quarter of an hour after the patient has puked, if his stomach is settled, give this :— A large wineglass of castor-oil, With 30 drops of the spirits of turpentine; and, if this does not purge in two or three hours, give clys- ters, until the bowels are well emptied (see page 70). Some- times the pain is so severe that the patient can not take medi- cine, or lie still. In that case, give this :— A teaspoonful of laudanum, 5 grains of camphor,. rubbed up with a little white sugar; and put into a wineglass of warm water. -Give this at one dose. After this, you must always purge the bowels out as soon as the stomach will bear it, with this :—. 8 grains of calomel, 15 grains of jalap, at one dose. If the patient is very strong and hearty, and the medicines are slow in operating, you must bleed. After all the pains and severe symptoms have been removed, the bowels well purged out, &e, if the part about the pit of the stomach is tender when you press it, and the tongue red at the edges, and with a fur in the middle, you must put leeches over the stomach or a blister, and afterward warm poultices, and if the inflammation is obstinate, follow the directions for acute inflammation of the stomach (see page 104). When colic is not severe, and-arises from chronic irritation of the stomach .and bowels, it will be only necessary to rub the belly well with a brush or-dry flannels, and give this :— From 5 to 10 grains of camphor (well powdered), 30 drops of vitriolic ether, 30 drops of laudanum, in a little warm water and sugar. BILIOUS COLIC. 155 BILIOUS COLIC. Premonitory Symptoms.—A bitter taste in the mouth, headache, loss of appetite, sick stomach, thirst, and some- times puking of bile. After these, a sharp pain, sometimes very severe, is felt particularly about the navel; the pain gen- erally moves about from one place to another, in the bowels. There'is generally considerable sickness at the stomach, and puking of bile, from the commencement of the attack, and the bowels can be pressed upon without pain, but they gen- erally become tender afterward. Patient generally relieved for a time by the puking ; bowels generally very costive from the commencement of the attack. Sometimes one of the first symptoms is a yellowness' of the skin and eyes, but more fre- quently this does not pome on until about the second or third day of the disease. Treatment.—If there is much sickness of the stomach, and the patient does not puke freely, give a dose of tartar-emetic, Or two, if necessary (see page 46). If, however, he pukes very freely, let him drink freely of warm camomile or flaxseed tea. Next, cover the bawels with warm mustard-poultices (see p. 68), or put on a blister, if necessary, and when it makes the place red, take it off, and then put>on the mustard-poultices (see page 68). When the stomach has been well emptied, and is settled, or as spon as you can get it down, give this : a half a grain of calomel, in a little sugar and water, every half hour; this will settle the stomach. As soon as the stom- ach is settled, give this :— 15 grains of calomel, and about three hours afterward, a wineglass of castoivoil, if a grown person. If the medicine is thrown up, as is apt to be the case, you must give this : 5 grains of calomel every three hours, giving at the same time a purgative clyster (see pao-e 70), until the bowels are well purged out; then give a full dose of opium (see page 29). If ail these fail, you must crive the calomel and opium pills, one every hour (see page 71), until the gums are-sore. The bowels must be kept con- stantly open, during the whole attack, by castor-oil, clysters, or a dose of calomel every now and then. Two or three passages a day will be sufficient. If, at the commencement of the disease, the patient is 156 painter's colic. strong and healthy, and you see symptoms of a fullness of blood in the system, called plethora, you must bleed, partic- ularly if the pulse is strong and tight, like a cord, or the belly is tender when you press on it. This may be repeated from time-to time, if the pulse and other symptoms indicate it. The warm bath is very useful every now and then. When the patient is recovering, particular care is necessary to pre- vent a return of the disease, from eating anything unwhole- some, or taking cold. Put a flannel bandage around the belly, and let the patient, wear it for some time, and give for nourishment rice-gruel, sage-tea, chicken-water, &c. 'PAINTER'S COLIC. This is sometimes called the dry gripes. It is always caused by the.poisonous influence of lead in some way. Symptoms.—It generally comes on slowly, with costive- ness, belching disagreeable air, sick stomach, weariness, drowsiness, and a disinclination to exertion of mind or body, a feeling of weight and tightness, with occasional wandering pains in the belly. These symptoms generally increase, and the pain about the pit of the stomach and the navel gradu- ally increases; the belly becomes hard, and tender on pres- sure, the bowels very costive, and the stomach generally very irritable. A great many other symptoms may appear, par- ticularly in severe eases, as cold sweats of the hands and feet, pale face, convulsions. Treatment.—If the pulse is strong and full, bleed imme- diately until the patient is sick, and then give this :— 5 grains of Calomel, 2 grains of powdered opium, made into one powder, and given every two hours until the pain is relieved. When the pain is relieved, give this :— 3 grains of calomel, \ grain of powdered opium, made into one powder, and give every three hours, until the gums are sore. As soon as the gums are sore, give this :__ A wineglass of cast or-oil, 2 teaspoonfuls of spirits of turpentine, given at one dose : if this does not purge in three hours, give cholera-morbus. 157 half this dose every hour, until the bowels are well purged ■ out After the bowels have been well purged out,if the pains return, you must give the calorriel and opium powders again, as directed, every three or four hours, until the patient is salivated. Should the powders have no effect, give purgative clysters, until the bowels are well emptied.—(See page 70.) Should all these remedies fail to relieve the pain in the belly, give this:— 20 grains of-alum'(powdered), . 1 grain of opium (powdered), made into, one powder, and given every three or four hours, until relieved. After this, you must^again give a dose of castor-oil, and one of calomel and opium, as recommended, every now and then, and keep the bowels open with clysters. When the patient is getting better, he must take chicken water, and meat broths, and be careful not to drink cold water or spirits. Diluent drinks must be given.—-(See page 39.) CHOLERA-MORBUS. This is produced by the same cause as flatulent colic, and in fact\ is the same, only that in the latter, the violent pains are prevented, and the patient relieved by the puking and purging which takes place. Symptoms.^Sickness at the stomach, every now and then, and belching acid, disagreeable stuff. Cutting pains in the bowels, particularly screwing pains about the navel. These symptoms generally come on at night, after the patient has been a little while in bed, or. asleep. The bowels rumble frequently, and the patient soon begins to puke and purge rapidly, a sour, disagreeable stuff, in which you can detect the unwholesome food, which was the cause. Treatment.—Give an emetic of hippo immediately (see page-46), and as soon as the patient's stomach is settled, give a dose of castor-oil and laudanum.—(See page 71.) Should the stomach be too weak for the castor-oil, give two of the 14 158 CHOLERA OF INFANTS. calomel and opium pills (see page 71), and repeat them until the patient is relieved. Put cataplasms or warm mustard poultices to the belly.—(See page 68.) Should the disease prove obstinate, follow the directions for flatulent colic.— (See page 154.) • CHOLERA OF INFANTS. This disease generally occurs in children, between three months and two years of age. Symptoms.—It generally comes on gradually; you will observe a looseness of the bowels for several days, when the child-begins to puke. The passages are generally frothy, or watery, or whitish, or thin and colorless. The child is apt to die in a few days, but if not, it generally wastes away; hands and feet become cold, head and belly hot; the face pale and shrunk, or pinched, the eyes dull and sunken, skin dry, pulse small, irritated, and quick. If the child now does not get better,'it becomes sleepy, lies with its eyes half open when asleep, and rolls-its head about when awake, and, at last, becomes insensible, as if in apoplexy, or goes off' in convul- sions. Treatment.—If the child is teething, and the gums swollen, cut them. Next,-put-Jen or twelve leeches behind the ears, or to the temples ; I prefer behind the ears ; make the bites bleed freely, with flannels wrung out in hot water, and then put a blister the size of a dollar, or larger, according to the size of the child, behind the ears, over the leech-bites.° Next give this:— 2 grains of calomel, 6 grains of hippo, well rubbed together, and made into twelve powders. Give one powder in a little sugar and water every hour; or, if the child is not very ill, every two hours, and keep on giving them until the passages look good, and you see bile in them. °Then you can stop and keep the bowels open with moderate doses of CHOLERA OF INFANTS. 159 castor-oil.—(See page 33.) Regulate the dose according to the age of the child—for a child three months old, a teaspoon- ful of the best oil (give none but the best). At the same time that you commence giving the powder, cover the child's whole belly with warm mustard poultices (see-page 5S), and when the skin is made quite red, put on simple warm poul- tices instead, frequently. Every now and then, when you go to change a poultice, you must put the child into a warm bath, and while it is in the water, put cold wet cloths to the head. If, however, the child is very sick, lose nO time, but put a large blister over the pit of the stomach, and let it cover a little lower down. When the blister has been on about four hours, if the place is quite red (that is, if the blister has drawn, it must not draw until it makes bladders), take it off, and cover the whole of the bowels from the pit of the stomach to "near the privates with a warm mustard poultice (see page 68), the quantity of mustard in the poultice, according to the age of the child. As soon as the bladders have risen well, take off the poultice and dress the place with a rag spread with fresh mercurial ointment, and repeat the dressings to keep the place running. If the powders which I have directed, do 'not open the bowels enough, or seem to be too slow, give one grain of calomel every hour (for a young child), Until they are ; and then go on with the powders. If after the violence of the disease has been subdued, the child remains emaciated, with a dry, shrunk skin, &c, give this (that is, if you see no symptoms of a determination of blood to the head, as sleepi- ness, &c.):— 1 grain of calomel, 3 grains of Dover's powder, 1 grain of rhubarb, made into six powders; give one powder every two hours, or you may put a quarter of a grain of sulphate of morphine, in place of the Dover's powder. Sometimes when the child is slowly getting better, it is distressed with wind pains in the bowels. To relieve these, give' two drops of the spirits of turpentine, in a little boiled milk, every one or two hours. If this does not answer, give this—a. teaspoonful of common soot, pour on it a wineglassful of water, strain it, and sweeten with white sugar;, give a teaspoonful every half hour or so. During the whole course of the disease, the child must have, for nourishrrient, nothing but a little boiled milk, or 160 ILIAC PASSION. thin arrow-root, or rice gruel; when it is very weak, you may give beef-tea, or chicken water. If the child is nursing, the milk is the best nourishment Lastly ; if the disease is obstinate, try change of air, to some warm, dry place, put on flannel, and let the child have exercise, and fresh air, in mild weather. Keep wool- len stockings to the feet. SLIPPING OF ONE GUT INTO ANOTHER, CALLED ILIUS, OR ILIAC PASSION. This accident, and consequent disease, may be produced by various causes; as powerful emetics, or purges, indigesti- ble- food, green fruit, and any hard substances swallowed accidentally, which clog the passages of the guts, violent cholera-morbus, and puking, or colic. Again, it may arise from wounds in the belly, hernia (or rupture), &c. It is one of the most difficult diseases to discover by symptoms at its first' attack ; for the symptoms are, at times, -very like those of flatulent colic (see page 153), or cholera-morbus (see page 157), or spasms of the belly. By careful attention, however, to these symptoms which follow, you may detect it; and if you happen to mistake it for colic, the treatment will'be tolerably correct. Symptoms.—Sometimes, but rarely, it comes on slowly and insidiously, taking months, or a longer time, before it is de- veloped; but it usually comes on suddenly, like flatulent colic, without any warning. Violent spasms and pains in the belly, belching up winds, belly puffed out; the patient tosses about, and tries frequently to have a passage, but can not, and you may-see all the symptoms which occur as flatulent colic. After these symptoms, the bowels becomes obstinate- ly costive, and if you give injections, the passages which come away are mixed with; or composed entirely.of clotted blood. Sometimes hiccough, and puking what may be in the stomach and even dung. If you feel different parts of the belly, you are apt to find a hard, irregular swelling, shaped like a gut, folded back and forward, which is the place where a part of COSTIVENESS. 161 one gut has slipped into* another, like a glove-finger drawn off hastily, or a small gut into a large one. Treatment.—As soon'as the patient is attacked, examine him and see if he has hernia (or rupture, as it is commonly called), if so, push it up. If the pulse is full and hard, and the patient strong-and hearty, bleed freely. Next, give this, if a grown person :—■ 10 grains of .calomel, 1 grain powdered opium, made into one dose, and given in a little syrup. If this does notrelieve the pain, give this:— 5 grains of camphor, 2 .grains of opium, rubbedup with a little white sugar, and given in a little warm water or syrup. You must lose no time, but keep giving injections (purgative clysters, see page 70),until you get one or two good passages, when you may conclude that the gut has-slipped out again, or the contraction and spasm removed. If, however, you do not get passages quickly, keep giving ten grains of calomel every now and then, followed in a quarter of an hour by a teaspoonful of castor-oil, and give the castor- oil in. these doses, every quarter of an hour. Put the patient also, into a warm bath, every now and then. Lastly, if you can not succeed in getting passages, give emetics of hippo, in large dosesA (see page 46), cover the bowels with warm mustard poultices (page 68), or blisters dressed with the mustard poultices, and keep throwing warm water up the fundament with a forcing injection apparatus; pump up a whole basinful, if you can, or more. Do not let your patient die for want of exertion to get purges through him, or clysters, or from neglecting any means to give relief, and loosen the gut, as emetics, warm bath, quicksilver, an ounce or more at a dose. . Tobacco injections may be tried. . COSTIVENESS. This is too often neglected, and may give rise to ill-health, or serious and dangerous diseases, or it may lead to such dis- agreeable and disgusting results, as to make life a burthen, as ill-temper, hypochondria, dyspepsia, piles, bad breath, &c. • 14#- 162 PILES. The means by which it may be prevented or removed when it is habitual, are the following:—Never neglect trying every day; take exercise on foot or horseback. If you are a female and in a family way, take a dose of castor-oil every now and then ; it will give you an easy time in labor. Take your meals regularly, and do not eat as much as your appe- tite will let you. Eat such things as these—vegetables well boiled, hard biscuits, brown bread ; eat a very little meat, and let that be game, or the meat of old animals, as beef- steak, mutton, poultry, and these rather rare. Never remain too long without eating, and take a little walk after each meal. Ripe fruit is wholesome, alsb good olive oil, eaten frequently with your meals. But avoid such articles as the following: fresh bread, highly-seasoned dishes^ as hashes and French condiments, pies and pastry, cinnamon and nutmegs, cabbages, turnips, salad, &c Should the habit be obstinate, you must use the soap as directed in page 70, or a mild clyster -every morning when you wake.—(See page 70.) If these fail, take this:— • „ 40 grains of blue pill, mass, 6 grains of powdered aloes, well rubbed up, and made into six pills, one or two every night if necessary. Or if these do not open the bowels suffi- ciently, take every morning early, besides, a moderate wine- glassful of the compound tincture of rhubarb. Should all these means fail, you must give from five to eight grains of blue pill, with the same quantity of the compound extract of colocynth, every night and morning, and continue these until the patient's gums are sore, using ari injection every morn- ing, also. HEMORRHOIDS, COMMONLY CALLED PILES. These are of two kinds, which will be described as follows: Symptoms.—A feeling of weight and tightness about the hips, and near the opening of the fundament. This feeling usually goes off in three or four days ; after a while, however it returns, and you will notice very red bipod on the surface of your passages, but not mixed up with them. This pain and these symptoms may appear and disappear from time to piles. 163 time when you will notice tumors, or risings, of various sizes, sometimes large and sometimes small, and painful or other- wise, inside, or just about the orifice of the fundament. This is one-kind. The swellings are of a dark color, and bluish, soft when you touch them ; are lessened in size When you press them, but quickly return to their former size when you remove your fingers. These tumors are generally found in clusters, and extend some way up the fundament. These are called the blind piles. Another kind are of a pale-red or brownish color, look like small fleshy warts, or hang down from the orifice of the fundament; they feel hard and spongy. These tumors ap- pear generally to be filled with blood, and are apt to become dark after a while. Several other symptoms, besides those which I have described, are apt to appear just before the, piles make their appearance. Frequently also there is a dis- charge from these piles, which is very disagreeable. Treatment of the Blind Piles.—Wash them every now and then with cold water, particularly after having.a pas- sage. If they are up the fundament, use with care an in- jection of cold water, with- a little Castile soap dissolved in it; and put a soft piece of lint over the orifice of the funda- ment, which must-be kept from slipping by a cross bandage- fastened to a band above the hips. If the piles become in- flamed and give much pain, you "must apply soft poultices, sprinkled over with lead-water (about four 'grains of sugar - of lead dissolved in a wineglass.of water). Or apply anodyne poultices (see page 68), and if the piles are outside, scarify them with a lancet, arid let them bleed well. The bowels must be kept loose, but not purging; with mild medicines.— (See page 30, Aperients.j If there is a discharge of white matter from thefundament, as sometimes happens, use care- fully injections of this :— 1 grain of blue vitriol, ", In a wineglass of cold water. Or this:— 2 grains of sugar of lead, In a wineglass of cold water. If the piles are outside, and give much trouble after this, they must be-cut. off" with a knife. 164 DIARRHC3A. DIARRHOEA, OR LOOSENESS OF THE BOWELS, CALLED BY SOME, BOWEL-COMPLAINT. Symptoms.—Large, loose passages frequently, with gri- ping, but no straining, as in dysentery, and no fever. AVhen, however, the disease lasts a long' time, there is apt to be a slight fever toward evening, or a short time after eating; the skin becomes dry and harsh, the pulse small, quick, and irri- tated ; the body wastes away, and the feet and legs generally swell, or water is formed on the bowels. The patient is apt also to feel severe pains like colic, wind in the bowels, and to have discharges from the bowels just after eating, and fre- quently you see pieces of food in the passages but half digest- ed. The passages are sometimes* slimy, or abundant and watery; sometimes dark, reddish, or whitish. This disease may be produced by various causes, as indi- gestible fbpd and drink, unwholesome bile and secretions in the bowels, or acid in the stomach or bowels, acid fruit, &c. Some persons, however, are particularly liable to it, from a natural weakness of the bowels. It is also very frequently produced by cold and exposure in damp, rainy weather. And it arises sometimes, again, from the same causes which pro- duce dysentery, as cool, damp nights in the fall after a hot day. When it arises from this last, you will generally observe the following symptoms before the disease comes on : a weight and uneasiness about thexhest, a feeling of fullness and tight- ness in the belly, bitter taste in the mouth, and bad appetite, headache, and.disturbed sleep, creeping chills every now and then, slight weariness, and aching pain in the back. Treatment.—The treatment of this disease must depend upon the cause which produced it, and must be varied from time to time, according to thesymptoms. As a general rule, follow these directions: when the disease is ofrecent occur- rence, that is to say, before it has run on so long as to be- come somewhat habitual, open the bowels with this :— A tablespoonful of castor-oil, 5 drops of laudanum,' four times a day. At night give this :— 2 grains of calomel, 2 grains of hippo. And next morning— 5 grains of rhubarb, 3 grains of Dover's powder. DIARRHOEA. 165 If the looseness of the bowels is not now checked, give this: a calomel and opium pill every three hours (see' page 71) un- til bedtime ; then stop, and if the patient is not relieved, give him warm flaxseed or starch clysters (see page 70), and put warm anodyne poultices over the whole of his bowels (see page 68). This treatment is especially proper when the dis- ease is produced by cold and exposure. If the'disease has lasted for Some time, and the discharges from the bowels are great, you must give one or two moderate doses of castor- oil, until you find that the bowels-are emptied. Then give this:— 16 grains of blue pill, 1 grain of the sulphate of morphine, well rubbed together, and made into four pills: give one pill every three hours, and if -the bowels are not checked, go on until the gums are a little sore ; then give a moderate dose of castor-oij. If the disease has just commenced, and you see symptoms of bile, and acrid substances in the bowels, which is apt to be the case when the disease comes on from cool nights in the fall, and which you can discover by observ- ing the symptoms described on page 164, give a moderate dose of the best castor-oil, and when it has operated, give these pills :— : 12 grains of hippo, 3 grains of powdered bpium, 4 grains of calomel, and just enough of the conserve of roses to make pills ; rub them up well together, and divide into twelve pills : give one pill every two hours until bedtime ; then stop, and if the bow- els are not checked, go on again with the pills. . Or you may give this after the oil has operated:—- 2 grains of calomel, A little white sugar,. rubbed up and made into eight powders; give one powder every two. hours, or every hour if necessary. If the patient is a young child, give this :— 1 grain of calomel,. 6 grains of crabs'-eyes, A little white sugar, rubbed well together and made into six powders; give ono powder every two hours. If the disease becomes obstinate 166 INDIGESTION, OR DYSPEPSIA. and chronic, and the patient wastes away, as is very apt to be the case, give this :— 2 i grains of Dover's powder, 3 grains of sugar of lead, . A little white sugar, well rubbed together, and made into four or five powders ; give one powder every three or four hours. If this fails to check the-bowels, see page 112, and follow the directions for the treatment of chronic inflammation of the mucous mem- brane of the bowels. INDIGESTION, OR DYSPEPSIA. This complaint may arise from various sources, as eating indigestible food, eating too much at a meal, eating too fast, eating meals irregularly, chewing tobacco, drinking, not chewing the food sufficiently, depressing and harassing emo- tions, a sedentary life, &<:. Symptoms.—It would be iinpossible to enumerate all the symptoms-which attend oiv precede this disease. The most important, however, are the following: variable, weak, or total loss of appetite, at the commencement of the disease; wind in the bowels, and colic pains, belching acid stuff; spirits depressed and gloomy; a constant uneasy feeling, at the pit of the stornach, and a craving of food at times, but suffering and uneasiness after eating ;-weariness, or a languid and relaxed state of the whole system, particularly a short time after eating; bowels bound, or not sufficiently free,-and tongue covered generally with a white fur; various other symptoms, also, as a feeling of choking and sinking at the stomach, &c. These symptoms differ-also, or others may appear in different subjects, according as the disease is pro- duced by one or the other of the causes which I have stated as giving rise to it. This disease, also, is of two forms.: one in which the digestive organs appear to be merely sluggish, as when the disease arises from inactive life, irregular meals, overloading the stomach, &c. When this is the case, you will see the following Symptoms.—Tongue covered with a white fur, bad appe- tite, costiveness, belching acid and disagreeable stuff, pulse INDIGESTION, OR DYSPEPSIA. 167 not much altered, and no tenderness about the pit of the stomach, wind and colic in the bowels every now and then. Treatment of the first Form of the Disease—Attend to the directions in regard to your meals, laid down in page 162, for costiveness, with this exception, eat no vegetables. By strict attention to these directions, you may have your health quickly restored. If, however, your digestion remains obstinately weak, and you do not experience relief, particu- larly if your bowels are costive, take this :— 8 grains of rhubarb, 2 grains of aloes, rubbed up with a little of the conserve of roses, and made into four pills; give one pill every night and morning, and take during the day some, mild tonic, as wormwood, camo- mile-flowers, columbo-root, gentian, or some of the prepara- tions of iron.—(See from page 64 to 67.) The second form of dyspepsia is that in which there is in- flammation and irritability of the digestive organs, and you will generally observe'the following Symptoms.—A red, somewhat marked or creased tongue, with little pimples or granules all over it, and sometimes glossy or "shining; tenderness at the pit of the stomach and near by, when you press on it; a small, somewhat hard and quick pulse, and slight fevers or irritability of the system' toward evening ; body and face thin, bowels irregular, with loose, slimy, watery, or bilious passages every now and then ; sometimes severe pain just below the pit of the stomach, a little after eating, &c. Treatment.— With regard to the treatment of this form of dyspepsia, you must pay especial and particular attention to the directions given for chronic inflammation of the mucous membrane of the bowels (page 112), as it is pretty much the same disease. If the eyes and skin are yellowish, the urine and the-passages have bile in them, as is frequently the case, give this :— 30 grains of blue pill, 10. grains of aloes, rubbed well together, and made into ten pills; give one pill every other night until the symptoms of bile are removed. Use this every now and then also : \ pint of flaxseed-tea, made a little slimy; put in four grains of saltpetre, and give a wineglass, when cold, every,hour or two during the day. 168 HOOPING COUGH. Use flaxseed and starch clysters also every now and then.— (See page 70r) In either form of the disease, if you see the symptoms of bile which I have described, you may give small doses of blue pill, with a little , opium or morphine. Use this :— 12 grains of blue pill, 2 grains of powdered opium, rubbed together, and made into four pills; give one pill ev- ery night. Or these :— •2 grains of blue pill, •i grain of sulphate of morphine, made into one pill and taken every night. Be careful not to salivate, or even-to make the gums sore. Stop with the pills every now and then. If all these fail, and the patient gets no better, carry him to Aiken, or the warm springs of North Carolina, not forgetting tlie directions about food, clo- '" thing, &c. HOOPING COUGH. Symptoms.—This disease generally commences with the usual symptoms of cold, such as uneasiness and difficulty of ' breathing, slight hoarseness,-sneering, and headache ; bow- els costive, appetite weak, patient a little feverish toward evening, and starts in its sleep. Then a dry, ringing cough begins, which lasts for two or three Weeks generally; the fits of coughing are at this time generally short, and there is no hooping. After a while, however, the fits of coughing be- come more frequent, and last a longer time ; the child expe- riences great difficulty-during-the fits, in catching its breath, from the closure of the neck of the windpipe, and you will hear a peculiar,Toud, hooping noise, every time it draws its breath in coughing, which'can not be mistaken. Notice this also : just before a fit of coughing comes on, the patient feels a tickling in the throat and chest, and a tightness in the breast, as if a cord was tied around the-chest;,which symptoms will enable you to distinguish it from any other cough. Very frequently, just after a fit of coughing, the child spits up a quantity of clear, slimy,stuff, or mucus, and sometimes pukes. The fits of coughing last longer in some cases than in others. HOOPING COUGH. 169 Sometimes they are very short, and sometimes long and very severe, and the child will turn purple in the face, or seem to suffocate; sometimes convulsions come on, or blood will gush from the mouth and nose. The disease also may last a fort- night, or four and six weeks, before it begins to abate. This is a very contagious or catching disease, but not often dan- gerous, unless very severe, or the child catches a cold. It may be taken, but not often,"by grown persons, and you never have it twice! Treatment.—If the pulse is full and strong, bleed, and if there is much pain and oppression at the chest, put leeches over the chest and to the pit of the stomach. When the fits of coughing ai'e very severe arid the patient is much dis- tressed, put your finger down the throat, so as to make it puke ; if this does not succeed, you must give an emetic of white vitriol (see page 47), or of hippo'(see page 46)"; and to relieve the cough, give this : one pint of flaxseed-tea, made a little slimy, with one grain of tartar emetic in it. Give a wineglass of this every hour, when cold. Or this :-— A teaspoonful of the syrup of squills, 1 do. antimonial wine, 1 do. paregoric, 2 do. spirits of nitre; take two wineglasses of boiling water, dissolve a little liquor- ice in the water, and mix" them all together. Give a tea- spoonful of this every hour or two. You may try this also : 1 teaspoonful of vinegar of squills, , 1 tablespoonful of the emulsion of asafcetida, made by pouring a wineglass of boiling water on 15 grains of asafcetida; mix them together, and give a teaspoonful in the same manner. Various other remedies may be used, when the cough is very violent, as syrup'of poppies, hippo in small dose's, lobelia inflata, belladonna, &c. When the dis- ease is mild, it will, in general, be only necessary to pay par- ticular attention to the patient's food and clothing, and keep it from exposure, or catching cold. Change of air is gener- ally beneficial in this disease 'K and the air of Aiken being dry and light, peculiarly suitable. 15 170 WORMS. WORMS. The worms which inhabit the human system are of several kinds, but that which we most frequently meet with is the long round worm, which varies from two to ten or twelve inches in length, and are of. a dingy-white or reddish-brown color, and larger in the middle t)f the body than at the two ends. Symptoms.—It is a difficult matter to determine the pres- ence of worms in the system by symptoms; but the symp- toms which generally appear are the following: pains in the belly, generally about the navel; bowels bound, or frequent and slimy passages ; face pale' or lead-colored, with the cheeks flushed every now and then ; eyes heavy and dull, with a blu- ish mark under the lower eyelids; upper lip swelled, and the child picks at its nose frequently; tongue covered with a fur or slime; belly swelled and hard, dwindling away of the body, fretful temper, and sometimes a voracious appetite. Other symptoms may also appear. One of the most certain symptoms is the constant picking at the nose. It must be borne in mind, however, that a child may have worms with- out any of these symptoms, and the first indication is seeing them in the passages. Worms also occasion a great many alarming complaints, as convulsions or fits, dropsy, delirium or craziness, &c. All the complaints, however, are generally cured as soon as the worms come away. Treatment.—Open the bowels well with this : a tablespoon- ful of castor-oil, with five drops of spirits of turpentine, every three or four hours, until the child has two or three passages (this is for a child five or six years old). Continue this treat- ment for two or three days'; then give this :— A wineglassful t>f the pinkroot (broken up), put into a pint of boiling water and boil down to a half-pint. Sweeten this and give a wineglassful every hpur, for a child from five to eight or ten years. About an hour after the last dose, give this :— 2 tablespoonfuls of castOr-oil, 1 teaspoonful of spirits of turpentine Or this:— 5 grains of calomel, 3 grains of jalap, 3 grains of rhubarb, ASCARIDES. 171 rubbed up, and made into one or two doses, according to the age of the patient. If this does not bring away worms, try this:— 10 grains of calomel, 15 grains of powdered pink-root (spigelia), 15 grains of rhubarb, well rubbed together, and made into five powders; give one powder in the morning, one at midday, and one at evening, for a child ten years old ; two of the powders a day for one younger. This treatment must be persevered in for several days; and, to prevent the calomel from salivating, give the calomel, pink-root, and rhubarb powders, every other day, instead of every day, and on the odd or intervening days give the castor-oil and turpentine, as directed. Should this fail, which does not often happen, see pages 25 and 26, and try some of the medicines mentioned there. The child, while it is taking these medicines, niust take nothing but very light or liquid food, as corn or rice gruel, or meat-soups, but no vegetables. Little negroes are much improved, and the ex: pulsion of worms assisted, by giving them a little good fat bacon, fried, to eat. ASCARIDES. These are very small white worms, which are found about the fundament, and cause a most distressing tickling and itch- ing about the part, which are the symptoms by which you may discover them Treatment.—Give two grains of calomel at night, for a child ten years old, and the next morning give a clyster of this:— 1 teaspoonful of spirits of turpentine, To a wineglass of warm milk. Or this:— 1 teaspoonful of powdered aloes; pour on this a wineglassful of boiling water, strain, and add when cool a wineglass of warm milk: inject with it. The injections must be repeated three times a day, and every other night give a dose of aloes, in powder, with sugar.—(See page 172 TAPE-WORM. 31.) Sometimes these little worms get into the privates of females. Then use this: — 1 teaspoonful of vinegar, A wineglass of cold water; Syringe out the privates well with this, with a female syringe, which you can get at any apothecary's. If the patient is a grown person, use larger doses; or it may be necessary to purge out the bowels more frequently and more freely. TAPE-WORM, This is a long white worm ; sometimes \t is twenty, thirty, or forty feet in length, and is found in the stomach and upper bowels. It is composed of a great many joints, about the size of a gourd-seed, which the joints resemble somewhat. This worm is apt to come away in pieces. Treatment.—A great many remedies have been recom- mended for the expulsion of this worm, and as they are not very frequently met with, my experience in the treatment for them is rather limited. I have, however, treated several cases in the following manner. As soon as a portion of the worm is seen in the passages, give this, if a grown per- son :— 10 grains of calomel, 10 grains of'jalap, rubbed up, and made into one or two doses; give one dose two hours after the other. As soon as the medicine begins to work, give a purgative clyster.—(See page 70.) When the bowels, have been well emptied, let the patient have a good bowl of gruel, or beef-tea, or chicken-water, made very salt; and he must drink very freely of green tea for five or six hours. On the following day keep the bowels well open, by giving a teaspoonful of castor-oil with a teaspoonful of turpentine every three hours, and giving this injection every now and then :— A wineglass of warm milk, A teaspoonful of turpentine, A half-wineglass of sweet-oil, well mixed. If this does not succeed in bringing away more DROPSY. 173 of the worm, repeat the medicines for three or four days. If this does not succeed, try some of the medicines mentioned in pages 25 and 26 (Anthelmintics). There is another kind of tape-worm, which has no joints : the treatment for this is the same. DROPSY OF THE CELLULAR TISSUE UNDER THE SKIN—CALLED ANASARCA. Symptoms.—Drowsiness and sluggishness of the mind, pale or sallow skin ; and when you press hard on the skin with your fingers, a pit or hole is left. The disease gener- ally commences in the feet and legs, and then spreads over all or most of the body. It may proceed from cold and a check of perspiration, irritation of the bowels, weakness after illness, eruptive diseases struck in, long-continued diarrhoea, discharges of blood from different parts, &c. It is also fre- quently complicated with dropsy of the bowels, and is then a more serious disease, and frequently is seen iri persons who have suffered much from country fevers, or live.in unhealthy places. Treatment.—If the disease is produced by continued and repeated country fevers, open the bowels with this:— 8 grains of calomel, 10 grains of jalap, given at one dose, for a grown person. If the patient is stiong, as soon as the bowels are well opened, give this: acetate of potash, as directed in the table (page 43), and give at the same time every morning, or every other morning, a dose of cream of tartar (see page 32). The patient may drink freely also of such drinks as the following: flaxseed- tea, a pint, with four grains of antimonial powder, .or a ta- blespoonful of antimonial wine, or twenty or thirty grains of saltpetre in it If, after following this plan for five or six days, you see no improvement, try some of the medicines mentioned under the head of Diaphoreticsf in the table, and also under the head of Diuretics. It is a good plan to return to the remedies which I have recommended first, every now and then. The same treatment is proper when the disease arises from cold, checked perspiration, &c. But if it is the 15* 174 DROPSY IN THE CHEST. consequence of long illness, or produced by any weakening complaint, as diarrhoea or flow of blood, or the patient is weak, you must not give large doses, but give the patient good wine, camphor, seneka, Dover's powder, &c. (see pages 14, 37, and 36). When you find that the cream of tartar gripes and produces small watery passages, with pain, stop it for a day or so, and give this :— A teaspoonful of the bark of slippery elm ; pour on a pint of boiling water: give a wineglassful every hour. DROPSY IN THE CHEST. This disease generally comes on slowly, and water may have been in the chest some time' before you notice the fol- lowing - . Symptoms.—A feeling of weight and tightness at the pit of the stomach or just above it; slight difficulty of breathing when the patient is standing up arid standing still; and when he lies doWn, walks up stairs, or walks fast, a great suffoca- tion and difficulty of breathing. He is apt to start in his sleep also, and become much alarmed; short, dry cough, particularly while lying down or walking fast, swelled feet, anxious, alarmed, and pale countenance; great thirst, irreg- ular pulse, urine high-colored, with a sediment, and small in quantity. The patient generally prefers sitting up, or lean- ing his chin over a bench or chair, to .lying down. Some- times the water is only in ,one side of the chest, and may be produced by neglected pleurisy, &c, or, when in the whole chest, by high living and drinking, and a full state of the system. Treatment.—If the pulse is full and hard, and the patient strong, bleed from the arm. Next, put a large blister over the chest, or between the shoulders, and purge out the bow- els well with two or three doses of cream of tartar (see page 32). After the bowels have been well emptied, say five or six hours after the last passage, give this :— -20 grains of powdered squills, 60 grains (1 drachm) of saltpetre, 3 grains of calomel, DROPSY IN THE BELLY. 179 well rubbed together, and made into five powders; give one powder every three or four hours. If this makes the patient sick at the stomach or irritates the bowels, divide the pow- ders in half and give them as before ; or, you may give this :— 10 grains of saltpetre, 5 grains of calomel, 2 grains of powdered opium, 5 grains of powdered squills, rubbed together, and made into two powders ; give one poW- der in the morning, and the other in the evening. If the pa- tient is weak and relaxed, as a female, after flooding, the courses long continued, &e, give this :— 3 grains of camphor, 2 grains of opium, 1 grain of powdered squills, 3 grains of calomel, rubbed together, and made into six powders.; give one pow- der every hour. Continue this treatment for five or six days, and if the patient is not better, .apply to a physician. . DROPSY IN THE BELLY, CALLED ASGITES. This disease may be mistaken, in females, for pregnancy, but you may easily distinguish it from pregnancy by attend- ing carefully to the following - Symptoms.—In dropsy in the belly, when the patient lies on her back, tbe'belly falls, as it were, to one side, and you can notice a distinct tumor or swelling, on striking which with the ends of the fingers of one hand, while those of the other hand are place opposite', you will notice what is called a fluctuation, which is a feeling as if water was in a bladder or skin. When the'patient lies on her back, also, the belly seems to flatten on the top, and press out at the sides. In this disease, the breathing of the patient is much oppressed, when lying down. There is a dry skin, thirst, the urine is small in-quantity, and when the patient breathes, the hips and the belly seem to rise higher than the chest (notice this), which symptoms do not appear in pregnancy. When the disease is 176 DIABETES. far advanced, the feet are apt to become dropsical, and some- times the greater portion of the body. This disease is gen- erally brought on by the following causes : chronic inflamma- tion of the peritoneum (the membrane which surrounds the bowels of the abdomen)—(see page 119), disease of the liver or spleen, long-continued indigestion, inflammation- of the liver, fever and ague of long standing, drinking to ex6ess, &c. Trcat?)ient.—Purge out the bowels, as directed for dropsy of the chest (page 174). Put several leeches over the belly, and when they drop off, cover the belly with a large blister, and dress the place when the blister is taken off, with cloths spread with mercurial ointment. Let the patient take the acetate of potash, as directed for dropsy under the skin (page 173), and follow the directions given there for the drinks which are to be taken. Remember also, what I said about the cream of tartar, and purgatives, when they act too violently (see page 174), attend to the directions. Lastly, if you find that your patient is not getting better, give him small /loses of calomel and opium, or blue pill and morphine, until his gums are a little sore, but do not salivate. When all medicines and remedies fail, either in dropsy under the skin, or of the belly, have the patient tapped. The food, during the whole course of the disease, must be very light, as chicken water, rice gruel, with boiled milk, &e, and when the patient is getting better, he must wear a broad flannel bandage, a little tight, around his whole belly. DIABETES, OR EXCESSIVE FLOW OF URINE. As this disease is of two forms, I will describe first, that which is called Sweet Diabetes, and may be known-by the following Symptoms.—The urine is generally in great quantity, of a pale straw color, or sometimes of a greenish shade, sweet- ish taste, and has a faint smell, like milk, or meat broths. Tongue white and foul, or sometimes red and clean; bowels generally costive; pain and weakness in the loins; pain and some inflammation about the foreskin and head of the DIABETES. 177 privates in a man ; great thirst, dry skin, mouth hot and dry, great appetite, and a feeling of weight and uneasiness about the stoniach after eatingC The patient is thin, weak, and dis- likes exercise or exertion ; headache, giddiness in the head, andv confused and indistinct eyesight; pulse generally not much altered, except when the disease is far advanced, when it is sometimes very frequent and quick, and many other alarming symptoms appear, as drowsiness, great emacia- tion, &c. This disease may last four or five weeks before the patient dies, or several months, or even years; and the patient may get better, and the disease return again and again. Some persons are much more liable to it than others. This disease is seen in children also. With regard to the cause which produces it, very little is known; but it arises immediately from weakness of the kidneys. . It must be borne in mind, that every excessive discharge of urine is not to be consid- ered as diabetes, so great attention must .be paid to the symptoms which I have described. Treatments—Physicians differ very much with regard to the treatment of this disease, and a great many remedies have been used, with various success. The disease is exceeding- ly dangerous, arid you must not delay, but resort to medicine as soon as you are satisfied of the nature of the disease. If the pulse is full and harsh, and there are other signs of in- flammation, and a fulness of the system, bleed moderately, and repeat the bleeding from time to time, taking a small quantity of blood at a time, until the bowels are natural. <. If the bowels are costive, keep them gently open with small doses of castor-oil, and laudanum, and clysters. Put cups over the kidneys (see plates), and blisters to the back, just above the fundament, or to the inside of the thighs, high up. As soon as the bowels are in a good state, give five grains of Dover's powder every four hours until the flow of urine is checked ; or this : thirty drops of laudanum in a wineglass- ful of lime-water, three or four times a day. A great num- ber of remedies have been employed in this disease, with various success, which you may try, if the treatment which I have recommended does not succeed. Some of the preparations of iron, particularly,the phos- phate, magnesia, three or fours grains of the calcined; twice a day. In cases where the patient is much debilitated, five 178 INSIPID DIABETES. grains, gradually increased from day to day, of the carbonate of ammonia, three times a day. Peruvian bark, quinine, alum, nitric, sulphuric, muriatic acid, spirits of turpentine, tinct. cantharides, camphor, asafcetida, kino, &c.—(See table of medicines, for doses, &c.)" As a general rule, the patient must wear warm clothing, avoid exposure, take gentle exer- cise, drink no wine or spirits, except "good brandy and water (weak), and take very light and wholesome food, such as is recommended for chronic inflammation of the mucous mem- brane of the bowels.—(Page 112.) INSIPID DIABETES. Under this head are comprised all of those complaints in which there is an excessive flow of urine, except the one just described as sweet diabetes. In order, therefore, to distinguish them, you must pay great attention to the symp- toms of each, as I have described them, particularly the color and appearance of the urine, remembering that every tempo- rary profuse discharge of urine, is not to be regarded as di- abetes ; as this may occur from drinking, changes of weath- er, particular drinks, teas, or vegetables, &c. Again the urine of a person changes color .frequently 'without disease; sometimes it comes away very freely, and is nearly white, or it may be dark colored, with a muddy sediment, as you may have observed in the chamber, of a cold morning, &c. But by attending carefully to all the symptoms which I have pointed out, you will find no difficulty in distinguishing the different kinds of diabetes, which is of great importance, as one kind is much more dangerous and difficult to'cure than the other. The next form of diabetes, is that in which a much great- er quantity of what are called the earthy substances, or earthy phosphates, are formed in the urihe. For, I must here remark, that the urine is composed of a great many dif- ferent substances mixed in certain proportions, when in a healthy state. And whenever one substance is formed in greater quantity than another, it produces great distress. In sweet diabetes, a quantity of sugar is formed, and this, of course, is taken away from the nourishment of the body; INSIPID DIABETES. 179 and so, also, when any of the other-substances comes away in too great a quantity. Symptoms of this form of diabetes.—An unnatural quan- tity of urine, sometimes-.very great, generally of a pale color, and sometimes white and altogether colorless. Sometimes, however, when the quantity is much greater than natural, the color is dingy or not transparent, and after it has stood some time, you will see a quantity of pale-colored grounds or sediment in the bottom of the Chamber. It generally, too smells bad after remaining a while. The patient generally suffers from indigestion, wind in the bowels,^costiveness, or loose bowels, sick stomach, bad appetite, and great uneasi- ness after eating; a feeling of pain and uneasiness, or weak- ness, in the' back or small of the back.' The passages are sometimes black, or else the color of clay, or look like yeast. When the disease has far advanced, several other bad symp- toms appear. Treatment.—If the bowels are costive, give small doses of this mixture :— 20 grains of rhubarb, 40 grains of calcined magnesia, well rubbed together, and put into a wineglassful of mint- water, or sugar and water; give half at a dose. When the bowels are opened, keep them open by giving two or three seidlitz powders a.day. Give this, also :— 2 drachms of the bicarbonate of soda, 10 grains of sulphate of quinine, rubbed up, and made into six powders; give one powder every two or three hours during the day ; and at night, give five grains of Dover's powder. Every other night, give this also :— 4 grains of blue pill, 2 grains of hippo, made into one pill. Put a strengthening plaster, which you can get at any apothecary store, over the kidneys (see plates), or if you have not this, rub the place gently with turpentine or opodeldoc. ' After you have continued this treatment for some time, give this :— 1 teaspoonful of nitric and muriatic acids, in equal proportion, mixed together, and put into a tumbler of water. Let the patient suck through a quill, a wineglass- ful of this mixture every three or four hours during the day 180 GRAVEL AND STONE IN THE BLADDER. until the sediment in the urine changes color. After this, you may give quinine, or some of the preparations of iron. (See page 67.) With regard to the patient's food follow the directions for chronic inflammation of the mucous membrane of the bowels. (See page 112.) There may be said to be two other forms of diabetes; one in which a greater quantity of what is called urea (one of the constituent principles of urine), is formed, than in any of the others. The last form, that in which one or more of the fluids which exist in the stomach and bowels, for the purpose of digesting the food, and nourishing the body, are brought away in the urine in quantity. These fluids are called chyle and albumen. But, as the symptoms which appear in these two forms, are by no means as conspicuous as those in the other two, and the complaints themselves by no means as dan- gerous, I must trust to your own judgment to treat them, af- ter the remarks which I have made. In both of these last forms, the flow of urine is more or less increased, but the constitutional symptoms are, by no means, as conspicuous,' important, or severe. GRAVEL AND STONE IN THE BLADDER. You must be careful not to confound this disease with dia- betes, as you will see some of the symptoms much alike in both. By attending, however, to the following symptoms, you may easily distinguish them. You will either see a powder pf a reddish brown, or yellow color, sticking to the sides and bottom of the chamber after the urine-has heen allowed to stand awhile and cool, or small, irregular grains, like gravel, or coarse sand, which -sink to the bottom of the chamber immediately as the urine is passed. Sometimes this powder and these grains unite and form a solid mass, of different sizes, which is called stone iri the bladder. Symptoms.—A frequent desire to pass water, a very little coming at a time, without giving relief: a heat and irritation about the neck of the bladder, and pain and uneasiness in the small of the back, about the kidneys. Wind-pains, and acid in.the stomach and bowels, and symptoms of indigestion generally. GRAVEL AND STONE IN THE BLADDER. 181 Treatment.—Attend particularly to the patient's food and bowels. He must eat nothing but the lightest and most wholesome food (see page 112), and keep the bowels open with these pills :— 30 grains of blue pill, 8 grains of aloes, made into eight pills ; give one pill every other night, and if }t does not operate, give two or three Seidlitz powders next mornino-. You may give this also—a teaspoonful of salaera- tus, in a wineglass of water. Soda water is good also; and the patient should take a little of the infusion of gentian, or columbo root, three or four times a day. Sometimes you will see the urine in quantity/and of a pale color, and by ex- amining it, when it has remained awhile, you will observe something like a thin, shining skin, all over the surface; when this is the case, the urine is very apt to become offen- sive and putrid, and the symptoms, generally, are apt to be very distressing, as wind pains, sick stomach, costiveness, or loose bowels ; and the passages are sometimes black, whitish, or like yeast; pain and weakness in the loins, &c, as in diabetes. Treatment.—If the pulse is hard and full, and there are other symptoms of irritation and inflammation, cup the loins. —(See plates). Next put a compound galbanum plaster (commonly called a strengthening plaster), over the kidneys, and give opium in large doses, say from three to four grains at a dose, three times a day, until the patient is relieved. The patient must drink rain water, as hard water is very bad. Mercury, in no form, must be given, unless in very small doses, with opium.' If necessary, keep the bowels open with castor-oil, and injections; but if they are very lodse, then give the mercury as directed. When an attack of the gravel comes on (which you will know by the hard grains which I described), and there is much pain and distress, bleed,.cup the kidneys, put the patient frequently into the warm bath, and give large doses of mer- cury, say eight or ten grains of calomel, with four grains of antimonial'powder, at a dose, until the bowels are well emptied, and pay strict attention to the patient's food. 16 182 SUPPRESSION OF URINE. SUPPRESSION OF URINE FROM INFLAMMATION, OR PARALYSIS OF THE KIDNEYS, OR SOME MECHANI- CAL STOPPAGE, AS'CALCULI, &c. This disease must not be confounded with mere stoppage of the urine in the bladder, as it is very dangerous. There maybe a complete, or only partial stoppage of the urine. The first is much more dangerous than the last. Symptoms.—-When the urine is not entirely suppressed, the patient passes a small quantity every now and then. He feels a dull, heavy weight about the hips, and sometimes pain aud tenderness about the whole of the lower part of the belly, occasionally sickness at the stomach, or puking, &c. There is generally a good deal of fever. When the suppression is complete (that is to say, when he passes no water at all for some time), the patient can taste the urine in his mouth dis- tinctly, and sometimes the whole body smells of urine. When the suppression occurs from paralysis of the kidneys, the pain- ful symptoms seldom occur. From whatever cause," how- ever, the suppression of urine occurs" if relief is not given, and the urine made to flow in about thirty-six hours, the head is apt to become affected. Other symptoms may appear, as a discharge of urinous fluids frorn the stomach, ears, &c. When the.suppression is complete, the patient is apt to die in four or five days, or even sooner. Treatment.—The treatment in this disease must depend upon the state of the kidneys, if it arises from inflammation of the kidneys.—(See inflammation of the kidneys, page 121.) Attend to the symptoms there described, and.follow the di- rections. If the suppression is the consequence of paralysis of the kidneys, from a blow, fall, or any other accidental cause, or there is no active inflammation and pain, give spirits of turpentine and balsam copaiva, say twenty oi .thirty drops of either, every two hours during the day. ^ And if the bowels are costive, give castor-oil and turpentine, until the'bowels are well purged.—(See page 71.) If this treatment does not cause the urine to flow, put a large blister over the kidneys, and give doses of calomel or blue pill (see pages 31 and 20), until the patient is salivated, and give at the' same lime, diuretics freely.—(See from page 42 to 45.) RETENTION OR STOPPAGE OF THE URINE. 183 RETENTION OR STOPPAGE OF THE URINE IN THE BLADDER. This may arise from inflammation of the bladder or sur- rounding parts, from clap, c.antharides, turpentine, using the catheter carelessly, cold and damp feet, fevers, stoppage of the courses in women, falls and blows, and various other causes. When the stoppage is from inflammation, you will observe the following Sjjmptoms.—A desire to make water frequently, attended with pain and distress; a severe burning pain, high up at the neck of the bladder, and just above the hair of the pri- vates, and the parts between the privates and the fundament feel tender when they are pressed Upon. Fever,,and some- times sick stomach, and puking every now and then. Great pain when you run a bougie or catheter up the penis. Treatment.—If the patient is strong, bleed until he is sick at his stomach, then put several leeches between the privates and the fundament, and cup him just over the hair of the privates ; or, if he is very hairy, shave some off very clean. When the leeches and cups have come away, he must sit down for some time, in a tub of warm water, up to the hips, to make the blood come away freely (that is, if he is not too weak from the bleeding), if so, wait awhile. Next, give him several mild flaxseed clysters, waTm (see page 70), until the bowels are well emptied; then let him take this:— 8 grains of blue pill, 4 grains of antimonial powder, at one dose; if it does not operate in five hours, give a dose of castor-oil, or some mild-purge. The patient must, at the same time, drink this; a cupful of flaxseed tea, warm, with one or two grains of antimonial powder in it, every two hours. If this makes him sick at his stomach, lessen the qnantity or stop awhile. When he is relieved, and the water comes away, he must drink the flaxseed tea alone, and take three or four grains of the super-carbonate of soda, in a little water, three times a day, and keep on with the hip bath, and keep the bowels open with the clysters, and some mild purge every now and then.—(See page 30.) If the water does not come away, put in a catheter. Should the disease remain obstinate, see page 122, inflammation of the bladder, attend to the symp- toms, and follow the directions given there. 184 RETENTION OR STOPPAGE OF URINE. Retention of urine may also be occasioned by chronic in- flammation of the mucous membrane of the bladder, produced by clap badly treated, chronic diseases of the skin struck in, piles, gout and rheumatism transferred to the bladder, &c, arid in this form is generally met with in old people. Symptoms.—An uneasiness and tickling in the bladder, which extends down toward the privates. After some time, this feeling is changed to a constant gnawing pain, and there is difficulty in making water ; and sometimes the water comes away of its own accord, and gives pain. The water has in it a quantity of mucus, like egg white, sometimes mixed with matter. This form of the disease is very serious, as the bladder is apt to be diseased. Treatment.—(See page 124), chronic inflammation of the bladder—let the treatment be active or not, according to the symptoms, and follow the directions given there. . It may be produced by paralysis, or loss of power in the bladder; which may be brought on by various causes, as cold, and indisposition, looseness of the bowels (diarrhoea), piles dried up, fatigue, &c. , Symptoms.—The patient has to stand some time, and strain before he can make water, and when it does come, it flows gradually weaker, and in a small stream, and keeps him con- stantly straining, while the desire to make water is increased. No symptoms of inflammation, and'the catheter can be passed in easily. This form is not dangerous, and is common in old persons. Treatment.—Draw off the water with a silver catheter, or a bougie, every five or six hours. In introducing the catheter, be careful to turn the point upward, so that it may glide along the upper surface of the water passage, in the penis; and if you find it stop, do not push on, as there are folds of the membrane like little pockets, which you may tear, but draw it back a little, and push it gently again. Always push gently. Give this, also: 20 or 30 drops of the tincture of cantharides, in a little water, two or three times a day, until it produces painful -symptoms, then stop, and rub the belly with it. If this does no good, put a blister just above the hair of the privates ; and give spirits of turpentine (see page 45), or bal- sam copaiva (see page 50).- Use clysters of cold water, &c. The stoppage may occur suddenly, and the patient feel a great desire, and make frequent attempts to pass his urine RETENTION OR STOPPAGE OF URINE. 185 without being able to pass more than a few drops, and those with great pain. In this case, the stoppage is caused by a spasmodic contraction and closure of some part of the urethra, or water-passage, There is a cutting pain in the bladder, and a feeling of bearing down, such as women in labor feel. The patient generally feels a tenderness from the orifice of the penis,,throughout, and is frequently troubled with erec- tions of the penis. The pain is greater just after the last few drops of water come away, and the patient feels a spasm about the place between the privates and the fundament (called the perinaaum). In this variety, the pain is not con- tinued, and the disease frequently terminates with a free dis- charge of urine. No fever, pulse small, difficulty of passing a catheter, very great. Spasmodic retention' of urine may also occur as a consequence of inflammation of the urinary organs, and may arise from cold, damp feet, clap, stimulating injections, distressing or exciting emotions of the mind, &c. It is not, in general, very obstinate or dangerous, unless neg- lected, or inflammation comes on. Treatment.—Put the patient into a warm bath, and give him twenty drops of the tincture of the muriate of iron, ev- ery fifteen minutes, unless there is much inflammation, or you suspect that the patient has a stricture. Give anodyne clys- ters, also.—(See page 7.0.) If these fail to bring away the water, and the patient is distressed, put in a catheter; but, if you find the catheter stopped, or stick in the passage as if it was grasped by"something, stop and rub the place between the privates and the fundament with the fingers of your other hand, but do not jerk. Lastly, if these fail, give large doses of opium (see page 15), or these pills :— 5 grains of opium, 40 grains of gum asafcetida, 5 grains of hippo, rubbed up with a few drops of the oil of peppermint, and made into twelve pills; give one pill every hour, until the patient is relieved. ' Retention of urine may occur from stricture, and requires very prompt treatment. When this happens, bleed immedi- ately from the arms, cup the loins, and put several leeches about the fundament, and near by. Then put the patient into a warm bath, and give him injections of warm water, with a little sweet oil, frequently. After the bowels have been 16* 186 STRANGURY. well emptied in this way, give anodyne clysters (see page 70), and five grains of Dover's powder every three hours ; putting the patient into the warm bath every now and then, and giving him to drink freely of such drinks as flaxseed tea, warm, and such as are mentioned under theliead of diluents (page 39). Should these means fail, intioduce a small bougie, with great care, if possible. If the patient is a female, use the female catheter. Lastly, retention of urine may occur from some obstruction of the water-passage, or neck of the bladder, from a calculus, (stone), clotted blood, tumors, &e, and in women from preg- nancy, the heavy womb.pressing on the water-passage. In every case, the treatment must depend on the cause of the stoppage. Follow the directions which I have given, and use your judgment. STRANGURY, OR DIFFICULTY AND PAIN IN MAKING WATER. . Symptoms.—Water passed slowly, frequently, with pain, and a straining about the fundament, particularly just as the last drops comes away; an uneasy feeling high up in the bladder, and a burning or cutting pain in the water-passage. This complaint is common and very distressing, and may be brought on by the following causes, as taking cantharides, blisters near the bladder, piles becoming inflamed, drinking, eating too much, and unwholesome food, excessive venereal indulgence, suppressed courses in women, calculi, gravel, and stone in the bladder, gout, rheumatism, from worms in chil- dren, fevers, clap-injections, and some other causes. Treatment.—The treatment of this complaint must depend upon the cause which produces it. If it arises from acci- dental irritation, as clap, or recent inflammation, open the bowels with some-mild purge, as castor-oil, or Epsom salts, give the patient an anodyne clyster, put him to bed, and let him drink freely of warm flaxseed tea, and diluent drinks.— (See page 39.) If these do not relieve, put leeches to the privates and the fundament; let the patient sit frequently and for some time, in' a large tub of warm water, and give a table- STRANGURY. 187 spoonful of spirits of nitre in a pint of tea ; or, if necessary, introduce a catheter carefully. Use this same treatment when it arises from cantharides. Sometimes it occurs in females from the whites ; when this is the case, take two grains of lunar caustic, dissolve them in a small wineglass of water; then take five or six grains of opium, and dissolve it in the same quantity of hot water, strain it clear; mix the two mix- tures together, and syringe with this three times a day. Use a, female syringe, to be had at any apothecary store. To cure the whites, use this at the same time; five grains of white vitriol, or fifteen grains of alum, dissolved in a large wine- glass of warm water; syringe with this carefully, frequently, during the day. When the complaint is brought on by gravel, stone, or sediment in the urine, see these diseases (pages ISO and 181), and follow the treatment there directed. When it arises from the piles, see pages 162 and 163, and attend to the directioris given there. When it occur in nervous and hysterical vvorrien, who are liable to it, and feel great pain in the bladder, at times, just after making water, give this :— 4 grains of Dover's powder, 2 grains of camphor, rubbed up, and made into one powder; to be taken three or four times a day. When it occurs in infants, from teething, they generally scream when making water. In such cases, open the bowels with rhubarb, or castor-oil (see page 33), and giye this :—" , 1 grain of calomel, 2 grains of hippo, rubbed, up, and made into five or six powders; give one powder twice or three times a day, and in the evening, two or three drops of laudanum, in a little warm flaxseed tea. This complaint is seen also in old people, and is generally caused by some disorder of the bladder; in these cases, let a physician examine carefully, and find out the cause. 188 .NABILITY TO RETAIN THE URINE. INABILITY TO RETAIN THE URINE — IT COMING AWAY INVOLUNTARILY, BY DROPS, OR ALL AT ONCE. This complaint rmy arise from various causes, as injuries of the spine from falls or blows, stone and gravel in the blad- der or kidneys} paralysis of the bladder, as in old people, from injuries of the brain, from difficult labor in women, tumors about the bladder, pregnancy. It is seen in nervous and hysterical persons, and in children, and may occur from many other causes. Treatment.-^-The treatment of this complaint must depend on the cause which produces it As a general rule, always examine the water, to see if there is any sediment, or gravel in it, particularly in children, or get a physician to examine it. If you find sediment, or gravel, see pages 180 and 181, for directions. When the complaint seems to arise from paralysis or weakness of the bladder, you may adopt the fol- lowing treatment, according to circumstances : 20 grains of alum, in a little mucilage of gum arabic, every four or five hours during the day, for a' grown person; or 15 drops of the tincture of cantharides, three or four times a day, In a little water, until the patient feels a difficulty and pain in making water. The dose of this last medicine may be in- creased to twenty, twenty-five, or thirty drops at a dose, or even more, every day. Use, at the same time,bathing with cold water, frequently repeated ;- injections of cold water up the fundament, and Cold water poured, from a height, on the belly, over the bladder, just above the privates. — (See plates.) If these do not succeed, put blisters to the back, just above the fundament, or cup the place between the fundament and the privates, called the perinceum. When it occurs in ner- vous persons, give anodyne clysters (see page 70), Dover's powders, soriie of the preparations of iron and zinc, uva ursi.—(See pages 36, 45, and 67.) When in females from the whites, see page 149, and follow the directions there given. When from piles, or ascarides, see pages 162 and 171. GONORRHOEA, OR CLAP. 189 GONORRHOEA, OR CLAP, ALSO CALLED THE RUNNING. Symptoms.—About three or four days, sometimes two days, and sometimes eight or ten days, after a person has been with a female of bad character, he will feel a disagreeable itching about the orifice of the water-passage, at the extremity of the privates. WTien this itching has lasted about a day, the mouth of the water-passage will appear inflamed and swollen, and a whitish or yellowish matter, Will ooze out of it. After this the stinging and itching increase, and when the person makes water, it burns or scalds very much. The disease soon becomes worse, and the patient is apt to feel very pain- ful erections of his yard, particularly after going to bed, called chordee. Wlren this disease occurs in women, they do not feel the same inconvenience as men, and they may even have it very bad, without suffering much pain. Sometimes, how- ever, they feel a severe scalding, on making water, and there is a great deal of inflammation about their privates, which causes great soreness and pain, and considerable running, which, at times, gets on,the inside of the thighs, and causes pimples, &c. Treatment.— Whether the patient is a man or woman, at the commencementof the disease, give every day, for three or four days, a dose of Epsom salts, with half a grain of tar- tar emetic in each dose. At the same time, the patient must drink freely of warm flaxseed tea, all day, each pint of the flaxseed tea having in it, eight or ten grains of saltpetre, or a tablespoonful of spirits of nitre. Bathe the privates, also, frequently in warm water, or put warm, soft poultices to them. If the chordee is troublesome,-take one grain of opi- um, with eight grains of camphor, just before you go to bed. Sometimes bleeding takes place from the water-passage; when this occurs, do not attempt to stop it, unless it is very great, as it generally relieves the inflammation. But, if it becomes profuse, just seize the yard with one hand, and squeeze it for 20 or 30 minutes, when it will stop. The pa- tient must remain quiet, not ride on horseback, walk much» or drink any wine or spirits, nor eat rich or salt food. When you have continued this treatment about three orTour days, and the inflammation is somewhat subdued, give this:— 190 GONORRHOEA, OR CLAP. ■j wineglassful of balsam copaiva, 1 tablespoonful of spirits of nitre, 2 teaspoonfuls of laudanum, 30' grains of gum arabic (powder), dissolved in a wineglass of hot water. Mix and shake well: Give a teaspoonful of this mixture four or five times a day. When the patient can not take balsam in this way, give the copaiva capsules, beginning with three a day, and increasing to six a day. If the disease is of long standing, give this :— ^ wineglassful of balsam copaiva, \ . do. tincture of cubebs, 1 tablespoonful spirits of nitre, 1.teaspoonful laudanum, " 1 teaspoonful of powdered-gum arabic, in a tumblerful of warm water, sweetened with white sugar. Mix and shake well, and give',a tablespoonful 4 or 5 times a day. After the disease'has lasted sometime, and the pain, sore- ness and inflammation seem to have subsided, if the running is obstinate, and becomes white, like cream, or ropy and stringy, give this :— 3 teaspoonfuls of tincture of cubebs, 1 teaspoonful of spirits^of turpentine, in a little water, three or four times a day, or this:— 20 to 25 drops of tincture of cantrharides, increasing the dose daily, until the patientfeels pain and diffi- culty in making water, then stop awhile.—(See page 184.) If these fail, try injections, as follows:— 1 grain of the sulphate of zinc, dissolved in a wineglass of water; syringe this carefully up the penis. You will find it necessary to change the injection every now and then, another is:— 1 drop of sulphuric acid, In a wineglass of water. These may be increased in strength gradually. Another is :—• 6 or 8 drops of pyroligneous acid, Or, 4 drops of kreosote water, in a large wineglass of water. There are several other kinds of injections. • A gleet is sometimes very obstinate, and will resist almost every remedy. When this is the case, smear a bougie with mercurial ointment, anrd push it some distance up the penis. This, however, must not be done if there is tenderness and inflammation. Some persons get rid of thia disease more easily, and in a shorter time than others. VENEREAL DISEASE. 191 THE VENEREAL DISEASE—THE SIMPLE VENEREAL. ULCER. Symptoms.—From three to five, or even eight days, after connexion with a female of bad character, you will feel an itchino- generally about the inner part of the foreskin of your yard, and see a redness about the place, and a short time af- terward, a small pimple or pustule, surrounded by a red edge or margin. This pimple, in a few days, is changed into a thin crust, with matter under it, and becomes quite painful. By degrees the scab becomes larger, of a round or triangular shape,°and of a yellowish or dark-brown color. < The scab now soon falls off, and leaves an ulcer, or sore, of an oval or round shape, of a reddish or dirty-yellow color, glossy or shining, and having a narrow red circle of inflammation around it. After this, the sore begins to fill up from the bot- tom, until it is higher than the surface of the skin around, of a healthy color, smooth, of a somewhat spongy or fungous appearance, and the bottom and edge of a darker-red color than the rest of the sore- The sore is at its greatest height about the fourteenth or fifteenth day, and about this time the ulceration and inflammation cease or have ceased. The foreskin, in this disease, is. apt to become inflamed and to close over the head of the yard, preventing the urine from coming away, and causing what is called phimosis. A discharge like clap also very frequently comes on. This°disease is produced by the matter of clap, or unclean and vitiated matter, in the organs of the female, and is not classed among those called- syphilis or pox, although, like them, it is sometimes followed by secondary or constitutional symptoms, which are as follows:— Slierht fever and headache, pains in the joints, and some- times°in the chest; after this an eruption of pale-red or deep- crimson spots or pimples, which become of a paler or copper color and generally scale off when they are about to disap- pear'and they come about five weeks, or even three or four months, after the commencement of the disease. The throat and tonsils also become swollen, but not ulcerated, as in true syphilis. - - - . ,. , Treatment— From the commencement of the disease, the patient must keep quiet; keep the bowels open with gentle 192 THE SUPERFICIAL VENEREAL ULCER. medicines, and take very fight food. If there is much in- flammation and irritation of the system, bleed and keep him in bed. If the skin closes over the yard, and there is pain, inflammation, and swelling there, put warm soft poultices to the place (see page 69), and observe if matter is forming un- der the string of the yard : if so, you must get a physician to let it. out. When there is not much irritation, put on warm, soft, light poultices (taking care not to let them get hard) until the scab comes off the pimple—that is, if the pimple is on the outside of the yard; but when it is on the inside of the foreskin, keep a piece of linen rag, wet with weak lead- water, between the skin and the head of the yard. After the scab has dropped off, you may use this as a wash to the sore:— 6 .grains of corrosive sublimate, In 4 wineglasses of lime-water; wet a rag, and wash the sore gently four or five times a day with it. the superficial venereal ulcer, or pustule, With well-marked and raised edges. Symptoms.—A small pimple or pustule, generally on the outside of the foreskin, or the skin of the yard itself; some- times on the forepart of the stone-bag.. Sometimes it is seen all around the front edge of the foreskin, and when it heals, leaves a lasting phimosis. The pimple soon breaks after it is formed, and leaves a crust, beneath which the skin breaks or ulcerates, and makes a sore or ulcer, of a round or oval shape. After the crust comes off, an ulcer is left, of a red- dish-brown color, with raised and distinct edges,-and having its surface on a level with, or somewhat raised above the level of the skin around. There is no-hardness around the ulcer, not much pain, and its size varies from that .of' a pea to a ten-cent piece; but if neglected, or badly managed, it is apt to spread and become much larger. This ulcer gener- ally takes some time to heal, but does not spread. In this form of the disease, secondary or constitutional symptoms generally or always come on at various periods from the com- mencement of the disease, which are as follows : an eruption HARD-SLOUGHING VENEREAL ULCER. 193 on the skin of various parts of the body, of pimples or pus- tules. These -pimples or pustules do not come out all at once, or run their course at the same time; but while some are just forming, others are scabbing. You will see also small ulcers, or sores, from which the scabs have already fallen, between these pustules, and the skin discolored in spots and patches, showing where the ulcers have been and healed up. The throat and tonsils also are very apt to be- come inflamed and ulcerated,- and the patient aptto feel pains like those of acute rheumatism. Treatment.—If the irritation of the system is great, bleed, purge out the bowels well, and give such medicines as are directed under the head of Diaphoretics (see pages 35 and 36) Nitre, and Antimonials, and put soft warm poultices to the sores, if there is much inflammation (see page 69). If there i,s not much pain and inflammation, wash the ulcers with this, four or five times a day:— 4 grains of the white vitriol (sulphate of zinc), Or sugar of lead, dissolved in a wineglass of water. The use of calomel or mercury, in any form, is generally considered wrong in this disease. THE HARD-SLOUGHING VENEREAL ULCER. Symptoms.—This species of venereal ulcer or sore is seen frequently where the foreskin folds or doubles, at the neck of the yard) just behind the ridge of the head, called the crown of the glans of the penis or yard. It is attended with much inflammation and pain about the sore, and gen- eral bad health. The sore is very apt to slough as it is called which is a destruction or rotting of the flesh around it and generally forms a deep ulcer or hole between the skin and body of the yard. The ulcer is hard, like cartilage or gristle, at the bottom, unless.it is on the head of the yard. The sore is frequently seen also on the inside of the foreskin, covered with a dark, liver-colored stuff, like decayed flesh, which soon falls off; and this goes on until the ulcer becomes deep, but it does not spread much. Mortification of the parte 17 194 HARD SLOUGHING VENEREAL ULCER. around the sore, is very apt to occur, sometimes to a consid- erable extent, and in a very short time. After the sores are healed, the spots where they have been, remain hard, and it they are rubbed or bruised, or not kept clean, are apt to break out again. This form of the disease is frequently followed by consti- tutional symptoms, which appear at times so soon, that they may be said almost to attend the disease. They are as follows: Secondary Symptoms.—A feeling of weariness and sickness generally, restlessness "at night, pale> countenance, and dull, drooping eyes, for some days. Sometimes a soreness of the chest and breast, some difficulty of breathing, tenderness of the scalp, and headache at night; and sometimes considera- ble fever. These symptoms, or some of them, usually last for several days, and then pimples, like warts, spots, or pus- tules, something like small-pox, come out, which quickly change into sores, with thick scabs, and spread around at the same time that they are healing in the middle. Pains of the joints, knees, and wrists, swelling of the testicles, ulcerations, destroying the soft bones of the nose, in the throat, destroy- ing the palate and tonsils, which, as they increase, are apt to reduce the patient to a state like consumption. Treatment.—If there is much irritation of the system, pain and swelling about the foreskin, great uneasiness, heat and dryness of the skin," bleed immediately and put the patient to bed ; purge out the bowels well, and give this:— 1 grain of tartar emetic, or, 2 teaspoonfuls of antimonial wine, in a large tumbler of water; give a tablespoonful every hour. Give this internally :— 4 grains of the sulphate of morphine, 40 grains of blue pill, - rubbed up, and made into eight pillsj give one pill in the morning, and another in the evening. Continue these until the gums are a little sore, then stop awhile. Or the calomel and opium pills.—(See page 71.) Give one in the morning, midday, and evening. If the patient, becomes very weak, give him quinine. Put warm soft poultices to the sores until the decayed flesh separates (see page 69), and then wash and dress the sores with this :— 8 grains of calomel, In a wineglass of lime water. SOFT SLOUGHING VENEREAL ULCER. 195 THE SOFT SLOUGHING VENEREAL ULCER, OR THE PHAGEDENIC ULCER, Symptoms.—This ulcer is generally seen on the head or glans of the yard, near the foreskin. The foreskin is apt to slough*or rot"and fall off, And frequently the whole head of the yard. When the head of the yard has dropped off, the sore begins to heal. Sometimes, also, but not often, the ulcer goes on sloughing, until the whole yard slowly rots and drops off". The ulcer, when it first makes its appearance, is of an irregular shape or appearance, as if eaten out by a worm, or corroded by some destructive caustic; but has wo hardness around it, as in the other form just described. It sometimes spreads rapidly, sometimes slowly. Treatment.—If possible, remove the patient to a pure air, (that of Aiken is excellent). But if there is much inflamma- tion, bleed -jmmediately, and put the patient to bed ; put warm soft poultices (flaxseed poultices are good), to the whole yard.—(See page 69.) Wash the sore frequently with warm water and castile soap. Let the patient take this :— 1 pint of flaxseed tea, warm, -1 tablespoonful of antimonial wine ; mix and give a small wineglassful every hour, or even often- er, so as to keep the patient sick at his stomach. - After the inflammation has been subdued, and the sloughing.checked, if the ulceration becomes obstinate, as sometimes happens, healing in one place, and spreading in another, wash the sore with this, four or five times a day:— 2 grains of the nitrate of silver, In a wineglass of water. If this does no good, try the wash, page 192, or that on page 194. If the ulcer is very ragged, you may^cut away the diseased or ragged part, carefully, with a sharp lancet or knife, and encourage the piece to bleed with warm water. _ Physicians generally agree that the use of mercury in this form, is decidedly injurious. Keep the bowels gently open, and if the patient is restless, give small doses of opium.— (See page 29.) 196 SYPHILIS, OR POX. SYPHILIS, OR GENUINE POX. The chancre.—This may be distinguished by die following Symptoms.—An ulcer of a round shape, as if dug out, or Bcooped out of the flesh, its inside surface perfectly smooth, with matter sticking to it, and the edges and bottom of the ulcer hard, like cartilage or gristle. This cartilaginous hard- ness is immediately around the ulcer, and does not extend any distance, but terminates suddenly, as you will observe, if you pinch up the ulcer between your fingers. This ulcer generally makes its appearance somewhere on the head or glans of the yard; but it is also seen on the body or shaft of the yard, and in this case has a somewhat different appear- ance, being of a dark liver color, with none, or very little, cartilaginous hardness around it, and having none of that Bcooped or dug-out appearance about it Remember this— a true chancre is always indolent or sluggish in its nature, and slow in its progress. You must not, however, suppose that every sore or ulcer which is found on the head of the yard, and has hard cartilaginous edges, is pox. The constitutional, or secondary symptoms of the Chancre.— These consist of spots on the skin, slightly raised, and covered with hard thin, whitish scales, wbich easily drop off, and leave smooth, shining marks, of a copper color. Sometimes these spots cluster together, and form patches of an irregular shape, copper color, and having portions of loose scales hanging to them. These spots are generally seen on the forehead, neck, breast, belly, arms, and legs. You will sometimes, also, ob- serve dry scales in the palms of the hands, and soles of the feet, which are easily broken up, and when they drop off, leave the place where they have been, thick and hard, and of a dark, dingy color. When the eruption comes out on the stone bag, between the cheeks of the bomb, under the arms, or in any concealed place, where the skin touches or rubs, the spots are not hard and scaly, but raised, soft and clammy, with a whitish matter oozing from their surface. The dry, scaly spots on the body, if not attended to when they first'appear, are apt to form scabs or crusts, with matter under them, and.where they fall off, to leave ulcers. These eruptions are frequently seen upon the mouth and throat. After some time, also, the throat becomes ulcerated, THE CHANCRE. 197 and the ulcers, which are generally on the tonsils, look like those first seen on the yard, not beingpreceded or surround- ed by much inflammation. The covering of the bones, also, and the bones themselves, near the skin, as the skull, breast- bone, and collar-bone, are apt to become affected, and en- large or swell, without much pain, or discoloring of the skin, until the disease is much advanced. These risings on the bones are called nodes. Treatment of fhe Chancre.—Wash the ulcer frequently, and dress it with a little simple ointment or lint—(See page 69.) Then give this;-— 24 grains of calomel, 3 grains of gum.opium (powdered), made into twelve pills ; give one pill morning, noon, and night, until the gums are sore. Or this :— 43 grains of blue-prll, 3 grains of the sulphate of morphine, rubbed up and made into twelve pills ; give them in the same way, until the gums are sore. As soon as the gums are sore, touch the edges of the chancre .all round with lu- nar caustic, and wash it, several times a day, with the wash (page 195). The 'gums must be kept sore (but avoid produ- cing severe salivation) for six weeks or two months, and con- tinue this treatment during this time. The patient,must wear warm clothing, avoid exposure, drink no spirits, eat nothing but light food, and keep quiet After this treatment has been continued for three months (as a general rule), and the patient seems to be no better, salivate him with this :— - 10 grains of calomel, made into one powder, and given, every night and morning, until he is decidedly salivated; then purge out his- bowels with a full dose of Epsom salts (see page 32), if the calomel has not purged him too severely. As a general rule, while you are giving medicine for the cure of this disease, you may give this, as a drink; a good handful of sarsaparilla root, broken up, and a large table- spoonful of the dry leaves of queen's delight; put these into a pot with a quart of water, and a teacupful of molasses. Boil them fifteen minutes, and then throw in. a teaspoonful of rhubarb, powdered. Cover the pot, and let it boil slowly for half an hour, or until about a half-pint, or more, of the. 17* 198 BUBOES. water has boiled away. Then take it off, put the mixture into bottles, well corked. Give a wineglassful three or four times a day, or, in obstinate cases; oftener. Should this treatment which 1 have recommended, not suc- ceed, you must apply to a physician. There are many rem- edies which I could mention, such as Fowler's solution of arsenic, ioduret of mercury, acetate of copper (or verdigris), carbonate of ammonia, and sulphate of zinc (or white vitriol). All of these have been frequently used, but according to my opinion and experience, some cases are benefited by one medicine, and other cases by others, and the directions that I have given, are the safest to follow, as a general rule. Some physicians give no mercury at. all. BUBOES. Whenever you see a rising or swelling, of a long shape, in the crease between the thigh and the belly, you may sus- pect it to be a bubo. You must be careful, however, not to mistake a femoral hernia, or rupture, for one. They are ea- sily distinguished, for if you make the patient lie on his back and put his feet up against the wall, if it is a rupture, the gut will either go up into the belly itself, and the rising disap- pear, or you can easily push it up with your fingers ; and you are apt to hear a gurgling sound, as the gut is going back. The gut, however, may have stuck to the parts-around, and so can not be pushed back, and the swelling will remain. In this case, the swelling will begint on the belly and run across the crease, on to the thighs. But a bubo generally lies in the crease, beginning above and running down toward the stone-bag. A bubo also feels either hard and lumpy, or is very painful and inflamed, while a rupture is puffy. Buboes are of two kinds : sympathetic buboes, which are seen in clap, are hard; lumpy, and generally not painful, and do not require any treatment. Those which are seenj in syphilis, or pox, may be known by the following signs :— Symptoms.—A rising in the groin, on one or both sides, either very painful, with a hard, full and quick pulse, and a BUBOES. 199 general irritation of the whole system, or, with no pain, hard, and a general weakness or debility of the system. If the bubo is inflamed and of the former kind, bleed the patient, and put leeches all around the bubo, and when these drop off, put on large, warm.Tight poultices.—(See page 69.) If the bubo comes to a head, like a bile, and does not break, and the skin is smooth, shining, and thin, showing matter in it, open it with a lancet, and keep it running with warm poul- tices. Rub the inner part of the thighs with mercurial oint- ment, once or twice ra. day; purge out the patient well with Epsom salts, and let him drink this—1 pint of flaxseed tea, kept warm, with 1 or 2 grains of tartar emetic in it, or a good tablespoonful of antimonial wine. Give a wineglassful of this mixture every two or three hours, so as to keep the patient sick at his stomach. Continue this treatment for two or three days, until the symptoms of inflammation disappear. Keep the patient in bed, on very simple and light food, and when the poultices are stopped, dress the bubo with rags wet with lead-water. If the bubo, on the contrary, is indolent, and remains with- out coming to a head, or scattering, put blisters on it. As soon as one comes off, and dries up,.put on another. If the blisters bring the bubo to a head, and you see matter in it, open it with a lancet, and put on warm, soft, light poultices, to keep it running. Sometimes after a bubo has burst, or been opened, the place remains soft and unhealthy, and discharges a watery stuff. When this happens, use this ; 5 grains of corrosive sublimate, dissolved in 8 large wineglasses of lime-water. Squirt some of this into the bubo, with a small syringe, three or four times a day, and put on it warm, soft poultices, each mixed with two or three teaspoonfuls of Peruvian bark pow- der. If the patient is weak and much debilitated by the disease, give one grain of opium, or a quarter of a grain of sulphate of morphine, every night. Keep the patient -quiet, the bowels open, and give gentle sweats. Sometimes the opening in the bubo will not heal, and has fungous, projecting edges, like proud flesh; in such cases, a physician must cut them off with a knife or lancet 200 MIDWIFERY. MIDWIFERY. How to put a woman to bed and deliver her.—As soon as the labor pains come on, let the woman go to bed. Next, when you wish to fix her for delivery, bring her down to the foot of the bed, draw up her knees until the heels touch the breech ; then draw the knees wide apart, so as to open the thighs well, and support the knees by putting a pillow, or pillows, under each of them, on the outside, so.as to leave the space between the*-woman's legs clear. Fold up a sheet or blanket four times, and put it under her rump, for the waters, &c. Put a pillow under the small of her back, and one un- der her head, if she wishes. Get everything now ready. Two or three needlefuls of white Osnaburg thread, well waxed ; a tub of warm water, soft soap (castile is the best), and a sharp pair of scissors. Take a piece of soft linen rag, about eight inches square, cut a hole in the middle of it, about the size of a quarter of a dollar, and smear one side of the rag with fresh hog's lard, or mutton suet, for the navel-string. When the waters have come away, if the pains do not come on strong in a quarter of an hour, or so (as a general rule), put your hand into cold water, and put it on the woman's belly above the hair of the privates, to make the womb con- tract, and you may even rub the belly gently, or squeeze it a little. If the pains slacken, the woman may change her po- sition for. a while, or even get up and walk about the room, until the pains come on strong enough. Then put her back in the same position. When the child's head shows, it is always a safe plan (particularly with women in their first confinement), for the midwife, or physician, to press the back of the hand (that part between the thumb and first finger of the right hand), up against that part of the woman which is between the hole of her fundament and the bottom corner of her privates, where the slit begins. Because, the privates here are very thin, and the child's head coming yery suddenly against it, or through it, before it has had time to stretch, is apt to tear it. Besides, some women have a short slit and a deep pit or bag here inside ; and when the child's head slips down into this, it requires to be pressed up', that it may come through the slit of the woman. As soon as the child is born, tie the navel-string strongly MIDWIFERY. 201 about four inches from the child's belly, with one thread, and about three quarters of an inch from this, tie the navel-string again, then cut between the two threads. You may now bring the woman's knees together, and let her lie comfortably, until the next stiong pain, which brings the after-birth. If the pains do not come on in a quarter or half an hour or so, put your cold hand on her belly, and do as I directed before. When the after-birth comes down so that you can see it, or feel it with your fingers, take hold of the cord with your left hand, very gently, and pass your right hand gently up until you can grasp the afterbirth. Then, if a good pain comes on, or the woman bears down well, draw the cord very gently and slowly until the whole of the after-birth comes away. Be careful not to pull hard or to be in a hurry, and see that you take away all the bags of the waters (or membranes), along with the after-birth (or placenta). As .soon as the after-birth has come a.way, the doctor or midwife should put their hand on the woman's belly, just above the the privates, and, by grasping it and pressing the finders down gently, feel if the womb has contracted. If the womb has contracted, you will feel a hard ball under your hand. You can then go away; but unless you feel this ball, you should remain ; because the womb is apt to bleed inside, and the mouth being shut up, it will bleed until it gets so full that it can not hold more blood, and the mouth of the womb will suddenly open, and the blood gush out in such quantities as to kill the woman suddenly, sometimes even while she is sleeping quietly. No doctor or midwife ought then to leave the room or let the woman go to sleep, until they have felt and satisfied them- selves that the womb has contracted into a hard ball; then there is not much danger of its.bleeding too much. Just before a woman is confined, give her, a dose of castor- oil, or an injection ; it is apt to give her an easier time. And after she is confined, she must be kept quiet and still in bed, for several days. Because, if she gets up or exerts herself to rise, and sit up in the bed, she is apt to produce falling of the womb ; and if she talks much, to have fever. After confinement, put a swathe, or band, around the woman's belly, not too tight . . Dressing the Child.—As soon as the child's navel-stnng is cut, wash it carefully all over, head and all, in blood-warm 202 SURGERY. water and soap (castile soap if you have it, if not, any other kind). I have seen it stated in a certain book of medicine, that "it is wrong to wash the child, and that it should be dressed just as it comes from the mother." Such a practice I think not only filthy, but positively injurious to the chikl; because, the sticky matter which covers the child, if it be- come dry and hard under the arms, and other tender parts, is very apt to produce sores. And I can assure the reader, that I have had every child that I ever attended, wasned, and not one was injured. . Now wipe the child carefully, taking care not to rub or jerk the navel-string, for it is apt to become dry and stick to the towel; and I believe that a good many cases of locked-jaw are brought on by handling the navel-string too roughly. Cut off the ends of the thread, then push the navel- string carefully through the hole in the rag, which I have directed, letting the dry side lay flat on the child's belly, the greased side up ; now turn-the navel-string down on the rag, pointing upward toward the child's chest, and fold the lower part of the rag over it, fold the two sides of the rag again over this, and put a loose, light bandage over, all around the child's belly. Now dress it, and as soon as you can put it to the mother's breast, let it nurse. A black stuff always comes away from the child for some little time after it is born (called the meconium). The mother's milk is generally sufficient to bring this away. But if it does not come away freely, give the child a teaspoonful of svveet- oil, or best castor-oil. If a child is still-born, rub the body and limbs with some spirit, and put vinegar, burnt feathers, or even hartshorn to the nose. I have sometimes, in obstinate cases, even poured hartshorn up the child's nose, and saved it. SURGERY. How to cure a Cut.—Wipe the blood off dry, and bring the edges of the cut together as soon as possible, with your fin- gers, then cover the cut with a piece of adhesive strap, the yellow side held over a shovel of hot coals. Leave a little corner of the cut uncovered, for the matter to ooze out, always the lowest corner, so that the matter will not run on the strap. SURGERY. 203 If the cut has been left open, however, and is much inflamed, put warm poultices, until the inflammation is reduced, and then put on the straps. Put on fresh straps-about every two days (unless the wound runs much, then every day), taking care to leave one old strap on until you put on a fresh one. Always wash the cut clean with water and castile soap, and wipe it dry or the straps will not stick. Boils.—Bring the boil to a head, by using warm, soft poul- tices (see page 69), and if it does not burst itself, open it with a lancet Be careful not to open it before it comes to a head. Gunshot Wounds.—If no physician can be had, keep the wound constantly clean, by washing it with castile soap and warm water; and keep on it constantly, warm, soft, light poul- tices, changing them and putting on fresh ones frequently. Never let the poultice get hard or cold. A gunshot wound seldom bleeds much, unless some large blood-vessel is cut. But it sloughs and becomes very offensive, until all the flesh destroyed by the shot, or ball, rots and falls off; then it be- gins, to heal. When it begins to heal, treat it like other wounds, dressing it with soft linen rags, smeared with simple ointment.—(See page 69.) Burns and Scalds.—These are the most unmanageable kind of injuries, and when bad, sometimes defy all treatment. As a general, rule, keep the burnt or scalded places con- stantly covered with soft rags, smeared with fresh hog's lard, or wet with lead-water. Be careful not to let two surfaces of the skin touch, or they may stick, and when burns or scalds are near joints, keep the" limb stretched, or it is apt to draw up and -grow so. Carbuncle.—This is generally seen on the back, and looks like a large boil, is very painful and hard to come to a head. It must be cutopen, and all the diseased stuff squeezed out, or pulled out with a pair of dressing forceps, then washed out clean, and the hole filled- up with lint, greased with simple ointment. (Seepage 69.) This must be pulled out every morning, and fresh lint put in. When the wound is clean and disposed to heal, put poultices on it, and treat it as a boil or other wound. . . Broken Bones.—-If no doctor can be had, put the limb straight and try and set it. You can generally tell when a bone is straight by looking at the other limb.and passing your finger along the bone. Keep the limb quiet and straight, by 204 SURGERY. putting on splints of pasteboard wet and moulded to the shape of the limb. Over these put light wooden splints, but be care- ful not to bandage a broken limb tight, for it swells and be- comes very painful. When the bone is knitting, you will see a lump. Take great care that the patient does not break the bone again, for it is very weak just after it has knit. A bpne generally knits in about six weeks, but the bandages ought to be kept on sometime after. It is useless to say anything about dislocations and other surgical cases, for they require a physician, and no person should attempt to manage them without a physician, and, of course, the patient must take his chance, if one can not be had. How to pull ^a Tooth.—Take the instrument called the key instrument; fix the claw so that the bolster will always press on the gum inside the jaw, next to the tongue. Cut the gum close to and all around the tooth, down to the bone, with a gum lancet. Wrap a piece of rag around the bolster, so as not to bruise the gum. Let the patient sit down in a chair, and throw his head back, and open his mouth wide. Now for the upper jaw stand behind him, for the lower, before him (as a general rule). When the bolster of the instrument touches the gum, put the claw over the tooth, and let the sharp points pass in between the gum of the opposite side and the neck of the tooth. Try your instrument by turning the handle a little, to see if it is firmly fixed. If so, turn steadily, but not with too much force, always inward toward the tongue, the bol- ster kept steady on the gum, and the tooth will come out. If the tooth is hard to come, try another claw, but do not force. How to bleed.—Let the patient sit up in the bed, or in a chair; make the arm which you are going to bleed from bare. Tie a piece of list or broad tape, by winding it three or four times around the arm, just above the elbow joint, mode- rately tight, but not so tight as to stop the pulse of that arm. Next, feel the vein in the hollow of the elbow, below the ban- dage, to try if it has swelled out, and feels tight, grasp the arm with your left hand, and keep your thumb pressed upon the vein, just below where you are going to stick it Next, bold your' lancet in your right hand, and let the point touch the middle of the vein, just above the thumb which is on it Now push it firmly arid steadily into the vein ; taking care not to move your thumb, and not to let the point of the lancet go too EPIDEMIC CHOLERA. 205 straight or too deep down, for you may cut through the other side of the vein; but cut from you upward. A small cut just allowing the point of the lancet to go into the vein is gen- erally sufficient. As soon as you take off your thumb, the blood flies. When vou have taken enough, generally from a pint to a pint and a half from a strong grown person, untie the bandage and take it off, then double a small piece of linen rag into four, and put it on the cut; tie the bandage round the arm, over this rag, not too tight. EPIDEMIC CHOLERA. The symptoms and treatment of this disease may be given under three heads or periods, which are easily separable, and each of which requires the administration of remedies prop- erly adapted to it:— I. The first stage (called by some premonitory) consists in most cases of a diarrhoea or bowel complaint of more or less intensity. Sometimes a degree of languor, sometimes nausea accompanies this condition of the bowels, attended by a sense of general uneasiness and discomfort In many cases, how- ever, the diarrhoea is the sole symptom. After the contents of the bowels have been evacuated, the discharges becomes thin and watery, and most commonly very copious. This condition of the patient varies from a few hours to three or four days ; and can in almost every instance be arrested by the administration of ten or fifteen drops of laudanum, with the same quantity of spirits of camphor in two or three tablespoonfuls of water. The dose may be repeated every half hour or every hour (according to the urgency of the symptoms) until relief be obtained. When much languor or - depression is present, the addition of from a half to one tea- spoonful of tincture of red-pepper, compound spirits of lav- ender, tincture of ginger or tincture of cardamom, or ten or fifteen drops of the aromatic spirits of hartshorn, will be found very serviceable. Should the means justindicated fail, one of the following powders may be givenjit an interval of one or two hours according to circumstances: calomel two to five grains, sugar of lead from a half to one or two grains; or one of the following pills, at the interval indicated above: 18 206 EPIDEMIC CHOLERA. sugar of lead one to two grains, powdered opium half to one grain. In connexion with these means, hot mustard poultices must be applied to the belly, and absolute rest enjoined. The diet should consist of arrowroot or rice gruel. II. The second stage of the disease is characterized by oppressive nausea and vomiting; the matter thrown from the stomachdaeing thin and watery. Violent cramps ensue, first of the stomach and intestines, and afterward of the muscles of the body and limbs, especially the latter. The evacuations are large and frequent. The patient very soon sinks into a state of collapse; the body becomes cold and clammy; the tongue pale and cold to the touch ; the ,skin especially about the fingers wrinkled and sodden, as if the parts had been soaked in water; the countenance pale and sunken ; the pulse which has been gradually becoming more and more feeble, is now scarcely perceptible ; and the voice is hoarse, husky, and whispering. In this condition of things, all efforts must be directed to the re-establishment of warmth over the surface, and as prompt a return as possible to the healthy secretions of the body. To effect the first: hot mustard poultices with prompt and assiduous frictions with dry mus- tard, cayenne pepper or any stimulating liniment, or the ap- plication of hot air to the surface, should be commenced im- mediately. Bottles or tin cans containing hot water, bags of hot salt, ashes, &c, should be assiduously applied about the body and limbs. To effect the second result: internal stim- ulants, with or without opiates, according to the condition of the patient, should be carefully administered. The following recipe has well served this purpose:— 40 grains of calomel, 30 grains of best cayenne pepper, 15 grains of camphor, 10 grains of powdered opium ; make into twenty pills; one of which may be given from ev- ery half hour t6 every two or three hours according to cir- cumstances. III. The third stage, that of reaction from this state of collapse resembles very strongly, with some modifications, an attack of mild typhus fever. As the frequent anomalies, how- ever, which are exhibited, can not well be given in detail, it is impossible to offer any special treatment which would be generally applicable. DIRECTIONS FOR RAISING NEGROES. 207 When the disease attacks suddenly after a full meal (which it sometimes does, the patient being suddenly seized with vio- lent and excruciating cramps), the exhibition of some prompt emetic is absolutely necessary. The following will answer all the purposes required, viz.: one tablespoonful of common salt, and a good teaspoonful of strong mustard carefully rub- bed up in a half tumbler of warm water. This dose may be repeated in the course of ten or fifteen minutes if necessary. After the stomach has-thus been evacuated, the means indi- cated above may then be pursued, as the condition of the patient may demand. Nothing'has been said in reference to bleeding, because no general directions on this point can be-made applicable. A physicianjnust judge of the necessity before the remedy should be employed. Under the head of preventives, nothing is of so much con- sequence as general and individual cleanliness, combined with a simple wholesome diet. Should the disease break out upon a plantation or appear in its neighborhood, a general purifi- cation should be rigidly insisted upon; and immediately upon the occurrence of the'first case, a strict system of isolation should be at once commenced and continued during the prevalence of the disease. GENERAL DIRECTIONS FOR RAISING NEGROES. On every plantation great care should be taken in the buildingof negro-houses. The ground on which negro-houses are to be built should be raised higher in the middle, to allow the water to run off, for negroes will throw slops about them. If the spot is low, it should-be well drained. Every house ought to be raised on blocks, or pillars, at least three feet from the ground, to allow the air to circulate under thpm free- ly and to avoid dampness. The floors should be tight not only to prevent cold wind from affecting them, while asleep, but to prevent them from pouring slops through the floor; which, in my opinion, frequently gives rise to typhus fever. Every house should have a good chimney, for negroes sleep as often by the fire as in their beds. Some believe that smoke 208 DIRECTIONS FOR RAISING NEGROES. is wholesome. I do not deny it; but if a patient is sick, particularly with any complaint of the chest, as pleurisy or pneumonia, breathing an atmosphere filled with smoke is ex- ceedingly injurious, and' frequently fatal, as I have expe- rienced. One sleeping room, at least, in every house, should have a seat with a hole and cover, for the calls of nature ; because there are seldom or never any conveniences in the way of chambers; and if they had them, they would immediately break them. It is almost a universal practice among negioes to go into the open air for the calls of nature, in all kinds of weather. This may answer when they are well, but in sick- ness they require more comfort. 'I have known several cases of relapses which proved fatal, only because the patient was taking medicine, and was compelled to relieve himself in the open air, in the most inclement weather. Planters can not attend to these little matters always, and plantation nurses generally will not. On every plantation, also, there should be a capable and trusty nurse, to attend the sick and to report all new cases. A faithful and trusty woman (not as is commonly the case, a decrepit old woman), but a strong, able, and healthy woman to attend the negro children ; for mothers who have infants at the breast will frequently obtain leave of absence from the field to nurse their infants and employ the time given them in sleeping. The person Selected for the little negroes should also be made to cook for them, and to see that they are fed regularly with victuals well cooked. For it is a common practice among negroes to eat victuals half raw, and of course to give the same to their children. Some do it from laziness, others from ignorance of cooking, and some leave the feeding of their children entirely to their little nurses. I have several times been called to attend little children on plantations, who were poor and emaciated, and as the planter or overseer termed it, not thriving, but who were evidently suffering actually from starvation and want of water, owing to the negligence of their parents and little nurses. Now a planter who would make such a regulation as to insure each child having two meals well cooked, a day, and which, even on a large plantation could be performed by one person cooking for all at once, in one large, or two or three cooking utensils, would, in my DIRECTIONS FOR RAISING NEGROES. 209 opinion, be richly repaid, not only by the number of children raised, but he would positively save in provisions ; for it is a common thing for negroes to keep their week's allowance of provisions carelessly emptied on a shelf, or table, in their houses, exposed to rats, fowls, and to general waste. Their salt is kept in the same way, and it is evident that they or their children, who are so improvident, must frequently suf- fer, or the loss must be made up by stealing from the others. Now it is evident that the average of a peck of corn a week, to each grown negro, is ample allowance, for with all their waste, some raise several fowls and hogs, and few are without a dog. It is an old custom to give each negro their allow- ance, and no doubt the provident save the surplus, and with the proceeds, either sold or bartered, procure many comforts. But I believe that if the experiment was generally made of having the food of the grown negroes all cooked together, and meals served to each regularly, it would not only be more satisfactory to the negroes themselves, generally, but the planter would be enabled by what he saved in provisions, to give them many a meal of bacon, than which no food is more palatable or wholesome for a negro. The negroes, also, would be more healthy, for they would eat at least two meals well cooked, during the day, and be,in a measure, prevented from sitting up and gourmandizing at night, a practice which is very common, and seldom fails to induce indigestion, di- arrhoea, and constant indisposition. The use of bacon, also, is a great preventive of indigestion, for the grease acting mechanically on the bowels, causes the food, even if half cooked, to pass through the bowels more easily and quickly. It has been observed, that in all countries where the work- ing-classes use olive oil (and among most of them the food is worse than that of our negroes), diseases from indigestion, such as dyspepsia, cholera-morbus, diarrhoea, dysentery, &c, with'which our negroes are constantly affected, very seldom occur. It is a notorious fact, also, that in all countries, the peasantry who are much more exposed, and work much harder thin our negroes, nevertheless increase rapidly, and raise a great many children, while the reverse takes place on our plantations. And I sincerely believe that it is owing to the causes which I have mentioned, and the planter who wishes his negroes to be healthy, must not allow them to indulge 210 DIRECTIONS FOR RAISING NEGROES. their natural propensities. In Africa, in their free State, they are among the most barbarous inhabitants of the earth, living in the woods and subsisting chiefly on the natural productions of the earth. They retain their habits and propensities the same among us, and we must not expect to find among them the same providence or civilization as is observed among the poorest classes in Europe. I have known plantations on which the increase of the negroes bore a fair proportion to the crop, and made up the losses of them, and where planters, working poor lands, thus kept,pace with those planting the best, and even surpassed them. In one case, ten infants were born the same year, and all raised, and no death occurred on this place for three years, except one from old age. The regulations here were such as I have recommended, and strict attention paid to the cleanliness of the negroes, and a punish- ment inflicted on all who were seen ragged and dirty. I have observed that those negroes who were the most filthy in their persons, were generally, also, the most unhealthy, and many diseases of the skin which are supposed to be scrofula, and treated as such, arise entirely from filth of the body. Planters should also supply their negroes with combs, and enforce the use of them daily. Many of the eruptions which appear to be diseases of the scalp, are caused entirely by vermin, and consequent scratching. Finally ; I am convinced that if more system and discipline (like regulations in an army), were pursued on plantations, the condition of the negroes, as well as'that of the planter, would be materially improved, and the per-centage of the latter, which seldom reaches, or at least exceeds, in the course of years, seven per-cent. on his investment, would be much increased, as also the condition of our entire population at the'south rendered more flourishing, all classes of which, professions and trades, are affected, more or less, by the success or failure of the planter. THE END.