WR mm Boats THE INDIAN DOCTOR'S PRACTICE OF MEDICINE. DAILY'S FAMILY PHYSICIAN: IMPORTANT TO EVERY ONE ! % HEALTH THE POOR MAN'S RICHES!—THE RICH MAN'S BLISS! GIVING THE SYMPTOMS OF DISEASES, AND A ^> VEGETABLE TREATMENT OF THE , / J.i MEN, WOMEN, AND CHILDREN. BY WILLIAM JUILY, M. D LOUlVlLLE: N. H. WHITE, PBINTER, MARKET STREET, 1848. \Af-BA United States op America, District of Kentucky, * * Beit remembered, That on this 26th day of Septemb^S, William Daily, of said District, deposited in thii^ce the title of a book, which is as follows, to wit: "The V^afl Doctor's Practice of Medicine. Daily's Family Physat* • Important to every One : Health the poor man's riches lbs rich man's bliss I Giving the Symptoms of Diseases, ad » Vegetable treatmenftrr-^ diseases of Men, Women, and QuV- dren. By William Daily, M. a>.»*-. _ The right whereof he claims as author- *^ n-oprietoT, in conformity with an Act of Congress, entitled "an ActitrTMaend the sevpral acts respecting copy rights." {Attest) JNO. H. HANNA, Clerk District of Kentucky PREFACE. The study of health, in opposition to that of disease, is but of modern date. From the remotest period to the present time, men of the profoundest erudition, of unquestionable virtue, knowledge, and laborious industry, have devoted themselves to the study of disease. What is the result ? Is mankind more free from pain and misery ? Are fixed principles, simple and. easy of comprehension, more publicly known and applied ? Has conviction on any well founded theory united in one mind and one judgment, men of such laborious study ? Alas ! we too well know a direct negative to each of these must be giv- en ! Diseases, with names unknown to our forefathers, and of awful nature, are constantly presenting themselves to afflicted humanity, baffling the skill of the most learned physicians, and setting at naught all their boasted knowledge; witness the scourge of nations, Cholera Morbus. Instead of any known, fixed principles, by which men are enabled to apply effective remedies to ordinary appearances of disease, and thereby pre- vent it, all is veiled in studied mystery; from the dissecting- room to the most common prescription, all is darkness, igno- rance, and gloom to the people, and that "Doctors disagree" among themselves has become a proverb. How long shall such a state of things continue ? When will men open their eyes to their own dearest interests on earth, and reason and act with regard to their health as they would on any other sub- iv feet ? When will men cease to brand with opprobious epi- thets, and treat with contempt, those who dare to tread out of the beaten track! True it is, some (perhaps many) may with mistaken views seek .their own interest: but do not all seek this ? And are not all, the most regular, as well as the most irregu- lar, acting from the same motive with the 3ame object ? Then from whom does mankind suffer most ? Let disease and let death answer ! But now a brighter day is dawning. OB the earth; the sun of a simpler system is struggling through the clouds which would in vain retard its beams', and the Science of Health is rising to dispel the darkness of ignorance and pre- judice, and to light men on the direct pathway, in their search after happiness. This system will approve itself to all; it veils itself in no mystery; its affects no concealment; it "comes to the light;" it grasps all diseases—and, without dis- tracting by endless diversities, points them at once to the root of all. It does more; it tells all how to apply a remedy; and yet more, it brings in its hand, health and cure, and avows the nature of its medicines. Let us view the works of Nature for a few hours. Standing on a hill or a mountain in the East, and casting our eyes over the the surrounding valleys, we behold with admiration the dif- ferent kinds of trees, sending forth their buds and flowers, of different hues and colors—the peach, the apple, the oak, and the pine, and the fields of wheat and corn. With a second glance of the eye, we view with equal admi- ration, the water, with it silvery brightness, desending to the centre of the valley. As we pass along the stream, and hear the birds chirping and singing, we are struck with amazement at the melody, and involuntarily exclaim—What is this ! A still voice utters—Nature! Nature!! Nature!!! 0, Nature, I V will follow you farther, and trace your streams up the Alloga- mies, and every thing is glittering: green Nature is here. 1 travel still farther, to the Western Praries, in autumn, and there I behold beautiful flowers with the richest odour: Na- ture still. If I travel to the Rocky Mountains, and over them to Oregon, and there I see the valley studded with vegetables ; Nature still. Let us travel from Maine to the shores of Louisiana, and we will find that every fruitful valley has her different diseases. As we have been viewing Nature, let us see if she has not plac- ed there a remedy for every disease. iBy aid'ung Nature, she will begin her healthy action as naturally as water rolls over a cleft or doAvn a descent. We see every science on the advance; and there is still room for improvement in Louisville, as well as elsewhere. In the treatment of Dysentery or -Cholera Morbus, we hear of deaths every day. Perhaps our medical brethren do not aid nature, or they would not lose so many of their patients. If they would give a little soda to neutralize the acid, or some mint tea, essence of peppermint, essence of cinnamon, or No. 6, to relieve the cramps, and a strong tea of brier root and cin- namon bark with, slippery elm and charcoal, they might in an hour or two cure their little sufferers. I am curing from five to ten each day, without the loss of any, by the above practice. A physician never should destroy the system with strong medi- cines, while there are so many innocent, yet powerful medi- cines in Nature's garden. I give in this little book the names of the diseases that 1 have treated with a vegetable treatment. I only intend giving my own individual practice. I wish the reader to bear in mind, after he has examined his Vi patient in acute forms of disease, that the great object to be accomplished in the treatment of fevers is, to use the most prompt and energetic means to expel the disease from the sys- tem. If is inconceivably important to attend to the skin. The dry, hot, and parched state of the skin points out the necessity of promoting perspiration in all cases. Where debility is great, obstructions exist in some parts of the system, but espe- cially in the skin. Hence the insensible perspiration, by Avhich several pounds are daily discharged from the healthy subject, is checked, and by the matter thus accumulated, retained in the system. Therefore, you must equalize the circulation, and you will expel the disease, and nature will perform her healhy action with the use of milder means, such as tonics, &c. WILLIAM DAILY, M. D. SYMPTOMS OF DISEASES. Contagious—the result of organic actions. Miasmata—the result of physical changes. Heat. Specific temperature of the human body, 98 °. Most agreeable temperature of surrounding air, 65 °. Atmospheric heat not a deleterious agent; predisposes to the influence of morbific causes, increases the secretion of bile; indirect cause of disease, by favoring the generation of mias- mata. Dr. Johnson observes, that solar heat only produces the predisposition; while terrestrial exhalations, and vicissitudes of temperature, call into action the prin- pal diseases of warm climates. Cold. No positive existence—a mere relative-degree of tem- perature ; lessens the action of the heart and arteries; causes a shrinking of the surface of the body; diminishes sensibility and contractility; produces irresistible disposition to sleep, and depresses the moral and physical energies of the system, when long and intensely applied. Suddenly or transiently applied, it excites the nervous system. In alternation with heat, a fertile cause of disease; the diseases resulting from its influence, mostly pneumatic, catharrhal, or rheumatic : cold water externally a pplied, or received tnto the sto- mach when the body is heated and in a free state of perspi- ration, often proves suddenly fatal. Always more injurious in its influence when accompanied by moisture. Miasmata. Heat and moisture essential to the production of 8 miasmata.* Moisture need not be abundant; inundated grounds extricate little or no miasmata; hence the rainy sea- sons of tropical countries are the most healthy. Miasmata are seldom generated at a temperature below 80 °; their precise nature unknown; there is reason to believe that they consist of particles of putrid vegetable and animal matter, dissolved in aqueous vapor. Chemical analysis can detect no difference between'the air of marshes and atmospheric air. Gaspard's experiments on putrid matters received into the body, support the opinion that marsh miasmata consist of putrid vegetable and animal matter suspended in the air. Miasmata possess greater specific gravity than atmospheric air; they are conveyed to a considerable distance by currents of wind; the distance of which they are capable of infecting, by being thus carried, is from two or three miles (Bancroft says, but one-fourth of a mile;) storms and violent blasts disperse and render them innocuous; more danger in mias- matic atmosphere at night than during day; most danger about the rising or setting of the sun; situations are protect- ed from the effects of miasmata, by interposing articles, as houses, walls, wood, hills, &c.; long and gradual exposure to miasmata, destroys the susceptibility of the system to their more violent influence. Persons unaccustomed to them sel- dom escape disease, when subjected to thek-action. They produce intermittente and remittents, of various grades of violence. Contagion. A deleterious agent, generated by the living body in a state of disease. The diseases produced by this class of causes, preserve a determined or specific character; contagi- ous diseases divided into chronic and acute; the latter seldom affect the same person more than once; the former may af- fect repeatedly; in the acute, there can be no relapse. Con- tagious matter either a palpable substance, or an impercepti- *It has lately been contended, that moisture is not essential to . the generation of miasmata; but as I believe, withoui good grounds. 6 9 ble effluvium"; chronic contagious affections always produced by the former, and by actual contact; some acute contagious diseases communicated both by contact and through the me- dium of the air, that is, both by a palpable virus and an effluvium. Typhus fever, under certain circumstances, con- tagious ; appears to be propagated by effluvia only. Contagious effluvia extend but a short distance sufficiently concentrated to produce disease. The experiments of Dr. O'Ryan make it but a few feet—four or five feet; currents of air will convey it much further; contagions rendered harm- less by diffusion in the air; hence the utility of free ventila- tion; contagion attaches itself to various substances; the sub- stances most apt to receive and retain it are, wool, hair, cot- ton, wood, cloth, &c: contagion influenced by certain oc- cult conditions of the atmosphere; contagious diseases com- municated from the inferior animals to the human species. Disinfecting means—cleanliness; free ventilation; muria- tic and nitrous vapors, lime, fumes of sulphur and heat. SIGNS. Signs divided into those exhibited by the countenance; the attitude; the nervous system; the digestive organs; the circu- latory system; the respiratory organs; the circular surface; the lymphatic system; the secretions. The Countenance. The features to be particularly examined, are : the eyes; the prolabia; the nostrils; the lips; the brows. In acute simple fever—eyas and face red; respiration hurried; motions of the nostrils rapid. In acut9 sympathetic fever these signs are absent.—Hall. Acute pain from inflammation in the chest; features much con- tracted; the alae nasi acute and elevated, the nostrils con- tracted and expanded by the acts of respiration, sometimes a vivid flush terminating abruptly—heat inconsiderable, 10 Dull pain in the chest: less constriction of the features; an expression of great anxiety; nostrils widely dilated before inspiration. Effusion into the lungs: countenance livid, anxious, turgid, with great dyspnoea, and dilation of the nostrils on inspi- ration. The phthisical countenance. Acutepain in the abdominal viscera: features acute; forehead wrinkled; brows knit; nostrils drawn up and acute; un- der lip drawn down, exposing the teeth. Organic affections of the heart: countenance anxious, vividly flushed ; prolabia livid : face turgid, cedematous cold. In hydreihorax, the face has a pale-livid aspect. Soporose affections: flushed, livid, tumid, eyes closed or open and fixed, mouth frequently drawn to one side. In syncope: pale, shrunk, cold, and death-like. In chlorosis: pale, exsanguous, icterode; puffy; a peculiar darkness accupying the eyelids, and extending towards the temples and cheeks, and sometimes surrounding the mouth. Distinction between the icterode appearance, and the different shades of icterus, (Hall;) the yellojjish tinge in the latter is particularly seen in the albuginia of the eyes; in the former the eyes remain untinged. The tinge of icterus depends on bile, that called icterode, on a morbid action of the cutane- ous capilliaries. (Hall.) Chronic irritations of the bowels: puffy countenance; upper lip pale and swollen; occurs in verminous affections and in scrofula. Attitude. The healthy attitude : *fe. Advantages to be obtained from position, in the treatment of diseases. Preternatural determination to a part, diminished by elevating such part; the head to be raised, in apoplexy; the extrem- ities when affected with inflammation. 11 Supine position, with tremulous motion, indicates much mus- cular debility. Fever from acute local inflammation: not attended Avith mus- cular prostration. Characteristic position in hydrothorax.* in slight cases, herd and shoulders elevated Avhen in bed; in severe cases inabi- lity to lie down; the erect position more urgent, Avhen com- plicated Avith organic affection of the heart. When sitting up, hands forcibly pressed on the chair on Avhich the patient sits, or leaning back, with the arms and hands placed behind the back. Thoracic effusion, distinguished from mere organic disease of the heart and lungs by the effects of firm pressure on the epi- gastric region, and bodily exertion. Effects of pressure, in effusion: general agitation, cough and a sense of suffocation; not so, or but slightly in organic affections of the heart and lungs; bodily exertion excites more dyspnoea, and distress in effusion, than in organic affections. Position assumed by the patient in abdominal inflammation, with acute pain: fixed, carefully avoiding all motion and pressure; generally on the back, knees drawn up, and head and shoulders a little elevated. Positions assumed of spasmodic pains in the abdomen.- con- stantly changing posture, desirous of pressure on the abdomen, recumbent on the belly, &c. Position on the back, with knees constantly elevated in the latter stage of acute diseases, a sign of retention of urine. The Tongue. Attention to be paid to its color, its surface,, its ' shape, and tne manner in which it is protruded. A white aud slightly loaded tongue, indicative of slight gastric deranyfnent and moderate febrile excitement. A clean, deep red, smooth tonge, indicates inflammation or high irritation of the mucous membrane of the stomach and intes- tinal canal. Toiaeue seldom much affected in acute symptomatic fevers, from Avounds or external inflammations. 12 Florid papillae, protruding through a layer of white fur, charac- teristic of scarlatina. (Hall.) Diagnosis, from the appearance of the tongue, between phthisis, and hectic with cough from hepatic and gastric affections : tongue natural in the former, covered with brown fur in the latter. A pale and tumid tongue, with large papillae, indicative of gas- trie debility—met with in chlorosis. A contracted and pointed tongue, frequently an attendant on cerebral or meningeal inflammation. A flabby and dilated tongue occurs in congestive states of fever. (Miner.) A yellow and bitter tongue, indicative of biliary derangement. Morbid States of the Nervous System. Disturbed Sleep. Coma always denotes oppression of the brain. Wakefulness, a sign of great irritation or exhaustion. Sudden starting in sleep—intestinal irritation from worms, &c. Hurried wakings, with a horrific sense of suffocation, a sign of organic diseases of the heart. Strabismus, double-vision, signs of celebral affection. Torpor of the sense of touch. Morbid sensations. PAIN. Pain may arise from inflammation, from spasm, and from ner- vous irritation. They have each their peculiar character. Inflammatory pain: tenderness of the part, increased by pres- sure ; throbbing or burning continuous, and attended by fe- brile excitement. Spasmodic pain: paroxysmal, not throbbing nor burning, re- lieved by pressure, and seldom attended with fever. 13 Neuralgic pain: transient but violent paroxysms, darting along the nerves with the rapidity of lightning; no swelling, no heat, and readily renewed by the slightest touch. Inflammatory pain, modified by the nature of the structure in which the inflammation exists. Diagnostic inferences. Pain referred to parts remote from that in which the primary af- feetion resides. Alimentary Canal. Nature and appearances of the alvine discharges. Clay-color- ed faeces indicate deficiency of bile—met Avith in jaundice. Diagnosis between infantile remittent and hydrocephalus— the alvine discharges in the former are a dark brown, or mud- like and very foetid—in the latter, glairy dark-green, like chopped spinage. (Cheyne.) Watery and reddish stools, like the washings of flesh, Mucous and bloody stools. Respiratory Organs. Accelerated respiration always attend- ed with frequency of the pulse. Irregular and unequal res- piration indicates cerebral oppression : slow, irregular, and stertorous breathing attends a high degree of cerebral compres- sion. Abdominal respiration, indicates pneumonic inflammation. Breathing with the intercostal muscles, without the accesory action of the abdominal muscles, indicates abdominal inflam- mation. Peculiar respiration in hydrothorax: inspiration quick, and with great effort; respiration slbwer, without effort. (Hall.) The effects of corporeal exertion on respiration produces great dyspnoea in hydrothorax, and still more in organic cardial af- fections. Wheezing respiraiion—in asthma, cynanche trachealis. Hur- ried, panting, and heaving respiration, with sighing, often at- tends intestinal irritation and exhaustation from haemorrhage. (Hall.) 14 Cough. When the efforts of coughing are anxiously repressed, there is probably inflammation in the chest or abdomen. Spasmodic cough—in pertussis—sometimes from irritation of the stomach. Si'uta. White cream-like, in'chronic bronchitis. Effects of full inspiration and expiration, as a diagnostic Cuticular Surface. Its temperature; its color; its state of dryness or moisture; its fullness or construction ; its rough- ness or smoothness. A yellowish tinge indicates biliary derangement, not to be con- founded with the sallowness which occurs in eancer and chlorosis. A purple or blueish color occurs in infants, from previous fora- men ovale. Dark colored or purple spots—extravasions of blood. A pale, semi-transparent skin, particularly of the prolabia and face, manifests paucity, or very serous, blood—after profuse bleedings and from anamia. Cold skin, with a feeling of internal heat, denotes internal di- gestions. Color mordax—in typhus. Permanently dry and husky skin, indicates torpor or chronic disease of the liver. Urine. Small in quantity, and red in inflammatory affections ; copious and limpid in nervous diseases. Bilious urine. The various sediments—lithatas; phosphates;" the former are red or purple—the latter, Avhite or pale yellow. 15 THE PULSE. The pulse varies with the age of individuals; at birth it beats from 130 to 140 in a minute: mean rate for the first month, is 120 ; limits during the first year, are 106 to 120; for the second year, from 90 to 100, for the third, from 80 to 90— nearly the same for the fourth, fifth, and sixth years; in the seventh year, pulse about 78; from the twelfth year, it differs but little from that of adult age, which is estimated from 60 to 80, according to individual constitutions, &c. (Heberden.) The common standard of frequency may be placed at from 70 to 75 beats in a minute. (Falconer.) From the 45th to the 6th year, the pulse gradually becomes sloAver; after this period, it again rises in frequency. (Floyer.) Generally more fre- quent in women than in men. (Falconer.) Climate influen- ces pulse; more frequent in hot than in cold countries. The time of day: sloAver in the morning than at other times; most frequent soon after dinner; slower during sleep than in the waking state. Bodily exercise accellerates the pulse; varies according to the position of the body; slowest while lying down; slower Avhen sitting than when standing. (Dr. Robin- son.) Mental excitement influences the pulse; joy, and an- ger, render it fuller and more frequent; grief, sorrow, and fear, depress it. Mode of examining the pulse. [Celsus, Rush.] Not to be examined immediately on entering the patient's room;—the examination to be repeated at short intervals; should be felt in both wrists, the arm. having its muscles relaxed by proper positions ; two or three fingers to be applied to the artery; thirty or forty pulsations are to be felt at each examination; examined in different positions of the body : talking must be forbidden. Pathological Condition op the Pulse ; considered in re- lation : 1. To the force of pulsations. 2. To the rhythm or mode of the pulsations. 16 The most prominent and useful pathological states of the pulse, consist in: frequency, quickness, strength, fulness, hardness and irregularity. A frequent Pulse is one in which the pulsations suc- ceed each other with preternatural rapidity; a pulse beating more than 160 in a minute, is scarcely to be counted; great frequency of pulse always connected with great prostration of the vital energies; frequency, with fulness and strength of pulse, more dangerous than the same degree of frequency, with softness and moderate fulness. When it rises above 120, in inflammatory fevers, much danger is to be appre- hended. (Heberden.) Slow Pulse : occurs from cerebral compression—inter. nal.venous congestions, and impairment of the vital energies; as in apoplexy, congestive fevers, and malignant fevers. Quickness of Pulse : often confounded, improperly, with frequency. Quickness refers to the suddenness with which each individual pulsation is made—-frequency has re- ference to the number of pulsations in a given time. Quick- ness, however, is generally attended by frequency. A strong Pulse is one which gives the sensation of pre- ternatural resistance to the finger, during the diastole; not to be confounded with a hard pulse. It is hard, when the artery is felt firm under the finger like a tense cord, both in its systole and disatole—sometimes called corded. Strength and great frequency never united, a strong pulse seldom ex- ceeding 115 beats in a minute ; a strong pulse indicates en- ergy of the vital poAvers, and is therefore favorable. A feeble Pulse, the reverse of a strong pulse: it is feeble, Avhen the artery produces a weak impulse against the finger, during its diastole. Feebleness and softness of pulse, not synonymous—the artery may resist pressure, and yet pul- sate very feebly. The pulse is soft, when the artery appears to be filled, and yet offers no resistance, vanishing by slight pressure. 17 A very soft Pulse seldom attended with great frequen- cy, or Avith irregularity; occurring in advanced stages of fe- - vers, favorable, Avhen joined Avith great difficulty of respira- tion, and suffused countenance, in pneumonic inflammation. indicative, of much danger. Full Pulse. Never very frequent; sometimes much slower than natural. Small Pulse—the diameter of the artery is smaller thar natural; in inflammation seated above the diaphragm, the pulse is generally full—when seated below it is small. (Borden.) Depressed Pulse: small, and apparently feeble, and occasionally quick, does not depend on actual debility or exhaustion, but on intenal venous congestion; small and ob- scure in the beginning of acute diseases, we may presume it is depressed. Intrmittent Pulse : when not attended by other alarm- ing symptoms, not in general a dangerous sign; pulse- sometimes habitually intermits; it is said to be of dyspeptic origin ; occurs frequently in old age, and then probably depends commonly on some affection of the heart; occur? also in affection of the brain; a very unfavorable sign, in the advanced stage of fevers, with great prostration ; is said fre- quently to precede a critieal diarrhoea. (Senac, Solano, Coxe.) Unequal Pulse: synonymous with irregular pulse.—Charac- terised by a constant variation of the pulsations, in frequency. quickness, size, hardness, &c. More dangerous than an intermittent pulse. Dicrotus pulse, twice-beating. Gaseous Pulse: tumid—inflated—soap-bubble: always indicates much prostration. Undulating Pplse: a Avave-like rising and falling of the pulse; generally large, soft, and feeble. When very small, it is termed creeping; highly dangerous. B 18 A morbidly natural Pulse: occurs in malignant fevers; exceedingly unfavorable; can only be distinguished from a healthy pulse by the concomitant symptoms. Shattered Pulse: pulse feels like a shattered quill under the finger—occurs in opium eaters. Orstructed Pulse: artery remains equally full during its diastole and systole. The Compound Pulses. The principal are the synocha; synochus; synochula ; typhoid ; and tyvhub. 1. Synocha: hard, full, frequent, and strong; indicates high inflammatory excitement. 2. Synochus: full, round, active, but not hard: occurs in the hot stage of intermittents; in remittents, &c. 3. Synochula: quick, tense, small, hard, A'ibrating; occurs in sub-acute rheumatism—inflammation of the intes- tines, peritoneum, &c. It is the hectic pulse. 4. Typhoid: quick, small, slightly tense, not hard, and somewhat frequent: in the advanced stages of bilious fevers—the result of irritation in an exhausted state of the system. 5. Typhus: small,very frequent, somewhat quick: occurs in the advanced stages of jail, hospital, and other varieties of typhoid fevers.. (Eberle.). The evidence of a single, symptom not sufficient to give a decisive prognosis; the causes, the concomitant phenomena, the temperament and habits of the patient, &c. must be care- fully estimated. Tlie Countenance. The more it varies from its natural express- ion, the more unfovorabl'e. Hippocratic Countenance—nose pointed, eyes sunk, temples holloAV, ears cold and shrivelled the lobes everted; skin on the forehead hard, tense, and dry countenance pale, livid, or leaden: a fatal symptom in the 19 last stage of acute diseases. One eye becoming smaller than the other, a bad sign; still worse (Stoll) when objects ap- pear less to one eye; lividity of eyelids, lips, and alee nasi, unless in chills, very unfavorable;—pointed nose, and much motion of the nostrils during inspiration, bad. Attitude. Constant position on the back, and sliding towards the foot of the bed, unfavoiable; it betokens great prostration: same position, with open mouth, dilated pupils, or involuntary discharges, still worse. Insensibility, with mouth firmly closed and eyes fixed, a forerunner of convulsions; great desire to sit up, with dyspnoea, and livid countenance, fatal in pneumonic diseases; still more certanily fatal, Avhen attended with a good pulse. (Baglivi.) Most favorable posture, that which approaches nearest to health; reaching into the air, and picking the bed-clothes, bad; always unfavorable when visceral inflammations supervene to simple fevers; tumefaction of the abdomen, and tenderness to pressure indicate danger; laborious breathing, with short, irregular, and interrupted acts of inspiration, is a bad sign; a still more dangerous sign, is exclusive abdominal respiration, attended with strong: motion of the aim nasi by the respiratory act; stertorous breathing, attended with a rattling in the upper part of the. chest, is highly dangerous, though not invariably a fatal s'gn; short and very accelerated breathing, ahvays a bad sign; free and easy respiration, favorable; hiccough, in the advanced stages of fevers, indicates danger. Constant wakefulness, or somnolency, is unfavorable—when great pain in the head, pulsation of the carotids, and a puff- ed red countenance attend the latter, there is much danger. Unequal distribution of temperature—a sensation of cold externally, and of heat internally, are bad signs; still more unfavorable, when a sense of burniug heat on the surface is attended by a feeling of cold iternally. Intellectual and moral habits. When these are changed; Avhen old associations are interrupted; new antipathies form- ed ; Avhen the moral become profane and loose in their language, it is a dangerous sign. b* 20 Partial insensibility of the sensorial functions, more favorable than great acuteness in this respect. Intolerance of light, with involuntary flow of tears, filmy, protruded, or very sunken eyes, very bad. The excretions. Urine: black, chocolate-colored, fetid—or watery and fetid, highly unfavorable; a good sign, Avhen aftsr having been crude and watery, it deposites a reddish sedi- ment—still more favorable, Avhen attended Avilh a moist skin, of natural warmth. Suppression of urine, in pro- tracted and violent cases of fever, a very bad sign. Perspiration: when general, Avith no very low or high temperature of the skin, favorable; profuse and cold sweats, about the head, face, and on the arms and legs, highly dange- rous; partial sweats, appearing in large drops, a bad sign; profuse, clammy and cold, always dangerous; and when attended with a very small and frequent pulse, fatal. Alvine discharges: very liquid, frothy, green—bad signs; wa- tery, reddish discharges, resembling the washing of flesh, and attended Avith tympanitic swelling of the addomen, a most unfavorable sign. The expulsion of wind ivith crepitus, a good sign. (Rush.) Bloody stools without tenesmus, in the latter periods of bilious, malignant, or other violent typh- oid fevers, highly unfavorable; less dangerous in strictly in- flammatory fevers. Involuntary discharges of faeces, among the most unfavorable signs. Vomiting. Black flocculent discharegs, from the stomach, ex- ceedingly dangerous ;—less dangerous, Avhen the black or porraeeous matter is not flocculent but uniformly mixed with the "Other fluids throAvn up. A rumbling noise in the stom- ach, when liquids are swalloAved, a bad s'gn—never occurs in the early periods of fever, and generally attended with meteorism. Sudden and very forcible ejection from the stomach is unfavorable—it occurs in yellow fever. (Rush.) Very frequent vomiting, with great tenderness in the epigas- trium, in fevers, a very unfavorable sign. The tongue: covered Aviih a broAvn or black crust, Avith deep 21 cracks in it, dangerous; black and dry, with black sordes adhering to the teeth, highly unfavorable; a dark brown, contracted, hard and shrivelled tougue, almost ahvays fatal; tongue soft, moist, and light red, favorable; secretion of sa- liva, a good sign; difficulty of putting out the tongue, and then keeping it between the teeth a long time, without re- tracting it, is a bad sign—a total inability to protrude it, alike unfavorable; a red, smooth, and shining, or a pointed, dry and red (round the edges) tongue, indicates considerable danger—it is a sign of strong gastro-enteritic inflammation, Total absence of thirst, Avith a dry and rough tongue, is & bad symptom. (Ebeiie.) Besides the,appearances enumerated above, a variety of other circunistauces demand attention, in forming an opinion as to the probable event of diseases. Thus, in- flammatory fevers are generally less dangerous than re- mitting fevers; and these latter, less dangerous than ty- phus and malignant fevers. In general, the more a le- ver is connected with local inflammations—or rather, ' the-more serious the local inflammations are, from the importance of the parts they attack, the more danger is to be apprehended. The type, too, must be taken into vieAV. As a general rule, intermittents are less danger- ous than remittents, and remittents less than continued fevers. The more irregular the type of typical fevers, the more unfavorable. The appearance and propSe.-. ef what are termed the crises will also aid in forming a prognosis. Unusual or contradictory phenomena are unfavorable; when a patient declares himself Avell, at the same time that the symptoms indicate considerable disease, it is a bad sign. CRISES--CRITICAL DAYS. The ancients observed certain regular periods in the course of many febrile diseases, at Avhich prominent changes are wont 22 to occur, accompanied by certain evacuations, and folloAved generally by temporary or permanent abatement of the symp- toms. These evacuations, and their associated phenomena, are termed: Crises: No febrile or noxious matter, as Avas once supposed, thrown off by- these critical evacuations. Critical dischar- ges, the effect, not the cause of the melioration of disease Avhich folloAVS, or attends their occurrence. The doctrine of critical days generally discredited at present; their is pro- bably good foundation for the doctrine. Crises divided into simple and compound; in the simple, the evacuation is made through one emunctory only—in the compound, through several, The most prominent precursory pheno- mena 'perturbationes critcd) of crises are: an increase of all the symptoms—Avatchfulness, chills and rigors—tremor of the whole body—anxiety and jactitation—quick and irregular respiration—obtuseness of hearing—vertigo—co- ma, &e. There are certain days in the course of fevers, upon Avhich crises are particularly apt to occur. These are the critical days; crises occur, however, occasionally on other days. The critical days, according to Hippocrates, are the 3d, 5th, 7th, 9th, 11th, 14th, 17th, 21st, 27th, and 34th. According to Cullen, the 20th, not the 21st day, is the critical day—he acknoAvledges no critical day beyond the 20th. Critical days divided into perfect, secondary, and intercurrent. Galen regarded the 7th, 14th, 21st, 28th, or the septenary periods as the true critical days;— the secondary, are the intermediate days between these sep- tenary ^periods, i. e. the 4th, 11th, 18th, 25th, &c. The intercurrent days are the 5th, 9th, 13th. (Galen.) All forms of fever appear to have a tendency to some one of the principal types. A single tertian may be regarded as fever in its elementary form. In this form a paroxysm and crises occur on every odd day. Noav if we consider a continued fever as made up of tertian paroxysms, protracted and running into each other, we perceive from its tendency to the original 23 type, how the phenomena of crises should occur on the odd days. Salutary may be distinguished from insalutary discharges by the following circumstances. To be salutary, they must be neither too copious nor too scanty; they must correspond with the nature of the fever—hae- morrhage is most salutary in inflammatory, and diarrhoea, in bilious fevers—perspiraton is more beneficial in catar- rhal fevers than diarrhoea. A discharge from one emunc- tory only, seldom beneficial; perspiration is never salutary unless the urine at the same time becomes charged Avith a sedimentious matter; and vice versa. The evacuations (critical) which usually attend the commence- ment of convalescence, are: Critical hozmorrage: generally preceded by increase of arterial action; and salutary, partly from the loss of the blocd, a»d chiefly by the new arterial excitement by which they are attended. It is owing to the previous excitement of the arterial .system, essential to this kind of critical evacuation, that it cannot be substituted by an artificial abstrac- tion of blood. This fact proves, that such evacua- tions do not, strictly speaking, produce the amend- ment Avhich follows, but that they are effects or mani- festations, of a previous salutary change in the vital actions. Crises by haemorrhage is cheifly confined to inflammatory fevers; occurs sometimes in typhus fevers; epistaxis, the most com- mon critical haemorrhege—usually preceded by flushed face, red and suffused eyes—sneezing, ringing in the ears, &c. Uritical sweat. The most common crises; must be general over the body, attended with a warm skin and turbid urine. Its approach indicated by : a soft, full, wave-like pulse; a stinging, or itching sensation on the surface, red, warm skin, and scanty urine. 24 Critical discharge of urine: must be copious : the morning urine best for inspection; critical urine exhibits at first, a cloud, floating in the upper part of the vessel—then a globu- lar body about the middle—and finally a sediment; (VogeJ, Richer, &c.) should be attended with a soft or moist skin; preceded by pains in the loins; frequent inclination to uri- nate ; uneasy or burning sensation in the genital organs, dry, harsh skin; thirst, and a soft and active pulse. Critical alvine discharges: most frequent in bilious fevers— occur during the remission of fevers—are copious; signs of approach, a peculiar trembling of the under lip—'Stammering —a full, active pulse, pain and noise in the boAvels; dis- charge of wind—moist tongue—paucity of urine, (Ritcher.) Critical emesis, very uncommon. (Eberle.) By crises, in the most general acceptation of the term, is understood that period in the course of a fe- ver, at which a determination either to death or con- valescence takes place, and in which therefore the fate of the patient is determined. This decision must necessarily always occur in the ultimate point of vio- lence in the disease. 25 OF THE GENERAL COURSE, TYPE, AND STAGES OF FEVER. Fevers divided in relation to their course into ; Acute, and Chronic. The former generally make tbeir attack suddenly, and proceed through their course in a comparatively short pe- riod. The latter commences less violently, and pass slowly through their course. In general, the more violent the disease, the more rapid its progress. The course of a fever may be divided into five periods. 1. The forming stage—the period between the impression of the febrific cause and the developement of the fever;— distinguished by certain phenomena, called premonitory symptoms. Its duration very various; not always attended by signs of deviation from health. In general, the more protracted the premonitory signs, the more protracted, or sIoav, will be tlfe course of the subsequent fever, &c.— It is during the struggle between the system and the morbi- fie cause—Avhile the former is gradually yielding to, and passing under the dominion of the latter, that the premoni- tory symptoms occur The most common premonitory symptoms are : loss of ap- petite : irregular bowels; yaAvning, stretching; mal aise; in- terruption of ordinary habits and appetites, such as disgust for tobacco, coffee, &c, thirst, nausea, eructations, dry skin, slight chill, healing up of old ulcers, &c. These symptoms show that the nervous system, the digestive organs, and the skin, are the first to suffer in the evolution of fever. Some diseases have peculiar premonitory symptoms, as the measles. A morbific cause may produce the _premonito- 26 ~rg synptoms, Avithout being adequate to the full develope- ment of the disease. The cold, or second stage: a sensation of cold almost in- varibly produces a febrile reaction; frequently no real sub- duction of temperature in the febrile chill; it depends therefore often on an altered state of sensibility to heat. Symptoms attending this stage:—skin pale, contracted, dry —shrinking of the surface*—respiration irregular, oppress- ed, anxious—a small dry cough—tongue dry—head con- fused, pulse small and frequent—nausea and vomiting; the sensation of cold may be generally or partially diffused over the body. The relation betAveen the violence and dura- tion of the stage, to the ensuing stage of reaction, is direct; the former being violent and short, the reaction will most probably be vigorous; weak and protracted chills usually followed by feeble reaction. A chill occurring in an advanced period of a remittent, indicates that it is about altering its type or form; occur- ring in the advanced period of visceral inflammations, in- dicates the occurrence of suppm-ation; crises and metastases sometimes preceded by chills. Hot, or third stage of fever: characterised by increased heat of the skin; return of the natural fulness and color of the surface; pulse full, vibrating, and vigorous; pain and throbbing in the head; eyes prominent, and very sensible to light; a dry skin; urine small, and high colored. The fourth period or siveating stage: profuse and gen- eral perspiration; sedimentious urine; diminution of pains in the head, loins, &c.; pulse soft and full, &c. The fifth period or the period of convalescence: The course of every fever is either: Continued: very slight evening exacerbations, and morning remissions. Total absence of remissions and ex- acerbations very rare, if ever. Remitting: prominent and regular remissions and ex- acerbations. 27 Intermitting: regular paroxysms and perfect intermis- s'o is, One paroxysm, with its intermission, constitutes its re- volution. According to the duration of the revolution, fevers are divided into : Quotidian, occupying 24 hours. Tertian, do. 48 do. Quartan, do. 72 do. The form which fevers assume in this respect, is called their type. There are, therefore, three principal types: i. e., the quotidian, the tertian, and the quartan types. Quoti- dians generally come on in the morning; tertians about noon; and quartans in the afternoon. Tertians divided into simple and double. Double tertians: paroxysms occur daily; but the parox- ysms of the alternate days are similar in violence, time of occurrence, and duration, and differ in these respects from those which occur on the intervening days. Intermittents rarely are of the double tertian type, from their commencement: they generally commence as shn- ple tertians, and duplicate their type afterwards; tie new or accessory paroxysms generally milder than the original; double tertians generally return to the simple type, before they terminate; a change from the simple to the double type, is unfavorable. Other variety of compound types : tertiana duplicata; hamitritozus;—tertiana triplex. The quartan type is also susceptible of duplication. Tie double quartan has twro paroxysms every fourth day. Authors mention triple quartans, three paroxysms oc curring on every fourth day—these are very uncommon. The difficulty of arresting the course of an intermittent, in general, is proportionate to the time occupied by each paroxysm. Intermittents are said to be anticipating, Avhen the paroxysm comes on earlier every succeeding recurrence—and pos*. 28 poning, when it occurs later at each returu. V\ hen the paroxysm is postponed to about eight o'clock in the eve- ning, it frequently does not come on until the next morn- ing. In like manner, the paroxysm of an anticipating ague, occurring at eight o'clock in the morning, will have its next paroxysm on the evening of the day preceding that on Avhich it should happen. (Wilson.) Favorable, when the paroxysms are postponed; unfavorable Avhen anticipa- ted. Attypic, or erratic fevers: no regular type; rheumatism- catarrh al fever. Fevers often change their type—the conversion of type seldom suddenly effected. ON INTERMITTING FEVERS. General Character. A succession of regularly recurring fe- brile paroxysms—commencing Avith chills, and terminating in profuse perspiration, Avith intervals of perfect remission from fever. Types: the quotidian, the tertian, the quartan, and complica- tions of these primary types. &ages : the cold, the hot, and the sweating stages. Symptoms—Of the cold stage: lassitude, yaAvning; skin pale and shrunk; pulse small and frequent; rigors more or less •juong; m'nd confused and inattentive—Avhen violent, coma- tose ; urine pale and crude; thirst great; respiration quick and anxious; lasts from fifteen minutes to several hours. Hot stage: at first, nausea and bilious vomiting ; skin hot and dry : face flushed and full: pulse, full, frequent, and strong: respiration free and regular; head-ache—urine, high colored and scanty. Sweating stage: profuse perspiration; pulse soft and mode- rately full; urine copious and sedimentous; a gradual abate- 29 ment of all the symptoms of the previous stage, until it ter- minates in the state of intermission, or apyrexia. Anomalovs symptoms: the cold stage has been absent; sweat sometimes^absent in the third stage, being substituted by oth- er evacuations. Masked Agues, (Febres Intermittents Larvata.) Intermit- tents under various, assumed forms: as epilepsy, mania, hemicrania, tooth-ache, cramp in the stomach, dysentery,'cho- lera, &e. Diagnosis of masked agues; their periodicy; the cotemporaneous prevalence of intermitting fevers; slight sen- sations of cold, preceding the attacks; gentle perspiration, with torbid urine attending their disappearance. In infants, the paroxysm sometimes commences with convul- sions. Distinct rigors are not common in infants. In- termittents divided into the : Inflammatory intermittents : of frequent occurrence ; quotidians more apt to assume this character than terti- ans, and tertians than quartans. Occur most common- ly in young and plethoric subjects, and in the spring and winter seasons; rigors strong in the first, and ac- tion intense in the second stage; intermission imperfect, the pulse retaining a preternatural quickness and ten- sion, and the thirst and heat of the surface remaining greater than natural; often slight pectoral affections^ The prima via, seldom much loaded with bile and sa- burral matter; little or no manifestation qf intestinal irritation. The congestive variety: not common; occurs in per- sons of debilitated habits of body—in the irritable and nervous. Cold stage, very protracted, attended with deep-seated pain in the head, vertigo, syncope, a sense of weight in the breast, coma, and a small, trembling, Aveak pulse. Hot stage, imperfectly developed—the system remaining oppressed; the surface cool; the broathing confined and anxious; countenance pale; 30 pulse frequent, small, and somewhat tense, and a sense of heat internally. The Gastric variety: the majority of our autumnal intermittents are of this character; they are attended with strong marks of irritating matters in the prima vim; there is nausea, bilious vomiting, bittter taste; weight and fulness in the epigastrium; great pam in the forehead; foul tongue; quivering of the upper lip; countenance, and tunica albuginia, tinged with yelloAV; urgent desire for acid drinks. Malignant Intermittents. Rapid in their course— SAveat, in the third stage, generally very copious and fe- tid; haemorrhages from the nose, boAvels, gums, &c; petechia; and other symptoms denoting malignity. (Alibert.) In relation to the natural duration of intermittents, it would ap- pear that quotidians, when left to themselves, have a tenden- cy to terminate on the 14th; tertians on the 21st; and quar- tans about the end of the 6th week. Prognosis. When simple intermittents prove fatal, it is gener- ally in the cold stage—death then occurs in the Avay of ap- oplexy ; most dangerous, in weak and cachectic habits of body. Postponing more favorable than anticipating agues ; scabby eruptions, re-appearance of suppressed discharges, &c. favorable; integrity of the digestive functions, a good sign; change from the quotidian to the tertian favorable. Delirium more unfavorable than mere coma; occurs in the worst foims of the disease. Tumid and painful abdomen, with oppressed respiration, hiccough, &c; colliquative diarr- hoea ; bloody urine, red and suffused eyes—are bad signs. Great debility during the intermission, Avith cedema of the legs and feet, restlessness, languor, sighing, dry tongue, or bilious vomiting, very unfavorable. Circumstances peculiar to the various types: Cold stage long- er in tertians than in quotidians—hot stage longer in the lat: tar than the former; &c. &o. 31 causes or Intermittents. The principal—almost exclusive—cause of intermittents, is marsh miasmata, called by the Italians, malaria. Intermittents are the first grade of miasmatic fevers—most common during the autumnal months,in the marshy districts of temperate climates. The operation of miasmata is favor- ed, by sudden changes of Aveather, dampness, and whatever debilitates the body. TREATMENT. Treatment divided into that which is proper during paroxysm* and that Avhich is to be used in the intermission v The former is palliative, the latter curative. Treatment in, the paroxysm. Cold stage: mild and warm diluent drinks. In debilitated and nervous subjects, exter- nal stimulants, particularly artificial heat. In vigorous subjects, however, such practice is by no means proper. An emetic given in this stage, one of the best means to shorten its duration. Treatment in the hot stage. The object is to moderate the violence of the febrile reaction, and to hasten the super- vention of the sweating stage. The remedies employed for this purpose are: cool diluent drinks; Avashing the body with Avarm vinegar; ice or cold applications to the temples and feet. Emetics not proper in this stage : vo- miting best checked by peppermint or soda. Treatment during the Intermission. It is in this stage, that the radical cure of the disease is to be attempted. In prescribing with this vieAV, attention must be paid to the four modifications described above. In inflammatory iniermittents, the febrifuge tonics are not to be used, until the phlogistic state of the system has been reduced by a strict antiphlogistic treatment. 32 In congestive and malignant modifications, stimulants and tonics must be resorted to, early and freely. In the gastric modification, emetics and cathartics are impor- tant and preliminary remedies. Cinchona—the most efficacious tonic febrifuge we possess— must be employed during the apyrexia. Not to be em- ployed where a phlogistic diathesis prevails—that is, where the pulse is tense and quick, with a sense of general unea- siness, headache, dry and warm skin, are present in the in- termission ; in such case, antiphlogistic measures must be premised. The bark to be promptly and largely given, in cases of great weakness, or in such as are of a malig- nant character. Authors express contradictory opinions, with regard to the necessity of purgatives and emetics, as measures preparatory to the use of the cinchona. They are very generally useful, and should be premised ; not al- ways indispensable, however—more essential in the young and plethoric, than in the infirm and aged. The cincho- na has no peculiar tendency, as Avas once, and by some is still supposed, to produce visceral indurations; these are the consequences of the improper use of the bark—in oth- er Avoids, of its employment in a prominent phlogistic state of the system—other tonics will do the same. The existence of visceral obstructions form an objection to the use of the bark; a mild physic must be premised— or the bark may be given in conjunction. From an ounce to an ounce and a half, will in general suffice for a cure. When much acidity exists in the primae viae, combine it with an alkali. The bark often advantageously combined with aromatics, as serpentaria, cloves, calamus aromati- cus, black pepper, capsicum, &c. &c. Sulphate of Quinine, a most valuable preparation of cin- chona ; given in doses of from one to three grains, every one or two hours; sometimes purges, for which essence of cinnamon is the proper remedy. A variety of other vegetable tonics have been recommended in this disease : as Agustura bark, cornus florida, Leriondendron tulipife- ra, aristologia serpentaria, oak bark, the various species of willow, horse chestnut, and the officinal tonic bitters. The power of the imagination over the system, is often stiik- ingly illustrated in its effect on this disease ;—the source of the occasional efficacy of all the various charms, amulets. &c, so frequently resorted to against this disease, by the ignorant and superstitious. v Intermittents exceedingly apt to relapse; relapses particular- ly favored by exposure to a damp and cool air; by errors in diet; the depressing passions, &c. Intermittents apt to give rise to secondary affections, the most common of Avhich are: oedema of the feet; enlarge- ment and induration of the spleen and liver; jaundice, dropsy;—sometimes hemicrania, vertigo, epilepsy and phthisis. (Eberly.) REMITTING FEVER. Character. Fevers whose symptoms suffer regular exacer- bations and remissions, but no perfect intermissions. Symptoms: Symptoms of the forming stage, similar to those of intermittents. When the disease is fully developed, j there are pains in the head, back, and lower extremities; \ an icterode tinge of eyes; nausea; sometimes bilious voirt- iting; fulness and tension in the praecordia; pulse full, frequent, and rather soft; tongue foul, at first white, after- wards broAvnish; taste bitter. In the course of about twenty-four hours, a remission of these symptoms takes place; after a short remission, the febrile symptoms rise again; and after a certain period, again suffer more ot less j remission. This ansAvers to the mild form of the disease. The Type of remittents is generally the doubla tertian; some- j 34 times the quotidian. The exacerbations; of quotidian remittents commonly begin about nine or ten o'clock in the morning; those of tertians considerably later. Remittents sometimes assume a very violent and even malig- nant character : the febrile heat is intense ; thirst excessive; head-ache, and pains in the loins, very violent: great anx- iety of feeling; distressing sense of fulness in the epigas- trium. In twenty-four hours, nearly a complete intermis- sion ensues. A second and more violent paroxism soon comes on; the eyes become red and watery; the epigas- tric distress i3 horrible; there is nausea, with constant retching or bilious vomiting. Another remission occurs, followed by a third exacerbation, which often terminates in death, or a favorable crisis. The disease sometimes assumes more of a chronic character ; and in this case, great prostration ensues, Avith almost constant delirium, a quick, irregular, and frequent pulse: in some instances, ihe pulse becomes almost natural—a sign of great danger. Besides the foregoing symptoms, the following occur, in violent cases of this form of fever: tongue clammy, fetid, black; eyes red, watery, or dry; urine brown, blackish, offensive—sometimes wholly suppressed; alvine dicharges watery, red, black, or bloody; abdomen tympanitic, pe. techiae, haemorrhages. In the temperate climates, and in situations not abounding in materials for the production of miasma- ta, remittents are generally mild and regular in their course. In proportion as we approach the tropical regions, Ave find the disease assuming a more violent and anomalous character. Remote Cause. Marsh miasmata the principal cause of this form of fever; other causes may produce it—as Avorms, and other irritants, acting on the alimentary, canal. Pkoktmate Cause. Irritation, or sub-acute inflammation of the mucous membrane of the intestinal tube, with prom- incnt hepatic derangement. 35 In some cases, prominent intestinal irritation is con- nected with an abundant secretion of bile ; in others, the intestinal irritation is connected with great con- gestion and torpor of the liver, little or no bile being thrown into the bowels during the early period of the disease. To the former class of remittents, we may therefore apply the term Gastric ; and to the latter that of Hepatic Gastric Modification; characterised by: bitter or putrid taste: tongue covered with a thick yellowish slime, which by degrees becomes dry, cracked and blackish ; disgust for every kind of food; urine jumentose; distress and Aveight in the stomach; abdomen tense and tender; pain in the loins and knees; intense pain in the forehead; distinct re- missions and exacerbations. Hepatic Modification: the most rapid and dangerous form of the disease; characterised by: intense febrile heat during the exacerbations; delirium, fulness, tension, and pulsation in the right hypochondrium; tongue at first clean, great irritability of the stomach; continual vomiting of a glairy fluid; the skin becomes icteric; towards the termination of the disease, the liver, in most instances, pours out an abundance of dark colored bile, Avhichis evac- uated by stool, and sometimes by vomiting. The stools, in such instances, are black and pitchy. The diathesis of remittents always essentially inflammatory, though in some violent instances much nervous depression and debility exists. There are no remedies more useful in the treatment Of remittents, than purgatives; and yet there are perhaps no other medicines so frequently employed to an in- jurious extent. Violent and irritating cathartics, Avhen frequently administered, seldom fail to excite a degree of irritation in the mucous membrane of the alimentary canal, Avhich but too often brings on a train of symptoms of the most dangerous and fatal character. The thin watery stools, of a muddy or c* 36 reddish color; the tympanitic state of the bowels ; the abdominal tenderness; the suppression of urine, &c, which are sometimes obsen^ed in the advanced stages of this disease, are generally the result of the impru- dent employment of active cathartics. Although I Avould strenuously protest against the frequent em- ployment of active cathartics during the course of re- mitting fever, I would by no means proscribe them wholly (as is done by Broussais) as remediate means in this form of fever. In the c ommencement of the disease, one or two active purgatives are not only ad- missible, but according to general experience, decided- ly useful. Subsequently, hoAvever, the milder laxa- tives only ought to be employed; and these are indis- pensable, throughout the whole course of the disease. Sangunaria: An important remedj in remitting fevers. In tl e commencement given with a view both to its purgative and constitutional effects; should be early and regularly given, until its specific operation becomes manifest; nev- er to be continued until ptyalism comes on ; strong excite- ment, injurious. In the advanced periods of the disease, the influence generally detrimental. In the high or malignant grades of this disease—thatAvhich I have termed hepatic, from the engorged and inactive stale of the hepatic system—emetics, emeto-cathartics, and strong purgatives, useful in the commencement of the milder forms of the disease, are altogether inadmissible. The first object is to allay gastric irritability, Avhichis generally very great. For this purpose, sinapisms to the region of the stomach, are good ; a draught of cold water has been recommended; the Avarm bath after. When the irritability of the stomach is in some degree sub- dued, B. Root is an important remedy; it should be given in doses from ten to twenty grains every four or five hours, until the evacuations beeome bilious. If the B. Root do not prove purgative, mild laxatiA'e must be occasionally given with it. Two or three alvine evacuations daily are 37 indispensable, so soon as the liver has been excited to ac- tion by the Sangunaria. Acidulated drinks are salutary. Physicians do not agree Avith regard to the propriety of using tonics during the remissions. Lind, Clark, Balfour, and others, strenuously contend for the vigorous employ- ment of bark. Johnson, Burnet, and others, condemn this practice as pernicious. My own views on this subject are, that the cayenne, may be used Avith advantage during the remission, when there are no violent visceral congestions, and Avhere the liver has resumed its proper action. As long, however, as the liver remains engorged and in- active; after the bile makes its appearance in the alvine evacuations, and a complete remission occurs, the liberal use of the sulphate of quinine will general- j ly prove decidedly beneficial, or any of the tonics I will give a list of. TREATMENT OF REMITTENT AND INTERMITTENT FEVERS. The indications are—1st. To moderate the action of the heart and arteries. 2. To remove the irritating contents of the bowels, and moderate intestinal irritation. 3. To restore | the healthy functions of the liver to answer those indications. If the fever is high, pulse full, vigorous and hard, the skin j very hot and dry, and head ache intense, my plan is first to j apply cold applications to the head and feet, spunging the whole surface with diluted warm water, warm vinegar, so- da, or saleratus. Apple vinegar is the best, a3 the vinegar made in cities is principally made of muriatic acid, and oil of vitriol. By these applications, applied every ten or fif- teen minutes, the fever will abate in from forty to ninety minutes: then, when the surface becomes moist, you may commence the second by an emetic to cleanse the stomach, j and to operate on the bowels until the stools present a heal- thy appearance: three—tonic—sulphate of quinine twenty grains; capsicum ten grains; pepperine fifteen grains in a 38 "two ounce vial, in solution, given in teaspoonful doses each hour. Being confident that this Book will find a home in many families, in new settled countries, I therefore give a number of compounds that I have used in my practice, so that if the reader cannot procure one he can another. TONIC PILLS FOR THE CURE OF CHILLS AND FEVES. Extract of dogAATood, 1 ounce. Extract of boneset, 1 " Oil of sassafras, 1-2 •' Gum goacum, 1-2 " Sulphate of quinine, 1-2 " Roll out into pills, size of a sugar pea. Dose—one pill each hour. TONIC PILLS. * Extract of blood root, 1 ounce. Best gum myrrh, 1-2 " Extract of wild cherry, 1 " Oil of sassafras, 1-2 " Extract of anthemis cotula Mayweed, 1-2 " Quinine, 1_2 « These pills will act on the liver, and may be taken before taking medicine, to cleanse the stomach, as they will operate mildly on the bowels, and may be taken Avith full confidence of a perfect cure. In case the extract of blood root cannot be obtained, use the powder of the root finely pulverized. Roll into common size pills. Use from one to tAvo pills each hour, according to the age, temperament, or streno-th of the user. 39 INDIAN TONIO For the cure of Chills and Fever, Ague, and Dumb Ague and Fever. Serpentaria, 1 ounce. Wormwood, leaves and stem, 1 " Blue flag root, 1 " Sassafras, bark of the root, 1 " Rattle weed root, 1 " Put the above into an iron, copper, or brass pot or kettle; add five pints of water; boil down to one pint; clear the pot, and strain the liquid; put it in the pot and bring it to the boil; skim off the light part that rises to the top : then take three ounces of alcohol from 76 to 90 per cent.; add just as much of the oil of sassafras as it will cut; then add the essences to the pint of liquid to preserve it any length of time; then put it into six ounce vials. Dose for an adult, one tablespoonful each hour in the absence of the chill. The rattle foot will sometimes affect the head; if it does, give it in less quantities. Have the stomach well cleansed before giving this tonic. RECEIPT TO CURE CONTINUED FEVER. Take pulverized poplar bark (of the root,) 2 ounces, and 4 drachms of cayenne pepper; add a proper quantity of water, stew it for ten minutes, give it freely, and the patient will be invigorated in thirty or forty minutes, and it will strengthen the most feeble patient. N. B. Where the pa- tient has a distaste for pepper, roll the mass into pills with the extract of boheset, and use from one to five pills each hour according to the patient's age and strength. TO CURE THE HEADACHE. Take 15 drops of alum oil every other night before going to bed. It never fails to cure chronic headache. 40 PREVENTATIVE BITTERS. These bitters will keep off an attack of fever, and prevent a return of fever after a cure. Blood root, 1 ounce. Cherry bark, 3 « Bark of spinnel wood, or waughoo, 2 " Black root will answer in place of blood root—pulverke and add one quart of spirits. Dose—from one to three Avine glasses full each 24 hours. If black root is used, take 3 ounces. A Tonic pmch used among the Indians for Chills and Fever. Water willow bark (of the root,) best, 1 ounce. Prickly ash, 1 « Rattle weed root, 1 « May weed, gathered in bloom, 3 " Draw the strength like store tea—drink freely five or six hours before the expected chill. A TONIC PILL. 1 hate used much in my practice— Extract of Peruvian bark, 20 grains. Quinine, 10 " Gum myrrh, 5 « Oil sassafras, 20 drops. Roll into 20 pills. Dose one pill each hour : the ex- tract of boneset will answer in place of the Peruvian bark extract. 41 FEVER BITTERS. Cream tartar, 1 ounce. Peruvian bark, 1 " Extract of black pepper, 1 " Cloves, 1 " Add spirits one pint: use freely, before the chill, for five or six hours. These bitters will cure Eastern ague, as 1 know from experience. DUMB AGUE PILLS. Extract of iron weed root, 1 ounce. Mussel shells or oyster shells, pulverized, 3 " Oil of black pepper from 1 to 5 drachms. Roll into common size pills. Dose from 2 to 4 pills each hour, after the stomach is Avell cleansed. This receipt may appear strange to some, but the oyster shells will cure chills, given in teaspoonful doses three or four times a day. TONIC PILLS. I have used much in my practice— Quinine, 20 grains. Pepperine, 5 Extract gentian, 10 Roll into 20 pills. Dose from one to two pills each hour, after the stomach is cleansed. These are the different compounds 1 have used in my prac tice in the treatment of fevers of different grades, and found each of them to have the desired effect. But re- member—after all the different tonics—you must use me- dicines to act on the liver from ten to thirty days after you cure the chills, if you want to be successful in curing chills and fever. 42 YELLOW FEVER. Synonymes. Typhus Icterodes; Maladie de Siam; Bulam Fever; Vomito Prieto; Causes. Symptoms. First stage: faintness, giddiness, slight chills; then sudden evolution of intense febrile reaction, with se- vere pain in the head, inflamed eyes; intolerance of light; dry and burning skin; great thirst: pain in the loins and loAver extremities; tongue coverd with a mucus, or but little altered from its healthy aspect; nausea and vomiting; transcient and partial SAveats. This stage lasts from twenty-four to sixty hours. The disease sometimes commences Avith sudden loss of muscular power, and depression of nervous ener- gy: the patient falling doAvn as if stunned by a bloAv. Socond Stage. With the exception of vomiting, all the symptoms abate; the pulse sinks to the natural standard, the heat of the skin becomes reduced, and the patient ex- presses himself much relieved. The vomiting hoAvever continues, the fluid ejected containing membranous floccu- li; the desire for cold Avater is urgent, but Avhen SAvalloAV- ed, is immediately rejected ; the albuginia, and the skin of the neck and breast, acquire a yellow tinge. This stage lasts from tAvelve to thirty-six or forty-eight hours. Third Stage. Pulse sinks; frequent and forcible vomiting; matter thrown up of a black color, resembling coffee- grounds suspended in a glairy fluid; an acrid or burning sensation in the stomach ; diarrhoea of green or black mat- ter ; whole surface of a dirty yellow ;* haemorrhages vio- lent; delirium; hiccough, coma, insensibility, convulsions, death. " Soreness in the oesophagus; heat and acrid sensa- tion in the stomach; urgent thirst; hunger; violent delirium; despondency; enlargement of the blood- vessels and red-yellow color of the Avhite of the eye, Many cases are not attended by this yelloAv hue of the skin. 43 either singly or collectively, indicate extreme dan- ger." (Johnson.) Appearances on dissection. A black viscid fluid in the stom- ach; mucous membrane of this organ inflamed, and cover- ed with angrenous spots; sometimes large portions sphace - lated; small intestines inflamed ; colon generally sound, but often contracted; concave surface of liver inflamed. Cause. The effluvium generated by animal and vegetable matters, in a state of putrefactive decomposition, its com- mon remote cause-r-hence its almost continued prevalence in the marshy districts of intertropical regions. This opinion is disputed by many; but a great Bia- jority of those whose knowledge on this point is de- rived from personal observation, maintain its correct- ness. Europeans arriving in hot climates, where the disease is en- demic, almost exclusively obnoxious to it. Persons hav- ing once had the disease, lose in some degree their suscep- tibility to a subsequent attack. The influence of the remote cause is promoted by intemper- ance, excessive fatigue in the sun;' exposure to the damp and cool night air, &c. Not contagious. Many assert that under certain circum- stances, this disease is not contagious:—some maintain,its unconditional and essentially contagious churacter. Black \omit: not bilious matter;— appears to proceed from sanguineous transudation in the stomach. The hxer is torpid and congested, the biliary secretion being deficient. The yellow color of the skin is probably the result of a vi. carious secretion of a bilious matter into the subcutaneous texture. Different opinions on this subject. treatment.—There is a diversity of sentiment in relation to the treatment of this disease. It appears, however, that the weight of good authority is in favor of emetics. 1 treat- ed only four or five cases of this disease while 1 resided in 44 Arkansas. I gave first a prompt emetic; then from eight to ten grains of sangunaria, with from a tea to a table spoonful of spirits of turpentine, with the same quantity of castor oil. The operation was quick. I mix all together before administering. The turpentine discharges the bile quickly. 1 then give from five to ten grains of sulphate of quinine each hour, until 1 give from forty to sixty grains. In the second stage, I administer mild aperients, diapho- retic and cooling drinks, with tonics and stimulants if the pulse becomes feeble. In the third stage, stimulants and tonics—enemata, quinine, or eupaloriem extract. This is an excellent treatment in bilious fever. INFLAMMATORY FEVER. Synonymes. Ardent fever; febris irritativa ; synocha; febris vasorum. Character. Vascular excitement vigorous; pulse full, hard, and strong; heat of the skin intense; urine scanty and high colored: thirst great; eyes red, incapable of bearing the light; pulsating pain in the head; sensoral powers lit- tle affected. This form of fever is seldom introduced by a long train of premonitory symptoms; and in this, it differs essentially from typhus. The heat of the surface, of the kind called burning. Delirium not a common symptom. The pulse seldom beats more than 110 in a minute. The blood, when drawn, separates rapidly into its constituent parts— the crassamentum contracting into a firm mass, on the top of Avhich a yellowish mass of febr'me collects, forming what is termed the buffy coat, or inflammatory crust, Inflammatory fever never very protracted in its course; gen- erally terminates in some manifest critical discharge'; hae- morrhage from the nose, and increased flow of sweat the most common. Most apt to occur in persons of robus. 45 and vigorous constitutions, and between the ages of twenty and forty. Cause. The most common causes are; Atmospheric vicis- situdes ; violent passions; wounds and other injuries; a peculiar atmospheric constitution. Sudden suppression of perspiration by cold, is however the most common spora- dic cause. Hence inflammatory fevers most prevalent in cold and variable climates, or during the spring of temper- ate latitudes; more prevalent also in elevated, dry, and san- dy situations, than in localities of an opposite character. Diagnosis between sthenic and asthenie fevers sometimes ve- ry difficult. The constitution and habits of the patient, the nature of the predisposing and exciting causes, will aid us in the diag- nosis. In very doubtful cases, we must have recourse to the indices ex nocentibus et juvantibus—the indications drawn from the effects of immediate agents. Prognosis. Simple inflammatory fever, the least dangerous variety of continued fevers; Avhen attended with visceral inflammation, dangerous; the danger being proportionate to the violence of the local inflammation, and the impor- tance of the organ inflamed. When protracted it is apt to assume a typhoid character. A sudden and copious dis- charge of limpid urine, or thin watery alvine discharges, are unfavorable. Slight haemorrhage from the nose, a moist and soft skin, pale and turbid urine, are favorable signs. Delirium not generally a bad sign. Treatment.—The principal indications are to moderate the heart and arteries, and to restore the healthy functions of the cutaneous expalents. Emetics of eupatoriem, and ip- icac cathartics useful, not only by evaluating the irritating contents of the bowels, but also by their direct depletory effects. They should be combined Avith maloes, slippery elm, charcoal, nitre, capsicum, hops or yeast. The plan of treatment consists not only in the application of such 46 remedies as are calculated to reduce the action of the sys- tem, but also in the careful removal of every thing which has a tendency to vitiate or excite in an inordinate degree, Some will spurn at the idea of capsicum in this disease. But those Avho do not understand its power in inflamma- tion or haemorrhage, are behind the intelligence of the age. CATARRHAL fevbr. Character. A sthenic fever, with prominent irritation of the mucous membrane of the respiratory passages. Symptoms. At first lassitude and slight chills; then more or less febrile reaction—attended with a frequent, quick, and somewThat tense pulse; severe pain in the head, face, or jaws; sneezing, dry cough, and hoarseness; a watery discharge from the eyes and nose; eyes red and painful; transient stitches through the chest; often rheumatic pains in the back and extremities. There are considerable re- missions in the morning, and exacerbations in the evening, During the first three or four days, the urine is high color- ed and free from sediment. About the fourth or fifth day, the febrile symptoms begin to decline ; the urine then be- come3 pale and turbid, and the skin uniformly moist; the discharge from the nose and the bronchia becomes thick- er and yelloAvish. The existence of the latter cause is inferred from the circumstance of this form of fever occasionally prevail- ing epidemically—extending, itself over whole conti- nents, and even passing from one continent to anoth- er. Causes.^. Atmospheric vicissitudes—* specific miasma, or a peculiar constitution Qf the atmosphere. Prognosis. Not in general a dangerous form of fever ; most dangerous in infants and in very old people; aptto'excite phthisis in those who are predisposed to it. 47 Proximate cause. Irritation and inflammation in the mucous membrane lining the respiratory passages, with disordered action of the cutaneous capillaries. Treatment.—Moderate emetics of lobelia, Avith large or tea- spoonful doses of ginger, powder of Canada snake root, eupetoriem, sage, or camomile, with mild laxatives of sangunaria poAvder in teaspoonful doses. This will free the lungs. Local—When the pneumonic symptoms are severe, rub the breast Avith a strong tincture of cayenne and lobelia seed, and vinegar expectorants : to relieve the cough, eupetoriem, Indian turnip, hoarhound, skunk cab- bage, cayenne, asarum canadense, two grains of lobelia seed every two hours with four grains of capsicum. This fever needs emetics every day till the lungs are free of mu- cus. Sangunaria and May Aveed will cure this fever. Hot rocks, or bricks, or boiled ears of corn should be pla. ced at the back and feet; warm bath good, with an alte- rative treatment. ACUTE ENTERITIS. Symptoms. Fixed, burning pain in the abdomen, generally about the umbilical region; obstinate constipation, nausea and vomiting, the latter being sometimes so severe, as to communicate inverted action to the intestines, and pro- duce stercoraceous discharges by the mouth; fever, with a small, frequent, and tense pulse; very rarely, the pulse is full and hard; dry and red tongue, urgent thirst; dry and hot skin; urine high colored, and small in quantity; re- spiration short, and performed by the intercostals exclusive- ly ; position on the back, with the knees and shoulders elevated. When the upper part of the colon is affected, acute enteritis is often attended by symptoms of pleuritic or hep- atic inflammations. Diagnosis. In pleurisy, the pulse is full and hard—in en- 48 teritis it is small and tense; abdominal respiration m pleu- risy— not so in enteritis; abdomen-tender, andpainiulto pressure, in enteritis—not so in pleurisy. Spasmodic pain distinguished from enteritis by: the paroxysmal character of the pain; the constant change of position; the ease obtained by pressure on the abdomen; natural temperature and moisture of the skin, and the want of thirst, which characterise spasm of the intestines. The reverse, in all these circumstances, obtains m enteritis. The only favorable termination is in resolution; suppu- ration is rare, gangrene is more common, and is always fatal. The disease would seem sometimes to prove fatal, without any of the usual terminations of inflammation. Prognosis. Always very uncertain ; an almost impercepfi, ble pulse, with cold hand and feet, indicate great danger; diffusion of the pain throughout the abdomen dangerous; tumid and tympanitic abdomen, a bad sign; frequent vom- iting, in the latter stage, highly unfavorable. TREATMENT. Equalize the circulation by stimulants—hot rocks or bricks to the feet, jugs Avith boiling water to the back and um- bilical region. Begin brisk operations on the bowel?— two pills ea'ch hour, of gum myrrh and capsicum. Local. Rub the breast and umbilical region, with a strong tinc- ture of cayenne, essence of horsemint or essence sassa- fras : mild diluents, of the mucilaginous kind, very use- ful. Great attention to the diet necessary during conva- lescence : the most unirritating food is admissible. Infu- sions of catnip, or essence of horsemint, or peppermint, in teaspoonful doses, agitate over the pain Avith the oil of horsement and oil of annis. This oil, with the horse- mint, is a great pain lever. Apply mustard to the wrists and feet. 49 I give here a few receipts for the treatment of some diseases so common, that to occupy space with the various symptoms is deemed superfluous. FROST-BITE OR CHILL-BLAIN. 1. Place the frost-bitten part in cold Avater, and hold it there till the pain is removed. Spring or rain water is best. If any pain remains, rub with the tincture of cayenne, gum myrrh, and lobelia seed. 2. Should the parts be likely to slough or mortify, poultice with potatoes, cayenne or red pepper, salt, and the yellow of eggs. 3. Take balsam of Canada or fir tree one third, and two thirds of sweet oil. and anoint] the parts : the fir will heal it. 1. Apply a poultice of Avheat or rye flour with a proper quantity of sweet milk; mix hog's lard or rather butter with the poultice, and apply it to the part, and it will pre- vent the poultice from sticking. 2. Poultice with soft soap. 3. Take oil of annis seed and olive oil, equal parts, and rub every two or three hours. 4. Poultice Avith hops and onions. 5. Apply the balsam of fir. WHITLOW. 1. Bathe Avith the tincture of cayenne or lobelia, or hold in hot water, or a poultice of ashes and vinegar. 2nd form needs nearly the same treatment, with a poultice of eggs, table salt, and beef galls. 3rd form is called felon, is much deeper, and very painful: poultice Avith red pepper, beef galls, white oak bark, or any of the very bitter herbs— lance it very deep; it ought to be laid open to the bones —if fungus flesh appear, apply burnt alum : heal the sore with beeswax, rosin, and mutton suet. 50 KING AVOKM. 1. Take table salt, soft soapr and- boiled potatoes—poultice- tAVO or three nights. 2. Take tincture of blood root, and cincture of cantharadis : three or four rubbings will be sufficient for a cure. 3. Take caustic potash, apply three or four times : then wash Avith soap and warm water. 4. Take the juice of sheep sorrel: two or three rubbings will cure. SCALD HEAD. To cleanse the blood, use a syrup composed of sarsaparilla root and burdock root, in equal parts ; extract the strength by boiling in water. When the syrup is used, add sugar to preserve. Apply to the scald head the extract of red clover or sheep sorrel : Avash with castile soap. I have cured with a liniment composed of linseed oil, beesAvax, mutton talloAV, oil of pennyroyal, oil of cloves, oil of cin- namon, oil of sassafras, and oil of peppermint: neAV tar, with table salt, is excellent: poultice twice a day; the oil of corn cobs is a good remedy. TETTER WORM. There are five varieties of this disease of the skin. 1 : the miliary tetter. 2 : the eorrosive tetter. 3 : the ring worm tetter. 4 : the rainbow Avorm tetter, and 5, the local ring- worm or tetter. I here pass along to the treatment. 1. Keep the bowrels regular Avith mild cathartics, Avith the best of the tonics—such as boneset, dogwood, Indian ar- row roof, sarsaparilla, burdock root, sassafras bark: extrac the strength by boiling-—then add sugar, or molasses, or spirits, sufficient to preserve. Salt petre and charcoal are good, given in spirits, three or four times a day. Tetter will make its appearance nearly all over the whole system in red spots, itching after going to bed. When it is in the 51 blood, medicines must be used to purify the blood. I most generally use the above named roots in the form of pills made from the extracts, using from three to ten each day. Local Applications—Take the extracts of blood root, red clover, sheep sorrel, aad SAvamp ash: apply at intervals from one to five hours at a time, washing with castile soap. Tincture of blood root and tincture of Spanish fliess ap- ply three or four times a day. When the disease is on the fingers, hands, or feet, it is only necessary to kerp the bowels open, and apply the local applications to the parts. Take equal parts of muriatic, sulphuric and nitric acids; apply three or four times a day; follow with sweet oil; wash with castile soap. Boil the root of yellow dock to thick syrup; apply two or three times each 24 hours, < leaving it on from one to two hours each time: a sure cure for tetter j wash with castile soap. A SURE CURE FOR BED BUGS. Take Iavo drachms of corrosive sublimate to one pint of al- jj cohol—or even four drachms will dissolve if the alcohol is ' 90 per cent. One pint is sufficient for three pair of bed i steads—two or three rubbings will answer each year : the i smell of the poison Avill kill them in tAvo or three minutes. A CURE FOR THE ITCH. There are five different kinds of this disease. I need not give the symptoms, as every one that has the itch, will know it by the itching sensation ; therefore, I pass to the treatment. Take flour of sulphur (brimstone,) and stew it for five or six hours in a proper quantity of hog's lard, and anoint with the top of the mixture after it settles : rub for three or four evenings on going to bed. 2. Take yellow dock ropt, tincture the root in alcohol, and rub with the tincture^r-or stew the root in hog's lard, and anoint with, the mixture—or soak the root in sweet milk, and a- 52 noint with the milk. 3. Break a small hole in the end of a hen's egg, or any other kind of an egg, and pour out the white of the egg,, then fill up the egg with table salt and brimstone, then stop the end with dough, then put the egg in hot ashes, pour on some water next the egg, then cover up for three or four hours, then pulverize the hard substance to a powder, then spread the powder on the affected part, and, a cure is certain : wash the parts Avith castile soap. MUSQUITO BITES. 1. Rub three or four times with the tincture of lobelia. 2. Rub once or tAvice with equal parts of spirits of camphor and spirits of hartshorn. BRUISES. Take essence of pennyroyal, tincture gum of myrrh, and tincture of cayenne; rub two or three times a day: the leaves of burdock or colt's foot are excellent remedies—the burdoc will draw the bruised part white and extract the pain. Ginseng seed will answer a good purpose ; the leaves should be bruised before applying them. STRAINS. Take the tincture of lobelia seed, cayenne, spirits of cam- phor, spirits of hartshorn, sweet oil, and laudanum, in e- qual parts : rub the parts three or four times a day. Oil of pennyroyal, cut in alcohol, is a gocd remedy. f PUNCTURED AVOUNDF. Punctured wounds are made by small instruments, as pen- knives, splinters, pins, nails, Cvc. Wounds from nails are very dangerous, causing the lock jaw : take the tincture of lobelia seed, cayenne pepper tincture, and tincture of stre- 53 meriiem—keep the parts well bathed with equal parts of the above tincture: poultice with beef gaulds, cayenne pepper, lobelia seed, stremeniem leaves or the seed well pulverized. If the lock jaw should appear, use lobelia tincture or seed as an emetic : as the lobelia tincture is given the jaws will open in five or six minutes : keep the bowels free. FRESH CUTS, If the cut be a clean cut, it should be dressed by applying I balsam ofifir ; bring the edges of the wound together : the j bandage should draw the parts closely together : if it I swells much, use a tincture of cayenne to reduce the fever: I fresh or new milk should be applied : not best to remove the bandage under 24 or 48 hours: if bad flesh spring up, j use burnt alum: ginseng leaves are good to poultice Avith: Carpenter's square is excellent to heal up a fresh cut. BITES OF SERPENTS. People in newly settled countries are very liable to be bit- ' ten by rattle snakes. Master, grown in the western parts, is a good remedy : cukkel burr is good, stewed in sweet milk, applied in the form of a poultice. The Indi- ? ans that I visited used ash leaves and sampson snake root: i thesampson snake root will kill a snake in ten minutes,! by chewing the.leaves or root, and placing the spittle on! the end of a stick, and letting the snake bite at the end of the stick. Use the snake root by a tea, and the ash leaves by a tea, and poultice by the same. They also cured by drinking or chewing a tea of yellow poplar. Poultice with indigo and vinegar; the indigo being very poisonous, it counteracts the poison of the serpent: if the indigo is used give a good physic, or an emetic, which is better. Nearly every body has heard that an Indian Avould let a snake bite him for a quart of whiskey. 1 know this to bei a fact. The Indian must have the whiskey on sight. Iji 54 can relate a case. A white man gave an Jn*fta*f a quart 6f whiskey to let a snake bite him ; he let it bite him, and commenced drinking the spirits, and started across a small hill. The man attempted to follow the Indian; the Indi- an told him ifhe did he would shoot him. When the In- dian came back, he told me it made no difference whether he used any thing but the whiskey, as it would cure- in 20 minutes; but he would not satisfy the man who gave him the Avhiskey, by telling him that. 1 can find people in the western country who have tested its power : the patient can drink from a pint to a quart in from twenty to thirty minutes, without being in the slightest degree giddy head- ed, and thus cure the sting. When a person finds him- self stung, and has none of the above named remedies, he may scarrify the part, and if he can obtain 20 or 30 grains of calomel, he may apply it to the Avound : it will extract the poison in twenty or thirty minutes if applied in season, and no mistake. Remember, one poison will counteract another poison. If the calomel is used give some medi- cines to cleanse the stomach, either a physic or an emetic. Sweet milk is good : drink freely. TO CURE POISON: Such as poison oak, or any of the poisonous weeds or stings of bees : take the tincture of lobelia, and add to each ounce of the tincture 1-4 ounce of sugar of lead ; if applied in time, three or four rubbings will cure. The above receipt will cure hornet or bee stings : table salt is also a good remedy : calomel will cure any sting in a feAv minutes, even a cat fish snag, which is the greatest of all stings or bites, as they are very poisonous, RECEIPT TO MAKE VERMIFUGE. Take one ounce of castor oil, 50 drops wormseea* oil, 10 drops spirits of turpentine, and 10 drops oil of bare foot root. Dose—a teaspoonful each hour. Before using the vermifuge, it is best to ~'<*e plenty of sugar. 55 RECEIPTS TO MAKE TOOTH-ACHE DROPS, 1. Take of pellatory root 6 drachms; pepper, long, 4 drachms; capsicum 4 drachms; opium 1 drachm; gum camphor 2 drachms : add one pint alcohol—apply in the tooth with 'cotton, or rub on the part that aches : the pella- tory is an European root. 2. Take of opium 2 ounces; addl pint alcohol tincture, for five days : pour off the tincture into another bottle; add 2 ounces nut galls pulverized—tincture five days: put the tincture into another bottle; add 2 ounces gum camphor and 4 ounces pure tar—then the drops are ready for use. Apply in the tooth with cotton or lint: this preparation cures in one minute. RECEIPT TO MAKE STIMULATING LINIMENT. Gum camphor 1 ounce, oil cloves 1 ounce, oil horsemint 1 | ounce, aque FF. 1 ounce—apply by flannel or the hand : | this liniment will stimulate in 5 or 10 minutes, and blister in 20 or 30 minutes, RECEIPT TO CURE CORNS. Wash the feet in warm Avater; peal the corn as close as you can without making it bleed: then use wilted cabbage leaf the usual way of dressing blisters—apply three or four j thicknesses of the leaf at each dressing every evening for one week, and the corn will not hurt for 5 or 6 months. J RECEIPT FOR TAKING OUT CORNS. Take of oil spike 1 ounce, muriatic acid 1-2 ounce, and ni- | trie acid 1-2 ounce: put in a 4 ounce vial, add 1 or 2 drachm3 of common pot ash, shake it well, and let it stand j for two or three days—then pour off the oil and apply it \ to the corn and you can lift the corn out: then apply ij healing salve. 56 RECEIPT FOR TOOTH POWDER. Bayberry, opium, kircuma, golden seal, and snuff, finely pub verized : rub the teeth with the powder; let it stick to the teeth over night, and wash off in the morning : this is a sure cure for scurvy on the teeth. RECEIPTS FOR EYE WATER. 1. Take green ozera water willow bark 1 pound; scrape or pound fine; pour on one pint boiling water; let it stand two hours; strain, and add 3 grains pearlash, 3 drachms table salt, 10 drachms refined sugar, and 1 glass French brandy: rub three or four times a day. 2. White vitriol 1 ounce, and ground alum salt 3 ounces ; put them in an earthen crock ; put it on hot embers, stir- ring the vitriol aod salt till they become of a grey color; add one quart of rain or soft water; boil for five or ten minutes; then add three tablespoonsful of lump sugar, and strain and bottle for use : rub the eyes three or four times a day—for children, add one half water. For inflammation of the eyes or eyelids—Use the eye Avater, and poultice each night with ground ginger and slippery elm : use the tincture of lobelia seed and cayenne pepper, by rubbing near the eyes two or three times a day. For inflammation of the eye—Take one pint of vinegar and one pint of sweet milk; boil, add equal quantity of slippe- ry elm, and poultice: if the inflammation is very high, add a small portion of lobelia seed and cayenne pepper. rheumatic liniment—goodfor pains generally. Take of spirits of turpentine 1 gill, gum camphor 1-2 ounce, oil of sassafras 1 drachm, oil of origanum 1 drachm. Mix and keep in close stopped bottle : apply to parts affected, by the hand, several times a day. 57 RECEIPT for elder salve. Take of elder bark 2 ounces, mashed well; fresh butter 6 ounces; stew for five or six hours on embers; strain, and add 2 ounces beeswax, and one ounce balsam fir. BECEIPT FOR A MIXTURE That is infallible for the cure of sprains in man or horse. Camphor 1 ounce, pennyroyal oil 1 ounce, sweet oil 1 oune, and half a pint of spirits of Avine : mix these Avell by sha- king, and it is fit for use : rub the parts affected two or three times a day for five or six days. A CURE FOR BOTS. Many a fine horse is lost by bote. Take tarter emetic 1 teaspoonful, and add 1 pint water : drench the horse : it will not puke, but the system will relax, and the bots will yield. Give aloes to discharge the bots. FISTULA. Fistula is a disease well known as an ulcer on the rectun;, The tube through Avhich matter passes penetrates deeply into the flesh, its direction being inward and upward. Treatment. Poultice with white oak bark, beef galls, and slippery elm bark; inject with a small syringe castile soap; then inject Avith a strong tea of beach drops, or sheep sorrel, or oxalis acetocella ; burn sea grass to ash- es and make a ley combined with strong alum Avater and the juice of sassafras leaves, and inject three times a day for eight or ten days. Heal Avith a salve composed of sperm candle, balsam fir, beeswax, and the extract of gipsum leaves; introduce the plaster and salve to the bottom of the ulcer by a small probe. The cancer 58 plaster that I can furnish is excellent for this fornTof disease. Cleanse the blood with the best medicines for that purpose, A CURE FOR BLIND PILES, Annis seed one ounce, aloes 4 ounce, and brandy one pint. Dose—A table spoonful three times a day. 2. For blind piles—the oil of ear corn, given in from 20 to 30 drops a day, say 10 drops three times a day. PILE OINTMENT. Extract of stremeniun, sperm candle, snuff—mutton tal- low will answer, though not so good as the sperm : take equal parts, with a sixth part of balsam fir. Directions— For piles, rub three or four times a day till a cure is per- formed. If the piles extend up the fundament, you may cut nicks in a tallow candle and extend it for 10 or 20 hours, with the ointment on the same. TO MAKE EXTRACTS FROM ROOTS OR BARKS, This is the way I prepare my medicines, and give them in the form of pills or syrups, which is the best AATay to give medicines. Three or four pills of pure extract will have more power than a quart of tea. You will hear the patient remark, that he had rather have a new school doe- tor attend him, only he did not like to take a gallon of tea, or even a quart of tea at a dose. Well, this obstacle can be removed by using the extracts; and I strongly urge every doctor to use his medicines in this form, and every family can procure them, and use them when they need them. Take the herb when in bloom, or in seed, or when the seed are ripe. Barks may be taken when they will peal, as they can be much more easily procured. You may prepare for tonics, dogwood, boneset, waughpoo, yellow poplar, wild cherry, iron weed, willow, sassafrajs, 59 and May weed; for physic, elder flowers, rhubarb, butter nut, blood root, mandrake, black root, milk Aveed, and blue flag. Directions to make the extracts—Boil the roots or barks from thirty minutes to tAVO hours. Roots and barks need to be boiled much longer than leaves. After boiling a sufficient time, let your liquid settle; then strain, boil down to the consistency of molasses, skimming the light part that rises to the top : then put the extract into a vessel, and set it into a larger one of boiling water, and boil; your extract will thus become thicker, and not be so apt to get burned. It should be nearly thick enough for pills, and will keep for any length of time; if it is not thick enough it will sour, to prevent which, add alcohol. If you mean to use in the form of syrup, add as much al- cohol as will preserve it. WHITE SWELLING. The first form of this disease may be cured by cleansing the stomach, poulticing with bare foot root, and applying the oil of bare foot to the part, bathing it in by holding a hot iron near it, or holding it to the fire. When the boneis diseased, the Indian treatment is, first, to poultice with May apple, the green root, which will eat out the fuugus flesh : poultice with table salt, hen's eggs, and corn meal; then make a caustic, Avith a dough of eggs, salt, and corn meal, baking it to a hard crust, and sprinkling the powder on the diseased part: keep the orifice open for some time, so that the diseased part of the bone may slough off: pu- rify the blood with waughpoo and sasarparilla, and then poultice Avith light bread and slippery elm. There should be no healing salve applied, as. it will heal up too soon, and break out again : keep it running for months, and by the blood becoming full, the bone will become healthy, granulation will take place, and a cure will be performed. The general practice of healing up the sore too soon and letting the fungus flesh remain, causes it to break out again. Dregs of number 6 are good to poultice with. 60 hysteria nervous. Take the tincture of castor tincture of nervine, tincture of myrrh, spirits of camphor, equal parts: give in tea. spoonful doses each 30 or 60 minutes, or as often as the case may require. hysteria pills. Take the tincture of shell bark (hickory bark,) 1 ounce, beaver castor 1-2 ounce, capsicum 1-2 ounce, asafceitida 1-2 ounce, extract of nervine 1-2 ounce, lobelia seed 20 grains, gum myrrh 1 ounce: roll into pills—give from 3 to 6 a day, or according to age or temperament. uterine hemorrhage. Give a strong tea of red raspberry and Avitch hazel, Avith the application of jugs, filled Avith boiling Avater, to the back, and flannel cloths rang out of boiling water, renewed eve- ery 20 or 30 minutes, and Avarm applications to the feet. If this treatment has not the desired effect, give a teaspoon- ful each hour, for three or four hours, of pure capsicum. If the patient has a distaste for the pepper, roll it into pills with a few drops of the oil of annis seed or sassafras oil : you may roll the pills in cinnamon bark, finely pul- verized, or wheat flour, to avoid the taste. I have cured, after all hopes had fled, with pure pepper. female bitters—to regulate the catamenia. Take asarum canadense2 ounces, caulopbyllam chalictrades 2 ounces—extract the strength by boiling down to four ounces; then take 4 ounces 90 per cent, alcohol; add 60 drops oil pennyroyal, and 60 drops oil of winter green. Dose—A teaspoonful each hour ; three teaspoonsful of the . tincture of blood root each 24 hours to regulate the bow- els—one in the morning, one at noon, and one in the eve- ning. 61 hemorrhage of the lungs, If the lungs are much affected with phlegm, give ipicac to discharge it: then take equal parts of cayenne, Avitch ha- zel, red raspberry, bayberry, and crane bill—give a strong decoction of the above : alum water gives relief, mother's cordial For the cure of flour alius, whites, weakness in the small of the back, or debility of the system. Take yellow poplar bark, dogwood bark, golden seal, samp- son snake root, burdock seed, and hemp seed, 4 ounces each; add 1-2 ounce cayenne pepper; make into syrup, say 10 ounces ; add sugar and spirits to preserve. Dose —three wine glassfuls each day, with two pills of the com- mon size, of turpentine, from a pine tree, the yellow pine best. N. B. Best way is to take the extracts of these roots and bark, add the pepper and turpentine to the extracts, and roll into pills, and use from 3 to 6 pills each 24 hours, once, twice or three times a day. liniment—to reduce swellings. Take rosin, tallow, salt and soft soap—stew all together ; this liniment is good to reduce swellings. I use this lini- ment much on women before delivery, as it relieves. rheumatic drops. Rattle root, sulphur, prickly ash bark, polk root, and horse gentian one ounce each, hydriodate of potash 20 grains, blood root 1-4 ounce : add one pint good brandy. Dose —A Avine glassful three times a day. CANCER. Before the cancer commences to discharge, and when there is considerable hardness in the part, drink the tea of yel- 62 low dock root and skunk cabbage root, equal parts- drink freely : this tea will make the patient very weak, but it will destroy the cancer, and the parts will become soft and natural. Should the cancer break and com- mence discharging, boil down the same roots, and the extract will eat the cancer out: then you may cleanse the blood with the root of burdock, Indian arrow root and cu- cumber tree bark : rub in the commencement three times a day with rattle snake's oil over the cancer. CANCER PLASTER, Used by the Indians, Avhich is the most sure caustic for their removal—even rose cancers. Take of the root of crane bill, beach drops, sheep sorrel, white oak acorns, and the bark of parcimon tree, equal parts—boil and extract the strength to a plaster : apply the plaster tAvice each day till the cancer, with the roots drop out, Avith a little lifting round the edges. Remember to wash Avith castile soap every time the plaster is applied. Cleanse the blood, and give tonics, or combine together burdock root, cucumber tree bark, boneset, and Indian arrow root, sufficieut to re- lax and act on the liver. 1 use poultice instead of heal- ing salves to heal the sore, as they Avill heal as soon as the blood is purified. 2. Cancer Plaster—Take the extract of blood root, beef galls, rattle.snake's oil, and lobelia seed, equal parts—re- new this plaster three times a day till the cancer yields. Remember to cleanse the blood- 3. Cancer Plaster—Make a caustic or extract by boiling the ashes of swamp ash to the consistency thick molas- ses— add one half rattle snake's oil : apply the plaster once a day; use a little ginger when the plaster is remov- ed; poultice with slippery elm or molasses; give medi- icines to cleanse the blood, as no cancer will ever be cur- ed while the blood is impure. 4. Cancer Plaster—Take the the extract of dogwood bark, sassafras bark, Avhite sumach, black haAV and; green par- 63 ci'mons or the bark of the root of the tree—boil and get the extracts, and apply twice each day : commence by leav- ing the plaster on one hour at first, and continuing it lon- er each succeeding day. 5. The French wash for foul ulcers, old sores or cancers— Take nitric acid and muriatic acid, equal parts : put the acids into a vial or bottle three times the size of the acids; add to each two ounces one copper cent, and let them dis- solve the copper : then apply it to the sore or cancer— this is an excellent remedy for foul ulcers, as it will change the smell in an hour or two : apply twice a day till the fungus flesh is destroyed. COUGH LOZENGES. Take hoarhound leaves 1 ounce, bark of the root of spinnel wood 1 ounce, boneset leaves or flowers 1 ounce, Indian turnip 1 ounce, and blood root 1-4 ounce, (all finely pul- verized) oil of annis seed 1-4 ounce, skunk cabbage may be added to it (if it can be had) one ounce : add 2 pounds lump sugar, finely pulverized, and from 3 to 6 ounces of slippery elm, Avith a sufficient quantity of boiling Avater to make a mass—roll out Avitn a roller: and with a piece of tin in the shape of a bloAving horn; cut Avith the little end; they will then roll out of the other end easy—use according to the violence of the cough. cough lozenges—made with extracts. Take the extract of blood root 1 ounce, extract boneset li ounces, extract of hoarhound 2 ounces, extract of Avaug- poo bark 2 ounces, extract of unicorn root 1 ounce, ex- tract of spikenard 1 ounce, extract of elcampaigne 2 ounces, powder of the root of skunk cabbage 1 ounce, 2 ounces of Indian turnip pulverized—add 3 pounds refined sugar and a sufficient quantity of boiling water, and pulverized slippery elm bark as will make the mass : roll out, cut and spread them until they dry—then preserve in a glass 64 iar. Dose—according to the violence of the disease, age, temperament, and strength : the blood root acts on the li- ver, lungs and bowels, and on the whole system, and is hard to be beaten in croup. WORM LOZENGES, Take the extract of lobelia cardenales 1 ounce, extract of the root of black haw (of the bark of the root best) 1 ounce, seed of Jerusalem oak 1 ounce, and finely pulver- ized pink root 1 ounce: add spirits of turpentine 2 drachms, and lump sugar 1 pound : roll, and give a common sized one each hour; then give elder fkrwers or oil to start the worms. If you cannot obtain all the articles, use what you can obtain; the powder of the root of black haw will ansAver a good purpose to destroy worms. N. B. Take melted pewter, and pour it into a goard by cutting a hole at the small end; shake the boiling pewter until cool; it will be in a fine powder ; give the powder for the removal of worms—20 grains two or three times a day, giving physic after a day or two. A small quantity of copperas, given three times a day, say 2 grains at a dose, is a good remedy for worms. CRAMP CH0L1C MIXTURE. Take oil of annis seed 60 drops, oil of pennyroyal 90 drops, oil of cinnamon 50 drops, oil of peppermint 50 drops, oil of catnip 80 drops, and oil of cloves 50 drops—add 1 pint of alcohol 76 to 90 per cent., gum camphor 2 drachms, tincture of myrrh 4 ounces, tincture of rhubarb or blood root 2 ounces, tincture of cayenne 1-2 ounce, laudanum 2 ounces, spirits lavender 2 ounces, and spirits aether 2 ounces. Dose—a tablespoonful in one of water. N. B. If all the articles cannot be obtained use what you have of them. 65 A CURE FOR FOUL ULCERS OR SORE LEGS, Very common at the present day. Take pure extract of stremoniem leaves as a common salve. If this fails, use the extract of the bark of beach tree, by boiling the bark: it will be clear as crystal, by pulling it like shoemaker's wax. Apply this as a common salve, or take the leaves of the beach tree, Avhich is excellent to heal old sores. and to cleanse the blood. TO STOP A'OMITING. Take cayenne pepper, poultice the stomach, and the puking will cease inStior 30 minutes. 2: take one spoonful of vine- gar, one .spoTJn'ful lump sugar, one spoonful of the Avhite of hen's eggs, and beat them together : give a spoonful each 20 minutes. 3 : take chicken gizzards; cast off the inside of the gizzard, boil, and give the tea. 4 : take 2 of the berries of blue, or rather the white on the top of cohash—it groAvs near the blue cohash : three or four of the berries are a sure cure for puking. The obove are" used by the Indians in Iowa. FEVER IN THE FEET. Leaves of bitter root and dog's bone will cure burning hands or feet by using the tea freely : they will also cure boAvel complaint: the leaves an astringent—the root a catlr-ii tic. WORM SYRUP. Take yellow poplar bark 1 ounce, black haw root, 1 ounce. wormwood leaves 1 ounce, and spice bush bark 4 ounces: reduce to a syrup by boiling; add sugar and spirits suffi- cient to preserve ; then add to each ounce thiee grains of copperas. Dose—A teaspoonful three times a day; give oil after using a day, or add to your syrup the tincture of E 66 rhubarb or the tincture of elder flowers sufficient to move the bowels. DRY BITTERS. Take pulverized unicorn root 1 ounce; poplar bark 1 oz.; myrrh 1 ounce, cloves 1 ounce, ginger 1 ounce, cayenne 1-4 ounce, golden seal 1 ounce, all finely pulverized : add 1 pound lump sugar. Dose—A teaspoonful three or four times a day, taken dry ©r in water. BOX LINIMENT. Take linseed oil 1 pint, cayenne pepr^JB ounces, mutton tallow 1 pound, beeswax 4 ounces, or just as much as will make it stiff enough to preserve : add oil of annis seed 2 ounces, oil of pennyroyal 2 ounces, oil of horse- mint 2 ounces, oil of cloves 1 ounce, oil of cedar 1-2 ounce, extract of lobelia 2 ounces, gum camphor 4 ounces, and oil of sassafras 1 ounce—stew and mix all together, box, and use freely on the diseased part. N. B. I find nearly all, if not all the liniments need spirits of turpentine to make them penetrate; if you want plenty of pains, rub Avith spirits of turpentine : the extract of lobelia relaxes sufficiently. CURES FOR DROPSY. Take mustard seed, juniper berries, horse radish, elder bar k (of the root,) mandrake root, and bitter sweet root, in equal parts, say one ounce each : add 3 quarts hard cider, 1 drachm copperas or 5 drachms iron rust, Avell pulver- ized. Dose—A Avine glassful three times a day, less or more', according to the patient. 2. Take the inner bark of white pine tree 5 pounds, shu- mach roots or bark best 1 pound, prickly ash bark 1 pound, barley seeds 1 pound, rusty nails 5 or 6 pounds— 67 boil in four gallons Avater to three pints; add spirits and sugar to preserve. Dose—from a teaspoonful to a wine glassful three times a day : bathe the [feet each evening for one hour, before going to bed, in bitter herbs, mustard, or Aveak ley- I 3. Take the express juice of elder bark, burdock roots and leaves, prickly ash bark, and green leaves cucumber tree or the hark—pulverize or pound equal parts of each, press out tls juice by means of a press or screw, such as a jack screAV : add one quart of whiskey to one quart of the juice —add 3 ounces of ;-the tincture of bitter root. Dose— from a teaspoonful to a wine glassful 3 or 4 times a day : bathe the feet in mullen leaA^es: boil the leaves and bathe in the wattfBfc^i.bitter herbs, from thirty to sixty min- utes each e^BBg. CROUP MIXTURE. Take express juice of green garlic and onion juice 1-2 ounce each, castor oil 1 ounce, spirits turpentine 1 ounce, spirits camphor 1 ounce : mix well. Dose—For children one year old a teaspoonful each ten minutes till the disease is checked. This compound answers Avhen an emetic canribt be obtained in a-few minutes : there is no time to be lost, as this disease is fatal in an hour or two. GRAA-EL. A tea of silks of corn—drink freely : preserve the silks when the corn is in the roasting state. COUGH DROPS. Take blood root 1 ounce, spinnel Avood bark 1 ounce, each, skunk cabbage 1 ounce, Indian turnip 1 ounce, el- campaigne 1 ounce, comfrey root 1 ounce, hoarhound 1 ounce, boneset 1 ounce : extract the strength by boiling 68 in one gallon water down to a pint—strain, boil and skim: add sugar and spirits to preserve. Dose—from a teaspoon- ful to a tablespoonful six or eight times a day if required. MORTIFCATION POULTICE. Take allum, gun powder, flour of sulphur and cayenne pep- per: poultice, and drink tincture of cayenne and gun mvrrh : hop tea and cayenne are the most poAverful : el- der blows, sassafras baik, ginger, camomile floAvers and slippery elm are good. ANTI-BILIOUS DRO^^Bfc Take senna leaves 6 ounces, turbeth or blood root 2 ounces : extract the strength by boiling in water—strain, boil, and skim; then add lump sugar t p mnd, scammonia 1 ounce, gum gamboge 1 ounce, and 1-2 pint fourth proof brandy or sufficient to preserve : this compound is sufficient to make three pints. Dose—A teaspoonful every hour un- til it operates freely :• the dose may be regulated from » teaspoonful to a tablesp ">onfi 1. ANTI-BILIOUS I'owrin. Take jallap 0 ounces, senna (pulverized) 1 ounce, cloves 1 ounce, rhubarb 1 ounce, and aloes 1 ounce. Dose—A teaspoonful in one half cupful of Avater—repeat in threo hours : if bilious fever, tAvo or three teaspoonsful at a dose till it operates freely. PILLS FOR PHYSIC. Mandrake 4 ounces, ginger 1 ounce, pleurisy root 1 ounc-. cayenne 1 4 ounce, all finely pulverized : mix well, and add honey, oil of pennyroyal and annis seed sufficient • > 69 mix into pills—oils 2 ounces. Dose 3 to 6 pills for an adult; 1 to 3 for under age. POLYPUS. If in the uterus, use a ligature ; if in the nose, use a ligature ©r the powder of blood loot snuffed three or four times a a day till a cure is effected. FAMILY PILLS. Take the extract of blood root 1 ounce, extract of black root 1 ounce, extract of boneset 1-4 ounce, extract of waughpoo root 1-4 ounce, oil of pennyroyal* 1-2 ounce. and oil of sassafras 1-2 ounce : add rhubarb sufficient to make into pills. Dose—from 2 to 6 pills; in bilious fe- ver larger doses. CURE FOR THRUSH. Take golden seal 1 ounce, sage leaves 1 ounce, borax 1 j drachm : extract the strength by boiling—then add honey (1 and wash every two or three hours. I EMETIC. J When you intend to give an emetic, first give freely of some stimulating teas, su< h as ginger, pennyroyal, peppermint, or boneset. By giving Avarm teas to relax the system, or even to expand the stomach, the patient will not cramp. It is h'i:■•, that in the case of children with croup, the eme''rr should be given as quickly as possible, as there is no time to be lost. Take of lobelia seed from 1 to 2 teaspoonsful, ipicac 1 tea- , spoonful : add a common teacupful of milk warm Avater, luid give a table spoonful every ten minutes until it vorn- I its freely : the extract of lobelia is best for an emetic, giv- j 70 en in pills the size of a pea, in three parts, ten minutes apart: give plenty of teas before and after it operates to make them puke freely and with ease. Emetic by tincture.—Take of the tincture of lobelia seed or leaf 1 ounce, tincture of blood root 1 ounce, tincture of boneset 1 ounce : this is the best form for children; use as before directed in from teaspoonful to tablespoonful do- ses every ten minutes. SOUNDS OR BISSING IN THE EAR* Take tincture of cayenne, tincture of lobelia, spirits cam- phor, and olive oil, equal parts : apply Avith cotton in the ear every three or four hours. 2. Fill a jug Avith boiling water, and introduce a goose quill through the cork, aril lay with the ear near the quill. A GOOD REMEDY IN TYPHUS FEVER. Take poplar bark (finely pulverized) 2 ounces, flour of sul- phur 1 ounce, cream "of tarter 2 ounces, and quinine 2 drachms : mix well—giAre in teaspoonful doses at inter- vals of from one to two hours; it may be given in vrarm water : a pill each hour of the extract of boneset. SCUM ON THE EYE. Take double F refined loaf sugar; grind fine iff rolling a glass bottle over it; put the sugar in the eye twice a day, and use the eye water that I have described Avith the salt in; use four or five times a day; if you do not cure by this treatment, take the tincture of blood root—touch with a feather on the eye tvricea day; then use the sugar. 71 VENEREAL, Take of sarsaparilla root 3 ounces, mandrake root 3 ounces, blue flag root 2 ounces, sassafras bark 2 ounces, polk root 1 ounce, white sumach root 3 ounces, blackberry root 3 ounces, burdock root 4 ounces, bark of cucumber tree 4 ounces : pulverize or pound the roots, and the strength will be extracted with less boiling; put the roots in an iron, copper or brass pot or kittle; add one gallon of water; extract the strength by boilng to one pint; clean the pot, strain your liquid, and put it in the pot; bring the liquid to a boil, skim, and then add one pound sugar and one pint best Holland gin. Dose—a Avine glassful three times a day, more or less, according to the strength of the patient; it should operate on the bowels from three to five times each 24 hours : this is a sure cure. If there are any ulcers, wash with castile soap; then drop 3 or 4 drops of nitric or silver luner caustic—dissolve it in water, say from 10 to 15 grains in an ounce vial: then you can heal with the extract of gimpsum leaves or any good healing salve, or by sprinkling calomel on the sore. Beach leaves pulverized and stewed in tallow, adding beeswax and balsam of fir, is excellent. 2. Receipt for Venereal.—Take lobelia sificilica, of the j leaves, (this species of lobelia groAvs in wet land from 3 j to 6 feet high, pods near the stock,) 2 ounces, blue flag | root 2 ounces : add one quart of Holland gin. Dose— | From three to five wine glassesful a day, less or more, I according to the patient's strength, &c. 3. Receipt for VenereaZ.-Iodine 10 grains, hydrodate of pot 1 ash 10 grains, in an ounce vial of water. Dose—a tea 1 spoonful three or four times a day. 4. Venereal Pills.—Extract of May apple 1 ounce, extract of blue flag root 1-2 ounce, extract of burdock root 1-2 ounce, copperas 1 drachm, salt petre 2 drachms, extract of blackberry root 1 ounce: take the powder of May apple root and thicken : roll into pills. Dose—from 3 72 to 6 pills, according to age and temperament. Use tho pills so as to operate from 3 to 6 times each 24 hours. GONORRHOEA. Take blackberry root 3 ounces, May apple root 3 ounces, bark of sassafras root 1 ounce, and white oak bark 4 oun- ces : extract the strength by boiling water to 6 ounces; then add 4 ounces lump sugar; then take 8 ounces of 90 per cent alcohol, and add 2 ounces of oil cubebs. Doso —3 wine glassesful each day, half an hour before or after meals : take less or more according to the patient's strength. GLEET. Take May apple root 5 ounces, Avhite oak bark 4 ounces, beach bark 4 ounces, blackberry root 6 ounces, and sar- saparilla 6 ounces : extract the strength by boiling to 8 ounces : add sugar 1-2 pound, alcohol 5 ounces, and oil of cubebs 1-2 ounce. Dose—according to judgment, from 1 to 3 wine glassesful per day. 2. Gleet Pills.—Extract of May apple 1 ounce, copperas 1 ounce, yellow pine turpentine, just as it comes from the tree, (the white pine will do, but not as good,) salt petre 1 drachm : roll into pills—use from 2 to 8 each day, with 3 or 4 pills each day of the turpentine. By itself the turpentine is excellent: the pills, may be rolled in wheat flour or the powdered root of May apple. DYSENTERY. Character. In inflammation of the mucous membrane of the intestinal canal, attended by fever, frequent bloody mucous stools, griping, and tenesmus. Symptoms. The fever generally becomes developed, before the enteritic symptoms—sometimes the reverse takes place. The violence of the tenesmus, a pretty correct criterion of 73 the violence of the disease; tormina most severe, just be- fore the calls to stool; constant soreness of the abdomen; evacuations sometimes wholly mucous; more commonly mixed Avith blood—occasionally, altogether blood, smell of the stools, at first, disagreeable, but not fetid—urwards the last, of a cadaverous, penetrating fetor. In violent ca- ses, colliquative diarrhoea sometimes comes on, a few days before death. Tongue at first white, afterward brown, rough, and dry along the middle, with a red and moist bor- der; clean and florid olong the edges and tip, or smooth, clean, and deep red over its whole surface, in protracted cases. In some very protracted cases, the tongue and fau- ces become aphthous. The stools are never colored with bile. The skin-iss always dry. Autopsic appearances. The traces ofinflamma'tion are some- times confined entirely to the colon; more commonly, however, marks of inflammation appear throughout the whole intestinal canal; but even where this is the case, the colon and rectum exhibit much stronger marks of disease than the other portions of the intestines. Very frequently. the mucous membrane of the colon and rectum is found ulcerated, thickened, soft, pulpy. The liver is frequently found to have suffered structural derangement; it is most commonly enlarged, and in a state of great sanguineous congestion. Causes. Cheecked perspiration, by the application of cold. Analogy between dysentery and catarrh, founded on thr similarity of. their aetiology. Suppressed perspiration al- Avays among the first morbid phenomena of dysentery. Deranged function of the liver and the skin are invariably present. (Johnson.) "The period.most favorable for the production of dysentery, is when a cold and moist au- tumn succeeds a warm and dry summei." (O'Brien.) Dysentery appears often to be the production of the joint influence of atmospheric vicissitudes and marsh miasma- ta, Sporadic causes, such as, unripe fruit; indigestible and umyholcsome food; irritating substances received into the 74 bowels, Not contagious. Scyballa have been much ac- cused of giving rise to dysentery; the correctness of this ac- cusation is denied by Dr. Johnson, and I believe very just- ly. I have seen a very great number of dysenteric pa- tients: and yet the number of cases in Avhich I have noticed the discharge of these hardened balls of faeces, is exceed- ingly svnalL Prognosis. Cases in AA'hich the stools consist almost entire- ly of blood, are generally more tractable than when the discharges are principally mucous. Colliquative diarrhoea, at an advanced period, very unfavorable; stools of a pen- etrating and cadaverous smell, a very bad sign.—Tymp- anitis, with small mucous stools, or with fetid sanious dis- charges from the bowels, highly unfavorable. A small, frequent pulse, with a sunken and cadaverous countenance, hiccough, and cold extremities, indicate a fatal termination. Bile appearing in the stools, is a favorable sign. In estimating the comparative importance of these indications, it is necessary to recollect, that suppression of the cutaneous exhalation, and consequent torpor of the liver, with an engorged state of the portal circulation, is antecedent to and causative of the intestinal phlogosis, and that, the reaction of the heart and arteries is con- secutive to this local inflammation. From these circumstances, therefore, it seems evident that the restoration of the cutaneous hep- atic functions, constitutes the most important in- dication in the treatment of this malady; for in proportion as we succeed in the fulfilment of this indication, so do we equalise the circulation, les- sen the determination to the bowels, and conse- quently moderate the local inflammation upon which the peculiar symptoms of the disease de- pend. Treatment. The indications are—to moderate febrerial ex- citement Avhen excessive; to restore the functions of the 75 skin and liver; to subdue the local inflammations and. affections of the bowels, to answer this emetics of lobelia or ipicac, and a mild cathartic of rhubarb, oil, or elder floAvers. MUCILAGINOUS DRINKS. Slippery elm, malloes, enemata3 if required, of the tincture of gum myrrh, Avith a tea of Avitch hazel, slippery elm tea of deAv berry root or beach buds—2 ounces of either ©f these roots are sufficient for one patient for two or three days. Take 2 ounces of the "root of crane's bill, elm root, jocklet root, even root, jeranium (known in different countries by these different names,) use it in a strong tea. In the fall of 1841, I cured over 200 persons with this root. It will stop hemorrhage: the green root pounded and laid on the part of a broken vein or even an artery. dysentery pills. Nutmeg 1 ounce, chalk 1 ounce, opium 1-2 ounce, rhubarb 1 ounce : roll into common size pills. Dose—1 pill in the morning, 1 at noon, and 1 on going to bed, drinking elm tea ormoksses, or brown flour;, DYSENTERY DROPS. Essence of oil annis seed, essence cinnamon, spirits cam- phor 1 ounce of each, with 1 ounce calcined magnesia ; mix in-a 6 ounce vial. Dose—15 drops to a teaspoonful each hour if required, using slippery elm as a diin.? to soothe and heal; if an adult add tincture of myrrh 1 oz., laudanum 1-4 ounce : use warm bath to draAV the deter- mining powers to the surface. Sampson snake root is said to be excellent: I have chewed it but it produced no effect. Parcirhons will check instantly : dry the green parcimons, and give the powder in from 5 to 10 gram do- 76 ses every 3 or 4 hours. The Indians, when they cannot obtain crane's bill, use a powder of white oak acorns : 2 or 3 acorns will cure a common case, by using slippery elm, or malloes, or a tea of the bark of gum tree: the gum wax will cure, if given in pills. CHRONIC ENTERITIS. This modification of enteric inflammation is of frequent oc- currence. Itssymptr.ms are often obscure and equivocal- Most of the cases usually termed marasmus, consist of chronic inflammation of the mucous membrane of the bow- els. Chronic diarrhoea also generally depends on this grade of internal phlogosis. Symptoms. No distinct abdominal pain; obtuse pain on firm pressure on the abdominal parietes; a sense of soreness also is felt; muscular debility; pulse small and weak; cold hands and feet; slight febrile exaceibations in the evening; pain in the bowels, or nausea, after taking food; frequently constant dianhcea; in inveterate cases, the skin is dry and "Sallow; sleep interrupted; tongue smooth and red round uV edges, and broAvn in the middle; great emaciation; painful d.arrhcea, alternating also with costiveness; appetite varic- ble, being sometimes voracious, at others einirely gone; the food is often evacuated from the bowels, in an imperfectly digested state; the alvine evacuations vary in appearance; sometimes slimy and small in quantity, at others copious, liquid, and dark. The disease continues for many months, and even for sjveral years. Causes. Sometimes the consequence of acnte phlogos:s of the mucous membrane of the bowels; irritating and indi- gestible food; the influence of a cold and damp atmosphere: drastic cathartics, and other irritating substances, whether received from Avithout, or generated in the boAvels. Tkeatment. Bayberry, ginger, cloves, cayenne in powder. Dose—A tea to a tablespoonful 3 times a day, and 3 pills 77 3 times a day, composed of equal parts of cayenne, gum myrrh, and slippery elm. I have used a pill composed of extract of blood root, cayenne and slippery elm : these pills will act on the liver, and cure Avhen every other re- medy fails. Diet must be light and vegetable : strong coffee, tea, and bread may be used, but no liquor of any' kind as it will feed the disease for years. INFLAMMATION OF THE LUNGS, AND THEIK APPENDAGES. ACUTE PLEURITIS. Symptoms. Pungent pain in the chest, much increased by inspiration; cough dry, or attended with a glairy and near- ly colourless sputa; pulse full and hard; difficulty of lying on one side; respiration chiefly performed by the abdomi- nal muscles. When the inflammation extends to the sub- stance of the lungs, there is generally bloody expectora- tion. Causes. Sudden exposure to cold, when the tody is in a state of free perspiration; atmospheric vicissitudes; metas- tases of gout, erysipelas, acute and chronic cutaneous afln-- tions, suppressed catamenia, rheumatism. It appeals sometimes to depend on epidemic causes. Autopsic phenomena. The pfeura is red, and punctuated with an infinite number of red points; frequently covered with an immense number of miliary tubercles; false mem- branes sometimes adherent to its interna] surface, adhesions between the pleura costails and pleura pulmonalis; occa- sionally, effusions of sero-purulent, or serous fluid,-into the chest. Prognosis. Acute pleurisy not a very dangerons disease; it* 78 consequences to be dreaded, in persons predisposed to phthi- sis; the more the inflammation extends to the lungs, the more danger; the supervention of diarrhoea, a fatal sign; con- vulsion and coma no less unfavoable. PERIPNEUMONY, In peripneumony, the inflammation is seated principally in the substance of the lungs. It is characterised by the fol- lowing. Symptoms. Difficult and oppressed breathing; dull pain in the chest; cough, with viscid sputa, mixed frequenly with blood; pulse at first hard; afterwards weak, soft, obstructed, and irregular; inability to lie on the sound side; the sputae are of yellowish, or greenish white; exceedingly tenacious: somewhat diaphanous, and intermixed with bubbles of air. (Laennec.) Autopsic phenomena. The structural charges classed under three heads. f. Engoument, or choaked lung. Lungs partially crepitous, of a livid color, containing an abundance of frothy, serous fluid, in its substance. 2. Hepatised lung. Lungs not crepitous; resembling the liver in weight, consistence, and color, having entirely lost its cellular structure, and acquired a granulated ap- pearance, with no extravasated fluid in its substance. 3. Hepatised and granulated structure, with an abundance of an opaque, yellowish, viscid matter, in its substance. This fluid is the result of pulmonary supuration. Percussion. In peripneumony, the sound of the disease side is obscured, and differs from that produced on the sound side, which is more clear. In pleurisy, percussion pro- duces the same sound on doth sides. Pressure made on the abdomen, in pleurisy, does not aggravate the pleuritic pain; in peripneumony, strong abdominal pressure imme- 79 diately excites distressing involuntary cough, oppression, and a sense of suffocation. Position. In pleurisy, the patient lies on the affected side; in peripneumony, on the sound side. Pressure on the intercotal spaces, produces pain in pleurisy, but not in peripneumony; the pain in the former is lancinating, in the latter it is dull. Prognosis. Favorable signs: a copious expectoration of a thick yellowish matter; increased discharge of urine; gen- eral, but not profuse perspiration, with an abatement of the pain, oppression and cough. Unfavorable signs: pain and oppression diffused; dry cough, or thin dark colored expectoration; countenance livid; great dyspnoea; weak, soft, and frequent pulse; delirium; coma; internal feeling of cold, while the surface is hot; a copious and limpid u- rine in the commencement; rattling in the chest; disposition to elevate the head and shoulders, and bare the breast. Treatment. Emetics of the utmost importance : mild lax- atives beneficial. Expectorants—Ipicac, lobelia, seneca snake root, and Indian turnip : rub with the tincture of lobelia, essence of annis seed and cayenne : mucilaginous drinks combined AA'ith, camphor :—the bowels should be operated on with pills of cayenne, gum myrrh, gum cam- phor, and ipicac. . PNEUMONIA B1LI0SA. This variety of pneumonia is produced by the combined agen- cy of marsh miasmata, and sudden atmospheric vicissitudes. Symptoms. Along with the ordinary pectoral symptoms of phneumonia, there are others, indicative of much function- al derangement of the hepatic systems, such as: fulness in the right hypochondtium; pain in the back and limbs; yel- loAvness of the tunica albuginea and skin; sometimes mu- cous and blood discharges from the bowels, Avith tenesmus and acute head-ache.—These symptoms generally precede the occurrence of the thoracic affection, for several days. The attending fever i3 somewhat remittent; bilious vomit. 80 ing is frequent; tongue covered Avith a brown fur; pulse commonly small, quick, frequent, and slightly tense. Treatment. Emetics; gentle cathartics—procure several bilious stools; expectorants useful : settle the stomach Avith vinegar and the white of an egg mixed together, or soda and French brandy. ACUTE BRONCHITIS. .This variety of pulmonary inflammation is generally describ- ed under the name of peripneumonia notlia. It consists of acute inflammation of the mucous membrane of the bronchia, with great sanguineous congestion of the lungs. Much of the peculiar character of the disease depends^on this congestion. Old people and infants most subject to it. Symptoms. Great oppression and tightness to the breast; cough; severe pain in the forehead, greatly increased by coughing; expectoration; at first, a viscid, and frothy Avhite mucus, becoming mixed with blood, as the disease advances; sometimes vomiting; febrile excitement not violent; pulse and heat of the surface, not much above the natural standard; tongue moist and Avhite; counte- nance pallid; little or no pain in the chest; the pain is dull, and attended with very oppressed breathing; vertigo; delirium seldom; wheezing respiration. There is in this disease a particular tendency to effusion in the substance of the lungs; and it is generally fromVfhe occurrence of this circumstance, that the disease proves fatal. Autopsic phenomena. The lungs do not collapse; b;on- chia filled with a tough mucus, mixed with bloody serum and pus; a frothy fluid escapes from the substance of the lungs, when cut into; capillaries of the mucous mem- brane, red and enlarged ; sometimes the pulmonary struc- ture is more or less hepatised. The mucous membrane of 81 the bronchia, is manifestly the principal and primary seat of the disease. Treatment. Emetics among the most useful remedies in this disease : they may be advantageously repeated two or three times. Expectorants of the stimulating kind, ac- tive stimulants, must be given, Avith expectorants, Avhen the pulse becomes very small. Rub the breast with tinct- ure of cayenne and lobelia : the steam of vinegar should be inhaled, combined with garlic or hops; lobelia, ipicac, eupatoriem in small doses to expectorate. CYNANCHE TRACHEALIS. Character. An inflammation of the glottis, larynx, and up- per part of the trachea, attended Avith a hoarse and ringing cough, sonorous respiration, and a sense of suffocation. Symptoms. It commonly comes on gradually:—At first a hoarse cough, Avith slight difficulty of breathiag; afterwards fever, respiration becoming more and more difficult, each inspiration being attended with a peculiar ringing sound; countenance full and flushed, during the first stage.—The dyspnoea becomes at last exceedingly great; the head is thrown back, and the mouth kept open; the eyes are pro- minent, and the countenance pale, livid, and expressive of great agony; the breathing becomes wheezing, in the latter period of the disease; expiration is quick, inspiration diffi- cult and slow; cough sometimes attended with a rattling sound, and the expulsion of very tough mucus. Insensi- bility and stupor generally close the scene. The symp- toms occasionally remit for a short time. Causes. Exposure to a cold and damp air, the most com- mon cause; most prevalent in spring and autumn; children between the ages of one and seven years, almost exclusive- ly the subjects of this disease—it very rarely occurs in adults. Proximate cause. Ratio Symptomatum. The suffocated respiration may de- pend on one or more of the folloAving circumstances:—1, 82 Tumefaction and inflammation of the glottis; 2. Obstruc- tion of the glottis by coagulable fluid, in the form of a false membrane or a concrete mass; 3. From the inflammation extending to the minute ramifications of the bronchia, anu giving rise to effusion into the aircells. Prognosis. The disease is always to be regarded as highly dangerous. The more the inflammation extends into the bronchia, the greater the danger. When the attack comes on suddenly, with high febrile excitement, there is more danger than when its approach is gradual. Very shrill sounding cou»b and respiration unfavorable. In gener- al, however, it is difficult to form a correct prognosis. Spasmodic Croup, essentially distinct from inflamma- tory croup. They may be distinguished by the follow- ing circumstances—viz. Spasmodic Croup is sudden in its°attack, and unattended with fever; Cynaclie Trachea- Vis generally comes on gradually; when its attack is sud- den? it is always Av'tth fever. In the former there are in- termissions, iri the latter remissions only. Cough, with a discharge of viscid mucus from the trachea, always pre- sent in inflammatory croup—in spasmodic croup, cough- ing is rare and always dry. Jn the latter, no shrillness of voice—the pulse small and contracted. Treatment. A prompt treatment with emetics of lobelia or ipicac; if the emetic does not act promptly in ten or twenty minutes, you may conclude that there, is a large quantity of acid ; to neutralize- the acid give soda oi salera- lus : snuff or tobacco leaf laid on the breast; warm bath, washing Avith' vinegar and saleratus—the vinegar to l^ be Avarm. Give an enemata of table salt and the tinct- ure of lobelia. By this means a general relaxation of the system will take place—then the emetic will operate: it may be aided with the tincture of sangunaria, given in teaspoonful doses with the saleratus. I have attended children that I had to repeat the emetic and sangunaria for three or four days. I have cured this disease with gar- lic and onion iuice : common cases yield to one emetic 83 of lobelia and a dose of oil or elder flowers. Take of garlic 1 ounce, sangunaria 1 ounce, and colt's foot 1 ounce; after pulverizing them, add 1 pint of spirits : this may be given to prevent a return of the paroxysm; and it will cure if enough is given to act as an emetic. The dose may be varied from ten drops to a teaspoonful each hour : table salt will cause puking until medical aid can be procured. When I say the tincture must be used once each hour, I mean after the emetic has operated, to pre- vent a return, which will be in 24 hours or 3 or 4 days, and sometimes in 8 or 10 day7s. As there is danger in de- lay, either of the above medicines should be used as earlv as possible, as a person may be Avell one- hour and dead the next. (1 will give a receipt in another part of this book.) CYNANCHE TONSILLARIS. Character. Inflammation of the tonsils, soft palate and fauces, Avith synocha fever. ' Symptoms. Tonsils, and soft palate, red and much swol- len; deglutition very painful and difficult—sometimes im- possible; more difficult in swallowing liquids than solids: respiration impeded; speech indistinct; hearing dull; tongue sAVollen, white, and covered with a thick layer of trans- parent mucus, pulse full, hard, and frequent, copious se- cretion of a ropy saliva. Cause. Cold and damp air, or cold in any manner appli- ed, so as to cause a suctden check on the perspiration, mov be regarded as the exclusive cause of this disease. Per- sons become predisposed to the disease, by suffering an attack of it. The principal danger arises from the swel- ling of the tonsils, which may proceed to the extent of en- tirely interrupting respiration. When it does not end in resolution, it almost alwrys terminates in suppuration. Frequent attacks of the disease are apt to produce perma- nent enlargement of the tonsils. The inflammation has 84 been knoAvn to extend into the larynx, in which danger is greatly increased. Treatment. Gargles of salt and cayenne; poultice the throat; rub with oils or liniment. PAROTITIS. Character. Inflammation and tumefaction of the parotid glands, occasionally epidemic, and manifestly contagious. Symptoms. Hard swelling of one or both parotids, the swel- ling increasing till the fourth day, and then declining gradually. Skin over the tumor seldom red or inflamed; the breasts in females, and testicles in males, often swell, about the period of the declension of the parotid tumefac- tion; a sudden metastasis often takes place from the par- otids to these parts. Fever generally mild, sometimes violent. Children, and young persons are most sabject to this disease —it rarely occurs in old age. It is most common du- ring cold and damp weather. Prognosis. Not in general a dangerous affection; becomes more or less dangerous, by being translated to other parts, as the genital organs, the lungs, the brain, the stomach. I have known a case terminate fatally in less than an hour, by metastasis to the brain; when transferred to the t.-sticles, they occasionally suppurate—an occurrence al- ways exceedingly painful, and sometimes fatal. Treatment. In mild cases, little mere is necessary than keeping the bowels open, and using gentle diaphoretics. The parts should be kept warm; great care must be taken, to avoid taking cold. When the inflammatory symptoms are violent an active antiphlogistic treatment is necessary. When the swelling disappears in the neck, and shows it- self in the testicles, rub with a liniment of hartshorn, camphor, cayenne, tincture of lobelia, and oil of annis ^ed. 85 ACUTE PERITONITIS. Symptoms, At first, lassitude, pain in the limbs; chills: then, head-ache, a sense of weight in the epigastrium; an acute pain in some part of the abdomen, at first confined to a small space, but soon extending itself over the Avbole bel- , ly: the pain is acute and constant; sometimes fixed, and at others Avandering from one part to another. As the disease proceeds the abdomen becomes tumid, and exceed- ingly painfid to pressure. The patient's position is on his back, Avith the knees and shoulders raised, carefully avoiding all motion of his body. The bowels are con- stipated, and moved Avith much difficulty; pulse common- ly small, hard, and quick; tongue Avhite and moist, the ed- ges and raphe being sometimes very red; nausea and vom- ■ iting in the early stage: the face is generally pallid, ex- hibiting a peculiar sharpness of feature. Constant wake- fulness throughout the whole course of the disease; deliri- um, except towards the end of fatal cases, rare; breathing, in the latter period, laborious—inspiration being particu- larly difficult, and attended with an expression of pain in the countenance; suppression of urine, a common occur- rence. When the disease occurs in the puerperal state, the lochia cease, and the breasts become flaccid. Causes. Mechanical injuries of the abdominal viscera; vio- lent and long continued corporeal exertions; stricture of itlie colon and rectum ; extravasations of blood, bile, urine, faeces, chyle, &c. into the cavity of the abdomen; the ac- iion of cold on Hie surface of the body; wet and cold feet; drinking cold Avater, Avhen the body is in a state of free perspiration; perspiration; sudden suppression of hemor- rhoidal dbschaage of lochia, &c. Prognosis. Favorable symptoms. Abatement of the pain. Ability-to bear abdominal pressure, a soft, moderately full, and not vrery frequent pulse; moist and warm skin ; free alvine evacuations; power of changing the position, and resting easy on either side; free discharge of urine; restora- 86 tion (if in the puerperal state) of the lochia; refreshing sleep. Unfavorable signs. Suppuration, or effusion, is indicated by diminution of abdominal pain; a feeling of Aveight in the hypogastric region; irregular chills; cold- ness of the extremities, a soft and feeble pulse, Gan- grene, by sudden and entire cessation of pain; extreme smallness and frequency of the pulse, with great prostra- tion; Hippocratic countenance. Autopsic phenomena. Redness and thickening of the peritoneumjfalse membranes. A collection of fluid, sometimes turbid or whey-like, at others limpid and reddish—rarely blood.. Adhesions be- tween the bowels are common. Gangrenous spots, and red flakes adhering to the peritoneum. Treatment. Active and drastic purgatives, such as jallop, gum gamboger with a large quantity of spirits of turpen- tine, in conjunction, Avhich will operate in an hour Or two: large doses are required. Emollient—poultice with cayenne and lobelia : use stimulating drinks with cayenne, ginger and colt's foot—warm : rub with stimulating lini- liniments, in conjunction Avith jugs of boiling water laid near the back and umbilical region. CHRONIC PERITONITIS. When not the consequence of the acute form of the disease. its approach is so gradual and insidious, that it rarely be- comes the object of medical attention, until organic disor- der or effusion has taken place. Symptoms. A constant feeing of .uneasiness in the abdo- men, with soreness to pressure, or sudden motions of the body, as coughing; sneezing; the skin and abdominal mus- cles often lie loosely over the peritoneum, giving a sensa- tion to the touch, as if a tight bandage were underneath, over Avhich the skin and muscles easily slide. (Pember- ton.) Sometimes, a sensation as of a ball rolling about the abdomen, is experienced. (Broussais.) Pulse rarely af- fected, except towards the evening; Avhen it becomes slight- 87 ly accelerated. The duration of the disease very varia- ble— from a few months to several years. Very rarely cured—Broussais at first thought it incurable. It always terminates either in effusion or disorganisation of the per- itoneum—most commonly, in both these Avays- The ef- fused fluid is either serous, limpid, whey-like, or reddish, with purulent flakes; the peritoivum is thickened, or cov- ered with an infinite number of military tubercles; the in- testines are often found agglutinated into one mass. Most cases of incurable Ascites depend on chronic inflammation of the peritoneum, and consequent struc- tural derangement. Indeed, it is not iinprobabl'-, that in all cases of dropsy of the abdomen, the per- itoneum is in a state of chronic or sub-acute inflam- mation. Treatment. External vesicating or rubefacient applica- tions are of primary importance : jallop, cream of tarter, elder flowers, and warm bath, steaming the part—rub 3 or 4 times a day Avith tincture of lobelia; small doses of bitter root and dog's bane: simple and unirritating diet indispensable, ACUTE HEPATITIS. Symptoms. Acute pain in the right hypochondrium, aggra- vated by external pressure, and generally by lying on the left s"de; pain in the shoulder and clavicle of the right— sometimes on the left side; commonly a dry cough, with difficulty of respiration; nausea and bilious vomiting; gen- erally an icteric hue of the albuginea and skin; urine char- ged Avith bile; scalding of the urine; thirst great: heat of the surface intense; tongue white, or covered Avith a yel- lowish fur; pulse, liaid, full, and strong; boAvels costive. In hot climates, acute hepatitis is often attended from the beginning, with small liquid and slimy discharges from the bowels. These cases are violent and rapid in their 88 progress, although the pain in the region of the liver is sel- dom very great. (Johnson.) Delirum more common in hepatitis, than in any other of the phlegmasial affections, except phrenitis. The symptoms vary accordiug to the part of the liver princi- pally affected; more pain in the thorax and shoulder when the convex surface is inflamed; when the concave part is the seat of inflammation, there is more gastric distress, vom- iting, and nausea. Inflammation of the interior part, known by the great aggravation of the pain or external pressure. Diagnosis. Distinguished from pleurisy, by the greater se- verity of the cough and dyspnoea in the latter. The eas- iest position in hepatitis, is on the affected side—in pleurb tis, on the sound side. In hepatitis, pressure on the right hypochondrium aggravates the pain, pressure on the inter- costal space does not—the reverse obtains in pleuritis; of- ten bloody expectoration in pleuritis—in hepatitis seldom, if ever. In peripneumonia, as in hepatitis, the patient lies easiest on the affected side, but in-the/orwer, respira- tion is principally performed by the abdominal muscles, Avhereas, in the latter by the intercostal muscles exclusive- ly. The diagnosis between hepatitis and gastritis not dif- ficult—-the extreme prostration—the immediate rejection by the stomach of every thing swalloAved—the small and tense pulse, &c, Avhich attend gastritis, distinguish it prom- inently from hepatitis. The absence of fever, and the in- termiting character of the pain, distinguishes spasm of the gall ducts; and the passage through them of biliary concretions, from hepatitis. Hepatitis, if it does not end in resolution, generally termin- ates in suppuration. The degree of danger from suppur- ation, depends much on the situation of the abscess, and the nature of the contiguous parts. When the abscess points outwardly, it may be opened by an incision, and the matter discharged externally. It sometimes breaks in- to the bowels; the matter being discharged by stool; occas. By ionally it bursts through the diaphragm into the cavity of the thorax, or into the substance of the lungs, in which lat- ter case the matter is expectorated. Recoveries after this latter accident are exceedingly rare; always fatal when it bursts into the cavity of the abdomen. Gangrene an exceedingly rare termination of hepatic inflam mation. Doctrines of Saunders and Puchelt concerning the pathology of acute and chronic hepatic inflammation, introduced and discussed. Causes. The influence of cold after profuse perspiration: A-iolent exercise; contusions of the region of the livev; wounds and injuries of the cranium; the irritation of bili- ary concretions; suppression of haemorrhois; violent rage, or deep sorrow, excessive use of spirituous liquors.^ Dr. Johnson's cautaneo-hepatic sympathy, and its application to the aetiology of hepatitis, noticed. Hepatitis most com- mon in hot climates; solar heat and miasmata prominent agents in the production of this disease—they powerfully predispose to, rather than excite the disease: heed excite* the skhi, and miasmata the liver, to inordinate action; tha cold night air checks the former, and consecutively th* latter: fever is evolved, and inflammation established in the liver. Treatment. Emel'cs with an alterative treatment; stim- ulants in the inflammatory stage; ipicac, bitter root, lobe- lia, eupetoriem, and camomile may be given, to act as r:n emetic, each day. CHRONIC HEPATITIS. Symptoms. Dyspeptic symptoms; countenance sallow, con- tracted, and expressive of ill health; dull pain, with un- easiness, tension, and sometimes tumefaction in the right hypochondrium; bowels irregular, commonly costive; some- times diarrhoea alternating with costiveness; aching pain in the right shoulder; urine tinged with bile, and voided with a scalding pain; tongue white, rather dry; gums uu- BO naturally hard: a continued dryness aud constriction of the skin; difficulty of resting easy on the left side; a short and dry cough; slight febrile exacerbations, as the disease advances; emaciation, and finally, hectic with a puruloid expectoration. Terminations: occasionally in suppuration ; more frequent- ly in induration and enlargement; sometimes the volume of the liver becomes contracted. Though indurated, and more firm in its substance than natural,1 it is often speci- fically lighter than in its natural" state. (Saunders.) The substance of the liver usually exhibits an ash or clay co- lor. Causes. Chronic hepatitis sometimes the consequence of the acute form of the disease. Most frequently the result of the sIoav operation of marsh miasmata, &c. The abuse of spirituous liquors, a common cause of chronic hepatitis. Protracted dyspepsia produces it.. Treatment. Mild operations on the bowels with black root, Avith a pill of capsicum and gum myrrh;^ syrup of golden seal, spinnel, or Avaughoo root bark; stimulating liniments—hartshorn, cayenne: free use of slippery elm; internally with eupetoriem. NEPIIK1TI3. Symptoms. Pain in the renal region; frequent and small discharges of high-colored urine; naueea and vomiting; numbness of the thigh of the affected side; retraction of the testicle; pain relieved by bending the body forwards or to- Avards the affected side; costiveness; skin hot and dry: pulse full and strong. Diagnosis. In inflammation of the psoas muscles, bending the body forwards increases the pain; there is rio nausea and vomiting, nor retraction of the testicles, in this affec- tion, as in nephritis. Causes. The influence of cold; mechanical injuries; irrita- ting substances absorbed into the circulation, as turpentine 91 and cantharides; violent exercise, as jumping, lifting heavy Weights; metastasis of gout and rheumatism; calculous con- cretions. Un'ess resolution takes place before the seventh or eigth dav, suppuration generally ensues. The pus sometimes dis- charged with the urine; the suppuration often continued for a long time—producing hectic and great emaciation, or what has been called tabes renalis. Sometimes the matter points externally; in which case, fistulous open- ings are apt to remain. A puruloid fluid in the urine not to be confounded with pus. The. former may arise front mere irritation, from urinary calculi in the kidneys, or sub- acute inflammation of the neck ot the bladder. Puruloid matter distinguished from pus, by the latter fluid sinking down and forming a close layer along the bottom of the vei-sel in which the urine is left standing;—puruloid fluid remains more or less suspended in the urine. Gangrene a very rare occurrence in renal inflammation. Nephritis is apt to leave a predisposition to lithicacid calcu- li. (Prout.) Trratment. Active purgatives required; much relief ob- tained from emollient enemata and constant fomentatios to the region of the kidneys; Avarm bath ; uva ursy; part- ly roots, gravel root, and horse radish given in tea; cmdlient poultice of maloes or slippery elm; cumfrey root, ginger root, lobelia leaf. CYTIT1S.. Symptoms. Severe burning and throbbing pain, with a feeling of constriction in the hypogastric region; pain greatly increased by pressure; constant and ineffectual de- sire to pass urine; pulse, frequent, hard, and full; skin dry and hot; thirst very urgent; great restlessness; nau- sea and frequent vomiting; stillicidium of the urine ; a.< the disease proceeds, swelling in the loins; rigors; cold extremities; delirium, &c. 92 Causes. Mechanical irritation by the presence of foreign bodies in the bladder; retained urine; external injuries on the hypogastric region; irritation from acrid substances absorbed and conveyed to the bladder, as cantharides, tur- pentine, &c.; metastasis of rheumatism ; irritating injec- tions into the urethra; gonorrhoea; suppressed perspira- tion, from the sudden application of cold. Treatment. Cystitis rapid in its course, and highly dan- gerous. The most prompt treatment a warm bath ; poul- ticing the pubic, region and perinuem of great importance; fomentations and emollient enemata ; urine to be draAvn off by a catheter, and emollient fluids injected into the bladder: tincture of lobelia good. ACUTE RHEUMATISM. Character. Inflammation in the fibrous structures about the joints, wandering, and attended Avith severe pain, more or less swelling, and synocha fever. Symptoms. Chills, alternating with flushes of heat, total inappetency, general soreness of the flesh, and lassitude, introduce the disease. After some time, usually about twenty-four hours, the rheumatic inflammation manifests itself. One or more joints become swollen, red, and ex- tremely painful, the pain being greatly aggravated by mo- tion ; pulse full, hard, and frequent; bowels constipated; skin hot, and often covered with profuse perspiration ; re- missions in the morning, and nightly exacerbations. Tha inflammation generally passes from joint to joint. The blood is always buffy. Rheumatism rare in infancy and old age. Most common "between the ages of sixteen and forty-fi\^e. Very fat per- sons less subject to.it than lean and muscular ones. A predisposition to rheumatism sometimes hereditary; de- rangement of the digestive functions sometimes predisposes to it—so does the excessive use of spirituous liquors, and the imprudent use of mercury. 93 Causes: The influence of variable temperature almost the only exciting cause. Rheumatic inflammation seated in the fibrous textures of the body; essentially distinct from common inflammation; shifts its place like gout; metastases to important inter- nal organs, always very dangerous; rarely terminates in suppuration ; never terminates in resolution, without the concomitance of general, but not profuse, perspiration, and the deposition of a lateritious sediment by the urine. Neither of these occurrences to be regarded as critical, when they appear separately ; a very copious sweat is no uncommon occurrence in this disease; but it is never at- tended by any marked abatement of the rheumatic symp- toms, unless the urine at the same time deposits a red se- diment. Rheumatism is seldom fatal, except by metasta- sis to important internal parts. Ante rheumatism, occurring in persons exposed to the in- fluence of marsh miasmata, assumes a modified character. There are in such cases, conjoined with the rheumatic af- fection, prominent symptoms of derangement of the bilia- ry organs—such as, an icteric hue of the tunica albuginea; a brown and bitter tongue; great headache ; bilious vom- iting, &c. After each act of vomiting, the pains remit. This variety of the disease is called bilious rheumatism. Treatment. Sangunaria, an important auxiliary remedy, though not by itself adequate to subdue rheumatic inflam- mation. Its employment necessary to moderate the gene- ral and local inflammatory action, and thus to prepare the Avay for the beneficial operation of other remedies. Eme- tics all important in acute rheumatism to subdue rheuma- tic inflammation; cathartics always decidedly beneficial : they often subduct the general inflammatory excitement effectually; violent purging not proper, being incompati- ble with that regular action of the cutaneous expalents which is indispensable to the removal of this affectiow. I have known the operation of an emetic to produce im- 94 mediate relief, of several hours duration, in bilious rheu- matism. bitters. Cayenne 1 ounce, prickly ash 1 ounce, rattel weed 1 ounce, sangunaria 1-4 ounce, and sulphur 1 ounce : add 1 quart of spirit. Dose—From one half to a wine glassful three or four times a day, just as much as will not affect the head, as the rattel weed has that effect: the capsicum sub- dues the inflammation. Agitate the parts with stimulating liniment two or three times a day. CHRONIC RHEUMATISM. Symptoms. Little or no SAvelling, or redness of the parts affected; no fever, pain sometimes confined to one or two 1 joints—sometimes felt only on motion. In some instant ces, the rheumatic form is persistive; in others, after hav- ing continued for a time, it goes off, leaving the parts someAvhat stiff and debilitated. The skin is generally dry and harsh. Sequela. A thickened and knotty state of the tendons; hard- ness of the bursas mucosae; Avasting of the muscles obout the affected joints, rigidity and thickening of the ligaments. and consequent stiffness of the joints, are consequences of severe and protracted rheumatism. Diagnosis. Chronic rheumatism in the muscles of the loins, (lumbago,) distinguished from nephritis by the aggravation of pain on bending the body forwards, as well as by the absence of nausea and vomiting, retraction of the testicle, and urgent desire to pass urine, Avhich characterise the lat- ter complaint. Mercurial or syphilitic rheumatism, distinguished from rheu- matism produced by other causes, by the periosteum of the tibiae, ulnae or os frontis, becoming thickened and tender to pressure, together with the history of the case. 95 Causes. Frequently the result of the acute form of the dis- ease, continued exposure to a damp and cold atmosphere; improper exposure, while under the influence of mercuiy; atmospheric vicissitudes. Treatment. Cathartics—extract of sangunaria, milk Aveed, with capsicum, rolled into pills, common size: take from 2 to 4 each 24 hours, using bitters of gum guaiacum 1 ounce, poke root 1 ounce, cream tarter 1 ounce, bark of the root of spinnel Avood 2 ounces, and stremoniem seed 20 grains : add 1 quart of spirits. Dose—a wine glassful three times a day. Rub the affected part Avith the oil of bare foot and oil of cedar, equal parts, two or three times a day : this will cure when all other remedies fail. I will give the process of the oil of bare foot in another part of this book. GOUT. Gout is divided into the acute the chronic and the retroce- dent varieties. Symptoms. Of the acute from. Violent inflammation ol the ball of the great toe of one foot, attended with excruci- ating pain, redness of the skin, distension of the neighbor- ing veins, and, at the end of forty-eight hours, oedema.— Tue attack generally occurs between 12 and three o'- clock at night. There are slight remissions in the morn- ing, and violent exacerbations at night. The paroxysm seldom terminates before the sixth, or continues beyond the tenth day. The oedema continues some days after the inflammation has subsided. After the disease has disap peared in one foot, it sometimes makes an immediate at- tack on the other. The d'sease is generally preceded by a tram of premoni'.ory symptoms, most commonly indica- tive of gastric disorder. Though in its first attacks confined exclusively to the feet, gout seizes upon many other parts, during the same par- oxysm, after the system has become enfeebled by frequent 96 recurrences of the disease. Pulse, in severe attacks, full, hard, and strong; in slight cases, the constitutional symp- toms not prominent; the digestive functions always con- siderably disturbed; bowels torpid; urine scanty, and of a deep red color, depositing a pink or lateritious sediment. The inflamed parts are exquisitely sensible to the slightest touch. Sequela. Frequently structural deangement of the liver; permament debility of the stomach.—Thickening and shortening of the ligaments, and distension and induration of the bursoe mucosae, are the most common local conse- quences of gouty inflammation. Gouty concretions not very frequent. Predisposition. The predisposition to gout sometimes hered- itary, though not so frequently as is generally supposed. It is most commonly acquired, by the operation of the fol- lowing, and perhaps other causes—viz. the depressing passions, severe protracted study : the habitual use of high- seasoned animal food and vinous liquors, with an indolent or inactive course of life. Gout rarely occurs before the 20th year of age—most apt to commence its attacks betAveen the 30th and 40th years. Exciting causes. Excessive intemperance;—redundancy of bile; an accumulation of acid in the stomach; cold and humidity; violent passions. Proximate cause. Some writers regard the proximate cause of gout to consist in an excess of the clemeats of uric acid, (Brandt, Home,) and others, in an excess of phosphoric acid, (Bertholet.) Scudamore's objections to these doc- trines, stated and assented to. Debility and disorder of the digestive organs, has been regarded as the proximate cause of gout: — objections stated to this doctrine. Ac- cording to Broussais, the proximate cause of the disease consists in a peculiar irritation of the mucous membrane of the alimentary canal. I think it not not improbable that derangement of the assimilative functions, with gene- ral plethora, in conjunction with such a peculiar irritation 97 in the alimentary canal, constitutes the fundamental na- thological condition of gout. Treatment. To obviate the recurrence of the disease, we must remove as much as possible, the predisposing and exciting causes, and restore the healthy action of the di- gestive organs. A simple and digestible diet must be en- joined, and the use of wine and condiments interdicted. The occasional use of mild aperients, and some of the bit- ter tonics is proper. To answer these, use extract of eupatorium, extract of sassa- fras, extrdct of dogwood, extract of black pepper, extract of sanguinaria, and extract of yellow poplar, in equal parts, rolled into common sized pills. Dose—according to the temperament or strength of the system, from five to twenty pills each twenty-four hours : take half a hour be- fore or after meals—dose from one to five pills. Bitters of the bark of the root of spinnel or waughpoo, three ounces in one pint of spirits : Dose—a Avine glassful 3 times a day : these bitters will regulate the digestive organs. Treatment proper during convalescence. After slight at- tacks, and before the constitution has suffered much, little or nothing need be done during convalescence. But in violent and protracted cases—particularly after repeated attacks have impaired the constitution, medical treatment during convalescence is of the greatest consequence. In cases of this kind, it is necessary to restore the energies of the digestive organs, as well as of the liver, skin and kid- neys. For this purpose, use sanguinaria, rhubarb and magnesia, and a weak infusion of colomba, &c, in gen- eral answer very well. Gentle exercise also must be en- joined. The application of a flannel roller to the affect- ed parts, highly useful, Avhen permament swelling and de- bility remain. Chronic Gout. A strong gouty diathesis, Avithout sufficient constitutional vigor to produce high inflammatory affection of the joints. It is characterised by prominent and bar- G 98 .-.sing symptoms of dyspepsia; irritability of temper, and despondency and irresoiuteness of mind; palpitations, with a sense of tightness at the pit of the stomach; cramps in the extremities, particularly at night; dull pain in some of the joints, attended Avith a sense of numbness and weight in the affected part; sleep unsound, and interrupted by- sudden startings; permanent oedema left in the affected parts; tenderness and aching of the ankles, rendering pro- gression difficult and painful; skin salloAV, dry, and con- tracted.- bowels costive, and in very bad cases much gene- ral debility, Avasting of the flesh of the lower extremities, a dry and short cough, &c. Treatment. The principal indications in the treatment of this form of gout are; to strengthen the system in general, and the stomach in particular. For this purpose, a mild and digestible diet, with gentle exercise. Warm bath; tincture of stremoniem and opium, ten drops three times a day. Retrocedent Gout. The disease is called retrocedent,. Avhen the inflammatory affection of the joints suddenly and em tirely ceases, at the same time that some internal part be- comes affected. The part to Avhich it is most apt to be transferred, is the stomach; sometimes it falls upon the lungs, at others the brain,, and occasionally the heart be- comes its seat. When the stomach, intense pain, anxie- ty, nausea, and vomiting, occur; Avhen to the lungs^ asth- matic symptoms supervene; when the heart becomes af- fected, pain in the cardiac region, Avith violent palpita- tion and syncope, ensue; metastasis to the brain, produces insensibility, coma," apoplexy, or palsy. Any of these translations of the disease, are exceedingly dangerous. Metastasis to internal organs most commonly produced by the application of cold to the inflamed joint; anything Avhich rapidly debiliatos the system, as bleeding, violent purging, sudden fright, &c. may cause metastasis. m Treatment. When the disease attacks the stomach, warm brandy, or cayenne pepper; mustard to the feet and wrists: stimulating purgative, by giving plenty of cay- enn.3, in conjunction, and stimulating enemata, rubbing with stimulating liniments. small-pox, Small pox is divided into tAAro varieties, the confluent and distinct. The distinctive character of the former is: pus- tules confluent depressed, irregularly circumscribed, the intervening spaces being pale, and the fever continuing after the eruption is completed. The distinctive character of the latter is: pustules, distinct, elevated, distended, cir- cular; the intervening spaces being red, andlhe fever ceas- ing, when the eruption is completed. Description of the distinct kind. At first aching pain in the back and lower extremities, lassitude and loss of appetite, slight chills, nausea and vomiting, with some soreness in the fauces, and finally, fever. Towards the end of the third day of the fever, the eruption makes its appearance, first on the face and neck, and successively on the inferi- or parts. Just before the eruption appears, adults generally perspire freely; and sometimes become comatose. Children fre- quently suffer convulsions at this period; the fever ceases by the fifth day. At first the eruption consists of small red spots, rising, by degrees, into pimples, then becoming vesicular on the top, Avith a small pit in the centre, and finally about the eighth day, becoming pustular, and of a spheroidal shape. About this period, the face and eye- lids swell; the tumefaction subsiding again about the elev- enth day. The pustules are at their full and perfect state on the twelfth day; from this date begin to shrink and dry, the matter forming crusts of a brown color; in a few days more, these crusts fall off, leaving the skin underneath of a broivnish red color. 100 The pustules are surrounded by an areola, of a damask-rose color. When the pustules are numerous, some degree of fever occurs on the tenth or eleventh day. In these cases, there is usually some soreness of the throat, hoarseness, and a copious discharge of a thin fluid from the mouth. The eruptive fever is of the synochus, and not unfrequent- ly of the synocha grade. The confluent variety. In this variety, all the above-men- tioned symptoms of the early stage are severer. The ac- companying fever at first synocha, then typhoid; pain in the loins, in the forming stage very severe; the severer this pain, the more certainly will the disease assume the con- fluent character. (Ricbter.) Seldom any profuse per- splration, as in the distinct kind; istead of this, diarrhaa often occurs at this period. Great soreness and redness of the fauces, and generally a copious Aoav of saliva. The pustules appear earlier than in the distinct kind— seldom later than the beginning of the third day—very rarely as-late as the fourth or fifth day. The pustules not surrounded by an inflamed margin, where they are sepa- rated- the intervening skin remaining pale and flaccid; the face is always much swollen—the swelling coming on earlier than in the distinct variety, and declining about the tenth day. The matter in the pustules is never thick and yellow, as in the distinct variety; but of a whitish brown, and sometimes dark color. About the eleventh clay, the pustules break, aud pour out a fluid which hardens into broAvn or black crusts. When these fall off, the skin underneath desquamates, producing small and permamcnt depressions, or pits in the skin. The fever does not cease, but remits on the appearance of the eruption, increasing again about the sixth day, and continuing throughout the whole course of the disease. The regular course of small-pox includes, therefore, four dis- tinct stages, viz: 1st, The eruptive fever, including a pe- riod of from two to four days. 2d, the period of eruption, of about two days' continuance. 3d, The period of mat- 101 uratton, or filling, which occupies about three days. 4th, The period of exsiccation, or drying of the pustules, which terminates about the fifteenth day from the com- mencement of the disease. Crystalline small-pox. In this variety, the fluid in the pus- tules is colorless, having no purulent appearance. The pustules, though not confluent, are never surrounded by a florid areola; the sAvelling of the face is often suddenly transferred to the hands and feet; fever typhoid; pustules, pale or lead-colored. Small-pox often remarkably modified by the influence of the contagion of measles. These tAvo diseases cannot go on at one and the same time, in the same system. Hunter's doctrine of the incompatibility of two kinds of morbid ac- tion referred to. Its applicability to the explanation of the modus operandi of medicines, in the cure of diseases. Remarks on the power of this, and other foims of exan- thematous disease, of destroying the susceptibility of the system to a second infection. Autopsic phenomena. In violent cases, pustules in the larynx, trachea, and bronchia, in inflammation of the mu- cous membrane of the alimentary canal, is invariably found. Prognosis. The more the disease retains the distinct form, the safer. The confluent form, always dangerous; and the danger is greater, according as the fever assumes more of a typhous character. Observations on the origin of small-pox. The opinion maintained, that the disease of- ten originates spontaneously without the immediate agen- cy of contagion. Treatment- Mild stimulants, such as asrum, Canada snake root will answer, though rather heating; the bowels should be operated on with oil or senna, elder "flowers or rhubarb : use a tea of ground ivy or cat- nip : the treatment must be mild, not too heating, as that is very injurious: no drastic physics ought to b§ 10S Ssed by any means, as they are injurious, and hazard- ous : therefore, no treatment but a mild one- is safe. I have seen both the high stimulant and drastic physic fatal : therefore, I would condem them as injurious and fatal. Cool air. The free admission of cool air into the apart- ments of small pox patients, together with the use of cool- ing acidulated drinks, light and cooZ coverings, is one of the most important improvements in medicine that has ev. er been made. The patient should be laid on a mattress, and the temperature of his apartment so regulated, as to communicate to him rather a sensation of coolness than warmth. When the eruption of the confluent variety of the disease is attended by fever of a typhous grade—which is sometimes, though rarely, the case, the diet, instead of being cooling and diluent, must be stimulating and nourishing. Vvine, here, is a very useful remedy. When the postules are slow in filling up, or the fluid in them remains watery, warm fomentation- to the feet: vomiting always dangerous in small-pox. Epileptic convulsions, just before the erup- tion, not particularly dangerous in distinct small pox— more dangerous in the confluent variety. To prevent the pits from scaring, bathe with Avarm water and slippery elm, or apply a salve made of lard, golden thread, bitter . sweet, and bark of the root of elder and annis root. VARIOLA VACCINA. Origin of the disease. The vaccine matter, originally ob- tained from a pustular disease affecting the udders of cows —hence its name. The grease of horses, and cow-pox,. Avere, at first, thought the same disease: and this opinion is strongly supported by the experiments of Mr. Ring, Friese, Loy, and Sacco; they having produced genuine cow-pox, both in the vaccine and human systems, by the matter of grease. Dr. Jenner could not communicate 103 the vaccine disease to a person Avho had previously been affected by the disease produced by the grease. Mattel taken from a peculiar pustular disease, which occurs a- bout the head and nose of sheep, will, according to Rieli- ter, Sacco and others, produce a pustular affection in the human subject, similar to cow-pox, and capable, it is said, of destroying the susceptibility to the subsequent influence of the variolous contagion. Description. The vaccine disease can only be communica- ted by inoculation, or by bringing the virus in immediate contact Avith t part denuded of the cuticle. The matter being inserted under the cuticle, the pustule commences and proceeds in the folloAving manner—on the second day a small point; on the third day more distinct; on the fouit'i day slightly elevated like a small pimple, and surrounded I with a narrow and faint areola; on the fifth day more ele- ' vated, vesiculor, circular, its surface flattened, Avith a small j dark depression in its centre, containing a colorless fluid; on the ninth day the pustule is in its full state of perfec- tion, the areola being large and of a beautiful damask-rose color; at this period, slight constitutional symptoms gene- rally occur. The areola efflorescence not essential to the protecting poAver of the disease. On the eleventh or twelfth day the centre of the pustule becomes darker, which gradually extends to the circumference, so that a brown scab is formed by the fourteenth day. The scab becomes darker until it acquires a dark mahogany color, and hi- five or six days more falls off. There is seldom more than one pustules; instances uf several, and even numerou.' pustules have, hoAvever, occurred. The A^accine disease often subdues other affections; crust a. lactea, scrofulous swellings, ophthalmia, whooping cough, have yielded permanently to the influence of this disease.. Herpetic and other cutaneous affections, may occasion such a deviation in the vaccine pustule, from its genuine char- acter and course, as to render it ineffectual as a preventvc of small-pox. Diseases of the skin, from which a fluid exudes, capable of conversion into a scab, are particular!* 104 apt to disturb the specific character of the vaccine disease. Measles and cow-pox may go on simultaneously in the same person. Diagnosis, between the spurious and genuine disease. In the spurious, the point of inoculation is already considera- bly inflamed and elevated on the second day; on the fourth or fifth day, an irregularly defined efflorescence appears, and scabbing is completed as early as the seventh or eighth day; the pustule is irregular or angulated in its circumfer- ence, and without a depression in itfs centre. The spurious disease may be produced by; 1. The existence of some cutaneous affection in the vaccinated patient; 2. Matter taken from a spurious pustule ; and 3. Matter that has suffered some change by long keeping. The matter should be taken from the pustule for vaccination, between the seventh and ninth day. The scab is general- ly used for vaccination. Appearance of the genuine scab. Smooth, dark-brown, rath- er brittle than tenacious, and of a regular circumference. In taking either matter or the scab for vaccination, it is of the utmost importance to be well assured that the person from whom it is taken is healthy; and particularly that he Avas not affected Avith any other cutaneous disease, during the progress of the vaccine infection. General remedial treatment, very rarely necessary. Local ap- plications, such ascold water, emollient poultices, to mod. erate the local inflammation, are sometimes required. The prophylactic power of the vaccine disease discussed. VARIOLOID. Some regard this disease as sui generis; others, and with correctness, I think, consider it as small-pox modified, by the system having previously undergone the vaccine, or some other modifying influence. Varioloid, or modified small-pox, is no new disease—^having been observed an atures round the limb, above the part to which the aura (where the sensation precedes the attack) has risen, in warding off an approaching paroxysm, in cases that con- tinue from habit, after the original exciting cause no Ion- ger exists. I have known an eleptic person, who could prevent the paroxysm, when he felt it approaching, by a draught of cold water. Eberly says: the tincture of lo- belia, cayenne, gum myrrh, nervine and blood root, given in tablespoonful doses, will prevent paroxysm, by the re- moval of every thing which may compress the veins of the neck, and sinapisms to the feet, may be beneficially em- ployed. No treatment will either materially mitigate or shorten the paroxysm. The radical cure is to be attempted during the intervals. Where the exciting cause can be ascertained, and is of a nature capable of being removed, this should be immedi- ately attempted, as the first and most important curative measure. When gastric irritation from worms, acidity, and other causes exists, as its cause—as is often the case with young children, anthelmintics, emetics, absorbents, and tonics, are proper. When suppressed perspirarion has given rise to the disease, diaphoretics should be em- ployed : here, camphor, guaiaeum, sulphur, together with the warm bath, warm clothing, and dry frictions, particu- larly serviceable. When repercusston of cutaneous af- fections, or the drying up of old ulcers, was the original cause, issues, vesicatories, pustulating applications, waim bathing, frictions and stimulating diaphoretics, are the ap- propriate remedies. When the disease arises from men- strual irregularities, means must be employed to obviate the morbid determination to the uterine system. An in- dispensable remedy—the warm semicupium, frictions a- bout the back and loins, stimulating enemata, the inter- nal use of spirits of turpentine. I have used a pill com- posed of equal parts of the extracts of nervine, misseltoe, smart weed, blue copash, sanguinaria, May weed, bever pastor, assafceidita, with equal parts of cayenne and lobe- 139 iia seed : roll into common sized pills. Dose—one to two pills three times a day. These pills will cure asth- ma or asma, and all diseases of the lungs. I give from 2 to three pills each day, one on going to bed, one in the morning on an empty stomach, and one at noon if re- quired—if not two pills each 24 hours. The Indians us« blue copash, prickly ash, blood root—man in the ground, resembles sweet potatoes—and blue flag : they give them in teas or powders, in teaspoonful doses, from one to three times a day, one half hour before or after meals. Tt*e dose may be regulated according to the age or tempera- ment of the user. They use, as their most poAverful rem- edy in this disease, lobelia syphilica : they give this in teas—but mostly in tincture—from a tea to a desert spoon- ful doses three times a day. This species of lobelia doe* not act promptly as an emetic, though it will puke some- times : but cold water will be rejected from the stomach, if it is in a torpid state. The Indians use pola poda, which grows out of the bark of trees, blooms in the win- ter, leaves from one to six inches long—in powder, in tea- spoonful doses, three times a day. This medicine is dan- gerous in females, as it will cause abortion: forty-nina times out of fifty they use it for that purpose. N. B. If this leaf is not spelled correctly, I stand corrected, as I have no books to correct me at present. PERTUSSIS--WHOOPING COUGH. Character. A contagious cough—paroxysmal, convulsive, and suffocative; inspiration during the cough, shrill—th« cough frequently terminating in vomiting. Whooping cough may be divided into three stages: 1. The forming stage; characterised by the usual symptoms of ordinary catarrh; i. e. lassitude, weakness, and head- ache; sneezing; slight hoarseness; discharge of thin mu- cus from the nose; restless sleep; inappetency; and gen- erally slight febrile symptoms; the cough is shrill, dry, and comes on in sudden bat short paroxysms, without 140 whooping. This stage lasts from two to three weeks. The convulsive stage: characterised by violent paroxysms of convulsive and suffocative cough, the inspiration being difficult and stridulous, and attended with a sense of ob- struction or spasmodic stricture of the glottis. These paroxysms return at first five or six times daily, and grad- ually increase in frequency, so as, at last, to return almost hourly. The approach of a fit of coughing, is always announced by a sense of stricture in the breast, and titil- lation in the larynx and praecordiae. The paroxysm lasts from a half to four or five minutes, and terminates by vo- mitting, or the discharge of a large quantity of viscid mu- cus from the bronchia. Pain is felt in the breast, imme- diately after the cough. The duration of this stage is ve- ry various : in general it lasts from four to six weeks: 3. The stage of declension; this stage begins, when the spasmodic and suffocative character of the cough begins to abate. The declension of the disease is always very gra- dual ; its duration is as various as that of the other stages —commonly from two to four weeks. Prognosis. Whooping cough is seldom fatal, except by the supervention of bronchitis, hydrocephalus, cynanche trachealis, puenmonia, convulsions, or marasmus.—Sequ- ela. Glandular swellings, dropsy, epilepsy, ophthalmia, ,ruma, rickets, general cachexy, phthisis, &c. Proximate cause The opinions on this subject are exceed- ingly various. Marcus, Whatt, and others, regard it as a peculiar species of bronchial inflammation. Webster regards the brain as Its primary disease. Albers considers it as depending on a peculiar irritation of the eighth pair of nerves. Some view the stomach as its original loca- tion ; and others regard it as a spasmodic disease, allied to asthma. My own opinion coincides Avith that of AJ- bers. My reasons for rejecting the doctrine of its being an inflammatory affection. The inflammatory symptoms which frequently occur in this disease, are not essential, but accidental to the disease. In many cases, not the 141 slightest febrile symptoms occur; and when we reflect on the almost constant agitation and irritation which the lungs suffer from the cough, we have good grounds for believing that the inflamed appearance of the mucous membrane of the bronchia, so commonly found on post-mortem exami- nation is the effect, and not the cause of the disease. Treatment. Emetics always beneficial—lobelia or ipicac. Warm bath beneficial. Expectorants—lobelia, Indian turnip, eupetoriem, ipicac squills, should be given, in small dose?, to relieve the lungs of the mucus. Syrup—lobelia seed 1-4 ounce, eupetoriem 5 ounces, Indi- an turnip 5 ounces, spikenard 5 ounces, hoarhound b ounces, blood root 5 ounces. Put all into a pot: add three gallons water, boil doAvn to two quarts, strain, and boil down to one quart—add one pound of lump sugar, three gills brandy. Dose—a teaspoonful, given from 3 to 6 times a day. A constant drink of a tea of shell bark: hickory is the best remedy. atsthma. Character. Great difficulty of breathing, attended with a sense of suffocation, great thoracic constriction, wheez- ing and cough. Symptoms. The attack usually preceded by premonitory symptoms; such as droAvsiness; head-ache; itching of the skin; flatus; heart burn; acid eructations; sickness; ful- ness and anxiety about the praecordia; weight over the eyes, &c. The paroxysm generally comes on at night, during sleep, It is characterised by inexpressible anxiety; very labori- ous wheezing, and suffocative breathing; gieat tightness about the chest; countenance bloated and lived—some- times pale; cold extremeties; intense desire for cool fresh air; incapability of lying down ; pulse frequent^ Irregular, and often intermitting; abdomen distended with wind; cough, at first dry; a copious expectoration of viscid mu» 142 Cus occurring in the course of some hours, bringing with it considerable temporary relief. The symptoms remit greatly, during the ensuing day. On the next night, how- ever, the fit generally returns. In this manner, it often goes on with remissions by day, and exacerbations by night, for five or six days; and sometimes much longer. Predisposition. The disease rarely occurs before the age of puberty. The predisposition appears to consist in an ir- ritable and weak condition of the respiratory organs. It seems, in some instances, to be hereditary. Persons of weak muscular power, and disposition to obesity and cor- pulency, are most liable to the disease. Exciting causes. Particular conditions of the atmosphere, in relation to its humidity, electricity and temperature; various irritating substances conveyed to the lungs; sup- pression of accustomed discharges; repercussion of cuta- neous affections; mestastasis of gout or rheumatism; gen- eral plethora; gastric and intestinal irritation; derange- ment of the digestive functions; certain odors; indigesti- aliment, anger, and terror. Authors have divided asthma into a great many varieties. It does not appear to me, that these distinctions are of any practical utility; although it is unquestionably of much importance to attend to the nature of the exciting cause, in prescribing for the disease. Proximate cause. The opinions on this sbject very various. Cullen ascribed it to a preternatural spasmodic constric- tion of the bronchiae. Parry to a vascular fulness of the bronchial membrane, by wich the air cells are mechani- cally diminished. Potter, to general venous congestion of the lungs. Bree, to an irritation seated within the air eavities, caused by a viscid and irritating serum. My own opinion is, that it depends on a peculiar irritation of th« pneumogastric nerves, in consequence of which, the regu- lar transmission of the nervous influence to the ltmgs, is uninterrupted. This opinion is founded: 1. On the ef- fects which are produced on respiration, by dividing the 143 eighth pair of nerves, Avhich entirely resemble the pheno- mena of asthma: 2. The suddenness with which the spasmodic breathing may often be allayed, by certain medicines, as the lobelia injlata, and, 3. The beneficial effects resulting from the transmission of the galvanic in- fluence through the lungs. Treatment. Emetics of lobelia inflata. Asthma pills- lobelia seed 1 ounce, cayenne pepper 1 ounce, assafceita- da 1 ounce, extract of blood root 1 ounce, extract of wild cherry 1-1 ounce, extract of shell bark (hickory) 1 ounce. Roll into common sized pills. Dose—three pills a day, morning, noon, and evening, half an hour before or after meals. From five to twenty peach kernels may be used each day. The root of the stramonium is to be cut fine, and smoked in pipe. Symplocarpus fatida. I have knoAV the infusion of the root of this plant, give great and prompt relief. Lobelia injlata. I regard this vegetable as decidedly the most valuable remedy we possess, for arresting or mitiga- ting the asthmatic paroxysm. I have known a violent fit of asthma completely allayed in the course of thirty minutes. Coffee. A cup of very strong coffee will often procure much alleviation in this complaint. Galvanism has in late years been employed Avith much ad- vantage in this complaint, by Dr. Philip and othere. The galvanic influence must be communicated with much force. The two wires of a Aveak galvanic trough, are to be attached, one to a piece of metal placed on the pit of the stomach, and the other on the side of the neck, over the par vagum. Bitters, Avith occasional mild aperients, moderate exercise, and above all, a light and digestible diet, with the use of the -cold shower bath, are to be used during the intervals of the attacks. 144 DROPSV. Dropsical effusion is not, properly speaking, a disease, but only an effect of disease. The morbid condition upon which the drposical effusions depend, is either inflamma- tion or a state of the exhalents closely allied to inflamma. tion. (Rush.) The doctrines Avhich allege, that torpor of the absorbents, or relaxation of the exhalents, is the proximate cause of the effusion, are examined, and their insufficiency pointed out. There is no doubt, always de- ficient venous absorption—because that condition of the capillaries, which disposes to to excessive exhalation, is essentially connected with a congested state of these ves- sels, and congestion, or vascular fulness, always impedes absorption. (Magendie.) Observations on the character of the urine, in hydropic diseases. In some instances, the urine contains more or less serum; in others, it is entirely destitute of it. According to the observations of Blackall, Willis, and Ayre, it is in the sub-acute and idiopathic forms of dropsy, that the urine is loaded with the greatest quantity of serum. In dropsy from scarlatina, there ia generally a large quantity of serum in the urine, fn lo- cal dropsies, not attended with general excitement, the u- rine is seldom charged with any serum. (Ayre.) When the heart sympathises with the local or fgeneral mor- bid action of the exhalents, febrile symptoms attend. When the morbid excitement of the exhalents does" not extend to the heart, the general circulation is languid, and debility and relaxation characterise the disease. The general indications in the treatment of dropsy, are; 1. To procure the absorption and elimination of the effused fluid: 2. To correct the morbid action of the serous ex- halents, from which the effusion takes place. Dropsy is divided into three principal varieties, viz. Anasar- ca, asciles, and hydrothorax. 145 ANASARCA--DROPSY. In this variety, the effusion takes place into the cellular tis- sue. It may be either local or general. A part that is anasarcous, pits on pressure. It almost always begins in the feet or legs—the swelling diminishing during the night, and increasing towards evening. The urine in this, as in other varieties of dropsy, is always scanty and h;gh color- ed ; the countenance is sallow, the general system slug- gish, and there is usually much sleepiness. Anasarca is frequently connected with effusion into the abdomen and chest. Causes. Local anasarca maybe produced, by whatever im- pedes the return of the blood from a part—as, indurated glands pressing on large veins, ligatures, &c. It arises from mere general debility; diseases of the heart; phth is, &c. General Anasarca may result from hemorrhages, diarrhosa diabetes, and other circumstances that rapidly exhaust the system. Observations on the manner in which these cau- ses produce dropsy. Sudden suppression of perspiration, particularly after scarlatina, measles, or while under the influence of mercury, a frequent cause of general anasar- ca. Dropsy from this cause always decidedly phlogistic- General anasarca may also result from the internal use of arsenic—from torpor of the kidneys—from amenorrhcea, general plethora, with a relaxed habit, chronic diseases, intestinal irritation, &c. Observations on the modus opt- randi of these causes. Proximate Cause. A sub-inflammatory action of the exha- lents of the cellular tissue, attended with increased exha- lation, and diminished venous absorption. It appears to me probable, that congestion in the venous capillaries, performs an important part in the production of dropsicd! accumulations. K 146 ASCITES--DROPSY. Abdominal dropsy. Its causes are sometimes local, at ott- ers general. The local causes are such as impede the circulation through the portal system of vessels—among which, visceral indurations, particularly of the liver and spleen, are the most common. Dr. Ayre denies that vis- ceral obstructions produce dropsy ; they notwithstanding frequently do so. The most common general cause, is cold, either generally or locally, applied. When the re- sult of this cause, its character is always conspicuously inflammatory; the blood usually exhibiting the buffy coat; the skin being dry and hot; the pulse frequent and tense, and the urine loaded Avith serum. Ascites is seldom wholly free from anasarca. Intestinal irritation some- imes gives rise to abdominal dropsy. It occurs as the se- quel tof peritonitis. Diagnosis. Proximate cause. A morbid action of the exhalents of the ..peritoneum, attended with capillary congestion, and di- minished venous absorption. HYDROTHORAX—DROPSY. Serum effused into the cavity of the thorax. It is character- ,...' .ised by the followining Symptoms. Oppression in the chest; difficult respiration, particularly Avhen lying down, or ascending heights; dry cough ; a sense of suffocation, when in a recumbent posi- tion ; sudden starting during sleep ; pulse intermitting, or irregular; thirst considerable; urine scanty; oedema of the feet; a pale bloated countenance, &c. Divided into symtomalic and idiopathic. The first arises from organ- k affections-^the latter from general causes. Causes. Organic affections of the heart. When from this cause, the effusion occurs on both sides. Chronk pleuri- tis, a frequent cause of hydrothorax. It may also result from a tuberculous state of the pleura, and even from structural disease of the stomach and liver. ThLs is by 147 Tar the most frequent variety of hydrothorax, and is almost always incurable. Jdiopathk hydrothorax, is of very rare occurrence, and gen- erally easily cured. The effusion almost always occurs only on one side—that side becoming sometimes consider- ably enlarged, by the pressure of the fluid. 'General plethora, predisposes to hydrothorax; particularly In persons who have passed the middle period of life, and who indulge in the pleasures of the table, and use but lit- tle exercise. Diagnosis. A sense of suffocation on lying down, and on firm pressure on the abdomen, Avill generally distinguish it from mere organic disease of the heart. Percussion pro- duces a dull sound, and stethoscope detects the absence of the respiratory murmur. Treatment. When the heart sympathises with the primary local irritation, or with the morbid action of the capillar- ies from which the effusion occurs. Emetics an impor- tant remedy. It is indicated in all cases in which there is tension and quickness of the pulse. Diuretks, are important remedies in hydropic disease. Thei operation is, however, rather palliative than curative— that is, they evacuate the effused fluid, rather than correct the morbid action on which the effusion depends. In ful, and phlogistic habits, their.operation is promoted by emetics and cathartics. When the effusion is very extensive, and the blood has deen deprived of a great portion of it serum, copious draughts of water promote the operation of diure- tics. The mode in Avhich diuresis removes dropsical effu- -sion explained. The most useful diuretics in dropsy, are: squills, digitalis, tobacco, cantharides; acetate, nitrate, aud tartrate of potash; colchicum, wild carrot seed, erigeron heterophyhum, and juniper berries. The squill is the best diuretic in hydrothorax. It is best a .dapted to cases in which the urine is very scanty, high col- 148 ored, and sedimerttous, and not attended with much febriler excitement. Jallap one third, cream tarter one third, copp3ras one eighth, given in from three to ten grain doses, from three to six times each twenty-four hours : this will bring copious discharges. If the discharges are too copi- ous, give tonics to brace the system : wild cherry barky dog wood, eupatoriem, waughoo bark, given in portions of tea, best cold or milk Avarm. Nitre is an excellent remedy, when the febrile excitement runs high. Diuretic drinks, such as infusion of juniper berries, wild carrot seed, &c, Bitter root, dog's bane, jallap, and cream tar- ter, equal parts, will bring copious discharges—one eighth of gambage may be added. Dose—according to judg- ment, The Indians use tilia, perera crab, swamp ash, wafer bush. I have cured three cases with it and blue flag, given in infusions of tea. I will give receipts for this disease in another part of this book. The bark of cu- cumber tree is an excellent remedy, given in tea every three hours. DIARRHfEA. Character. Frequent feculent stools, generully copious, al- ways more liquid than natural, commonly attended with griping, but free from tenesmus and fever. Causes. Some act directly on the alimentary canal; others indirectly, through the medium of the general system. Of the former kind; are: indigestible and irritating articles of food; acrid secretions; wotms; acid, and other irritating substances received into the stomach. Among the more general causes, are: dentition ; cold, particularly when connected with humidity; the repercussion of cutaneous eruptions; various general and local diseases, as phthisis, affections of the liver, &c. It may also be excited by vi- olent mental emotions, as terror and grief. Proximate cause. An increased irritability of the intesetins, giving rise to increaeed peristaltic motion. In protraectd 149 cases, the mucus membrane of the intestines is generally in a state of chronic inflammation, and frequently more or less ulcerated. (Broussais, Abercrombie.) According to Broussais, when diarrhoea continues beyond the thirteenth day, it almost invariably depends on organic disorder of the mucus membrane of the colon. He asserts, ihatchron ic inflammation of this membrane exists in all cases. This is doubtful. Wben ulceration exists, it is always most conspicuous in the caecum, and the lower part of the colon. Teeatnent. The principal indications'are: to subdue the irritability, or phlogosis of the bowels; and to iemove, aa much as possible, all local irritating causes. These indi cations are to be fulfilled: by determining the circulation to the surface, and thereby lessening the afflux of blood to the vessels of the intestines; and, by prescribing the most simple and unirritating articles of food. To allay in- testinal irritability, and determine to the surface. Use emetics. Should much acid exist, which generally does, use soda or saleratus : then use the tincture of crane's bill and nutmeg, equal parts, with the tincture of white oak acorns or green percimons, equal part, Avith one fourth part of the tincture of cinnamon bark, and one fourth spi- rits of camphor, with one fourth of the essence of annis seed oil or the tincture of annis seed. Mix all the above tinctures together, give from ten drops to a teaspoonful each two hours. The annis seed will heal and subdue the inflammation. If the annis seed is not used, use slip- pery elm, or wheat flour, after browning it in a pot or kettle : give from a half to a tea spoonful every two or three hours. Make a syrup by boiling malloes and the bark of the root of percimon tree ; this must be made each day—add no spirit to it. Warm bath all important once or twice a day : or sponge with water and vinegar milk warm. Astringents—dew berry root, crane's bill, beach buds. Mucilagenous drinks—slippery elm, malloes. Tonics—quinine, extract eupetoriem. 150 CHOLERA. Character. Frequent and violent vomiting and purging, with severe griping and cramps in the extremities. Symptoms. Its attack is almost invariably sudden. There is at first pain and tension in the epigastric region—fol- lowed soon by colic pain about the umbilical region, at- tended with nausea, upon which vomiting and purging speedily ensue. The discharges are at first watery and without bile; nor is there often bile thrown from the sto- mach, in the commencement. After the disease has con- tinued for some time, however, bile appears in the evacu- ations. The most distressing symptom, is the excessively severe cramps which occur in the obdominal muscles, and the extremities in violent cases. Cholera seldom contin- ues more than 24 hours—it often terminates in death, with- in two hours. Causes.—A superabundance of bile in the stomach is not, as Avas formerly, and is still thought by many, the immediate exciting cause of cholera. There is on the contrary, a de- ficient secretion of bile—the liver being in an inactive and congested condition. The torpor of the liver, is generally in direct proportion to the violence of the disease. The evidences of the approach to this country of the great pestilence are rapidly developing themselves. ' The epi- demic is moving through Europe with rapidity,, and is- marking its course with its usual fatality. We think it well enough for the public mind to arm itself with confi- dence in preparation to meet the visitation. These recommendations are made, according to the Lon- don Lancet, by the gentleman Avho was sappointed by the poor law commissioners to examine the condition of the London Poor Houses. In anticipation of the approach of cholera he says: 1. We would urge the necessity, in all cases of chole- ra, of an instant resource to medical aid, and also under svery form and variety of indisposition; for during the gr.«r 151 -valence of this epidemic all disorders are found to merge in the dominant disease, 2. Let immediate relief be .sought under disorder of the bowels especially, however slight. The invasion of cholera may thus be readily and at once prevented. 3. Let every impurity, animal and vegetable, be quickiy removed to a distance from the ha- bitations; such as slaughter-houses, pigs-styes, cess-pooh. necessaries, and all other domestic nuisances. 4. Let all uncovered drains be carefully and frequently cleansed. 5. Let the grounds in and around the habitations be drain- ed, so as effectually to carry off moisture of every kind. 6. Let all partitions be removed from within and without habitations, which unnecessarily impede ventilation. 7. Let every room be daily throAvn open for the admission of fresh air; and this should be done about noon, when tie "atnostphere is most likely to be dry. 8. Let dry scrub- bing be used in domestic cleansing, m place of water cleansing. 9. Let excessive fatigue and exposure to damp and cold, especially during the night, be avoided. 10. Let the use of cold drinks and acid liquors, especially un- der fatigue, be avoided, or when the body is heated. 11. Let the use of cold acid fruits and vegetables be avoided. 12. Let excess in the use of ardent and fermented liquors and tobacco be avoided. 13. Let a poor and insufficient diet, and the use of impure Avater for culinary purposes, or for drink, be avoided. 14. Let the wearing of wet or in- sufficient clothing be avoided. 15. Let a flannel or wool- len belt be Avorn round the belly. (This has been found serviceable in checking the tendency to bowel complaint, so common in the prevalence of cholera. The disease has, in this country, been always found to commence with a looseness in the bowels, and in this stage it is very tract- ible. It should, howeA'er, be noticed that the looseness is frequently unattended by pain or uneasiness, and fatal delay has often occurred from the notion that cholera must be attended with cramps. In the earlier stage here refer- G red to, tf ere is often no griping or^cramp, and it is at this jj period that the disease can be most easily arrested.) 1G jj 152 Let personal cleanliness be carefully observed. 17. Let every cause tending to depress the moral and physical en- ergies be carefully avoided; let exposure to extremes of heat and cold be avoided. 18. Let croAvding of persons within houses and apartments be avoided. 19. Let sleep. ing in low or damp rooms be avoided. 20. Let fires be kept up during the night in sleeping or adjoining apart- ments, the nights being the period of most danger from attack, especially underexposure to cold or damp. 21. Let all bedding and clothing be daily exposed during the winter and spring to the fire, and in summer to the heat of the sun. 22. Let the dead be buried in places remote from the habitation of the living. By the timely adoption of simple means such as thess, cholera or any other epi- demic will be made to loose its venom; so true is it that " internal sanitary arrangements, and not quarantine and sanitary lines are the guards of nations." These simple measures are worth all the nostrums or specifics Avhich have ever been vaunted for the cure of Asiatic cholera. Treatment. Give soda powdeis, and add to one of the glasses with the powder, from a teaspoonful to a table- spoonful of the cholera drops: give at intervals of from ten to twenty minutes. Local: rub the stomach with a strong tincture of cayenne, made by boiling it in a jug with the cork out, and placing the jug in a pot of boiling water : settle the water and boil for twenty or thirty min- utes; the spirit will boil in the jug; or you may bringthe spirit to the boil and set it off; when cool bring it to the boil again. You can make any tincture in one hour by this process. By rubbing the stomach, you will stop the puking as soon as you neutralize the acid. If the cramps should prove severe, rub the arms and feet with the tinct- ure of lobelia seed, with a warm bath. Cholera Pills. Extract of sanguinaria 1 ounce, cayenne 1 ounce, saleratus 20 grains, oil horsemint 1-4 ounce, oil of catnip 50 drops, oil of annis seed 30 drops, sulphate of quinine 2 drachms—roll into pills. Dose from 6 to 12 pillsas often as required. 153 Cholera Drops. Alcohol 1 pint, gum camphor l-2ounc© ■oil annis seed, oil catnip, oil horsemint, oil cinnamon, oil cloves 100 drops each, tincture cayenne 6 ounces, tinct- ure gum myrrh 3 ounces, tincture crane's b 11 b ounces: shake well when all are together. The tinctures ought to be made of90 per cent, alcohol. Dose—from a teaspoon- ful to a tablespoonful, in double the quantity of water, as often as required, at from ten to thirty m'nutes intervals. Sponge the surface with warm vinegar, saleratus, table salt, mustard and cayenne. Should the puking not stop with the above treatment, an emetic will be beneficial. Inject with No. 6 and the tincture of crane's bill, with a small portion of the cholera drops,' from a teaspoonful to a tablespoonful. Rub the region of the liver with the tinct- ure of cayenne. The crane's bill root ought to be made into a strong tea and given in teacupful doses; and if the purging should continue difficult to stop, give from 5 to 20 grains of roch or burnt allum every hour, for two or three hours, which will check the action. When the disease makes its first attack, if the cholera drops and allum are used, the disease will yield in a few hours, and I strongly urge their use in time. If the cholera drops, crane's bill root, and the burnt allum are timely resorted to, I would strongly urge them in an- swer to the second article of the London Lancet. Cay- enne pepper will stop puking. If the stomach is poulticed with it, the tincture will answer. Plenty should be rub. bed over the region of the liver to excite an aciion, which the tincture will do. I consider that opium ought not to be used, as the patient, under the influence of it, is not capa- ble of giving a correct answer to the symptoms of his dis- ease, when requested. COLIC. Colic is divided into several varieties, according to the nature of the exciting causes. Flatulent cdlk, so called from the prominent smyptoms of in 154 digestion and flatulency which attend. It is produced by irritating and indigestible articles of diet.—Debility of the digestive organs predisposes especially to this variety of colic. The colic pains comes on, an hour or two after the indigestible diet is taken. Sometimes ihe food passes into the bowels in an imperfectly digested state, and then the pain does not come on so soon, as is felt low down in the abdomen. At first, there is a sense of disten- sion in the pit of the stomach, folloAved soon by pain, which rapidly increases, until it acquires an intense degree of violence. The pain occasionally remits. During the exacerbations, the patient throws himself about, and press- es firmly on his abdomen with his hands. Large quanti- ties of air are from time to time forced up, or passes off downwards. Diagnosis. Distinguished from enteritis, by the agitation of the patient; by the relief obtained from abdominal pres- sure, and by the pain frequently remitting. In all these respects, the reverse obtains in enteritis. Prognosis. Generally not dangerous, unless it terminates in inflammation.which sometimes, though not often, occurs. It sometimes produces a paralytic state of a portion of the bowels, giving rise to habitual costiveness. Treatment. In slight attacks, carminatives and anodynes are often sufficient to procure relief.^—Remedies of this kind generally answer Avell when the stomach does not con- tain any irritating substances. When it does contain irri- tating substances, an ipecacuhana emetic must be given.— Purgatives to be used when the pain is below the sto- mach; they may be advantageously combined with aro- matics. I prefer castor oil and spirits turpentine in union, Enemata, always useful, where the pain is excessive.—It does net materially impede the subsequent operation of the necessary purgatives. Bilious colic, so called, from the bilious vomiting, and other symptoms, manifesting functional derangement of the liver. 155 The more urgent and upeculiar symptoms of this variety of colic, are generally preceded by head-ache, want of appe- tite, bitter taste in the mouth, thirst, und bilious vomiting. The colic pains are excessively acute; pressure at first gives relief; but the abdomen becomes tender to the touch, as the disease advances. Immediately after vomiting, the pain suffers a temporary abatement.—The bowels are generally immovably torpid. About the second or third day, the eyes and skin become yellow. Tremor, numb- ness, and paralysis of the arms, occasionally occur in this disease. Eructations are common, and afford temporary relief. Causes. Marsh miasmata. It occurs most commonly du- ring the autumnal months, particularly after a long con- tinuance of hot and humid weather. It may, however, bt produced also by cause of a sporadic character. It is generally believed, that the liver is in a state of morbid activity—that it secretes a superabundance of bile. Dr. Staly contends, that the liver is torpid—that there is a d* ficiency of bile. I have come to the same conclusion. That there is functional derangement of the liver in this variety of colic, does not admit of a doubt; but I do not believe the biliary secretion superabundant, but on the contrary diminished and vitiated. That this is the case, may be inferred from the analogy which subsists between bilious colic, and colera mor- bus. Dr. Gregory observes that bilious colic is close- ly allied to cholera, occurring along with it, and ap- parently differing from it only in some unessential features. Now it appears to be well established, I think, that in cholera, the liver is far from being over- active—that is, in fact, in an engorged and torpid condition, secreting but a very small portion of bile. Excessive irritability of the stomach, and torpor, Witt congestion of the liver almost always appear in con- nection with each other. We have a further support 156 for this opinion, in the fact, that whenever the alvino discharges become bilious an amendment takes place. Treatment. The principal indications are: To free the boAvels from irritating contents: To allay the irritability of the stomach and bowels: and to restore the healthy action of rhe' liver. Emetics are very useful in the beginning, when there is not full spontaneous vomiting. Purga- tives are of primary impoitance. They can seldom be given, however, with effect, until the gastric irritability is allayed. Our principal reliance must be placed on the full operation of purgatives. Mild aperients to be used, for several days after the bowels have been once freely eva- cuated. Epispaitics, sinapisms, andfomentatkns, are va- luable auxiliaries. Alkaline remedies are proper, A\'hen acid exists in the pri- mae via?; magnesia is the best article of this kind. The warm bath, is a useful auxiliary. The utmost caution is to be used in relation to diet and exposure, during the pe- riod of convaIescence. There are few diseases which are so apt to return, from errors in these respects, as the pres- ent one. Flannel should be worn round the abdomen. Very cold drinks must be avoided, during convalescence. TETANUS--LOCK JAW. Character. Tonic spasms of the voluntary muscles—the powers of sensation and thought remaining unimpaired. Tetanus is divided into different varieties, viz: trismus opisthotonos, emprosfhotonos, pleurothotonos In the first, the muscles of the jaw are chiefly affected : in the second, the extensors of the back,producing recursion of the body; in the third, those on the anterior part, producing incur- vation; and in the last, those on the side are principally affected, causing alateral curvature. It is divided also in- to idiopathic and traumatic—the former variety being the result of general causes—the' latter, of external injuries. 157 This division has an important bearing both on ihepiog* nosis and treatment of the disease. Symptoms. Its approach is almost always gradual, th© symptoms being developed in the following order. - Slight difficulty of deglutition and change of the voice ; an unea- sy sensation in the precordial region; stiffness in the mus- cles of the neck and jaws. These symptoms having in- creased to a considerable degree of violence, sudden pain- ful retractions about the ensiform cartilage, with simulta- neous retraction of the head, occur. Deglutition is pain- ful and difficult, and re-excites the spasms. The spasms require more and more violence and frequency, until the retraction of the head, and rigidity of the whole body be- come truly frightful. The mind is seldom affected; the appetite generally remains, and digestion goes on regular- ly. Costiveness almost always attends. The muscles supplied with ganglionic nerves, and those which move the fingers, remain free from spasms, until near the fatal termination of the disease. The disease usually terminates before the fifth or sixth day—-sometimes it continues much longer ; and occasionally it assumes a chronic form. Causes. Various injuries. Contused, lacerated, and punc- tured wounds, most apt to procure tetanus. A partial di- vision or laceration of a nerve apt to excite it. The in. traduction of cold and damp air into gun-shot wounds when casting off their slough, favors the introduction oj tetanus. (Larrey.) The application of caustic to ency- ted tumors; compound fractures; the insertion of artifi- cial teeth ; amputation; ligatures, including nerves; cut- ting corns too closely, &c. have all frequently produced the disease. Cold and damp night air, after fatigue and ex- posure to a high degree of atmospheric heat during the day, is the most common general cause. Hence its frequency in tropical climates. Atmospheric heat a powerful pre- disposing cause of tetanus. Traumatic tetanus generally comes on about the eighth or ninth day after the inflictiora of the wound; frequently not until it is cicatrized. 158 The favorable signs are: a very gradual supervention of the disease; abdomen not very hard; bowels easily moved; moist and moderately warm skin ; sound sleep; an increas- ed flow of saliva; a natural expression of the countenance. When the majority, or all of these circumstances occur we may entertain hopes of recovery. The unfavorable signs are: a sudden and violent invasion of the disease; great rigidity of the muscles of the back, neck, and abdo- men ; violent pain and retraction in the pit of the stomach; very hard and retracted abdomen; spasmodic twitches of the muscles of the neck and jaws, on firm abdominal pres- sure ; hydrophobic symptoms. Treatment. First poultice Avith beef galls, lobelia seed, and cayenne pepper, or apply every ten or twenty min- utes the tincture of stremoniem, lobelia, cayenne, and nervine to the wound. Emetics of lobelia; alterative doses of eupetoriem, camomile; cathartics; then warm bath; ten to twenty drops of the tincture of lobelia every five or six hours. Local: rub with the soakings of tobacco and lobelia leaves, every twenty or thirty minutes, in a dan- gerous case. INDIGESTION--DYSPEPSY. Symptoms. Variable appetite—generally none; fiatulenee, distension, acid eructations, and colic pains, after eating. These symptoms characterise the slighter cases of the dis- ease. By repeated errors in diet, or long continuance, it generally assumes a more aggravated from ; in which case the stools lose their natural appearance, becoming bilious, very fetid, sometimes of a very dark color, at others too light or greenish,—and often mixed with portions of un- digested food; the skin becomes salloAv; the urine high colored, and sedirnentous; diarrhoea, followed by consti- pation ; griping; a sense of weight in the right hypochon- dritim; tenderness of the epigastrium ; a foul and clammy tongue; debility, particularly after the operation of purg «ss; general despondency and irritability of temper; ema- 159 elation; a haggard expression of the countenance \ fre-- quently uneasiness of lying on the left side, and at last in- ability to rest easily on either side; a shrivelled and dry state of the skin, in protracted cases; great sensibilty to low temperature, &c. Causes. There are tAVO conditions necessary for healthy digestion, viz.: The secretion of a due quantity of healthy gastric liquor; 2. A healthy tone of the musclar coat of the stomach. Whatever therefore deranges either of these two functions, impairs digestion. The remote causes which are capable of effecting these morbid changes, act either directly on the stomach, or indirectly through, the medium of the general system. Of the former kind are : all kinds of substances capable of irritating the stomach —such as irritating and indigestible articles of diet; the habitual use of spirituous drinks; the excessive use of condiments, opium, and other narcotics; the immoderate use of very warm, or very cold drinks; chronic hepatie disease; over-distension of the stomach by food or drink— of all the causes of indigestion, this latter is one of the most common. The circumstance which most common- ly gives rise to over-distension of the stomach, is rapid eating; high seasoning, and frequent variety of food is also a frequent cause of over-distension. Over-distension does injury, by weakening the muscular fibres of the sto- mach, and by irritating the nerves of this organ, (Among the causes that affect the stomach, secondarily, through the general system, are : the depressing passions, intense stu- dy, excessive venereal indulgence, and whatever debili- tates the general system. Proximate cause. Irritation of the nerves of the stomach, and debility of its muscular fibres, either existing single or conjointly. In consequence of these conditions, the sol- vent gastric fluid becomes either depraved in quality, or deficient in quantity; and the contents of the stomach ar» not adequately embraced, and propelled forwards to th* 3»hyloric extremity. 160 Observations on the multifarious sympathetic effects of gas- tric irritation, horn imperfectly digested food in the primae via?, and on the morbid effects which result from the ab- sorption of imperfectly elaborated chyle into the circula- tion. Treatment. The treatment of indigestion is divided into dietetic and medicinal. In slight cases, a proper attention to diet, with the occasional use of mild aperients, and a rigid avoidance of the exciting causes, will rarely fail to establish a cure. In all cases, whether simple or compli- cated, mild or violent, an undeviating attention to diet, is essential to the management of the disease. No particu- lar direction in relation to the kind of diet, can be laid down, which is applicable to all cases. Some dyspeptics feel relieved by articles of food, which are altogether in- tolerable to others. Every dyspeptic must learn, in a great measure, from his own experience, what will, or will not agree Avith him. The degree of violence of the disease, too, has an important influence upon the power of the stomach, to bear particular kinds of food. What may be taken without inconvenience in the first periods, will generally become insupportable in the latter stages of the disease. At first, Avhen mere debility of the stomach ex- ists, the more digestible kinds of animal food, are decided- ly the best; but if the disease continues, until a high de- gree of irritation, or chronic phlogosis, exists in the mu- cous membrane of the digestive organs, animal food is no longer proper—the disease then requiring the mildest arti- cles of the farinaceous kind. Animal is more undoubted- ly more digestible than vegetable food; and where the gas- tric irritation is not very considerable, it will very gener- ally be taken with the least inconvenience. As a gener- al rule, therefore, we may lay it down, as an established principle, that animal food is the most proper; and of this, the most tender muscular parts are to be used. The flesh of old is in general more digestible than that of young an- imals. Mutton, and most kinda of game, are of easy di- 161 gestion. Pork is generally difficult to digest, yet some dyspeptics bear it better than other meats. Acescent and oily articles are most difficult of digestion. Venison is perhaps the most digestible of all meat. NeAV bread is of exceedingly difficult digestion. Simple roasting and boil- ing is the best mode of preparing meat for weak stomachs. All kinds of fried articles of food, are intolerable. Cheese, milk, cream, and butter are generally oppressive. Spices and condiments should be taken very sparingly. Fresh vegetables are very generally injurious, particularly, cab- bage, peas, and beans. Of fruits cucumbers, pears, mel- ons, currants, are the most indigestible. The food should be taken chiefly in a solid state. SIoav eating, and per- fect mastication, are all-important observances for dyspep- tics. Not much drink should be taken during meals, or soon after. Moderate portions of good brandy, answer well in slight cases, but are improper in the more aggra- vated ones. Simplicity in diet is of the utmost importance; and Avhat is of equal, if not still greater importance, is, to avoid over-distending the stomach. Indian Treatment. I here give the Indian treatment for the cure of dyspepsia, finding it to excel all other remedies in my knowledge, mineral or vegetable. The Indians use red bud, Indian arrow, waughoo, spinnel wood, white wood, —this bush is known in different parts of the country, or different States, by these different names—they give it in a tea three times a day one hour before or after meals. I sometimes use it in bitters, though I prefer it in syrup. For bitters, take bark of the root of waughpoo 1 ounce, golden seal 1 ounce, the outside bark of shell bark (hick- ory,) 3 ounces—pulverize fine in a mortar or by any other means, then add 1 quart of best rye whiskey, or French brandy, or any other spirit that may be in your reach. If the patient is of a nervous temperament, use the best wine, and add one ounce of finely pulverized nervine root. The dose must be given according to judg- ment, age, or temperament, from a teaspoonful to a table- L 162 spoonful three or four times a day, 30 or 40 minutes be- fore or after meals. Dyspepsia Tonic. Take waughpoo root or the bark of the root, best—if the root is used take 10 pounds, if the bark, take 1-2 pound—golden seal 1 pound, outside bark of shell bark (hickory) 3 pounds : pound .fine; put the roots into a pot or kettle; add four gallons water; boil down to three quarts; let it cool; then shire and strain, and put it back into your pot; then boil down to three pints by scimming; then, if you wish, you may clarify by bone dust, eggs, or egg shells; then add just enough spl- its to preserve it, in the winter less and in the summer more; add no sugar; if you add any sugar you will not cure quite as soon, as the sugar will cause distress in the stomach. Dyspeptic patients ought not to use any sugar in their diet, nor make use of tobacco or spirits : the su- gar will cause an accumulation of acid, and you will crave vinegar or saleratus to neutralize it. The saleratus will injure if used to freely. I find that the waughpoo Avill regulate the acid, and cause the bowels to become re- gular, without physic. The regular practiee is to give physic. I condemn it; and, in my estimation, every one that will use these bteters, will condemn it also. Relief is obtained, sometimes, in this disease by using steel dust or iron filings, taken in three grain doses, two or three times a day. Directwns for the dyspepsia tonic. Dose—from a tea- spoonful to a tablespoonful three to five times a day. If the stomach is weak, just use what it Avill bear with ease. Dyspepsia pills. Take equal parts of the extracts of waughpoo, golden seal, hickory bark and hoarhound : roll into pills: thicken with the bark of the root of waugh- poo by finely pulverizing. Dose—one pill three times a day, half an hour before or after meals. In the com- mencement of the disease, tAvo or three doses of my fam- ily pills will be of benefit. 163 ICTERUS--JAUNDICE. ^Symptoms. Skin and eyes yelloAv; fasces clay colored ; u- u rine bilious, communicating a yellow stain; generalh' ? slight pyrexia; occasional pain (sometimes very violent) in the epigastrium; indigestion; languor; nausea; a sense of fulness in the stomach; torpor of the bowels; colic pains; drowsiness; bitter taste; debility, and indisposition to mental exertion; disturbed sleep, &c. The fundamental affection is either an idiopathic or sympa- thetic derangement of the biliary organs, or of the duode- num, by which the bile is either obstructed in its passage into the intestines, or its secretion is suspended. The occasional causes are very various. The principal are: intemperance in the use of spirituous liquors; irritating substances in the prima? viae; cold; suppression of acute and chronic cutaneous eruptions; acrid bile irritating the common duct; biliary concretions plugging up the duct; violent anger; injuries and concussion of the brain; spasm of the duodenum, or of the common bile duct; induration and enlargement of the pancreas; grief; terror; constipa- tion ; viscid mucus clogging the orifice of the common duct; retained meconium; indurated liver; and, in short, Avhatever is capable either of suspending the secretion of bile, or preventing its natural egress from the liver. When it depends on spasm or biliary concretions, the pain is oc- casionally very violent. Proximate cause. The external icteric phenomena, depend on the secretion of bilious matter into the sub-cuticular tissues, in consequence either of the resorption of bile into the general circulation, or of the retention of its elements in the mass of the blood, in case of hepatic torpor. When this occurs, the general capillary system, and particularly the cutaneous capillaries, perform the office of the liver vicariously, and free the blood of a portion of its supera- bundant biliary elements, by depositing them into the.skin, .j&C 164 Observations on the ratio symptomatum. Great wasting of the flesh, and dropsy, are common sequela* - of very protracted arid obstinate cases. The jaundice of new-born infants, is generally transient, and of no par- ticular moment. Wnen it depends on chrOriic hepatic: disease, it is seldom cured. In general, however, it is not a dangerous affection, though often of difficult removal. Treatment. Purgatives, composed of equal parts of the extracts of blood root and wild cherry bark—roll into pills, by adding one third part cayenne to thicken. These pills will act on the liver,- and may be taken in doses of from 3 to 8 pills two or three times a day. One fourth of the cherry will answer. Bitters of wild cherry bark, blood root, and hops, equal parts, say one ounce or each, in one quart of spirits. Dose-^-a wine glass two or four times a day. Use tea of hops, poplar bark, hickory bark of the outside shell, and the yolks of hen's eggs, the yolk of one egg in three tablespoonsful of vinegar three times a day, . SCROFULA. Scrofula may be divided into tAvo periods, Or states; the one that peculiar diathesis, called the scrofulous habit; the oth- er, the disease in its state of development and activity. The scrofulous habit or predisposition, may be acquired from accidental causes, or from hereditary transmission. The scrofulous habit is characterised by the following cir- cumstances ; a particular delicacy and languor of counten- ance; smooth, soft, and flaccid cheeks; a dull lead color- ed circle around the mouth with fine red lips ; swollen up- per lip ; inflammation of the edges of the eye lids—partic- ularly in children; weak digestive powers; scabby erup- tions about the head; irregular state of the alvine dischar- ges; slow growth of the body; aptitude to take cold, &c.— This dormant state of the disease may continue for years, or pass off, under favorable circumstances. More gener- ally, however, it becomes gradually developed, under the 165 Influence of various exciting causes; the lymphatic glands along the neck, and other parts become enlarged and by degrees pass into a state of slow inflammation, terminating in induration, or suppuration: the ulcers thus formed, dis- charge a thin, milky, and somewhat viscid fluid—are but ! little painful, and exceedingly slow in cicatrising. The | cicatrices are uneven, and irregular; the eyelids and con- junctiva become inflamed, as well as the mucous mem- brane of the nose, and bronchia- In a more advanced state of the disease, the salivary and thyroid glands, and the pancreas, and other glandular parts, enlarge; erup- j tions appear on the.skin; emaciation ensues : the extrein- ' ities of the long bones enlarge ; ulcerations occur, particu- ', larly in the cartilaginous and glandular structures; some of the bones become carious ; the large joints inflame and suppurate; the spine becomes diseased ; the nose, and pal- > ate, are destroyed by ulceration; in short there is scarcely any part of the body, which is not sometimes the seat of j its frightful ravages. The most common course of scrofu- j la, however, is the formation of tubercles in the lungs and i consequent phthisis pulmonalis. ', Scrofula occurs more frequently in children, than in adults, ij The scrofulous habit, is rarely formed after the period off manhood. The most common causes which produce this | morbid habit, are: cold and atmospheric vicissitude; indi- _ gestible and unwholesome food; excessive indulgence in t eating; confinement and want of exercise; long exposure j to a humid atmosphere; mental disquietude; chronic irri- tation in the stomach andboivels, from worms and other g causes ; exposure to cold and humidity, during canvales-1 cence from various diseases, particularly measles, scarlati-1 na, whooping cough ; in short, whatever permanently de-1 rjilitates the system, more especially during childhood. Proximate cause. The scrofulous habit, cnnsists probably £ in constitutional, or acquired excess of irritability in thejj Jpmphatic system, in connectioa with a weak condition oflf the assimilative powers. ;i 166 Sr/rup. Sassafras bark 8 ounces, blood root 10 ounce.r,- burdock root 3 pounds, cucumber tree bark, 1 pound, polk root 8 ounces, waughpoo bark 3 pounds : put the roots- and barks into a pot; add five gallons water ; boil down to one gallon; let it cool; strain ; put on your pot again; boil and skim; boil down to two-quarts : add two pounds sugar and eight ounces spirits: bottle for use. Dose— from a tea to a tablespoonful three times a day, adding 1-2 ounce of salt petre to the syrup. Less spirits will answer in the A\unter. You must always put in enough to preserve, according to the weather. Pills for scrofula. Extract of blood root 1 ounce, ex- tract burdock root 1 ounce, extract cucumber tree bark 1-4 ounce, salt petre 1-2 ounce : roll into common size pills. Dose—from two to six pills in the evening on go- ing to bed. Wash for the sores. Sweet oil 1 ounce, cream tarter 1 ounce, flour of sulphur 1 ounce—add hog's lard 3 ounces. This will cleanse and heal the sores. Poultice the sores with hops, slippery elm, maloes and buckeye : pound and boil, and thicken with corn meal. ReneAv the poultice three or four times a day. Adder tongue is excellent to re-, duce the swelling and lumps. Wash for the ulcers- Nitrie acid and muriatic acid one ounce each: put them in an eight ounce vial; add one eopper cent; let them boil till the copper is dissolved; then wash the ulcer with the wash as often as the fungus ffesh appears. Tonic, to be given in tea three time a day, to be taken cold. Bark of cucumber tree, waughpoo bark, boneset, and dogwood bark. Dose—according to judgment. Some people extol the polk root to cure any disease in the blood. It is a good remedy. 167 NO. 5 SYRUP. Poplar bark 1 pound, bayberry 1 pound, cinnamon 1 ounce, smartweed 4 ounces, peach meats 6 ounces. Boil them in tAvo gallons of water; strain off, and add 7 pounds of good su^ar; then scald and skim. When cool add one gallon good brandy and keep it in bottles for use. Half a wine glass, two or three times a day, good to strengthen the stomach and bowels, and restore Aveak patients. It will cure dysentery. , vegetable tonic tFnicorn root 1 1-2 ounce, colic root 1, bitter root 1 l-2> golden seal 2 1-2, black root 1, seneca snake root 1, pop- lar 1, columbo root 1, nervine L 1-2, prickly ash 1-2, nutmegs 1, gum myrrh 3, angelica 1-2, coriander 1, fen- nel 1-4, annis 1-4, carroway 1-4, spirits 1 gallon, refined sugar 12 ounces. Dose—according to judgment, from three to six wineglassfuls a day—less or more, according to the age, temperament, or strength of the user. TINCTURE OF CAYENNE. Digest 4 1-2 ounces of cayenne in one pint of alcohol. TINCTURE OF LOBELIA. Digest 4 1-2 ounces of lobelia seeds in a pint of alcohol for ten days in a hot sun. Shake it often. FOR LIVER COMPLAINTS. Dandelion 1 pound, blood root 1 ounce, pleurisy root 2 ounces, nerve powder 2 ounces, bitter root 1 ounce, W. wood 2 ounces, liverwort 1-2 pound, aspen poplar 2 ounces. Extract by boiling one gallon water to three 168 pints: add sugar and spirits : dose from a tea to a table- spoonful from two to five times a day. FOR INFLAMMATION—of all kinds. Lard 1 ounce, flaxseed 1 ounce—roasted together: then add bread and sweet milk sufficient to thicken : then add 1-2 gill whiskey : then, when milk warm, add one egg. CONSUMPTION. Spikenard root 2 ounces, hoarhound 2, elcampaine 2, com- frey 2, liverwort 1, solomon seal 2, skunk cabbage 2, blood root 3. Add rain water and extract the strength by boiling: then add sugar. Dose—a wineglassful three times a day. PUTRID SORE THROAT. Two tablespoonsful of cayenne, of salt 2 do. 1-2 pint boil- ing water, and the same quantity of vinegar. Dose—two tablespoonsful every half hour. HOT BITTERS. Balmony leaves 8 ounces, bitter mot 8 ounces, bayberry bark 2 ounces, prickly ash leaves 8 ounces, rhubarb 2 ounces, caroway 1 pound, cloves 8 ounces, cayenne 1 1-2 ounces. Pulverize and mix : put one ounce of this pow- der and two ounces brown sugar into a quart of spirits: dose, a teaspoonful at a time. COUGH SYRUP. Elcampaine 1 ounce, comfrey root 1 ounce, hoarhound 1 ounce, wild cherry bark 1-2 ounce. Simmer in 3 pints of water down to one pint: then strain : add one pound sugar, and half pint Jamaica rum. Dose—a wineglassful morning and evening. 169 FOR RHEUMATISM. Burdock seeds 2 ounces, rheumatic root 3 ounces, wild cu- cumber 2 ounces, wild cherry bark 2 ounces, bitter sweet 2 ounces, golden seal 2 ounces, nerve powder 2 ounces. made into a syrup, by extracting the strength by boiling in tAvo quarts of water to one pint: add sugar and spirit. Dose—a wineglassful three times a day. FOR JAUNDICE. Bitter .root 2 ounces, poplar bark 2 ounces, wild cherry bark 8 ounces, cayenne 1 ounce, hops 2 ounces. Cover with with boiling water. Add one pint Holland gin. Dose— from a half to a wineglassful three times a day. CLARIFIED CHOLERA SYRUP. Colic root 1 pound, bayberry 1 pound, umbil root 1 pound, golden seal 1 pound, boiling water 1 gallon—steep for several hours on hot embers,' pore it off, and add 1-2 gal- lon more of boiling water, and steep it as before. Then strain through a thick cloth : add one gallon sugar house molasses, one gallon West Indian rum, one ounce cloves. one ounce tincture cayenne, one gill No. 6. When cool beat up the white of two eggs, mix well in the sy- rup. Then steep the whole together over embers; as it comes to a boil, carefully skim, and bottle for use.— Good in. all cases of cramp colic or spasms. Dose— from a tea to a tablespoonful as often as the case may require. RESTORATIVE CORDIAL. Comfrey root 1 ounce, solomon seal 1 ounce, spikenard 1 oz., columbo 1-2 ounce, gentian 1-2 ounce, golden seal 1-2 ounce, nerve powder 1-2 ounce, camomile 1-2 ounce, 170 angelica 1-8 ounce, coriander 1-4 ounce, fennel 1-4 ounce, capsicum 1 ounne. Add spirits, or extract by boiling : add sugar and spirit. VEGETABLE TONIC. Golden seal, bitter root, capsicum, Malaga wine. NERVINE TONIC. Ladies' slipper 3 ounces, ginseng 2 ounces. Pulverize and mix. Dose—one teaspoonful. STRENGTHENING PLASTER. Extract of mullen 1 ounce, extract of burdock root or leaf 1 ounce, rosin 2 ounces, turpentine from yelloAV or white pine tree 3 ounces -. add all together. Whan you melt your rosin, gum and turpentine iogether, add spirits of tur- pentine one to three ounces , stir; then pour the contents in a bucket of cold water ; then, as it cools, pull it like shoemaker's wax. If too hard, add spirits turpentine. This plaster may be spread on thin leather as thick as a common table knife, and may be Avorn for strains or Aveak backs. It will stick from one to five Aveeks. PILES. Sperm oil is a sovereign remedy for piles. Anoint three or four times a day. WARTS. Peal the wart; then poultice with table salt and the yelloAV of hen's eggs for three or four nights, and the warts will drop out. 171 CONSUMPTION. A tablespoonful of tar; three spoonsful of. honeys three yolks of eggs; one half pint wine. Mix and bottle for use. Dose—a teaspoonful from three to six times a day. DRAAVING SALVE. Beeswax 1-2 pound, rosin 1-4 pound, flaxseed oil 2-ounces,- turpentine 2 ounces, and the Avhite of an egg. STIFFNESS. Indian cure for contracted muscles. Poultice with the brains of deer or squirrel; anoint with the yolks of eggs; beat the yolks fine ; then add a little cold water; then sit near the fire and rub for one or two hours each day for two or three days, which will curer if medicines are taken inter- nally to operate on the bowels. I prefer the oil of eggs, obtained by putting a few dozen in a pot or kettle. Alter extracting the shells, add a small quantity of any soft oil; then, after roasting them on a sIoav fire for fifteen or tAven- ty minutes, turn the pot or kettle on its edge, and the oil will appear. Anoint ivith the oil. This is excellent for rheumatic pains; and also the oil obtained from common fish worms—small ground worms. The oil can be ob- tained in the same way, by roasting, and adding a small quantity of any soft oil. This oil is excellent for the cure of rheumatic pains, &c. You can obtain the oil by roasting the eggs alone, &c. AN INDIAN POULTICE For the cure of cancers or all foul ulcers, white swellings, sore legs, &c. Poultice with cranberries—pound them fine. Poultice for four or five days; then use the cran- berries and white or yellow lily, or you may make a caustic of the cranberries, by boiling them, and straining 172 the liquid : boil down to the consistency of tar; then fill the sore with the plaster twice a day. TO STOP VOMITING. Take a piece of unslacked lime of any size, and slack it: one tablespoonful of the water, after settling, to two table- spoonsful of new milk mixed together, and given to the patient, will stop the vomiting immediately. A weak lie of hickory ashes is an excellent remedy. Remember, in all cases, after and before the vomiting, to rub the stomach with the tincture of cayenne. A warm bath is good sometimes. SUPERIOR GAS BEER. Superior gas beer is very palatable, and has been recoin- mended by physicians as conducive to health. For a seven gallon keg, take one teacupful of brewers or distillers' yeast and one pint of flour. After it has risen, put it into the keg, and add a pint aud a half of molasses and two and a half gallons of cold Avater. Take two and a half tablespoonsful of allspice, and two of ginger and put them in a separate vessel, and pour four quarts of boiling water into it. Then put it into your keg, and add two pints and a half more of molasses, and fill up the keg with cold water. Shake it well. In the course of fifteen or twenty hours it will be fit for use. Your keg must be strong and tight, or the pressure of the gas, during fermen- tation, will burst it. To make the above beer in cold weather, it is necessary to put a pint and a half of skim- med milk into the mixture. pecurial soap—to take stains out of cloths. Take two pounds of white soap and shave it down fine; put it into a pot; then take two ounces of saleratus, two ounces of the supernate of soda, two ounces of soda of 173 -camphor gum, dissolved in three gills of alcohol; thm take two gills of rain water, and mix it all together; boil all well together; then take two ounces of charcoal, ground down fine, and when boiled, put in the two oun- ces of charcoal; stir Avell together; then take a piece of linen cloth and make a kind of moulds while hot; pour in the moulds, spreading it from one to two inches thick ; let it cool well; then cut it up in small cakes. CHILLS AND FEVER. Sulphate of quinine and prusiate of iron, equal quantities. Give from four to eight grains every hour until perspiration is produced. Should fever arise again, pursue the same course again. The second or third course never fails to cure any periodical fever. 2. Best lima two ounces, and carbonate of magnesia one half ounce : mix intimately, and divide into twelve parts. Upon the well day, give one part every four hours until four doses are taken. Omit the next day, and on the third day give four doses as above directed ; omit three or four days, and then give the remaining four doses : but if the case is of long standing, I give four more doses on the seventh day from the last above mentioned. I usually put a dose of the powder in a tablespoonful of spi- rits, and when all Avet with it, add about a teacupful of water, stir it well, and drink it off. TYPHUS FEVER. Typhus is by no means so common a disease as is generally- supposed. The term Typhus is frequently applied to fe- vers essentially distinct from typhus. Synochous and ca- tarrhal fevers are often improperly denominated typhus. Typhus divided into four periods, viz, the forming stage, the stage of invasion, the stage of excitement, and tne stage of collapse^ 174 Symptoms—Of the forming stage. Lassitude, giddiness, and dull pain in the head; a peculiar uneasy sensation in the stomach, nausea, and sometimes vomitingj want of ap- petite; thirst, pale and shrunken countenance; tremor of the hands; eyes dull and heavy ; muscular debility. This -stage lasts from three to seven days. •Stage of invasion. Slight chills, alternated with flushes of heat; tongue whitish or clammy; entire disgust of food; nausea and Aromiting ; asense of weight and anxiety in the praecordium. This stage lasts from six to twenty-four hours. ^Stage of excitement. Face full and flushed; pulse full, somewhat resisting, and accelerated; skin dry and warm; lips parched; thirst urgent, bowels constipated; eyes red and watery.; slight and transient delirium; vigilance; ob- ;tuseness of hearing; weight and oppression in the chest: tenderness and fulness in the hypochondria; catarrhal and fperipneumonic symptoms; mind about the third day, con- fused, as if stunned; great reluctance to mental and corpor- eal action. About the fourth day, a red miliary eruption often makes its apperance. Hildebrand regards this asaia essential exantheme of this disease. The voice is at first rather plaintive, but in the advanced periods of bad cases, it becomes guttural, and " at last, truly sepulchral.'' The body exhales a,peculiar odor in this disease. This stage lasts usually about seven days; at the end of this period, it terminates in the Stage of Collapse. This-stage is char- acterised by: great prostration of musculai power; torpor of the sensorial functions; a very frequent and feeble pulse: tongue brown, dry, at last black ; incrustation of the teeth with a blackish matter ; short and feeble respiration ; dif- ficult deglutition; almost constant delirium; coma; tongue tremulous, and ;put out with difficulty; subsultus tendi- num; hiccough; heat of the skin intense and acrid; une- qual distribution of the animal temperature; diarrhoea. with pain in the bowels, in the latter periods of severe ca^ -ees: urine pale; tympanitic bowels; sometimes petechias. 175 The foregoing sketch applies to typhus in its regular and simple form. In this form, there are manifest morning remissions, and evening exacerbations. Typhus is subject to various important modifications. In some instances, local inflammations supervene, forming what Dr. Arm- strong calls Inflammatory Typhus. The organs most liable to become the seat of inflammation are, the lungs, the brain, the in- testinal canal, the liver, and the peritoneum.—The mu- cous membrane of the brain, the most commonly affected. Tne theories of Broussais and Clutterbuck referred to. In some instances, the stage of excitement does not become developed, the stage of oppression continuing throughout the whole course of the disease. This variety constitutes Dr. Armstrong's Congestive form of typhus. This modification is character- ised by: a want of reaction; great prostration and sinking, from the commencement; deep pain in the head, and in vertigo face pale and dingy; respiration anxious and op- pressed; pulse small and variable; skin cool, damp, and relaxed; countenance bewildered or vacant; eyes dull, Avatery, and red, or glairy and staring, without redness; bowels at first constipated—towards the conclusion, co- pious involuntary stools ; tongue pale and tremulous, be- coming at last brown and rough; petechiae ; passive hae- morrhages ; coma ; sometimes, from the beginning, com- plete torpor and insensibility. Dr. Armstrong's opinion that the depressed and protracted state of the system depends on internal venous congestion, refuted. The internal congestions are most probably^ the con- sequence, and not the cause, of the impaired or de- pressed condition of the vital energies. When the remote cause of typhus acts with great intensity up- on the system, the vital powers are suddenly pros- trated ; in consequence of which, the heart and the •capillary system act feebly—the blood recoils £wm 176 the surface to the central vessels, and gives rise to internal congestions, which the enfeebled heart is now unable to overcome. Causes of Typhus. Typhus almost peculiar to the cold seasons of the temperate climates. Smith, Ferriar, and Wedekind, have seen it during the hottest Aveather in sum- mer. Propagated by a specific contagion: evidence ad- duced in support of this assertion. Typhus occasionally originated by other causes than contagion-—deficient and unwholesome food, and the contaminated air of confined and crowded apartments the most common cause of this kind. Upon the subject of the origin and mode of propaga- tion of this disease, physicians are by no means una- nimous. Some regard typhus as always and essen- tially a contagious disease, while others deny that it is ever communicated in this manner. The weight of good testimony is in favor of the occasional gen- eration of the disease, by causes entirely distinct from contagion. When once generated, it may, and fre- quently does, spread from the sick to the healthy, in the manner of a contagion. Free and spontaneous vomiting, in the beginning, particular- ly when it relieves the giddiness, generally indicates a mild course of the disease. Hamorrhage from the nose, about the seventh day, is favorable. Very manifest remissions in the morning, are always a good sign. Moderate diar- rhaa, during the first days, is favorable; but Avhen it oc- curs in the latter periods of the disease, it is a very bad sign. Great thirst, in the stage of collapse, is favorable; so also is a moist tongue, in this stage. The absence of important or violent local inflammations, always a good sign. Diminution of the frequency of the pulse, and of the acrid heat of the skin, is favorable. Anions the symp- toms which are particularly unfavorable, are: great change of the expression of the countenance, in the beginning of the disease; entire absence of thirst; constant and violent 177 delirium; early petechiae; strong peripneumonic symp- toms ; swelling of the parotids. The most dangerous signs, in the last stage, are: blindness, involuntary flow of tears; difficult deglutition; palsy of the tongue ; constant Ioav murmuring; and entire abandonment of himself; a very frequent and small pulse; pain In the region of the blad- der ; tenderness and tumefaction of the abdomen; floccita- tio; continued motion of the hands and fingers ; diarrhoea; insensibility to the vesicating effects of cantharides; hic- cough ; aphthae in the mouth; suppression of urine. Treatment. The first object is to remove as much as pos- sible the remote cause. The indications are: to overcome the torpor of the external capillaries; to determine the circulation to the surface; and interrupt the morbid sympathetic actions throughout the system. For this purpose, emetks are highly serviceable; given soon after the attack of the disease. Emetics—com- posed of ipicac, lobelia, eupetorium, and the tincture of blood root. - After the operation of the emetics, Mild purgatives should be employed. Tavo or three alvine evacuations should be procured daily. Penneroyal tea, eupatorium, catnip, sage, sanguinaria, &c. In the early periods of the disease, this article is often de- i cidly useful. Slight influence, the most effectual means of arresting typhus in its early stage ; fiive grains of san- guinaria may be given every four hours. Sanguinaria, no less beneficial, in the early stages of con- gestive fevers. It has a powerful tendency to equalise i the circulation; it raises the pulse, restores warmth to the. skin, and increases the general energy, i^ such cases. I In the stage of excitement, a more or less antiphlogistic treatment becomes necessary. Mild cathartics particular- ly in this stage—they moderate at once the fJenerol ex- I citement, the heat of the skin, and the force of the pulse, j Cold Affuswns. When the skin is hot and dry, in this ' stage of typhus, the affusion of cold water is often highly | 1T8 benencal. As the stage of collapse approaches,, the tem- perature of the water should be raised. Cold affusions are improper, when the skin is below the natural temper- ature, and a sense of chilliness is present. Use a tea of ginger, (wild ginger best,) combined with eupatoriem. I use a pill composed of sulphate of quinine, powder of blood root, powder of yellow poplar bark, powder of eu- patoriem leaves : stick the pills with the extract of black pepper, and give from one to three pills each hour; or you may use the powder in fusions, say a teaspoonful each hour, more or less. The blood root acts-on the liver, and it has a powerful tendency to equalize the circulation. You may use a pill of the extract of blood root with qui- nine : milder cathartics, rhubarb combined with oil. I find a tea of poplar bark and cayenne invigorates the most powerfully in this disease, if the powder is used. j)ose—a teaspoonful each, one of the poplar,, and one of the pepper. Local: sponge the body with milk warm vinegar and water. Diaphoretics, of the refrigerent class, useful during the stage of excitement. Collapse. In this stage, stimulants and tonics are the appropriate remedies : eupatoriem, cayenne. When stimulants render the pulse fuller and slower, and the skin moist and cooler, they may be continued with confidence; but when the pulse be- comes more frequent and corded, the countenance flushed,. with an increase of restlessness and delirium, under their use, they are doing iujuiy. Camphor particularly service- able, with nitre; useful even in early period, when the dis- ease is complicated with peripneumonic symptoms. Small doses of infusion of serpentaria, beneficial: a strong tea of poplar bark with quinine. Diet. Solid food injuri- ous : farinaceous and mucilaginous substances, the only nutriments admissible. Barley water, and thin oat-meal gruel, should be freely allowed, in the stage of collapse. Crackers and store tea, or wheat flour gruel, a little at a time. Pills, to be given one or two each hour : ipicac 1-4 ounce, cayenne 1 ounce, sulphate of quinine 1-2 ounce. Roll into pills : give from one to two each hour through 179 the day. Use a tea of May weed, milk warm or cold. Locals cayenne and vinegar, COLICA PICTONUM. This variety of colic is known by various names ; as pain- •* terh colic, dry gripes, Devonshire colic, colica pktavensis, rachialgia metallka, and saturnine colic. The disease generally comes on gradually, and is generally preceded by symptoms of gastric derangement such as ir- regular appetite; constipation ; foul eructations; transient pains in the abdomen; languor; pale countenance, &c. This variety of colic is attended with constant and ex- tremely severe pain about the umbilical region; the ab- domirnal parietes are hard, and forcibly retracted; and the bowels almost immovably constipated. The pain suffers occasional remissions but no perfect intermissions,, as in the other varieties of colic. It sometimes assumes a chron- ic form, producing wasting and palsy of the fore arms. The predisposition to,it is greatly increased, by having once suffered an attack. Causes. Lead; hence its frequency with painters, glaziers, and workers in lead factories. Sudden atmospheric vi- cissitudes, (Larrey;) new and sour wines; unripe fruits, &c. Treatment. Emetics—jallap, eastor oil, spirits of turpen- tine. To 'produce brisk operations in an hour or two, take warm bath and apply hot bricks to the feet. Ess. catnip oil, ess. peppermint, ess. cinnamon, spirits cam- phor, spirits lavender, aether, and No. 6, equal parts, giv- en in water. May weed, given in tea, is a sure cure. DIABETES. This disease consists in the secretion and voiding of an un- usually large quantity of urine, attended with a very dry skia; great thirst; slight febrile movements; voracious ap-. 180 petite; a sense of-weight and uneasiness in the stomach; white and foul tongue: great lassitude; pain and weak- ness in the loins; irregular bowels ; cold feet; dull and heavy eyes; and towards the last, great wasting of the flesh, and debility: vertigo: head-ache- difficulty of breathing: spongy gums:- offensive breath constant: drowsiness: and hetic fever. Prout mentions inflammation and uneasiness about the external orifice of the urethra. Diabetes occurs under two distinct forms, viz: diabetes mel litis, and diabetes insipidus. Of the latter there are three varieties: 1. That in which the urine contains an excess of urea : 2. That in Avhich the urine is albuminous; and, 3. That in which it is surcharged with phosphates. Diabetes millitus. In this variety, the urine is saccharine, of a pale straw color, sometimes approaching to a green- ish hue: its smell resembles that of milk. It always con- tains less urea than healthy urine: Prout who restricts the term diabetes to this variety, says, that diuresis is not essential to the disease. Of the exciting causes we know little or nothing. Proximate cause. T he opinions on this head are exceed- ingly Ararious. Sydenham, Rollo Cullen, and others, re- gard derarigment of the digestive functions, and Avant of energy in the assimilative powers, as the primary affection. Objections stated to this opinion. I regard diabetes, as a disease essentially and primarily located in the kidneys —the stomach, lungs, skin, and in short the whole sys- tem, becoming secondarily affected. The sugar contain- ed by the urine, is wholly the result of a morbid action of the kidneys, for the seium of the blood of diabetic patients, does not contain a particle of it. It Avould seem, that the urea which is secreted with the urine in health, is conver- ted into sugar in diabetes. The analogy between urea and sugar pointed out. Sugar contains just double the quan- tity of oxygen and Carbon, and the same quantity of hy- drogen, a large proportion of azote, of which sugar is des- titute. As diabetic urine contains very little or no urea, 181 we may regard the sugar which it contains, as a depraved secretion of urea. Prognosis. Diabetes mellitus, is an exceedingly obstinate and dangerous affection, the instances of recovery from it being comparatively very few. Treatment. I have only treated one case of this disease with satisfaction. I used tonics first. 1 used cathartic? composed of black root, cayenne, and the extract ot waughpoo root, equal parts, for about twenty days. I then used a syrup composed of poplar bark and bark of cucumber tree, wild -cherry bark, waughpoo bark, equal parts, three times a day. Local. I take alcohol 1 pint, oil of hemlock 1-2 ounce, oil of cloves 1-4 ounce, oil of annis seed 1-4 ounce, gum camphor 1-2 ounce, oil of cat- nip 1-4 ounce, add all together, shake well, and rub 3 or 4 times a day. By this treatment I cured one case. I had rather undertake to cure a cancer than this disease. VERMINOUS DISEASES--WORMS. Various opinions concerning the origin and formation of worms, in the intestinal canal. It does not appear that they are received from without, because they are never found out of the aaimal body ; and when they are remov- ©ut ef the body, they speedily die; and, lastly, earth worms, arid such as live in water, do not change their forms, when received into the intestinal canal. There are live varieties of intestinal worms. 1. Tricocephalus dispat. These worms are from an inch and a half, or two inches in length. About two thirds of their length is almost as thin as a horse hair, tthe remaining and posterior part being considerably thicker, and terminating in a rounded extremity.— 'They are found principally in the ccecuni. They are seldom numerous. -2. Ascaeisvermkularis, (pxyursivermicularis.) These are exceedingly short—not more tfean two lines in 182 length, very thin and white. Their usual seat is in the rectum, 3. Ascaris lumbricoides. These worms are from two to three, to ten or twelve inches in length, round, of yellowish white,tor brownish red color, of nearly a uniform thickness, except at the extremities, which taper to a blunt point. They are from tAvo to three lines in thickness. They inhabit the small intes- tines chiefly; but occasionally ascend into the stom- ach. 4. Tania lata, (hothrkephdlus lotus.) This worm of- ten acqeires a very great length—from twenty to thirty feet and more; it is from four to six lines in breadth, flat and white, resembling a piece of Avhite tape, and composed of a series of concatenated joints. It inhabits the upper portion of the bowels and the stomach. The head is armed with two processes, by which the Avorm attaches itself to the intestines. 5. Tania solium, (T. Cucurbitina.) This Avorm is rarely, if ever, voided Avhole, it generally passes off in short joints, resembling, in some measure, the seeds of Pgourd. Pieces, however, upAvards of twenty feet, of this Avorm, have been voided. The head is small, and furnished with four small apertures. (Oscula.) It inhabits the .small intestines chiefly. Symptoms. Countenance pale, lead-colored, with occasion- al transient flushes; eyes dull; pupils dilated, with a blu- ish semicircle around the lower eye-lids; tickling in the nose; tumid upper lip; occasional head-ache, and hum- ming in the ears; copious secretion of saliva ; tongue sli- my or furred: breath foul; variable appetite—being some- times voracious—at others wnolly gone; transient pains in the stomach; occasional nausea and vomiting; pains in the abdomen—particularly about the umbilical region; frequent slimy stools, or costiveness; urine turbid, yelloAV- ish, or milky; abdomen tumid and hard, with emaciation of the other parts of the body; lassitude: irritability of 183 temper. None of these symptoms, hoAvever, are certain indications of the existence of worms in the Rowels—the only ceitain indication being the appearance of them in the evacuations from the bowels or stomach. The opinion which is expressed by some, that worms are harmless in the intestinal canal, is without fonndation. It is. nevertheless probable that the peculiar condition of the alimentary canal, Avhich favors the production of worms, is more frequently the cause of mischief, than the Avorms themeelves. Worms give rise to a variety of affections, such as chorea, epilepsy, hydrocephalus; emaciation; con- vulsions ; paralysis, and a vast variety^of anomalous disor- ders. Treatment. In prescribing for the removal or destruction of worms, it is of some consequence to confine the patient to a spare and liquid diet, and to exhibit two or three mild cathartics a feAv days previous to the exhibition of the prop- er remedies. With these preparatory measures, the ordi- nary vermifuge. When 1 suspect that worms exist, I or- der large quantities of sugar for several hours before I ex- pect to give vermifuge. After giving the vermifuge, if the worms are not discharged, I give sugar; then I give tin filings, from five to thirty grains at a dose, three times a j day for two or three days; then I give a dose of butter- nut—its bitter properties appear to have the desired effect; I also give the powder of the root of black haw three times a day, as much as will lay on the point of a com- mon table knife, for one or two days; then I give the butternut physic. The black haw is a specific with the j Indians. Give a tea of the leaves of bare foot for a day j or two, three or four times a day, of two ounces of the t leaves : then give the physic. Sometimes there is an ad- j vantage to be derived from the use of sweet brandy toddy; I then use the vermifuge. I find the seed of Jerusalem oak j to be excellent, stewed in new milk or boiled in water, jj sweetened, and given for six or eight hours : then give the : physic. A syrup composed of equal parts of black haw | 184 root, the seed of Jerusalem oak, and butternut: boil say three ounces each : extract the strength to six ounces; then add sugar : give the syrup, and slippery elm in pow- der : use for three or four days if required. Table salt, given every morning for fifteen or twenty days, with one half grain copperas, and a teaspoonful of the salt. I use male ferren, gambage, and butternut for tape worm. CHRONIC GASTRITIS. Chronic inflammation of the mucus membrane of the stom- ach, is of much more frequent occurrence than is general- ly supposed. The worst forms of dyspepsia, and all that host of inveterate gastirc and bilious derangements, of which so much is heard, and the true nature of which is so often misunderstood, are, in nine cases out of ten, the conse- quence of a more or less phlogosed condition of the mu- cous membrane of the stomach. We are indebted to the French pathologists, and more especially to Broussais, for much new7 and valuable information, in relation to this va- riety of phlegmasial disease. Symptoms. A pricking, lancinating, or burning pain in the epigastric or hypochondriac region; the pain is constant and harrassing, generally confined to a very circumscribed spot, and often attended Avith a feeling of constriction: sometimes a sensation is felt, as if a ball were pressing on the diaphragm; at others, as if a bar were fixed across the stomach, impeding deglutition; depraved and impaired ap- petite, often general abhorrence of food; indigestion, vo- miting, or nausea; load at the stomach after eating; pulse but little excited, and heat of the surface natural, except during digestion, when they are a little elevated; great costiveness during the first period, but mucous diarrhoea af- ter the disease has become inveterate; the patient becomes irritable, dejected, taciturn, discontented; tongue of the color of logwood, with a strip of thin fur along its centre. In inveterate cases, emaciation, with the skin drawn tight 185 over the muscles, so that it cannot be pinched up. This tightness of the skin is the most constant diagnostic sign of the disease. Mere gastric debility may be distinguish- ed from it by the effects of an emetic; when fever, pain, and anorexia, become increased after the operation of an emetic, we may be sure of the existence of high irritation, or phlogosis, in the mucous membrane of the stomach. In chronic gastro-enteritis, the pain is generally ob- tuse ; often felt only on pressure; is never absent. Gas- tralgic pain, on the other hand, is often extremely violent; is often, when most violent, relieved, rather than increas- ed by pressure. It often radiates from the epigastrium to- wards the thoracic parietes, the back, and the shoulders ; is of an intermittent character, sometimes entirely disap- pearing, to return with more or less violence. In chronic gastritis, the tongue, which is generally red on the sides and at the top, is covered in the middle with a kind of dry mucous crust, resembling a false membrane, the breath is fetid, with a bitter taste in the mouth. Treatment. Emetics of epicac and lobelia. Give a pill composed of capsicum and rhubarb, equal parts, and one sixteenth of the oil of annis seed : stick the pills with gum arabic or the extract of butternut. Give from two to eight pills at a dose, with a tea of slippery elm, or maloes and hops, or charcoal and east: give at intervals of from thirty to sixty minutes. Charcoal is excellent, and may be given in from tea to tablespoonful doses. Local: sponge with milk Avarm vinegar and water: after the vinegar and water, rub with the tincture of cayenne. The stomach may be poulticed with a corn meal poultice. with a little cayenne and tincture of gum myrrh, three times a day. No. 6, in teaspoonful doses, is good, both as an internal and external remedy. Diet: light bread. store tea and crackers, wheat flour, and any light, digestible diet; no grease or warm biscuit. 186 SPLENITIS--AGUE CAKE, Inflammation of the spleen; pain in the left hypochrondrium, increased by pressure. This disease, according to Junker comes on with a remarkable shivering, succeeded by most, intense heat and very great thirst. A pain and tumor are perceived in the left hypochrondrium, and the paroxysms, for the most part, assume a quartan form; when the pa- tients expose themselves a little to the free air, their ex- tremities immediately grow very cold; if a haemorrhage happen, the blood flows out of the left nostril; the other symptoms are the same with those of the hepatitis of the liver. The spleen is also subject to a chronic inflamma- tion, which often happens after agues, and is called the ague cake, though that name is also frequently given to the scirrous tumor of the liver succeeding intermittents. The causes of this disease are, in general, the same as those of other inflammatory diseases ; but those which de- termine the inflammation to that particular part more than another, are very much unknoAvm It attacks persons of very plethoric and sanguine habits of body, rather than others. Treatment. The treatment for this disease must consist of the best medicines to act on the liver, to equalize the cir- culation, and to purify the blood. I contend that this dis- ease is caused by inaction of the liver. The liver is tor- pid in nine-tenths of the patients that are afflicted with the chills and fever. I have cured hundreds of cases with my anti-bilious pills. I cured by causing a regular action on the liver and bowels, by giving one or two pills in the morning, and the same number at night. The medicines to purify the blood may be taken in syrups or pills, as most convenient. Some patients have a dislike for pills; others will take them like green garden peas. If the pa- tient prefer pills, 1 give them, composed of the powder of blood root and the extract of the bark of the root of spinnel wood, blue flag root, burdock root, and the bark of 187 cucumber tree, all in extracts, equal parts : roll into pills. The powder of blood root will thicken the mass; if it is not thick enough, add the pulverized bark of the root of red sassafras. Give just as many pills as will produce 3 or four operations on the bowels every twenty-four hours, You may take say five ounces of each of these roots and barks, and after pounding them fine, add three gallons water—put the roots and barks into a pot, and boil down to two quarts ; let cool; then strain your liquid; then put on your pot again and boil down to one quart; then add one pound New Orleans or lump sugar and two drachms of salt petre, and from four to six ounces of spirits to preserve the syrup, less in the winter than in the summer. Give the syrup so that it will operate on the bowels from two to four times each 24 hours, less or more according to the strength of the patient. .Remember to rub the af- fected part with the oil of rattle snake, once or twice each day ; two or three ounces very freqnently cures. Bitters for ague cake. Take blood root 1 ounce, bark of spinnel wood 4 ounces, salt petre 2 drachms, in two quarts of spirits. Dose—from a teaspoonful to a wineglassful three times a day, less or more, according to the patient's tempetament—from two to four operations each 24 hours. These bitters ought to be in every family, and if used morning and evening, there will not be a tenth part the danger of the-family being afflicted with chills, &c. Re- member—one ounce of preventative is as good as sixteen ounces of cure. Pills for ague cake. Take blacksmith's cinders, pulverize them fine, and roll into pills with the extract of burdock root to stick the pills. Take of the cinders one ounce, and two ounces of the burdock extract. Dose—two pills at night and two in the morning, if required. 188 WINTER FEVERS. C find that these forms of fevers yield to a vegetable treat- ment. These fevers are most generally of an inflammato- ry 'character. The organs most liable, to become the seat ef inflammation are the lungs, the brain, the intestinal ca- nal, the liver, the mucous membrane of the alimentary canal. The brain and lungs are most commonly the seat of winter fevers. My mode of treatment in these fevers is, to subdue the inflammatory action. If the inflamma- tion is not subdued, congestion will take place on the lungs or brain. Let the treatment be prompt and ener- getic. My plan of treatment is, to give stimulants, as nine tenths of these fevers make their attacks from cold. When you are called to see a sick patient, before you have time to seat yourself to Avarm, and before you feel the pulse, he will say : -"Doctor, I am glad to see you, I have a very bad cold :" at the same time his cheeks are of a scarlet color, and there is great difficulty of breathing. The lungs and brain at the same time may he much in- flamed, and if not arrested, it will lay hold with an iron grasp. I commence my treatment with the best and purest stimulants, of which capsicum is the purest, aided with wild ginger or common ginger, May weed, horsemint, pennyroyal, Virginia or black snake root, spice bush twigs, and eupetorium, to stimulate and relax—aided, if required, with lobelia. These forms of fever need an al- terative treatment—tonics, relaxants and stimulants—with the application of hot- rooks or boiled ears of corn, laid as near the patient as not to burn or scald. The moisture will relax, and aid nature to resume her healthy action. When I examine a patient, if I find the pulse quick and hard, I give an emetic, then plenty of stimulating tea, of any kind I can find most convenient. If boneset is at ■hand I use it to aid the emetic; if May weed, I use it and camomile flowers or pennyroyal; if no herbs are at hand that are good, I add to the emetic from one to two tea- spoonsful of the tincture of blood root, which will stimu- 189 late, and excite an action on the liver, and cause perspira- tion to appear; it also relieves the lungs. I order $ sponge, with vinegar and warm water—vinegar 1 pint, water 2 pints. I rub the breast Avith the tincture of cayenne; the tincture excites the lungs, and they will dis- charge the phelm with ease witn the use of. eupatoriem and Indian turnip. Take Indian turnip 1 ouuce, honey 6 or 8 ounces, lobelia seed 1 drachm, blood root 1-2 ounce : stew them on hot embers for thirty minutes; just let it remain hot; then take it off, and give it in teaspoon- ful doses each hour, or oftener if required. Then I give a pill composed of extract of blood root 1 ounce, cayenne 2 ounces, best alloes 1 ounce, and extract of hoarhound 1 ounce—if I have not the extract of blood root, I use the powder of the root: roll into pills. Give from two to eight at a dose. If I have not the blood root, I use jallap or the powder or extract of black root. May apple will answer, the powder of the root. If I examine a. patient, and find he is not very dangerous, I just give him a dose of these pills. These pills will cure forty-nine out of fifty cases, if given in large doses. If the dose is very large, they may operate once or twice as an emetic; if they do all the better, as in an hour or two they will operate on the bowels : then give corn meal gruel or chicken broth. FEMALE PILLS. Take the extract of the bark of spinnel wood 1 ounce, ex- tract of yellow poplar bark 1 ounce, extract of wild ginger (colt's foot) 1-2 ounce, capsicum 1-4 ounce, extract of blood root 1 ounce, extract of elcampaine root 1-2 ounce. Roll into pills : thicken with more pepper, if not thick enough. These pills may be given from four to eight at a dose. They are good for the cure of all diseases of the uteras,debility in any part of the system, flour albus, whites, weakness in the small of the back, &c. You may add a little gum or turpentine to the pills. 190 INFLAMMATION. Pain, increased heat, redness, and swelling. Pain. Not always, though generally, present; generally, the looser the instructure, the less pain; sometimes absent, in peripneumonia, gastritis, pericarditis, &c; inflammato- ry pain always increased on pressure, and may be thus distinguished from spasmodic pain. The nature of the structure inflamed modifies the character of the pain. The violence of the general febrile reaction, proportionate to the intensity of the pain. Increased heat. Not always present; actual degree of heat never raised above 98°. The sensation of heat depends on the altered state of the sensibility of the inflamed part. Redness. Almost an invariable phenomenon of inflamma- tion ; arises from the intromission of blood into the serous capillaries; generally remains after death; redness, by itself, no certain sign of previous inflammation; the serous capillaries may become injected with red blood in articulo mortis, although sound before; importance of this knowledge, in autopsic examinations. Swelling. The effort of effusion into the surrounding cellu- lar tissue; the firmer the structure, the less swelling. Inflammation is located in the capillary system. The more abunbantthe capillaries of a part, the more apt is it to be- come inflamed. The mucous, serous, cellular, and der- moid systems, being very vascular, are very subject to in- flammation ; the contrary obtains with the osseous, the car- tilaginous, and the tendinous structures. (Bichat, Eb- erly.) JEtiology. Inflammation may be produced—By the direct operation of irritants on a part. By the indirect opera- tion on parts, through the medium of the nervous system. By general irritated vascular excitement. By metastasis. Whatever be the exciting cause of inflammation, the follow- ing changes take place in progress of its evolution: viz, irritation; then alteration of the vital properties; and fi- 191 ally, an afflux of blood to the part. These changes oftew succeed each other so rapidly, that they seem to arise si- multaneously. A change of the vital properties is essential to inflammation; preternatural determination to a part, without altered sensibility and contractility, constitutes congestion, or local plethora—not inflammation. (Bi- chat.) Are the capillaries of an inflamed part in a state of debility, and is the velocity of the blood circulating in them dimin- ished—or, are they in a state of increased action?. Vac- ca, Lubbock, Allan, Phillip, and Hastings, have written in support of the former opinion; but the subject is still subjudice. My own view on this subject is, that the inflamed ca- pillaries ought to be regarded as being in a strte of ir- ritated excitement; and that this irritated condition may be connected either with an increased or Avith decreased power of action. In this respect, local in- flammation corresponds Avith that generable irritated vascular excitement, which constitutes fever. The heart arteries are in a state of irritated action, with in- creased poAver of aching in synocha. In typhus, there is also general irritated excitement; but it is connect- ed with a fundamental debility of the vital powers. There is, therefore, according to my apprehension, a typhus and a synochal state of inflammation ; and this corresponds with the results we obtain from re- medial applications. May we not explain these dif- ferent diatheses of inflammation, by the greater or less degree of organic injury sustained by the nervous filaments of the inflamed capillaries? When a part Is irritated, so as merely to exhalt the sensibility of the capillaries, by exciting their nervous texture, the consequent inflammation will probably be one of in- creased capillary action,, and demand sedatives for its cure: When, on the contrary, the irritating cause acts with such violence a3 to cause structural leison 192 hi the nervous extremities, the inflammation result. ing from its action will, I conceive, be characterised by debility, and stimulating applications, as in the case in scalds and burns. 'Eesolutkn. Inflammation is said to terminate in resolution, when it declines and disappears without any structural lesion, or perceptible discharge. Resolution is more prompt, in proportion as the organ affected possesses a higher degree of vitality; in the serous membranes, the progress of inflammation is particularly rapid. (Bichat.) Resolution is often accompained by an increase of the natural secretions of the part: this is particularly noticed in the mucous and serous membranes; also, in rheumatic inflammation. Effusion. The effusion may be blood, lymph, or serum. The termination by effusion of blood, most common in the mucous membranes; effusions of lymph and serum, almost peculiar to the serous membranes—the former flu- id forms a bond of union between the serous membranes. Such adhesions never occur in the mucous membranes. Serum seldom abundantly exhaled, until the inflammation has assumed a chronic or sub-acute character. Dropsies are the consequence of this mode of termination. Effu- sion of lymph into the substance of the solid viscera, re- sult in induration. 'Suppuration. The cellular, serous, and mucous tissues, are most prone to this termination; the bones and tendons never suppurate. The mode of suppuration different in the different structures; in the mucous membranes, it is a morbid secretion, the pus having a Avhitish, cream-like ap^ pearance. In the serous membranes, pus is formed by a kind of exhalation, and is a thin whitish, or whey-like flu- id, sometimes mixed with flakes. In the cellular tissue, £us collects in circumscribed cavities, called abscesses, and is of thick and uniform consistence and pale yellow color, exhibting to the microscope minute globules sus- pended in a serous fluid. Symptoms denoting the occur- 193 rence of suppuration, in the inflammation of external or- ganst a sensation of weight in the inflamed part; change from the acute to a dull throbbing pain; rigors; pulse losing its tension, and hardness, and becoming soft and full; night sweats, and other symptoms of hectic. Gangrene. Never occurs in the cartilages, nerves, or bones. The cellular, mucous, and serous tissues, are most prone to it; more common in the peritoneum, than in any of the other serous membranes ; of the mucous membranes, that lining the alimentary canal is most subject to it. The occurrence of gangrene is denoted by, sudden cessation of pain; sinking pulse; cold extremities; cold sweat; deliri- um; and cadaverous countenance. There exists in the different form's of inflammation, an "original disposition to terminate in one mode, rather than.another: thus, in boil and withlow, it is to suppurate ; 'in carbuncle, to slough ; and in mumps, to resolve: and this disposition is so strong, that it is very difficult to procure any other termination.'' Varieties of inflammation. Inflammation occurs under five prominent modifications, corrsponding to the five el- ementary tissues—viz. the cellular membrane and par- enchyma of the solid viscera; the serous membranes; the mucous membranes; the skin or dermoid tissue; and the fibrous membranes. Inflammation of the cellular membrane, or phleg- monous inflammation. Characterised by, great savcI- ling, throbbing pain, and by its mode of suppura- ting ; the pus being collected in circumscribed cavi- ties. Diffuse cellular inflammation. Inflammation of the serous membranes, or serous in- flammation. Pain very acute and lancinating—rap- id in its course; no tumefaction; much sympathetic excitement of the general sanguiferous system, termi- nating in the exudation of coagulable lymph or se- rum, or the secretion of a whey-like pus; adhesions N 194 are pecular to this variety of inflammation; it rarely terminates in gangrene. Inflammatkn of the mucous membrane, or mucous inflammatkn. Almost always produced by sudden atmospheric vicissitudes, in consequence of the close sympathy which subsists between these membranes and the skin. _ Sometimes prevails epidemically.— Pain not very severe; unattended with swelling of the subjacent cellular tissue; concomitant fever not intense ; never terminates without an increase of mu- cous secretion. No adhesions ever formed. Inflammatkn of the skin, erysipelatous inflamma- twn. Pain of the stinging or burning kind ; spread- ing; forming vesicles; never suppurating in circum- scribed cavities; dependent on a specific cause. Inflammation of the fibrous membranes, or rheu- matic inflammation. Pain intense and aching; does not terminate in abscess or suppuration ; terminates by an exudation of a gelatinous matter ; or by earthy depositions; is wandering, accompanying fever al- ways synochal; rarely proves fatal, except by me- tastasis to organs essential to life. hflammatkns. The existence of internal inflammation is ascertained by: the continuance of the pain; the appear- ances of the blood; the state of the general vascular ex- citement; the effects of external pressure; the elfects of position ; the character of the functional d 3rangements; the temperature of the skin; and the nature of the excit- ing causes. ACUTE GASTRIC Symptoms. Burning and lancinating pain in the stomach ; frequent vomiting, particularly on swallowing fluids; ur- gent desire for cold drink; constipation; fever, with a small, hard, and frequent pulse. After a draught of cold water, a temporary mitigation of the gastric pain occur s 195 difficulty of swallowing; disgust of warm drinks; great prostration of strength from the beginning. Diagnosis. Distinguished from spasms and flatulent pains, by the following circumstances. In gastritis, the pulse is small and tense—in cramp, it is generally natural. In the former, there is violent and frequent vomiting—in the latter, this rarely occurs. Warm drinks excite instanta- neous vomiting, in gastritis—in spasm they do not. The pain of gastritis is continuous—that of spasm is paroxys- mal or intermitting. In gastritis, the patient lies on his back, without moving, with his knees drawn up—in cramp, he sits up, with his body bent forward, or writhes about during the violence of the pain. In gastritis, the skin is hot and dry—in cramp, it is generally cool and moist. Hiccough is a common symptom in gastritis—in spasm it seldom occurs. Autopsic phenomena. The inner coat of the stomach thick- ened and red, with gangrenous, eroded, or ulcerated spots. Causes. Mechanical irritants; poisons; cold water, swal- lowed Avhile the body is in a state of free perspiration ; o- ver distension with food or drink; the sudden application of cold to the surface; suppression of habital discharges, &c. Treatment. Emetics of lobelia and epicac combined. Give an enemata of slippery elm and fine ground char- coal. Give copious mucilaginous drinks, such as slippery elm—the powder best. Give the powder of slippery elm bark in teaspoonful doses, combined with charcoal and malloes. Use pills composed of capsicum, rhubarb, the powder of elder flowers, and gum myrrh, equal parts: roll into common size pills. Dose—from three to ten pills twice or three times a day, if the symptoms demand it, ac- cording to judgment. You will no doubt condemn this practice, but do not until you give it a fair trial. I have cured the most inveterate cases with cayenne and gum myrrh. Local. Rub with the tincture of capsicum and gum myrrh. After rubbing with vinegar and water, milk 196 warm, then rub with your tinctures, giving plenty of slip- pery elm and charcoal tea to drink. Yeast and hops are good, as a poultice or tea. Diet. The diet must be light; no grease of any kind ; light bread, crackers, gru- el, &c. 1 sometimes order a poultice to be laid on the stomach, composed of corn meal, slippery elm, hops, and a small portion of capsicum. If much vomiting, add the more capsicum. The capsicum will allay the vomiting and arrest the inflammation, and is a safe remedy. It can be used internally and externally. GRAVEL. Treatment. I here give the common name of the root and seed with which the Indians of Iowa used to cure gra- vel. Job's-tear-gravel-root. I found this root, in Iowa, in sugar tree and beach land. I found it, in Arkansas, in high rolling land, from two to three feet high, the leaves appearing on two sides of the stalk, and on the stalk, at the top of each leaf, the seed are as large as a large grain of Avheat, tensely hard, and of a Avhite color. No one who has ever seen it, will have any difficulty in recogniz- ing it again. Where it groA\-s, the children gather it to play Avith, as it resembles small beads. If the root is us- ed, give it in tea; take one ounce; pound the root and make a tea of it, and give the tea in from a table spoon- ful to a Avineglassful dose each hour for six or eight hours. or more if required. I find it to have an effect in from ten to fifteen hours. The seed Avill answer as well as the root, by pulverizing, and using them in a tea. Take from one half to an ounce of the seed. I have given it to fifty or sixty patients, and found it to have the desired effect. The Indians told me it would dissolve the gravel stones. I used it on a boy three years old. He discharged a stone as large as a common buck shot. The stone made its appearance, and I extracted it. I commenced giving the boy tea on Wednesday at about 12 o'clock, and on Fri- day at about the same hour, the stone made its appear- 197 ance. I mention this case on account of the boy's age. Hard-Fish, an Indian, near the Raccoon Forks, in IoAva, assured me that shumach berries would dissolve a gravel stone, given in tea, a Avineglassful three times a day : use the tea of one ounce each day : Or pulverize one pound of the seeds, add one quart of crab cider, and tincture for five days. Dose—three wineglassesful a day. Apple vinegar will answer; but the Indians use crab cider. I would advise those afflicted with gravel to give the sumach a trial, and report to the public. I will have a few cuts, in the next edition of my book, of the most desira- ble roots and plants. teething. Teething begins about the age of four months. Some chil- dren pass through this critical stage of infancy with scarce- ly any painful sensations. Others, on the contrary, suf- fer pain so excruciating as to bring on convulsions, and even death. Symptoms. Swelling and hardness of the gums; the cheek of the affected side is flushed ; there is much dribbling of salivTa from the mouth; the child is apt to thrust hastily in- to his mouth whatever he can lay hold on, and ai...:rward pinches the nipple while sucking; is feverish, restless, and painful; has frequent startings in his sleep, and sometimes com'ulsions; and these not unfrequently terminate in death. A short, dry cough, often occurs in teething. The stools are frequently loose, slimy, and tinged with blood: from which, and other protracted sufferings of this period, children, who had previously shown every appearance of health, have become so emaciated, as to render their re- covery entirely hopeless, or at least a labor of the utmosi difficulty. Treatment. As long as the symptoms continue to be slight. it will be necessary to attend to few circumstances only- It is always useful to rub the gums. It will be proper to 198 procure at least three motions every day, by any gentle laxative, as senna tea, or a tea of elder-flowers. When the skin is hot and dry, the whole body should be fre- quently washed with waim water, which will produce a relaxation and moisture ; this method, indeed, is very use- ful in many diseases attended Avith fever. In case of slimy and bloody evacuations—which are not very unfavorable signs, unless the child appear to be weakened by them—an emetic of the tincture of lobelia or ipicac. Let the child have a silver dollar, or something of the kind, to hold—an ivory ring will answer. ^ I object to lancing the gums, as I have known childien to bleed so profusely, that it was with difficulty the bleeding could be stopped. When the bowels are much relaxed, I use a syrup of cinnamon, bark brier root, and crane's bill root. Take one ounce of each and three nutmegs—boil in two quarts of water down to a half pint: then add sugar, spi- rits of camphor, and the essence of annis seed oil to pre- serve. Dose—from one to three teaspoonsful each hour. or as often as required. WATER IN THE HEAD. Children of all habits, especially those of a delicate consti- tution, are liable to this terrible malady. It is supposed to be frequently occasioned by the violent pain of teeth- ing, and by slow inflammation of the brain ; but seme- times it originates in causes at present unknoAvn. Symptoms. The first which appear are fretfulness and de- bility. The child is observed frequently to leave its toys and amusements, and go somswhere to recline its head; he spurns the light, and appears to motion; one or both cheeks are flushed, and there is a fur on the tongue; there is also a frequent inclination to vomit. As the complaint proceeds, the pain of the head continually increases, the child keeps it inclined backwards, and gen- erally rubs it on the pillow ; he is apt to totter when walk- ing, is affected with sleepiness or rather an habitual stu- 199 por; his eyes exhibit an unusually shining appearance, similar to glass, and about the time when this takes place, are affected with blindness, though, from their extraordi- nary brilliancy, they seem to a common observer to retain the faculty of sight. The patient frequently squints, and has a habit of rubbing one side of his head; starts and moanings occur during sleep. To these succeed violent shrieks and convulsions, with the loss of the use of one, side, corresponding frequently with the side of the head which the sufferer was aceu.Momed to rub. These symptoms are soon followed by death. Treatment. Though a cure cannot be reasonably expect- ed, yet it would be cruel not to att< mpt an alleviation of the symptoms, which the patient suffers in this dreadful complaint; but alas ! very little can be cone towards the ■accomplishment of so desirable an object. Lay clo*.hs. wrung out of cold vinegar and Avater, incessantly to the head of the child. Ought not to be importuned to take any medicines to Avhich heshoAvs a reluctance : this tends to harrass the mind in all complaints, but more particu- larly in the complaint of wlrich we are treating. I be- lieve that a cure is very rare in this disease, if ever. TENDENCY TO INFLAMMATORY DISEASES. Healthy children of a sanguine habit—that is to say, abound- ing in blood—are peculiarly subject to inflammatory com- plaints. When this constitution is first observed in a child, Avho shows marks of strength and health in other respects, the system ought to be gradually lowered, by di- minishing the quantity and nutritious quality of its food, and by increased exercise in the open air. When children have a quick and full pulse; wheezing, cough, and difficulty of breathing; when the skin is hot and dry, and the face bloated; Avhen there is frequent thirst, and little appetite for food, it may be concluded that the ten- dency to inflammation will soon terminate, if not prevent- 200 ed, in some dangerous disease, as inflammation on the brain, or the lungs. Treatment. Emetic composed of equal parts of the tinct- ure of lobelia, ipicac, and blood root : ginger tea and warm bath. Local: Sponge Avith apple vinegar, and, if the disease presents a dangerous appearance, rub with the tincture of capsicum, and poultice with corn meal, ginger and capsicum. Give oil or jallap, from three to five grains every 24 hours, with from a teaspoonful to a tablespoonful of castor oil. Sponing with apple vinegar all important, three or six times a day. CONSTIPATION. Some children are habitually costive, passing one, or even two days, without any evacuation; but this state of the bowels is totally unimportant in a child of healthy consti- tution, of which the fieshness of complexion, and lively appearance, will be evident indication. But in a child of a pale, sallow, and sickly countenance, every degree of costiveness. Ought to be removed. For this purpose, let the child take castor oil, a tea of manna, senna, elder blows, &c. or from five to twenty drops of the tincture of black root. INFLAMMATION. The Indians of Iowa use, as a specific for inflammation, in- digo—the roots of indigo—a small species thatgroAvs from tAvo to three feet high, commonly near the tall indigo, such as is common in Pennsylvania, Ohio, and Kentucky. I have not observed, since I left Iowa, Avhether the small indigo is of common growth in this section, Avhere the tall indigo grows. They pounced the roots of the small indigo, and made a poultice by boiling them for a few minutes, and, then adding a little corn meal to the mass, they used it for inflammation in any part of the system. I used the root for inflammation of the boAvels and stomac h, 201 and cured two patients, after all hope had fled. An olrt Indian insisted upon my giving the roots a fair trial, which I did, and cured two patients, all the cases in which I ever used it. I have said, that 1 had not observed, whe the small indigo grows in other Slates, as in Iowa, near the large indigo. I would recommend it, if it is within the reach of any one needing medicines for inflammation, so very common in children afflicted with the dysentery, it so much milder than the medicines commonly used. The poultice is attended with but little smarting : therefore, it will be convenient to use it. ALL HEALING SALVE. Take the extract ofgimpsum leaves 1 ounce, extract of blood root 1-4 ounce, balsam fir 1 ounce, sperm oil or sperm candle 2 ounces, extract of the bark of beach tree 1-2 ounce: melt and mix' all together: apply on cloth or cotton. The sperm is powerful to draw and heal: good for fresh cuts or old sores, sore shins, white swellings, scrofulous sores, &c. EMETIC DROPS FOR CHILDREN. In making tincture emetics for children, take lobelia seed 1 ounce, blood root 1 ounce, ipicac 1 ounce : add one pint of whiskey or any other spirit: let it stand for five days, and then it is fit for use. A RECEIPT For the cure of drunkenness, or to prevent one from wanting to destroy himself with whiskey, rum, gin or brandy. When you want to cure one of drinking, take a jug or bot- tle, and put some gin, rum, brandy or whiskey in it. Then procure a live eel, and put it in the gin, rum, bran- dy or whiskey. The eel will die in a few minutes. Then cast the eel out, and your tincture will be fit for use. 202 Give freely: it will act as an emetic. If you can give it two or three times, it will cure. POISON. Receipt to counteract the effects of rum, gin, brandy, whis- key, or wine. Drink a tea of mullen leaves. Make a tea of five or six ounces of the dry leaves ; if used green double the weight. This tea will cure in from twenty to thirty minutes, and the patient may attend to business per- fectly sober. TINCTURES. When I want to make a tincture of roots, powders, gums, herbs, or leaves, I first pulverize; then I add to each two ounces one pint of alcohol, Avhiskey, rum, brandy or wine: let it stand for four or five days, shaking it once or twice each day: if in the summer, let it stand out to the rays of the sun. This process will make strong tinctures : they can be weakened by adding more brandy or whis- key. My mode of making tinctures, when I want to use them in a few hours, is, to take one ounce of the kind of roots or leaves I Avant, and add 1-2 pint of spirits : put spirits, roots, leaves or powder into a jug; stand the jug in a pot of boiling Avater on the fire or coals; let the jug stand with the cork out for twenty or thirty minutes; the spirits will boil in the jug; then set the jug off for five or six hours; then strain and the tincture is fit for use. TIME TO GATHER ROOTS. Roots are best when gathered in the spring or fall of the year. Leaves are best after the seed are ripe, or in the fall. Crane's bill, and many other roots, must be gather- ed in the summer, as the leaves drop off at this season.— Barks ought to be gathered in the spring or fall. 203 I i CONVULSIONS. Convulsions occur very frequently in infants. They proceed | from Avind, or some offending matter in the intestines, Avhich occasions irritation ; or through a fulness of the r blood-vessels of the head; or they may arise from some un- | knoAvn cause—and in this case aie extremely dangerous. Treatment. When convulsions are excited by fulness of ' the blood-vessels, (which is distinguished by a hard, quick I pulse, redness of the face, and aveision to the light, give j an emetic of the emetic drops—warm bath. Local: rub I wTith milk warm Avater and vinegar, adding two or three i tablespoonsful of the tincture of lobelia; rub dry; then evacuate the bowels with custor oil, elder flowers or a tea of the flowers, senna tea • 10 to 20 drops of the tincture , of assafoeitida and the tincture of castor, equal parts, with \ 1-4 ounce of the essence of catnip or a little catnip tea, j- given in from a tea to a tablespoonful of water; you may a give from two to three drops of the tincture of lobelia , seed : if the bowels are distended with wind, rub the bel- | ly with spirits of camphor, or lay on a warm cloth, rung j out of hot water, which will give relief. INWARD FITS. j ■ j; This name has been given to a disease characterized by the following symptoms : moaning, or muttering, in sleep ; » sudden shortness and difficulty of breathing, which lasts a short time only, and frequently aAvakens the child. These fiits are not uncommon in children; they usually affect them when asleep, and often proceed from acidity in the stomach, Avhich occasions flatulency. Treatment. Though this disease is not accounted danger- ous, yet it requires attention. A gentle emetic, such as l the tincture of lobelia : then use, to operate on the boAv- els, castor oil, senna, a tea of elder flowers, or rhubarb : . use from three to five drops of the tincture of lobelia and 204 the same quantity of the tincture of castor ; warm bath : then wrap up warm. Remember, when you give the emetie, if it does not operate in fifteen or twenty min- utes, to give a small piece of saleratus, the size of a com- mon sugar pea. Bathing with vinegar and liquor is a good remedy for inward fits, &c. DISEASED STATE OF THE INTESTINES. Symptoms. These are, fever, with a Avhite tongue; loss of appetite; fretfulness; irregular movement of the bowels— sometimes loose, bloody, and Avith an appearance like jel- ly; thin flaky substances, resembling pieces of skin, are frequently found floating on the surface. Sensation of pain, and tenderness, are felt about some part of the bel- ly- Treatment. Give from five to six grains of rhubarb, with from two to three grains of jallap : then give castor oil or lea of senna; warm bath; apply warm cloth; rub with the tincture of iobelia, and give a tea of sage, pennyroyal or balm. cough. No disease attacks young children more ftequently than cou°h, with difficulty of breathing; this arises from their fulness of habit, and the blood being consequently liable to be impeded in its passage through the lungs. Treatment. Give a syrup composed of hoarhound one ounce, catnip one ounce, shell bark (hickory) a large handful; boil in three quarts of water down to three oun- ces : add time tablespoonsful of honey and the juice of three onions : then give a teaspoonful .each hour as long as required, bathing the breast with warm apple vinegar, &c. 205 r MUCOUS AND BLOODY EVACUATIONS. These evacuations, which are attended with considerable pain and distress to the child, may be relieved by the fol- lowing : Tincture of crane's bill, cinnamon bark, and \ spirits camphor. Give from five to twenty drops each I hour, if required, with a little slippery elm poAvder, or a tea of slippery elm bark : bathe with vinegar. ESSENCE. Take one quart of alcohol, and add from 1-2 to 1 ounce of the oil: shake, and you have your essence. The stron- I ger the alcohol the more oil it will cut. Whiskey will not make essence, as it is too weak to cut the oil- 10 per cent, whiskey will cut the oil. This is the mode to make any kind of essence. COMPLAINTS OF THE BOWELS. Complaints of the bowels are various, and arise from differ- ent causes, but may be reduced to two heads, viz.: costive- ness and diarrhoea. Each of these diseases may be oc- casioned by irregularity in the diet of the mother, when giving suck, as well as by improper food given to the in- fant itself. It will, therefore, be prudent for her to abstain, especially during the first four months, from acids, and from green vegetables and fruits. Any violent agitation of the'mind of the mother will affect the child also, and disorder its bowels. Pain, arising from any cause, suck as headache or teething, in the child, will often have the same effect, as will also worms. Sometimes these com- plaints arise from constitutional weakness. Treatment. Very little is required except to regulate the diet of the mother. Give a little oil; or if the bowels are too loose, give a little tea of beach buds or brier 206, root, or cinnamon bark, spirits of camphor, or a tea of crane's bill. TO" MAKE COMPOSITION POWDERS. Take of finely pulverized bayberry bark 1 pound, finely pulverized ginger 1 pound, finely pulverized golden seal 1 pound, nervine powder 2-ounces, cholic root 4 ounces, grated nutmegs 1 ounce, capsicum 1-2 ounce, and wild ginger 2 ounces; mix well, and they are fit for use. These powdeis will often cure a cold. If you have not all the above powders or roots, take what you have in your reach, and use them. They will expel cold, promote perspiration, remove canker, and clear the stomach and bowels. Fever or other forms of disease, if taken in their early stages, may generally be cured by a free use of this medicine. Dose, from one to two teaspoonsful in boiling Avater three or four times per day ; and as much oftener as the severity of the case may require. I prefer using them before going to bed. composition powders—-for bowel complaints. In all diseases of the bowels, where the stools are too copi- ous, such as bloody flux, &c. take bayberry bark 4 ounces, cloves 2 ounces, cinnamon bark 2 ounces, crane's bill 4 ounces, hemlock bark 2 ounces, nutmeg 1 ounce, white oak acorns 1-2 ounce, capsicum 1-2 ounce, browned wheat flour 1 ounce, all finely pulverized, and well mixed together. Dose—a teaspoonful from two to eight times a day. This powder can be used according to the violence of the complaint, with a teaspoonful of poAvdered slippe- ry elm bark, two or three times a day, or oftener if re- quired. Local: rub with vinegar and tincture of gum myrrh and cayenne pepper. 207 hiccough. This is a frequent affection in children. It arises from as internal convulsive motion, and is seldom dangerous, though sometimes troublesome. Treatment. It will, in general, be sufficient to sprinkle cold water on the face and hands; or you may hold at the nostrils of the child spirits of camphor or No. 6. If there is a recurrence of the h ccough after these applications, give an emetic of the emetic drops until the child vomits: once or twice will effect a cure. SICKNESS AND VOMITING. Children are very subject to an evacuation of the contents of the stomach, particularly of the milk, when they are suck- led. In some children this is only a healthy appearance, and needs little or no treatment. If the tongue is much furred with with a yellow fur, give an emetic of ipicac or lobelia, and a little oil, or a tea of senna, elder blows, or manna : sponge with vinegar. DIARRHOEA. If a child is attacked with excessive relaxation and griping pain in the bowels, a gentle emetic, consisting of ipicac or lobelia; then give caster oil and pulverized slippery elm bark; then use the tincture of crane's bill, or a syrup of brier root, cinnamon bark and nutmeg; boil 1 ounce of crane's bill, 1 ounce of cinnamon bark, and 3 nutmegs in one quart of water doAvn to four or five ounces : add sugar and essence of annis seed oil—2 ounces essence and 3 ounces lump sugar. Give a teaspoonful each hour if required. If you use the tincture of crane's bill, give from 10 to 20 drops each hour with lump sugar. 208 FLATULENCY. This disorder frequently occurs, and is very distressing to young children. Symptoms. Distention of the stomach, with sour eructations; distention of the intestines; also attended with a frequent voiding of wind, which gives immediate relief for a short intervals, if the child is not feverish or otherwise indispos- ed. Treatment. Let the child be Avell rubbed with rain wa- ter and vinegar; then well exercised in the arms. The bowels are to be kept regularly open with rhubarb or oil of elder blows. Give a tea of peppermint or catnip—the essence of catnip best, made as all other essences. If there is any indication of a foul stomach, it will be all important to give an emetic, composed of ipicac and lobe- lia. Bathe with apple vinegar or whiskey and water. Most generally the essence of catnip will be all that will be required. ORANGE WHEY. Take a quart of milk, and the juice of a bitter orange; boil them till the curd separates, and strain the liquor.—Lem- on whey is made by using a lemon instead of the orange. WINE WHEY. Take a quart of milk, and add to it a wine-glass of white wine; boil them till the curd separates, and strain. CIDER WHEY. Boil a wine-glassful of cider with a quart of milk; when th« curd separates, let them be strained. 209 DYSPEPSIA bitters. Take white ask bark 5 ounces, and sampson snake root 2 ounces. Cut or pound them fine, put into a bottle, and add two quarts of best whiskey or wine. Dose—from a teaspoonful to a vrineglassful three times a day. You car. make a syrup by boiling in water, and adding spirits to preserve. No sugar ought to be used; but should any be used, take the best lump or loaf sugar. Sampson snake root is hard to gather, but it is a powerful tonic, and acts like a charm in cholic, given in tea or tincture. TO THE PUBLIC. I have given in this book, the different compounds that I use in my practice, with the exception of two, viz.: One on Dys- entery, and the other the Pain Extractor, a compound for which I have obtained a patent right. I have not given them for two reasons. 1. Because the price for which the book is sold is too low to have so great a disco* ery revealed—a discovery that has cost me seven years labor and research. 2. I consider the treatment I have given for Dysentery is hard to be excelled. Should any of my readers be unsuccessful in the cure of this disease, by enclosing me 210' 61, they can obtain a medicine that willeffect a cure, by using a single tablespoonful. 1 will sell the exclusive right to make and vend my Magic Drops or Pain Extractor for States, Counties, Cities, or Parish- es, for a reasonable compensation, to be regulated according to location, population, &c. Those within the limits of my practice need not apply. 03" For further particulars address me at Louisville, Ky.. postage paid, and it will be attended to. Now is the time to make a fortune, and to save thousands- from an early grave. WM. DAILY,- M. D.- Louisville, October 27, 1848. GLOSSARY. Stramonium—See Datura. Boneset—-Eupatorium Perfoliatum. Po&e?-oo£—Epytolacca Decandra. Indian Turnip—Arum Triphillum. Golden Thread—Coptis Trifolia. Bearberry—Arbutus Uva Ursi. Blood Root—Sanguinaria Canadansis. Granesbill—Geranium Maculatum. Fever Root—Triosteum Perfoliatum. Hemlock—Conium Maculatum. American Hemlock—Cicuta Maculata. Pink Root—Spigelia Marilandica. Wild Ginger, or Coltsfoot—Asarum Canadense. Blue Flag—Iris Versicolor. Bittersweet—Solanum Dulcamara. .Lobelia—Lobelia Inflati. Golden Rod—Solidago Odora. Winter Green—Pyrolia Umbellata. Partridge Berry—Gaultheria Procumbens. May apple—Podophyllum Peltatum. Skunk Cabbage—Ictodes Foetidus. Marsh Rosemary—Statill Carobiniana. Cliolic Root, or Butterfly Root—Asclepias Tuberosa. Cowcumber Tree—Magnolia Glauca. Dogwood—Cornus Florida. Ginseng—Panax Quinguefolium. Seneca Snakeroot—Polygold Senega. Poplar—Lirodendron Tulipifera. Butternut—Juglans Cinerea. Gentian—Gentana Catesbaei. 212 Sassafras—-Laurus Sassafras. Bitter Root, or Dogsbane—Aoocynnm Androseamifoliuiifii, Blackberry—Rubus Villosus. Senna—Cassia Marilandica. Tobacco—Nicotiana Tabacum. Poison Vine—Rhus Radicans. Bayberry—Myrica Cerifera. Juniper Berries—Juniperus Communis. Cedar—Juniperus Virginiana. Crowfoot—Ronunclus Bulbosus. Black Snake Root—Aristolocia Serpentaria. Unicorn—Alebus Farinosa. Red Roseberry—Rhododendron Maximum. Pond Lilly—Nymphaea Odorata. Black Elder—Prinos Verticiallatus. Centaury—Sabbatia Angularis. Prickly Ash—Xanthoxylum Faxinium. Hops—Humulus Lupulus. Sheep Sorrel—Oxalis Acetocelia. Mayweed, or Dog Fennel—Anthemis Cotula, Blue Cohash—Caulovhyllum Thalictroides. Golden Seal, or Yellow Root— Hydrastis. Pennyroyal—Hedeoma Pulegioides. ( Rattle Root—Bothophis Serpentaria. Balmony—Chelona Glabra. Nervine—Cypripedium Luteum. Columbo Root—Frasera Verticilla. Witch Hazle—Hamamelis Virginiana, Black Root—Leptandra Alba. Cholic Root—Leatris Spicutra. Birth Root—Trilium Latifolium. Cucklebur—Agrimonia Eupatoria. INDEX. A tonic much used, Acute enteritis in inflammation, - - ^' A sure cure for bed bugs, - - - 51 A cure for the itch, - **}_ A cure for bots, - - " ■ " q A cure for blind piles, - - - ' ^ A cure for foul ulcers, - - * cq Anti-bilious drops, - - - " co Anti-bilious powders, - - ^ A good remedy in typhus, Acute bronchitis - Acute peritonitis, inflammation, Acute hepatitis, an inflammation of the liver, Acute rheumatism, Apoplexy, - Asthma, - B Burns, Bruises, 70 80 85 92 128 141 145 Anasarca—dropsy, - - - ^ Ascites dropsy, - - " .^1 An Indian poultice, - - ' Acute gastric, - - - _„.. All healing salve, A receipt, 201 49 52 214 Bites of serpents, _ _ - 53 Box liniment, - - - °o Bitters, ... - 94 Crisis, critical days, - - - ^ Causes of intermittents, . - ^ Catarrhal fever, . - - 46 Cancer, - - - - *'l Cancer plaster, . . - 62 Cough lozenges, made with extracts, - 63 Cough lozenges, . . - 63 Cramp cholic mixture, - - 64 Cures Tor dropsy, . . - 66 Cramp mixture, - - - ^7 Cough drops, - - - - 67 Cure for thrush, - 69 Chronic enteritis, inflammation, - - 76 Cynanche trachealis, - - 81 Cynanche tonsillaris, - - - 83 Chronic peritonitis, - - .86 Chronic hepatitis, inflammation ^ - 89 Cystitis, inflammation of the bladder, - 91 Chronic rheumatism, 94 Cholera, - 150 Colic, .... 153 Consumption, - - - 168 Cough syrup, - - - - 168 Clarified cholera syrup, - - 169 Consumption, - 171 Chills and fever, - - - 173 Coleca pictorum—painter's colic, - - 179 Chronic gastritis, inflammation of the stomach 148 Constipation, - - - 200 Convulsions, - - - 203 Cough, - - - 20'4 Complaints of the bowels, - - 204 215 Consumption, ... - 122 Composition powders for bowel complaints, 206 Cider Whey, - - .208 D Dumb ague pills, - - - 41 Dry bitters, ... 66 Dysentery, - - - - rAj Dysentery drops, - J5 Dysentery pills, - - - < 5 Dropsy, - 144 Diorrhoea, - -L^° Drawing salve, - - - ^f^ Diabetes, - - - - x'" Diseased state of the intestines, - - 204 Diarrhoea, - - - ~"^ Dyspepsia bitters, - - - 217 E Emetic, - - - - 69 Erysipelas, - . - - Ii~ Epistaxis, - - -. J*£ Epilepsy, - 1^ Emetic drops, - - ' - ~"£ Essences, - - - ^ Fever bitters, - - - - ^h Frost bite, or chill blain - 49 Fres.i cuts, - %\ Fistula, - li Female bitters, - *}" .Fever in the feet, - £jj Family pills, - ^ For liver complaint, - - At> l For inflammation, - - Job Flatulency - ™* For rheumatism, 5 it)y 116 For jaundice, Female pills, G Gravel, Gonorrhoea, Gleet, Gout, H Hysteria nervous, Hysteria pills, Hemorrhage of the lungs, Haamorrpagiae Haematemesis, Haematuria, Hasmorrhois, Haemoptysis, Hemiplegia, Hydrothorax, Hot bitters, Hiccough, I Indian tonic, Inflammatory fever Inflammations of the lungs, - Indigestion-dyspepsia, Icterus jaundice, - Inflammation, Inward fits, L Liniment to reduce swellings, 217 M Musquito bites, Mother's cordial, Mortification poultice, Mucilaginous brnks, Mucous and bloody evacuations, N Nephritis, inflammation of the kidneys, No. 5 syrup, Nervine tonic, 0 Of the general course, type and stage, On intermitting fever, Orange whey, P Preface, Pain, Preventative bitters, Punctured wounds, Pile Ointment, Pills for physic, Polypus, Peripneumony, Pneumonia bitters, Parotitis, inflammation of the parolid gland Phthisis pulmonalis, Paraplegia, Paralysis partialis—local palsy, - Pertussis—whooping cough, Putrid sore throat, 218 Pecurial soap, for taking out stains, Poison, R Remitting fever, Receipt to cure continued fever, Ring worm, Receipt to make vermifuge, Receipt to make tooth-ache drops, Receipt to make stimulating liniment, Receipt to cure corns, Receipt for' taking out corns, Receipt for tooth powders, Receipt for eye water, Rheumatic liniment, good for pains, - Receipt for elder salve, Receipt for a mixture, Rheumatic drops, Rubeola measles, Restorative cordial, - S Symptoms of diseases, Signs, Scald head, Strains, Sounds or bissing, Scum on the eye, Small pox, Scarlatina, Scrofula, Strengthening plaster, Superior gas beer, Splenitis, ague cake, Sickness and vomiting, 219 T The pulse, Treatment, Treatment of remittent, Tonic pills, To cure the head ache, Tonic pills, Tetter worm, To cute poison, To make extracts, The French wash, To stop vomiting, Tetanus, lock jaw, Tincture of cayenne, Tincture of lobelia, Typhus fever, Teething, Tendency to inflammatory disease, Tinctures, Time to gather roots, To make composition powders, U Uterine hermorrhage, V Venereal, Veriola, vaccine, Variloid, Vericella—chicken pox, Vegetable tonic, Verminous worms, 220 W Whitlow, . White swellings, - - Worm Lozenges, - Worm Syrup, L- - Warts, - Winter fevers, - Water in the head, - Wine Whey, - Y Yellow fever, t 49 59 64 65 170 188 193 208 42 DAILY'S PAIN EXTRACTOR, §30. Office of Designated Depository, ? At Jeffersonville, la. Oct. 24,1848. j I do certify, that Wm. Daily, M. D., of the city of Lou- isville, Jefferson County, and State of Kentucky, has this day deposited to the credit of the Treasurer of the United States> Thirty Dollars, the same being a fee for a patent for a new and improved liquid medicine. D. G. BRIGHT, Depositary. (A copy of the original.) The Pain Extractor is an efficient agent for the cure of consumption, liver complaint, rheumatic pains, pains on the lungs or breast, pleurisy, all acute pains, inflammation, swel- lings, wounds, old sores, tooth ache, enlargement of the spleen or ague cake, white swellings, lumps on the side of the neck or any part of the system, &c. &c. This medicine cures pain in a few minutes. WM. DAILY, M. D. Louisville, October 25,1848. The following certificates are givert attesting its value. Many more might be added, but it is deemed unnecessary : We, the undersigned, having used Dr. Wm. Daily's Pais 222 Extractor, have no hesitation in recommending it as a safe cure for pains: John A. Etherige, cured of rheumatism. Mrs. C. E. Watts, of ear-ache. Luther Crocker, of jaw-ache. /. C. Hale, of swelling in the arm. Lewis Tweydorff, of pain in hips. Morgan Harbin, of pain in side and sun pain* E. C. Reynolds. L. D. Farmer. T. P. Reynolds. I certify, that my daughter, about eleven years of age, had a wen on her wrist, and that one two ounce vial of Dr. Wm, Daily's Pain Extractor removed it. PETER TROUTMAN. Bullitt County, Ky. October 14,1848. I certify, that my little son, about ten years old, was violent, ly attacked with pleurisy in the left side. I used one fourth o a bottle of Dr. Daily's Pain Extractor, which cured it in twem ty minutes. I live in Louisville, Ky. October 13, 1848. JAS. M. CHAMBERS. This is to certify, that I have been afflicted with the inflam- matory rheumatism for twenty years past, and have tried more than five hundred remedies of different kinds; but of all I have ever used, I must pronounce Dr. Wm. Daily's Pain Ex- tractor the best, not only for rheumatism, but for pains of any kind to which the human bodv is liable. JOHN A. 'ETHERIGE, Market Street. Louisville, Ky. Oct. 15,1848. I hereby certify, that I was afflicted with the neuralgia for eight or nine years, and that I employed two eminent physi- cians of Louisville, Ky. and one of New Albany, Indiana, but all to no effect. I then employed Dr. Wm. Daily of Louis- 223 ville, who cured me in three days with his Pain Extractor. X consider it one of the greatest medicines of the age. Given under my hand on this 8th day of October, 1848. WILLIS H. RASOR. N. B. I reside in Louisville, Ky., on Main Street, between Tenth and Eleventh. This is to certify, that I was violently attacked with inflam- mation of the stomach and 'bowels. I thought my case a bad one to get over; but I was cured with Dr. Wm. Daily's Pain Extractor. I had also a knot or lump on my leg, and the Pain Extractor removed it. I think it one of the best things in the world for pains, knots or lumps on any part of the system. fl. W. CALVERT. Louisville, October 20, 1848, Notice to all those afflicted with inflammatory rheumatism.— This is to certify, that I Avas afflicted with the inflammatory rheumatism for about four months. For apart of the time I was not able to turn myself in my bed. I Avas attended by dif- ferent doctors, but not cured. I obtained some of Dr. Daily's Pain Extractor, and in one week after 1 commenced using it, I was able to walk without my crutches. Given under my hand this 26th day of October, 1848. HENRY D. MOORE. N. B. I am mending fast, and am now able to walk about town without crutches. Louisville, Ky. October 26, 1848. This is to certify, that I had a negro boy, whom I, with ma- ny others, thought to be in the last stage of cousumption, brought on after having the measles : and that 1 tioav believe him cured by Dr. Wm. Daily, residing on Second Street, i» this city. The doctor says his Pain Extractor Avas his princi- pal medicine, which article I know was used in the case. 1 L. D. FARMER. Louisville, October 23, 1848. We, the undersigned, are knowing to the condition of the 224 above named boy. In the spring of 1848, we considered him incurable. Physicians in our neighborhood had the same opin- ion. We know the principal remedy in his case, was Dr. Daily's Pain Extractor, for the boy worked- for us; boarded Avith us, and we used the remedy on him ourselves externally. He now makes a good hand in the livery stable, on Second Street, between Main and Market. J. L. REYNOLDS. T. P. REYNOLDS. JAMES WHITE. Louisville, October 26,1848. CO*" This invaluable medicine can be had at my office, or, Second Street, between Main and Market, at wholesale or re- tail. Prke—from 25 cents to $1 per bottle, according to size. A liberal discount made to those who purchase at whole,, sale. wm. daily, m. ».- *' DEC 191357 If* ~m