■WIW. WBA EgUp 1822 ■^ *.. ■«- •■ t ■.V.#v£#V ■<.:- NATIONAL LIBRARY OF MEDICINE Bethesda, Maryland e THE OR FAMILY PHYSICIAN: TREATING OF TBE SDSSIB^SSS Off ^mE WM2f m SViLVSft With their Symptoms, Causes, Cure, and Means of Prevention: COMMON CASES IN SURGERY, AS FRACTURES, DISLOCATIONS, &c THE MANAGEMENT AND DISEASES OF WOMEN AND CHILDREN. A DISPENSATORY, FOR PREPARING FAMILY MEDICINES, AND A motmavs, SEflpIatnfnfl Eccfjuical dermis. TO WHICH ABE ADDED, A. BRIEF ANATOMY AND PHYSIOLOGY OF THE HUMAN BODY, Shewing, on rational principles, the Cause and Cure of Diseases: AN ESSAY ON HYGIEINE, Or the Art of Preserving Health without the aid of Medicine: AN AMERICAN MATERIA MEDICA, POINTING OUT THE VIRTUES AND DOSES OF OUR MEDICINAL PLANTS. ALSO, THE SIXTH EDITION, REVISED, ENLARGED, AND VERY CONSIDERABLY IMPROVED. H^ AMESES fflWU* PHYSICIAN IN WASHINGTON^ FORMERLY OF SAVANNAH. "I have always thought it a greater happiness to discover a certain method of curing, even the slightest disease, than to accumulate the largest fortune; and whoever compasses the former, 1 esteem not only happier, but wiser and better too." SYDENHAM. Baltimore: PRINTED FOR THE PROPRIETORS, BY B. EDES. 1822. Trice Five Dollars. w6ft IE if? District of Columbia, to wit: BE IT REMEMBERED, That on the eighth day of November, in the year of our Lord one thousand eight hundred and twenty-two, and ******* of the Independence of the United States of America, the fony- gj L. S.% seventh, CORDELIA B. EWELL and OLIVIA F. EWELL, of •M£23:£* the said district, have deposited in the office of the Clerk of the District Court for the District of Columbia, the title of a book, the right whereof, they claim as proprietors, in the words following, to wit: "The Medical Companion, or Family Physician,- treating of the diseases of the United States, with their symptoms, causes, cure, and means of prevention: com- mon cases in surgery, as fractures, dislocations, &c. The management and dis- eases of women and children: a dispensatory for preparing family medicines, and a glossary explaining technical terms. To which are added, a brief anatomy and physiology of the human body, shewing, on rational principb s, the causes and cure of diseases: an essay on Hygicine, or the art of preserving health without the aid of medicine: an American Materia Medica, pointing out the virtues and doses of our medicinal plants. Also, the JYurse's Guide.—The sixth edition, revised, enlarged, and very considerably improved By James Eivell, physician in W ustdngton. for- merly of Savannah. "I have always thought it a greater happiness to discover a certain method of curing even the slightest disease, than to accumulate the largest fortune: and whoever compasses the former, I esteem not only happier, but wiser and better too."—Sydenham." In conformity to the Act of the Congress of the United States, entitled, "An Act for the encouragement of learning by securing the copies of maps, charts and books, to the authors and proprietors of such copies, during the times therein mentioned."—And also to the Act, entitled "\n Act supplementary to the act, entitled An Act'for the encouragement of learning, by securing the copies of maps, charts, and books, to the authors and proprietors of such copies during the times therein mentioned,' and extending the benefits thereof to the arts of designing, engraving, and etching historical and other prints." In testimony whereof, I have hereunto set my hand, and affixed the pub- lic seal of my office, the day and year aforesaid. EDM: I. LEE, Clerk of the District Court for the District of Columbia. M©®IIffil»AM« In testimony of the merits of this work, the fMowing commen- dations, by some of the most distinguished medical charac- ters of the United States, are inserted; together with the lit- ters of their excellencies, Thomas Jefferson, and G. Hyde de Neuville—also, a review by Professor Mtchill, of New- Fork. Baltimore, Nov. 18,1822. DEAR SIR, I have been truly gratified in the perusal of the Sixth Edition of your "Medical Companion, or Family Physician." The improvements made in this new impression of your work, compared with the former editions, are indeed extensive and important. Independent of your having enlarged considerably on diseases generally; you have intro- duced additional matter, which greatly enhances its value. The introduc- tion of the Nurse's Guide, as also the treatise you have given on the manage- ment of female complaints, will have the most happy effects, in correcting the gross errors daily committed by ignorant persons, and thereby save ma- ny valuable lives. I do not hesitate to say, that this new edition of your Medical Companion, is decidedly the best popular treatise on medicine, that has ever been pub- lished; and considering it, as I verily do, a safe and useful guide for heads of families, as well as for young practitioners of medicine, I take much pleasure in recommending it to the attention of our fellow citizens, both in town and country. I will only add, if your book meets with that encouragement, to which it is justly entitled, you will very soon be called upon, by the publick, for ano- ther edition. I am, dear sir, with much respect, Your friend and servant, COLIN MACKENZIE, M. D. Dr. James Ewell. Baltimore, ISth Nov. 1822. DEAR SIR, When the Medical Companion was first published, I considered it greatly superior to every work of that character I had read. I have now read the Sixth Edition, and am much gratified in having it in my power to say, that in this Edition you have so enhanced the value of the work, as to claim my un- qualified approbation. Doctor Rush, during my residence in his house, often spoke of his inten- tion to publish a medical work for the use of families, adapted to the climate of the United States. As he reserved it for the last act of his labours, for the benefit of mankind, unhappily he did not live to accomplish his design. In the work now pre- sented to the public, you have fulfilled the patriotic intentions of the great and good Rush, to the utmost extent, and I sincerely hope your reward may be as it deserves, ample. I am, dear sir, very trulv, yours, ASHTON ALEXANDER, M. D. Dr. James Eivell iv Recommendations. Philadelphia, August 13, 1816. DEAR SIR, I have looked over with some care, the copy of the Third Edition of the "Medical Companion" which you did me the favour to present to me. By the additions and revisions gi ven to this new impression of the work, it is not only enlarged, but exceedingly improved. After stating so much I need hardly repeat an opinion, which I publicly expressed on a former occasion, that I consider it, as indisputably, the most useful popular treatise on medicine with which I am acquainted. Compared with the European Books of the same nature, it has, especially in relation to the treatment of the diseases of our own country, a very decid- ed superiority. I trust that the success of this literary enterprize may be equal to your ve- ry generous and benevolent disposition. With great respect, I am, dear sir, vours, &c. N. CHAPMAN, M. D. Profssor of the Jntlitutes and Practice of Medicine and Clinical Practice, in the University of Pennsylvania. Philadelphia, Aug. \3th, 1816. DEAR SIR, I have derived much satisfaction from a perusal of the Third Edition of your ".Medical Companion" The additions and improvements which it contains, as compared with the two first editions of the work, are extensive and important. To families in the country, remote, not only from medical aid, but from places where common medicinal articles are to be procured, your Materia Medica alone, disclosing to them the healing resources of their own farms and forests, wjll be of high value. Nor, provided they be true to their best interests, and avail themselves of the advantages placed at their disposal, will your rules and directions for the preservation of health, be less useful to hem. In addition to these two important branches, now introduced into the Medical Companion for the first time, it contains a large amount of new mis- cellaneous matter, which cannot fail to be interesting'to the reader. On the whole, if I be not greatly mistaken in mj estimation of the charac- ter of your work, it is well calculated to prove extensively useful, and to place you in the midst of the permanent benefactors of your country. That you may receive, in reputation and wealth, your full reward, is the sincere wish of Dear sir, your very humble And obedient servant, f'H. OLD WELL, M. D. Now Piofessor of Materia Medica and Physiology in the Transylvania University. Dr. James Ewell. ---- Philadelphia, December 31, 1807. UKAR SIR, I lvivc read your book entitled "The Medical Companion," with pleasure, and think it worthy the attention of the citizens of the United States. W. SHIPPEN, M. D. _. r _, Professor of Anatomy. Dr. James Ewell. ____ J J Philadelphia, December SI, 1807. DF.AU sia, I have carefully perused your work, "The Medical Companion," and take much pleasure in expressing my entire approbation of the plan, and of the Recommendations. r utility with which you have conducted your inquiries. Your book cannot fail to be a very acceptable present to the public in general, and especially to our own countrymen. 1 really am of opinion, that you are entitled to much praise tor the pains which you have taken in furnishing us with a work, the want of which has long been experienced among us. Your friend, &c. B. S. BARTON, M. D. Professor of Materia Medica, Natural History and Botany Dr. James Ewell. " ti ,,„, „,. „ December 28, 1807. 1 have read" 1 he Medical Companion," by Dr. James Ewell, with -atisfac- tion. ItU a book containing a variety of matter in a small compass. The practice which he recommends in diseases, is modern and judicious, and the work cannot fail of being useful in all families in the United States. JAMES WOODHOUSE, M. D. Professor of Chemistry in the University of Pennsylvania. Dr. James Ewell. BEAU SIR, I have looked over your "Medical Companion," with pleasure. The ar- rangement of the various parts is judicious, the language plain and perspicu- ous, and the sentiments happily condensed; the modes oftreatment grow out of the most improved state ol our science, and may serve as a safe and useful guide to every family cut oft' from the services of able physicians. Accept the homage of my regard. JOHN B. DAVIUOE, M. D. Professor of Anatomy, Surgery, &c. in the College of Medicine of Maryland. Baltimore, Feb. 19, 1808. Dr. James Ewell. BEAK SIR, We have perused your "Medical Companion" with much satisfaction, and strongly recommend it to the attention of those families who cannot with con- venience procure medical aid. We think it the best publication we have ever read on the domestic treatment of diseases, more especially as it re- gards those of our climate. We are verj respectfully, sir, your most obedient servants, BROWN & MACKENZIE. Baltimore, March 4, 1808. Dr. James Ewell. SIR, I have read your book on Domestic Medicine with pleasure. The prac- tice recommended in it "is judicious, and being from the pen of a native physician, has great advantage over the publications of European authors. JOHN SHAW, M. D. Professor of Chemistry in the College of Medicine of Maryland. Dr. James Ewell. VI Recommendations. Charleston, May 7, 1808. DEAR SIR, Vour "Medical Companion" contains much useful knowledge in a small compass, and is particularly adapted to these states. Families remote from medical aid, will find their ace >unt in possessing a book which describes dis- eases so plainly, and prescribes for them so judiciously, as bid fair to save valuable lives, which otherwise might be lost. Your most obedient servant, DAVID RAMSAY', M. D. Dr. James Ewell. Charleston, S. C. May 12, 1808. DEAR SIR, The perusal of your "Medical Companion" has given me the greatest sat- isfaction. Such a publication has been much wanted, and I think the plan and execution of your work must answer the most valuable purposes. Yours very truly, ALEX. BARRON, M. D. Dr. James Ewell. Charleston, May It, 1808. DEAR SIR, I have with great pleasure perused your "Family Physician." I find it to be a well digested compend of the most modern and approved modes of treating diseases, especially those to which our country is most exposed.— You have subjoined a dispensatory, judiciously calculated to obviate those errors which too frequently ensue from the exhibition of medicine, where the aid of the practitioner cannot be obtained. Yours, &c. PHILIP G. PRIOLEAU. Dr. James Ewell. Washington, March 1, 1808. SIR, 1 return you my thanks for the copy of "The Medical Companion" you have been so kind as to send me, and must particularly express my sense of the favourable sentiments expressed towards me in the beginning of the work; especially too, where it recals to my recollection the memory of your respectable father, who was the friend and companion of my youth, and for whom I retained through life an affectionate attachment. The plan of vour work is certainly excellent, and its execution, as far as I am a judge, wo'rthy oftheplan. It brings within a moderate compass whatever is useful, levels it to ordinary comprehension, and as a manual, will be a valuable possession to every family. I pray you accept my salutations and assurances of esteem and respect, n ,. „ TH. JEFFERSON. Dr. Ewell. Washington, July 3,1819. I had the honorto thank you viva voce after my having received your book I owe you new thanks after perusing it. Such a work would be useful, very useful in every countrv, but it may be X™tV TT" 'n J'n l'nit:ed S,ates' andy°u have acquired true titles to ">e gratitude of your fellow-citizens, and specially that of 4he families who Recommendations. vii happen to be distant from medical aid, by pointing them out the sur- est and at the same time, the simplest rules to be followed in case of sick- ness. I above all offer up my prayers, that your wise hints to ladies may not be laid aside, and that mothers of families impress them into their minds. Consumption, that inexorable enemy of youth and beauty, is indeed, in most instances, but the mournful result of an imprudent fashion, and it can. not be too often repeated to young ladies who do not fear to show themselves at assemblies in winter, in light dresses, that which a great physician answer. ed to one of his friends who told him: lam well, I have only got a cold: 'Colds, says he, take away more people than the plague." Agree, Sir, with my sincere acknowledgments, the assurance of my truly distinguished consideration. G. HYDE DE NEUVILLE. Dr. James Ewell. The following Review is from that celebrated work the New York Medical Re- pository. Manuals of health, or popular publications on medicine, have become s» frequent as to have excited the censure of some grave and oracular mem- bers of the profession. They consider their publishing brethren as unne- cessarily divulging the arcana of the art, as depreciating its credit and es- timation, and as teaching the comihon mass of readers to know as much as themselves. This communicative disposition they conceive to be carried to a very faulty extreme. For when the secrets of the healing faculty are promulgated by its members, with such consummate knowledge and suc- cess, what is left for distinguishing the regularly initiated from those who are without the pale? The propagation of the Esculapian mysteries is view- ed to be faulty on another account; in as much as in diminishing the impor- tance, it lessens the profits of the practisers, and thus, for the gratifica- tion and emolument of one tell-tale author, the whole fraternity is dispar- aged. Let us, however, do justice to those sons of physic who are thus accused of faithlessness, in uttering abroad those matters which ought to be viewed as under the restriction of closed doors. Contrast their conduct with that of another class of medical personages, who forever deal in nostrums, and are incessantly boasting of their wonder-working powers; who assure the credulous world they can cure every possible disease of mind and body; but with a cunning equal to their effrontery, permit no mortal to become acquainted with their remedies. Compare the conduct of him who withholds nothing from his fellow citizens, with that of him who keeps every thing to himself. There can scarcely be a stronger exhibition of generous com- munication on the one part, and of selfish concealment on the other. What- ever may be pleaded in behalf of the persons who refuse to make a mag- nanimous publication for the good of mankind, of such valuable means of cure as they may possess, or who secure the profits of them under the stat- ute of patents, there certainly is a character of greater disinterestedness and philanthropy, and a temper of a brighter mould and finish in him, who, with- out fee or price, offers to his fellow creatures all he knows that will be beneficial to them. We know it has been said, that a smattering in the knowledge of the ani- mal economy, and of diseases, multiplies the number of patients, and encour- ages the practice of physic. Books on such subjects, addressed to the peo- ple at large, are peculiarly calculated to alarm their fears whenever they are unwell, and therefore, impel them to seek assistance from those on whose skill they rely. It has been surmised too, that the disciples of Buchan, Wil viii Recommendations. lich, and their coadjutors, have often been led, from superficial and conceit- ed knowledge, to become prescribers to others, and have, by their blun- ders rendered the attendance of the regular physician more needful than ever. Hence it has been argued, that publications of this kind fail to pro- mote the plausible object of their composition, and in reality, produce a mischievous, and not a beneficial effect. It has even been urged against them, that they are of no service to any person but the writer, who may diffuse his fame and increase his wealth in proportion to the circulation of his book and the consequent disturbance it works in society. Whatever may be the merits of this controversy among those who are toiling night and day in the service of the infirm and disabled, or in the compilation of volumes, for our own parts, as reviewers, we feel favourable to the general distribution of knowledge. We are not attached to monop- olies of any kind, and less than any, to that which confines to a particular order, the information which will teach man how to prevent sickness and pain, and to remove these ills when they invade. He who publishes whole- some precepts and directions, cannot be denied the merit of good intention; and it would be hard to refuse him the additional credit of having done sub- stantial good to those who have followed his advice. Having indulged these prefatory reflections, we advance to the consideration of the work before us. The author has prefixed to it a dedication to the President of the United States, a preface explanatory of his design, and a number of recommendato- ry epistles from his friends. Then follows a chapter of preliminary obser. vations, of which we were inclined to offer an extract for the gratification •f our readers; but our limits forbade. The body of the work is devoted to the consideration of the principal diseases which assail the human frame at different times of life. They be- gin with fevers, and end with rickets; without, however, observing any strict method or nosological arrangement. Each section stands by itself, and has little or no connexion with the preceding or subsequent matter.— But a table of contents and index are two good keys to the subjects dis- cussed. The diseases are severally considered in short and generally appropriate terms. After a definition, the observations are mostly comprised under the head of symptom!, causes, treatment, and regimen; to which, in some instances, are added paragraphs on prevention. And it is but justice to observe, that the author has manifested a careful and discriminating mind in condensing so much valuable instruction into such a moderate compass. The senten- tious, and, at the same time, intelligible manner of conveying his directions, is at once calculated to give the reader a clear idea of his meaning, and fa- vourable opinion of his understanding. Besides the observations that are strictly medical, the work contains a va- riety of directions upon surgical subjects. To render his compilation more generally useful and acceptable, the au- thor has annexed to it a dispensatory. This consists of two parts: the first comprehends a table of medicines for family use, with their doses and qual- ities annexed; and the second contains a collection of recipes for the princi- pal part of the compound medicines recommended in the course of the work. And this part of the publication is executed in a manner that justi- ces the opinion we hinted before, of Dr. Ewell's sagacity and skill. TO HIS EXCELLENCY PRESIDENT OF THE UNITED STATES. I beg leave to present this book to Mr. Jeffer- son, not because he is President of 1807, but be- cause he was the patriot of 1776; and still more, because, through the whole of a long and glori- ous life, he has been the philosopher and friend of his country: with all the ingenuity of the for- mer, exposing the misrepresentations of illiberal foreigners; and with all the ardour of the latter, fanning the fire of American science, and water- ing the roots of that sacred olive which sheds her peaceful blessings over our land. To whom then, with equal propriety, could I dedicate a book, designed at least to promote health and longevity? And to whom am I so bound by the tenderest ties of affection and grati- tude, as to Mr. Jefferson? The early classmate % X and constant friend of my deceased father, and instrumentally the author of my acquaintance with the first characters in the state of Georgia; among whom, with peculiar pleasure, I would mention the honourable names of JYlilledge, Troup, Bullock, and Flournoy. That you may long direct the councils of a united and wise people, steadily pursuing health, peace and competence, the main pillars of indi- vidual and national happiness, is the fervent prayer, of your Excellency's Much obliged and Very grateful servant, JAMES EWELL. wmm&w, ON the important subject of domestic medicine, many books have been written, which, though excellent in other respects, have greatly failed of usefulness to Americans; because they treat of diseases which, existing in very fo- reign climates and constitutions, must widely differ from ours. The book now offered to the public has, therefore, the great advantage of having been written by a native American, of long and successful practice in the southern states, and who, for years past, has turned much of his at- tention to the composition of it. The professed object of this book is to treat, in the most clear and concise manner, almost every disease to which the human body is subject—to give their common names and surest symptoms—to point out the causes whence they originate, and the most approved method of treatment— and, lastly, to prescribe the suitable regimen and means of prevention. A publication like this cannot but be exceedingly useful to all, but especially to those who live in the country, or who go to sea, where regular and timely assistance cannot always be obtained. Among the many and great services, to be rendered by such a book, we may fairly state its tendency to prevent that dangerous officiousness of ignorant persons, and, that equally pernicious neglect of the patient, at the onset of the disease, whereby so many lives are lost. These with many other evils resulting from the want of such a work, consti- tuted the motives which first led the author to offer this pub- lication to his countrymen. It is not for him to determine, whether it be happily executed or not; but, whatever may be the general opinion as to its merit, he has the high satis- faction to know, that it not only flows from the purest mo- tives, but also contains a faithful relation of facts, collect- ed principally from his own experience, and, in part, se- lected from authors of the greatest celebrity. 12 Preface. He has not hesitated, occasionally, to use the language of his favorite authors, where he found it sufficiently ckar and familiar for liis purpose; and he hopes this acknowledgment will be received in place of frequent reference and quota- tion. The reader will find, in the latter part of the work, a ta- ble of such medicines most commonly called for in families, with an adaption of the doses to the age of the patient, to- gether with directions to prepare and administer them. To have those articles always in readiness, would save not only a great deal of time and expense by sending on every trivial occasion to a distant physician, but afford, to a tender parent or master, an infinite satisfaction, because of the very great advantage it gives him over a disease, which he can meet with a suitable remedy at the first mo- ment of its attack. For, there can be no doubt, that thou- sands have perished, not because there were no remedies, but because the remedies were so distant that the patient was lost, before they could be procured. As it is impossible entirely to banish technical phrases when writing on medicine, the reader is presented with a Glossary, explaining the medical and scientific terms una- voidably employed in this work. The Autli >r, animated by the extraordinary success of the "Medical Companion," has greatly improved and en- larged it, by a synopsis of the anatomy and physiology of the human body; essays on air, food, exercise, sleep, evacuations, and passions; and a .Materia Medica. Thus improved, the Medical Companion not only treats of the art of preserving health, and curing disease, but also inculcates a familiar knowledge of the human sys- tem, in all its parts, and the laws that govern its economy. It is obvious, that by due attention to the non-naturals, by which is to be understood the means of preserving health, we may go far to protect this fabric from injury or disease. To inculcate this truth more universally and successively, the disquisitions contained in this work, are enlivened with appropriate illustrations, calculated to make impressions on the mind of the reader, as lasting as they are important. Not the least valuable portion of this work is the Materia Medica, pointing out those precious simples wherewith God lias graciously stored our meadows, fields and woods, for the healing of our diseases, and rendering us happily inde- pendent of foreign medicines, which, while they are some- Preface. 13 times hard to be obtained, are frequently adulterated, and always costly. To conclude; the author, sensible that.the Medical Com- panion might be rendered still more complete, and better calculated for general use, has in this sixth edition, intro- duced near three hundred pages of additional matter; and made such important improvements as can not fail greatly to enhance its value. In the present state of the science of medicine, daily im- proving by experience, and adding rapidly to the number of valuable remedies, he felt it incumbent upon him to enlarge considerably on the treatment of the diseases generally, as well as to make other additions, which a work of this na- ture require!!, in order to its increased usefulness. In a fV.niliar style he has pointed out the modus operandi of f! e c'iifrrent remedies; has given the prognostics of dis- eases;-'has noticed more particularly the circumstances wnen.-e the disorders originate, for the purpose of guarding agaii^r ok urrer-es; has distinguished those cases which yiel61 Sexual weakness >64 Pregnancy 468 Diseases of pregnancy 474 Abortion 484 Of labour 488 Progress of labour 490 Laborious labour 497 Management of child-bed 563 Diseases of child-bed 507 Profusion of the vagina 521 Falling down oi the womb ib. Polypus in the womb 524 Cancer of the womb 526 A mole, called false conception 52" Dropsy of the ovarium 529 Barrenness - ' 530 Management of children 5.'j3 Diseases of children 549 Materia Medica 5S3 Dispensatory 721 Glossary 767 Index 773. PRELIMINARY OBSERVATIONS. CowTEMMATiiro the numberless diseases to which man " JjaWe, and whkh may cause him to drag out a protract- ed life of distress, or suddenly cut him off in the bloom of his existence, and amidst his usefulness, we must adore the divine Excellence which has given us in medicine the means of counteracting their dreadful effects. As might have been expected, the attention to an art, rising in importance over all others, has ever kept pace with the general progress of intellectual improvement, commanding for it the respect and encouragement of every enlightened people. ' With the Greeks, especially, the wisest and most polish- ed ot all the ancient nations, medicine was held in the highest estimation. Its votaries were cherished and re- vered by them while living, and in some instances, carry- ing their enthusiasm so far as to deify them after death It is not indeed easy to conceive a more noble character, than a great and amiable practitioner of medicine, who has expanded his mind to the utmost extent by the brilliant attainments of science, and mellowed the dispositions of his heart by the habitual exercise of benevolence towards the afflicted objects of his care. How exemplary are Phy- sicians of this description? Such was Hippocrates, the father of medicine. Such was the pious, the enlightened Sydenham. Such was the benevolent Jones, of Savannah. Such was the enlightened Rush: and such are many others who have emulated their virtues and rivalled their fame- among whom, I have the high satisfaction to enumerate of my particular friends, the late Drs. Craik, of Alexandria, Weems, of Georgetown, Stevenson, of Baltimore, and Dr. Chapman, of Philadelphia, IS Preliminary Observations. But unhappily, all those who profess our art do not re- semble those bright examples. Medicine, more than any other good thing, is subject to abuse and debasement, by the sordid and mischievous "tricks and devices" of empi- ricism. Like noxious weeds impost )rs rise up at first, from the rank soil of their own effrontery; but they owe much of their subsequent erowth to the protection which they derive from the want of that information widely diffused, which would at once detect, and "laugh into scorn" their idle claims, and arraign to conviction their dangerous ten- dencies. They live but by tolerance. The slightest ex- amination of their pretensions would drive the herd into their holes and hiding places, and consign their widely spread fame to utter oblivion. It is strange, that so little popular curiosity prevails with regard to medicine, particularly when the public mind is so actively alive to subjects certainly of less mo- ment. Talk to the generality of mankind about property, and you would suppose they were all lawyers, they reason so sensibly on the various points of meum et tuum: but touch them about that which is of more worth than all property, I mean health, and they are silent as mutes. Did not experience evince the fact, we should think it im- possible that in things of such high concern, men could be so preposterously deceived! so careful of the dross, and yet so negligent of the gold. What can be more deeply interesting than the investi- gation of that beautiful organization which has, emphati- cally, been pronounced "God's master work?" What more important than acquiring the knowledge of preserving this admirable mechanism? And what more pleasant and use- ful than to investigate the medical plants of our extensive country, whereby we may remedy those painful maladies which assail the human frame? Half the attention and the time devoted to the minor po- , litics arising out of our party dissensions, assisted by very I little of that overboiling zeal given to the acquisition of property, would, if appropriated to medical studies, en- able any person of tolerable capacity to practice with safety and advantage in those cases of simple disease which are most common to our climate, and to determine between the "arrant quack" and the modest, well-educa- ted, and judicious physician. Assuredly, some care might be profitably directed to Preliminary Observations. 19 medicine. Why will not the intelligent citizens, who are scattered throughout the country, dedicate a part of their "liberal leisure" to it? Of all the sciences it is the most inviting, and that which opens the largest treasures to its cultivators. No one can lend his mind to it without re- . ceiving "usurious interest." Medicine is the digest of ' human knowledge. It is the great reservoir into which every stream of science pours its tribute, which in return spreads its fertilizing water over every field that brings forth its "ripe and abundant harvest." The want of a popular medical education, we have re- marked, promotes the success of empirics. To what else can the amazing increase of these creatures be ascribed? Would they dare to quit the shades of their native insigni- ficance, if they thought tlicy were to encounter the blaze of criticism, or to be inspected and scrutinized by the torch of truth? No: the terrors of such a process, were it practised, would exterminate the race, or leave to them only a "beggarly account of empty boxes." We repeat, that empirics are nurtured and sustained '* exclusively by the prejudices of mankind in their favour, arising from ther inability to judge rightly of their merits. For, can it be presumed that any one, acquainted with the subject, would repose the slightest confidence in the nostrums of the most stupid, illiterate, dishonest, and va- grant of society, who are confessedly destitute of even -* the elements, the mere alphabet, of medicine. Who can believe, that these nostrums, as generally as- serted by their proprietors, are applicable equally to a variety of diseases, opposite to each other as the poles, and that too, under every difference of age, constitution, / temperament, habit, season, and climate? Is it to be credited, that skill can be possessed in a pro- fession the most complex, without any preparatory devo- tion to it? Reason and experience combine to assert the impossibility. The powers of eloquence or poetry may be an inheri- tance; but, medicine is not intuitive. Whoever acquires it, that is, that thorough knowledge of it, which confers ^sur- passing skill," must undergo a slow, toilsome and arduous probation. Its temple is raised on the summit of the loftiest emi- nence, and the path which leads to it winds in tedious tor- tuosity, narrow, intricate and perplexed; but strewed, at its different stages, wiih flowers to tempt, and hung at its 20 Preliminary Observations. termination with fruits to reward. Few, very few, have ever reached it. The majority of those who set out on the enterprise become soon discouraged, and either linger by the way, or are lost in its mazes. The energies of genius, assisted by unwearied diligence, can only hope to surmount the difficulties and to gain the prize. But candour must still allow that the empiric strength- ens, in some degree, his credit with the public, by some- times performing great and imposing cures. Such in- stances, however, of occasional success, bring with them no solid claims to confidence. They are indeed calculated to excite distrust when properly viewed. Their cures, which are admitted to be few, are alone registered and promul- gated. Nothing is ever said of the failures or the deaths produced. No regular and impartial account is kept, nor any striking adjustment of balances: but, what must be the fatality of a practice conducted in a way so rash and indiscriminate, without the guide of either principle or ex- perience? The nostrums employed are uniformly com- posed of ingredients of the greatest activity, principally of the mineral poisons, as arsenic, corrosive sublimate, calo- mel, &c. and which can never be neutral in their opera- tions. Whenever administered they assume a side in the pending contest, and exert all their might either for the patient or the disease, till one or the other yields. The preceding is a faithful picture of empiricism—of its swaggering pretensions, of its danger, and its uncer- tainties; a plain and unvarnished tale, in which naught is extenuate or set down in malice. But with the too prevalent inclination for nostrums, we regret the strange aversion that exists, and which proceeds from the same neglect of medicine, to some of the most efficacious remedies. Tartar is denounced as a certain destroyer of the stomach; mercury, because it lodges in the bones; arsenic, as rancorously poisonous, &c. &c. Thus are those powerful and salutary agents, when in the hands of a judicious physician, stigmatised by the false views of vulgar prejudice. It has been wisely and truly dedared by high authority, "that all medicines in large doses are ; poisons, and that pois ns in small doses are the best medi- cines." This is no paradox. The efficacv of a remedy must be proportioned to its force, provided'it be adminis- tered with discretion, and its operation properly restrain- Preliminary Observations. 21 ed. On the contrary, the weakest medicine becomes poi- sonous when given in an undue quantity. In the use of medicines we should be careful to adapt- the n to the nature of the disease, and the condition of the patient's system at the time, for the salutary properties of a remedy are not positive, but entirely relative to the pe- culiar circumstances of the case. A remedy, therefore, may do harm, or prove beneficial, according to the degree of judgment exercised in its em- plovinent. This position might easily be illustrated and enforced by a variety of examples. We shall mention, however, only a few most pertinent. What then is more sanative in its effects than the Peru- vian bark in the treatment of intermittent fever or gan- grene; or more deleterious if given in an excited system? Where is there a readier cleanser of a foul stomach than emetics? yet, in inflammations of that organ, nothing would prove so pernicious. The same remark applies to cathartics, "nature's scavengers of a gorged alimentary canal." With regard to the lancet: what could we do without it? How quell those dreadful insurrections of acute disease which every where ravage our country? But indispensa- ble as it is in such cases, yet there is, perhaps, no remedy, which is more mischievous when wrongly applied. Who has not experienced the soothing restorative ope- ration of opium, that divine medicine, which has not with too much force been called, "magnum Dei donum," the great gift of God; and who has not known its demoniacal influ- ence when imprudently employed? In this way we might proceed through every class of the Materia Medica, deriving proofs to fortify our statement, and to warn us of the danger of abusing remedies. Enough, however, has been said. We trust the admonition will not be neglected. To apply, as we have indicated, the various medicines of which we are possessed, is the secret of successful prac- tice, and constitutes the wide difference between the dis- criminating physician and empiric. The practice of the one is governed by principles slow- ly and cautiously deduced from the contributions of long experience and diversified observations; that of the other is the result of daring experiment, sanctioned only by the chances and calculations of the lottery. In the revolutions Preliminary Observations. of the wheel, and amidst a thousand blanks, a prize may come out! Thus, an important cure by an empiric, like an enormous prize, seizes public attention, and is sounded abroad by the "clarion of fame," while the evidence of the murderous practice, like the blanks of the lottery, is hush- \ cd in silence or buried in forgetful ness. It may be proper to observe here, that, in using all ac- tive medicines, we should begin with the smallest doses, in- creasing them gradually, until the quantity suited to the strength of the constitution be discovered. For there are instances of constitutions on which one-fourth, and even one-tenth, of what would not effect others, will act power- fully. As the system speedily accommodates itself to the action of medicines, we should never continue one medicine too long at a time. When we find it is losing its efficacy, it should be changed for some other of the same class, and after a short interval the patient may, if he choose, return to his first medicine. By thus varying the remedies, as the sys- tem becomes accustomed to their action, we shall be ena- bled to cure diseases which otherwise would not have yield- ed; as obstinate intermittents, wherein I have frequently employed the bark without effect: but on changing it for i either the solution of arsenic, or vitriolic pills,* a cure has generally taken place, and when it did not, by exciting a slight mercurial action in the system and immediately fol- lowing it with one or the other of the above medicines, I have pretty constantly succeeded. On this account medi- cines should never be made too free with, as preventives of disease, unless there be evidently a morbid predisposition lurking in the system: for, by thus wantonly familiarising ourselves to medicine when there exists no necessity for it, we shall stand a very good chance to be disappointed of its proper effects, in the season of our need. Bitters, those especially made with spirits, like other cordials, have no doubt their use at times, as in damp weather, which hangs so heavily on the springs of lite: but to use them or mint slings, or drams, as some do every morning, even the brightest, when dumb nature herself is smiling, and every bird and beast are uttering their artless joy, is a species of suicide. It is a most wicked attempt to substitute artificial joys in place of those most pure and na- tural. Such an impious fighting against God and Nature, generally ends as might be expected. The wretched self •Vid. Dispensatory. Preliminary Observations. 23 destroyers seldom live out half their days. For the same delightful exhilaration, produced by one antifogmatic last year, requires two this year, and in that increase, till the habit of intemperate drinking is confirmed. How melan- choly is it that rational beings should act so madly, and that the all bountiful Creator cannot intrust us with his good things, without our shameful abuse of them! Thus " it is, that men turn into poisons those pleasant beverages given for cordials, to raise their depressed spirits, to invi- gorate their flaccid nerves, and to enable nature to repel the various attacks of a humid or infected atmosphere. Among the many remedies of disease, none perhaps holds a higher place than the bath, in its different forms. The told bath, by its sudden shock, is peculiarly fitted to invigo- rate the system, and to re-animate its circulations and se- cretions. Hence its acknowledged reputation in all cases of weak and relaxed habits, particularly those of the studi- ous and sedentary. It ought however to be remembered, that, like every other remedy, it belongs but to one set of diseases. In af- s fections of the viscera", obstructions and inflammations, it * is hurtful. If after leaving the bath, the patient do not feel a kindly glow on the surface, he has good cause to fear that . the angel of health was not there before him "to move the waters." On going into the plunging bath, as it is called, it were better to dash in at once head foremost. The shock in this way is more instantaneous, and the distribution of the blood more salutary than when it is driven, as by wet- ting the feet first, from the extremities to the head. It is on this principle that the shower bath possesses advantages ^ superior to the plunging. Immediately on coming out of the bath the body should be rubbed dry with flannel 01; coarse cloths, and moderate exercise taken. Besides the advantages of frequent cold bathing, its par- tial use is no less salutary in all cases of local action. In periodical headache, and indeed in most complaints of the head, the affusion of cold water, though a simple, is a very effectual remedy. If persons subject to the quinsy and sore throat, instead of muffling their necks, would bathe them two or three v times a day in cold water, they would find their account in > it. When the healthy resort to the cold bath, on account of its purifying and pleasant effects, they may continue in it for some, time: but to strengthen and give elasticity to 24 Preliminary Observations. the solids, every thing depends upon the sudden shock.— The time of day for bathing is a matter of indifference, pro- vided it be not immediately after a full meal, or when the body is warm and in a state of free perspiration. The warm bath, about the temperature of the blood, has nearly all the advantages of the cold bath, without, being liable to so many objections. Some indeed tell us, that it weakens the body, but so far from doing so, it may justly be considered as one of the most powerful and universal re- storatives with which we are acquainted. Instead of heating, it cools the body, diminishes the pulse, and takes off its unnatural quickness, according to the length of time the bath is continued. Hence tepid baths are of great ser- vice, when the body has been overheated, from whatever cause, whether by severe bodily or mental exercise. In all these cases, its happily composing and recuperative vir- tues seem to be owing to its tendency to promote perspira- tion, and to relax spasm. Warm battling can hardly be sufficiently commended, for its sovereign effects in promoting cleanliness, and conse- quently for curing all diseases of obstructed perspiration from foul skin. It is much to be lamented, that so many poor children should become the victims of their parents' laziness, and neglect of the most sweet and healthful virtue, cleanliness. For would they devote a little of their mispent time and money to the more decent clothing and frequent wa-hing of their children, there could be no doubt that the little innocents would enjoy ten thousand times more comfort than they can possibly have while covered with filth, and tortured with scald heads, blotches, itch, and ver- min. In fine, having seen the fatal termination of so ma- ny diseases, in my opinion easily curable by the bath, I cannot dismiss this important subject without earnestly recommending it to every gentleman to provide for his fa- mily the convenience of bathing, as not only oiil- of the greatest luxuries, but the best preservatives of health in these warm climates. It is essential to health, luxuriously, to refresh the per- son by bathing and washing off the impurities of the skin; and equal care should be taken to remove all filth out of the chambers of the sick, and frequently to change their linen and bed-clothes, which, when saturated with fuetid perspirable matter, must prove extremely unpleasant and hurtful to the patient. Preliminary Observations. SS And here T cannot but breathe the most fervent wish, that the agriculturists of the south and west would be per- suaded to insist more rigorously on cleanliness in the per- sons of their slaves. That the constitution of the African is more firm than ours, and better fitted to sustain the toils of warm climates, is very certain; but it is equally true that his daily labours, with the sudden changes of weather, ofteirput his constitution, good as it may be, to trials which loudly call for every aid that humanity can possibly afford him. Of these aids, next to plenty of wholesome food, cleanliness is one of the greatest. It is, indeed, a medicine both of body and mind. The poorest slave, however degraded his condition may be, has still left a portion of mind, which can never be totally insensible to his outward appearance. Cover him with rags and filth, and you not only injure his body by obstructing perspira- tion and corrupting the fluids, but you attack him in his mind. Knowing that he appears vile and loathsome to others, he becomes much more so to himself; and this idea embitters reflection, depresses his spirits, and in conjunc- tion with other causes, often brings on diseases which press him to an untimely grave. Whereas, by ordering him frequently to bathe, and by affording him thre» changes of apparel, of which one might always be clean, he would be greatly refreshed and comforted, both in mind and body. Thinking his appearance decent in the eyes of others, he becomes well pleased with himself, and look- ing on his new habit, however cheap and simple, as an evidence of his master's affection and value for him, he feels at once the touch of an honest pride in himself, and of friendship for his master, which lightens his task and sweetens all his toils. But, if cleanliness be of such importance to the healthful, how much more so to the sick slave. When sinking un- der the heat and burden of his labours, can it be good po- licy to suffer him to be put like a mere animal into a nar- row dirty cabin; there left, with scarcely a child to hand him "a cup of cold water," with no food but dry bred, and breathing the foetid atmosphere of a sultry, filthy habitation! In such circumstances, what but a miracle can save him from destruction? Having been frequently an eye witness of such scenes, of which the owner himself was, perhaps, ignorant, I feel itmy duty to advise him, not only far humanity, but inter- 4 26 Preliminary Observations. est sake, to erect for his slaves, especially if he have ma- ny, a cheap, coarse kind of building as an hospital. This building should be fixed on some spot, enjoying, in the highest degree, the double advantage of good water and air. It ought to consist of but one large room, quite open to the top, well aired by doors and windows, and with a plank floor, that it may be frequently washed and kept per- fectly clean. Some good-tempered, notable, old woman of the family, should be appointed to attend the sick and supply the proper nourishment. In this cheap and simple way, many a valuable slave might, we are certain, be saved to his owner, which alone were an ample reward, without counting the present comfort of such humanity, or the fu- ture blessings of Him, who has promised, that every act of love, even to the poorest slave, shall be remembered as if done to himself. To the truly wonderful effects of this regimen, embracing cleanliness, fresh air, good nursing and diet, I, myself, can bear the most public and unequi- vocal testimony. In the year 1805, when the Summer and Autumnal fever raged with uncommon violence and mortality in Savan- nah, having considerable practice among the shipping, I Was induced, chiefly from motives of humanity, to open a private hospital for seamen. And though I had usually from twenty to thirty patients during the sickly season, I lost but one of all who had been taken into the hospital at an early stage of the disease. This extraordinary success, I ascribe in a great measure to the virtues of the regimen above recommended. And in support of the plan recom- mended, I will venture to assert, that hardly an instance can be quoted, of the recovery of seamen, when left ne- glected, or badly attended, in the confined boarding-rooms* or steerages of the ships, where they were attacked. The very happy result, of the little hospital system above stated, cannot but excite the most earnest wish for a similar establishment, in Savannah, on a much larger scale. Such an institution could not fail to prove a great blessing to the state, but more so to the town, where num- bers of useful citizens, especially seamen, are annually swept off. It affords me pleasure to state, that since the appearance of this friendly hint, in the first edition of this work, the humane citizens of Savannah, have actually established a public hospital, and have found it abundantly productive Preliminary Observations. 27 >tf the good effects predicted. Fortunate would it be, if similar institutions were erected in all our seaports. In addition to the softer whispers of humanity, gratitude now lifts her louder voice: for surely our gallant sailors, prin- cipally the objects of such hospitals, have given glorious proofs in the late awful contest, that they deserve every mark of attention that a great nation in the plenitude of munificence can bestow. OF THE STRUCTURE 01 'Sam ann&AST m&Mnmssk How poor, how rich, how abject, how august,' How complicate, how wonderful is man! How passing wonder He who made him such! Who centered in our make such strange extremes' From different natures, marvellously Mixed! An heir of glory! a frail child of dust!. Helpless immortal! insect infinite! A worm! a God!—1 tremble at myself, And in myself am lost. Youno. "J am fearfully and wonderfully made, 0 Lord," ex- claimed David, on surveying the admirable mechanism of his own frame. Indeed, so complicated and curious is the structure of the human frame, that no person, who contemplates it, can possibly avoid joining with the pious Psalmist. That illustrious physician of antiquity, Galen, is re- ported in his youth to have been a Sceptic, but on wit- nessing a dissection, and examining the mechanism of the human body, the divine wisdom and design running through all its parts, he was struck with such a sense of the great Architect, that he immediately became a con- vert, and during his life devoted himself to the worship 3G Of the Structure of of the Deity with all the fervour becoming an enlighten- ed and grateful mind. Having himself happily caught the first spark of Divine light from a survey of this won- derful machine, he earnestly recommends to others the study of it as the noblest employment of the faculties, and one of the surest guides to rational devotion. His thoughts on this subject, though emanating from a heathen, are well worth the attention of all Christians.—"Those trea- tises," says he, "which display the excellencies of the great Creator, compose one of the noblest and most acceptable hymns. To acquaint ourselves with his sub- lime perfections, and point out to others his infinite power, his unerring wisdom, and his boundless benignity— this is a more substantial act of devotion, than to slay hecatombs of victims at his altar, or kindle mountains of spices into incense." Now, as one object of the "Medical Companion" is to treat of the art of preserving this divine piece of workman- ship in a healthy state, nothing can impress us more for- cibly than the absolute necessity of being made acquaint- ed with its parts, and the laws that govern them. With- out some knowledge thereof, it appears no more possible to take the right care of it, or to keep it in good order, than to perpetuate the regular motion of a clock, or time-piece, without a familiar acquaintance with its mechanism. The study of Anatomy, as it leads to the knowledge of nature, needs not,! says the illustrious Cheselden, many tedious descriptions, nor minute dissections, what is most worth knowing being soonest learned, and least subject to difficulty; while dividing and describing the parts more than the knowledge of their uses requires, perplex t!»e learners, and make the science tedious, dry and difficult. Upon this principle, the following anatomical descrip- tion of the human body is conducted; and to render it per- fectly intelligible to the uninformed readers, technical terms have, as much as possible, been avoided.. "When a master-builder," says the celebrated Hervey, whose sublime sentiments on this theme are at once so elegant and appropriate, that I have taken the liberty frequently to use them, "undertakes to erect a magnifi- cient edifice, he begins with the less decorated, but more solid parts, those which are to support, or to contain the rest." This order we will follow in considering the structure of the human frame. the Human Machine. 31 The Bones are the hardest and most solid parts of the human machine, cast into a variety of moulds, enlarged or contracted into a variety of sizes, and calculated from their strength, to support the whole body. The manner of their articulation is truly admirable, and remarkably various; yet never varied without demonstrating some wise design and answering some valuable end. They Contain marrow, which makes them less brittle, and are covered with a membrane, or thin substance like a blad- der, called periosteum, except on the skull, where it is called pericranium, which is exquisitely sensible in an in- flamed state, being plentifully supplied with nerves and blood-vessels. Its use is to sustain the vessels which en- ter the substance of the bones with their nourishment.— The head, designed for the residence of the brain, is framed in exact conformity to this important purpose, ample to receive it; strong to uphold it; and firm to defend it. The Bibs, turned into a regular arch, are gently move- able for the act of respiration. They form a secure lodg- ment for the lungs and the heart. The Back-bone is intended not only to strengthen the body, and sustain its most capacious store-rooms; but also to bringdown that appendage of the brain, which is usually termed Spinal marrow. The Arms, pendent on either side, are so exactly pro- portioned to each other, that the equilibrium of the struc- ture may not be disconcerted. These being the guards which defend, and the ministers which serve the whole body, are fitted for the most diversified and extensive ope- rations; firm with bone, yet not weighty with flesh; and capable of performing with singular expedition and ease, all manner of useful motions. To these are annexed the hands, and all terminated by the fingers; which are not, like the arms, of the same length, and of equal bigness, but consisting of various little bones, and a multitude of muscles. What shape can they not assume? what service can they not perform? The Thighs and Legs are alike substantial and stately columns; articulated in such a manner, that they adminis- 32 Of the Structure of ter most commodiously to the act of walking, yet obstruct not the easy posture of sitting. The legs swell out, to- wards the top, with a gentle projection; and are wrought off, towards the bottom, with neat diminutions. Which variation lessens their bulk, and at the same time increases their beauty. TheF^ef compose the firmest and neatest pedestal; in- finitely beyond all that statuary or architecture can ac- complish; capable of altering their form, and extending their size, as different circumstances require. Besides per- forming the office of a pedestal, they contain a set of the neatest springs, which help to place the body in a variety of,graceful attitudes, and qualify it for a multiplicity of advantageous motions. The undermost part of the heel, and the extremity of the sole, are shod with a tough, insen- sible, sinewy substance. This we may call a naturul san- dal. It never wears out, never wants repair, and always prevents that undue compression of the vessels, which the weight of the body, in walking or standing, might other- wise occasion. While many animals creep on the ground, while all of them are prone in their posture or their aspect, the atti- tude of man is erect, by far the most graceful, with an air of dignity, and bespeaking superiority; and by far the most commodious, fitting us for the prosecution of every grand scheme, and facilitating the success of all our exten- sive designs. It is likewise attended with the greatest safety; being, if not less than any other position exposed to dangers, more happily contrived to repel or avoid them. The Cartilages approach much to the nature of bones, being smooth and elastic. In them there is no sensible cavity to contain marrow, nor are they covered with any membrane to render them sensible as the bones are. They serve to make the bones, whose extremities they cover, move freely in their joints. They also contribute, in a great measure, to the formation of several parts, as th« wind-pipe, nose, ears, and breast. The Ligaments are tough, compact substances, more flexible than cartilages. They have n<> conspicuous cavi- ties, neither have they any sensibility, lest they should suf- the Human Machine. 33 fer upon the motion of the joint. They serve to unite the several limbs, and prevent their parting from each other as happen in dislocations. ' The Muscles are distinct portions of soft, red flesh, with strong tendinous heads and tails designed for insertion___ They are composed of the slenderest fibres, yet indued with incredible strength; fashioned after a variety of pat- terns, but all in the highest taste for elegance, convenien cy and usefulness. These, with their tendons annexed, constitute the instruments of motion. The former, con- tracting their substance, operate somewhat like the pul- lev in mechanics. The latter, resembling the cord, are fastened to a bone, or some portion of flesh; and, follow- ing the muscular contraction, actuate the part into which they are inserted. This, and all their functions, they ex- ercise, not like a sluggish beast of burden, but quick as lightning. A nerve or more in each muscle sets them at work, diffusing the power of sensation through the body; or, returning upon an impression from without, giving all needful intelligence to the soul; so that flesh and nerves are the principal constituents of a muscle. Inwardly they supply the several movements of the active machine: Out- wardly they render its appearance plump, well propor- tioned, and graceful. The strength of the muscles is astonishing in all per- sons, but especially in cases of pbrenzy, and in certain extraordinary characters, who, by the use of a few mus- cles only, will easily raise a weight much greater than that of their own bodies. The Tendons, although much smaller than the body of the muscle, are composed of the same number of fibres. They are not capable of contraction, but serve like ropes to pull when the fleshy fibres act, forthe commodiousness and firmness of insertion, and for the direction of mo- tion. The use of the tendons is to avoid a large quantity of flesh near the joint, to prevent clumsiness in particular places, and forthe better admitting of that friction, which, in less compact parts, would have been injurious. The Nerves are surprisingly minute, white cords, de- rived from the brain, running to every part of the body. 31 Of the Structure of They perform two distinct offices; conveying sensation from all parts of the body to the brain, and carrying the commands of the will from that seat to all the different parts of the body. Most of the muscles of the body pro- ducing motion are in the guidance of our will; some of them, however, entirely independent of it, as those of the heart and vessels which carry on the circulation of the blood; and some are partly under the direction of our will, and partly independent of it, as in respiration. But all the muscles, the involuntary, as well as the vo- luntary, are enabled to act only by their communication with the brain; for when that is cut off by the destruction of the connecting nerve, whatever impression is made on the part can no longer be felt; the orders of the will to that part can no longer be obeyed, and the part itself can no longer move. The Arteries are strong elastic tubes, which arise from the heart, and thence, striking out, as they go, into num- berless smaller canals or branches, distribute the blood to every part of the body. These being wide at their ori- gin, lessening as they branch themselves, check the rapid motion of the blood. To sustain this shock, they are in- dued with uncommon strength; by performing this ser- vice they oblige the crimson current to pass into the nar- rowest defiles, and distribute itself into all quarters. The blood thrown from the heart dilates the arteries, and their own elastic force contracts them; by which means they vibrate, in proper places, very perceivably against the finger; bring advices of the utmost importance to the phy- sician; and very much assist him both in discovering the nature of diseases, and prescribing for their cures. The larger arteries, \yherever the body is formed for bending, are situated on the bending side; lest, being stretched to an improper length by the inflection, their dimensions should be lessened, and the circulating fluid retarded.— They are not, like several of the considerable veins, laid so near the surface as to be protrusive of the skin; but are deposited at a proper depth in the flesh. This situa- tion renders them more secure from external injuries. The Veins are tubes or vessels accompanying the arte- ries, and are appointed to receive the blood from their extremities, and reconvey it to the heart. Small at their the Human Machine. 35 rise, and enlarging as they advance, they are void of any pulsation. In these, the pressure of the circulating fluid is not near so forcible as in the arteries; for which reason their texture is considerably slighter. In many places they have valves, because the slow motion of the blood in the veins, and their weaker contractile power, unas- sisted by a force adequate to that of the heart, have great need of such an invention to ensure its return to the heart. The Secretory vessels are minute tubes in the different organs, serving to separate and strain off the different fluids from the general mass of blood. The Excretory vessels, tubes also belonging to the dif- ferent organs, carry off the humours that are separated; The Glands, commonly called Kernels, are small bodies of finely interwoven vessels, whose office it is to secrete or separate fluids from the blood for particular uses, as spittle in the mouth, bile in the liver, milk in the breast, &c. Glands, when obstructed, become large and indurated, from which scirrhus and cancers are produced. The Membranes are thin tunicles or fine webs like a bladder, appointed to enwrap the fleshy parts; to form a connexion between some; to line the cavities, and make a separation between others. The Fibres are simple thread-like bodies, serving to form other parts; hence some are very hard, as the honey ones; and others soft, as the fleshy parts. The Skin, like a curious surtout, exactly fitted, enve- lopes the whole, formed of the most delicate net-work; whose meshes are minute, and whose threads are multi- plied even to a prodigy. The meshes are so minute, that nothing discernible to the eye passes them; though they discharge every moment myriads of superfluous incum- brances from the body. The steam arising from the warm business transacted within, is carried off by these real, though imperceptible, funnels; which constitutes what we usually call insensible perspiration. A single / grain of sand, according to Mr. Lewenhouk, will cover 36 Of the Structure of no less than one hundred and twenty-five thousand of these funnels, or what has been prettily styled "cutaneous chimneys." The threads are so multiplied, that the point of the smallest needle cannot pierce any single part with- out causing an uneasy sensation, and an effusion of blood; consequently without wounding, even by so small a punc- ture, both a nerve and a blood-vessel. The outermost covering of the body is that soft whitish tegument which rises in the pustle of a blister, and is called scarf skin. The next, or true skin, is that reddish and exquisitely tender part which appears when the blis- ter is broken, and the dead skin taken off. The first is void of sense, and intended to screen the second, not on- ly from the stroke of injuries, but even from the impres- sions of the air, which, mild as it may feel to the sheathed, would he too rough and sharp for the iiaked nerves. The natural colour of the cuticle is white. The ap- parent black or brown colour in the African or Indian, is entirely owing to the mucuous substance under it. The skin unites in itself two very essential functions. It is the organ of the sense of the touch, and the channel of perspiration. For this purpose, innumerable nerves and vessels are dispersed throughout the skin, which are in the continual act of feeling, and at the same time, of secreting and volatilizing noxious particles. It has been proved by accurate experiments, that the healthy individ- ual daily and insensibly perspires upwards of three pounds weight of superfluous and impure humours. It may, therefore, be confidently asserted, that no part of the body is provided with so many important organs, by which it is connected with almost every operation per- formed in animal life, as the skin. By this organization, we are placed in immediate connexion with the surround- ing atmosphere, which particularly affects us through the skin, and exerts its influence on our health: We farther feel, directly through that medium, the qualities of the. air, heat, cold, pressure and rarefaction. Important as the skin is to external life, it is no less to the internal economy of the body, where it appears to be peculiarly designed to preserve the grand equilibrium of the different systems, by which the human frame is sup- ported in its vital, animal, and sexual functions. If any stagnation, accumulation, or irregularity arise in the fluids, the skin is the great and ever ready conductor, the Human Machine. 37 through which the superfluous particles are separated, the noxious volatilized, and the fluids, stagnating in their course, effectually attenuated; a canal being at the same time opened for the removal of those humours, which, if they could get access to the vital parts, such as the heart and brain, would cause inevitable destruction. By the proper exercise of this organ, many diseases may be sup- pressed in their early stages; and those which have al- ready taken place may be most effectually removed. No disease whatever can be healed without the co-operation of the skin. The nature and constitution of this organ most certainly determine either our hope or apprehension for the safety of the patient. In the most dangerous in- flammatory diseases, when the prospect of recovery is gloomy, a beneficial change of the skin is the only effort by which nature, almost overcome, relieves herself, and ejects the poison in a surprising manner, frequently in the course of one night. The greatest art of a physician, indeed, consists in the proper management of thisexten- sive organ, and in regulating its activity, where occasion requires. To mention only one circumstance; it is well known to those who have experienced the beneficial effects of a simple blister, that its stimulus, like a charm, has frequently relieved the most excruciating pains and spasms in the internal parts. When the sensibility of the surface is impaired; when the myriads of orifices designed for the continual purifi- cation of our fluids, are obstructed, if not closed; when the subtle nervous texture is nearly deprived of its energy, so that it becomes an impenetrable coat of mail, is there any reason to wonder that we are so often harassed by a sense of constraint and anxiety, and that this uneasiness, in many cases, terminates in gloom and melancholy? Ask the Hypochondriac, whether a certain degree of the cold, paleness, and spasmodic sensation in the skin, does not al- ways precede his most violent fits of imbecility; and whe- ther his feelings be not most comfortable, when the surface of his body is vigorous, warm, and perspires freely? In short, the degress of insensible perspiration are to him the surest barometer of his state of mind. If our skin be dis- organized, the free inlets and outlets of the electric, mag- netic, and other matters, which affect us at the change of ' the weather, are inactive. Thus the origin of extreme sensibility, towards the various atmospheric revolutions, 38 Of the Structure of is no longer a mystery; for, in a healthy surface of the body, no inconvenience will follow from such changes. If we farther advert to those acrimonious fluids, which, in consequence of an imperfect state of perspiration, are re- tained in the body, and which affect the most sensible nerves and membranes, we shall the better comprehend how cramps and spasms, the torturing pains of the gout and rheumatism, and the great variety of cutaneous diseases, have of late become so obstinate and general. The just proportion of the fluids, and the circulation of the blood, are also determined, in no small degree, by the skin; so that, if these fluids become languid, the whole momentum of the blood is repelled towards the interior parts. Thus a continual plethora, or fulness of the blood, is occasioned; the head and breast are greatly oppressed; and the exter- nal parts, especially the lower extremities, feel chilly and languid. May we not infer, from what has been advanced, that the use of baths is too much neglected, and ought to be uni- versally introduced? Bathing is considered an excellent remedy for alleviat- ing both mental and bodily affections. It is not merely a cleanser of the skin, enlivening and rendering it more fit for performing its offices: it also refreshes the mind, and spreads over the whole system a sensation of ease, activity and pleasantness. It likewise removes stagnation in the larger, as well as in the smaller vessels, gives an uniform, free circulation to the blood, and preserves that wonderful harmony in our interior organs, on the disposition of which our health and comforts so much depend. A person fa- tigued or distressed in the body and mind, will derive more refreshment from the luxury of a tepid bath, and may drown his disquietude in it more effectually, than by in- dulging in copious libations to Bacchus. There subsists so intimate a relation between our in- terior and exterior vessels, that almost every error or ir- regularity in the organs within, shows itself first on the surface of the body, particularly on the face. How often are we struck with the countenance of a person who thinks himself in perfect health, but whose illness, the result of some morbid cause, concealed in the body, justifies, in a few days, the serious apprehensions we entertained at our last interview? Nature has wisely ordained,that the first appearance of internal irregularities should be indicated the Human Machine. 39 by the countenance; but to what do we generally apply this index? We refuse to avail ourselves of her beneficent intimation: and the continued use of pernicious substan- ces, instead of promoting the object we have in view, ul- timately tarnishes and impairs that beauty which we meant to adorn and preserve. The secret venom, circling in her veins, Works through her skin, and bursts in bloating stains, Her cheeks their freshness lose, and wonted grace, And an unusual paleness spreads her face. Granville. We imagine it in our power to improve the skin, without attending to the purity of the fluids, though it is indebted to them for its very existence: and yet we should smile at a person, who should attempt to cleanse an impure tongue by constantly scraping it, when a disordered stomach was the real cause of that impurity. The Cellular Membrane, so called from its numerous cells, adheres very closely to the skin, running between the muscles in general, and between their several fibres in particular; and communicating with the membrane which lines the inside of the breast and belly. All its cells com- municate with each other throughout the whole body, so that from any one part the whole may be filled with air, as is evident in beasts, from the butchers blowing up their lean meat with air when newly killed, and in emphysema, where the air from a broken rib, getting into one of the cells, forces its way into all the rest, distending the body to a frightful size; as also, in general dropsy, wherein all the cells, filled with water, may, by puncture, be emptied in the course of a night. In health this membrane is fil- led with an oily substance, giving an agreeable rotundity to the limbs. It is also the seat of biles, and contributes to keep the inner parts warm and pliant; and, by filling the interstices of the muscles, renders the surface of the body smooth and plump. The Head, that majestic dome, being the seat of the brain, in which the soul is supposed to reside, resembles the GeneraVs tent in an army, or the Monarch's palace in a ci- ty. It has a communication established with all, even the most remote parts of the system; having outlets and ave- 40 Of the Structure of nues, for the ready despatch of couriers to all quarters, and for the reception of speedy intelligence on every in- teresting occasion. It is furnished with lodgments where- in to post sentinels of various characters, and appoint to various offices, to expedite their operations, whether em- ployed in reconnoitring what passes without, or exa- mining what claims admittance within. The whole turns upon a curious pivot, most nicely contrived to afford the largest and freest circumvolutions. This stately capiiol is screened from heat, defended from cold, and, at the same time, beautified by a copious growth of hair. The great creator, profusely gracious to mankind, has made us an inestimable present of the senses to he the inlets of innumberable pleasures, and the means of ad- ministering the most valuable comforts. High in the head, bright and conspicuous as a star in the brow of even- ing, is placed the eye. In this elevated situation, like a sentinel posted in his watch-tower, it commands the most enlarged prospect. Consisting only of simple fluids, en- closed in thin tunicles, it conveys to our apprehension all the graces of blooming nature, and all the glories of the visible Heavens. How prodigiously wonderful, that ; n image of the highest mountains, and a transcript of the most diversified landscapes, shall enter the small circlet of the pupil! How suprisingly artful, that the rays of light, like an inimitable pencil, should paint on the optic nerves, paint in an instant of time, paint in the truest co- lours and exactest lineaments, every species of external objects. The Eye is so tender, that a slight accident, scarce per- ceivable by some other parts of the body, proves very in- jurious to its delicate frame. It is guarded, therefore, with the most solicitous care; with a care evidently proportion- ed to its nice texture, and extensive usefulness. It is en- trenched deep in the head, and barricaded on every side with a strong fortification of bones. The wisdom and goodness of the Creator appear in the astonishing appara- tus of muscles with which the eye is furnished, to produce all the necessary and convenient motions in the situation where it is placed. The eye-brows serve to defend this delicate organ from too strong a light; and as the incur- sion of the smallest fly would incommode the polished sur- face, it is farther defended by two substantial curtains the Human Machine. 41 (eye-lids) hung on a most slender cartilaginous rod, which secure it from floating dust and from every troublesome annoyance. In sleep, when there is no occasion to exer- cise the sense, but an absolute necessity to protect the or- gan, these curtains spontaneously close, and never fail to lie shut. On the inside of these curtains or eye-lids, lie glands, which secrete a limpid fluid, that lubricates the eye-ball, as often as we wink, or, as it were, oils its wheels, and fits it for a course of unwearied activity. The Ear consists of an outward porch and inner cham- bers, with tools of the most admirable contrivance, and finished workmanship. The porch is that cartilaginous substance, standing somewhat prominent from the head, covered with a tigbt expansion of the skin, and wrought into irregular bends and hollows; which, like circling hills, or surrounding rocky shores, collect the wandering undulations of the air, transmit them with vigorous im- pulse, to the finely stretched membrane of the tympanum, or drum of the ear. The avenue, or narrow entry, is secured from the insinuating attempts of little insects, by a moruss of bitter and viscous matter, disgustful to their taste, and embarrassing to their feet. The hammer and the anvil; the stirrup and the drum; the winding labyrinths, and the rounding galleries: these and other pieces of me- chanism, instrumental to the power of hearing, are, beyond description, curious. Amazingly nice must be the formation and inconceiv- ably exact the tension of the auditory nerves, since they correspond with the smallest tremours of the atmosphere, and easily distinguish their most subtle variations. With the gentle gales that fan us, or even with the ruder blasts that assault us, these delicate strings are but little affect- ed. Whereas, they are perfect unisons with those fine, those significant agitations of the air, which, the acntest is unable to discern. These living cords, tuned by the touch of an Almighty hand, and diffused through the echoing aisles, and sonorous cells, receive the impressions of sound and propagate them to the brain. These give existence to the charms of music, and reciprocate the rational enter- tainments of discourse. The eye perceives only the ob- jects bejore it; whereas the ear warns us of transactions above us, behind us, all around us. The eye is useless amidst the gloom of night, and cannot carry its obscrva- 42 Of the Structure of tion through the bolted door or the closed window-shut- ter; but the ear admits intelligence through the darkest medium, and the minutest cranny. Hence, when we cannot see a friend, because of an interposing partition, yet, by the friendly aid of this organ, we can learn that he is in the adjoining room by his voice, or that he is near by his steps. The eye is upon duty only in our waking hours; but the ear is always expanded, and alw ays acces- sible; a courier which never tires; a sentry ever in his box. To secure a resource, in case any misfortune should disable one of the hearing or seeing organs, our all gracious Maker has given us duplicates of each. As there are tremulous concussions impressed upon the air, discernible oniy by the instruments of hearing; there are also odoriferous particles wafted by the same aerial vehicle, which are perceivable only by the smell. The Nostrils are wide at the bottom, that a large quan- tity of effluvia may enter; narrow at the top, that when entered, they may close their ranks, and act with greater vigour. Fine, beyond all imagination, are the streams exhaled from foetid or fragrant bodies.—The very best microscopes, which discover thousands and tens of thousands of animalcules in a drop of putrified water, cannot bring one individual among all these evanescent legions to our sight. They sail in numberless squad- rons, close to our eyes, close by our ears; yet are so amazingly attenuated, that they elude the search of both. Nevertheless, so judiciously are the olfactory nets laid, and so artfully their meshes seized, that they catch these vanishing fugitives. They catch the roaming perfumes, which fly off from the opening honey-suckle, and take in the stationed sweets which hover round the expanded rose. They imbibe all the balmy fragrance of spring, all the aromatic exhalations of autumn, and enable us to banquet even on the invisible dainties of nature. Furnished with these several organs, -------------not a breeze Flies o'er the meadows, not a cloud imbibes The setting sun's effulgence, not a strain From all the tenants of the warbling shade Ascends, but whence our senses can partake Fresh pleasure. Akenside. the Human Machine. 43 Another capacity for frequent pleasure, our bountiful Creator has bestowed in the power of taste; by means of which the food, that supports our body, feasts our pa- late; first treats us with a pleasing regale, then distributes its beneficial recruits. The razor, whetted with oil, be- comes more exquisitely keen; so the saliva, flowing upon the tongue, and moisting its nerves, quickens them into the liveliest acts of sensation. This sense is circumstanced in a manner peculiarly benign and wise; so as to be a standing, though silent plea for temperance. The sight, smell, and taste, are not only so many sepa- rate sources of delight, but a joint security to our health. They are the vigilant and accurate inspectors which exa- mine our food, and inquire into its properties, pleasant or disagreeable, wholesome or noxious. For the discharge of their offices, they are excellently qualified, and most commodiously situated; so that nothing can get admission through the mouth, till it has undergone the scrutiny, and Obtained the passport of each. To all these, as a most necessary and advantageous supplement, is added the sense of feeling; which renders the assemblage complete. While other senses have a par- ticular place of residence, this is diffused throughout the whole body. In the palms of the hands, on the tips of the fingers, and indeed through all the extreme parts of the flesh, it is most quick and lively. The whole army of Xerxes drawn out in battle array, with his millions of supernumery attendants, were but like a few gleaners straggling in the field, if compared, either in number or order, with those nervous detachments, which pervade the texture of the skin, and minister to the act of feel- ing. The crowning gift, improving the satisfaction, and aug- menting the beneficial effects of all the senses, is speech. Speech makes me a gainer from the eyes and ears of other people; from the ideas they conceive, and the observa- tions they make. And what an admirable instrument for articulating the voice, and modifying it into speech is the tongue! The tongue has neither bone nor joint; yet fash- ions itself, with the utmost volubility, into every shape and every posture, to express sentiment, or constitute harmony—This little collection of muscular fibres, un- 41 Of the Structure of der the conducting skill of the Creator, is the artificer of our words. By this we communicate the secrets ol the breast, and make our very thoughts audible. By this we instruct the ignorant, and comfort the distressed; we glorify God, and edify each other. Who would not bless for this the gift of speech, And in the tongue's beneficence be rich? But still, what is this mansion of flesh, though so ex- quisitely wrought, compared with the noble and immortal inhabitant, which resides within? -------------"That intellectual being, Those thoughts, which wander through eternity." The Mind, or Soul, of much higher character than that of the perishable frame with which it is at present con- nected, has neither nerves, nor the nervous fluids. These are only its agents, in this its imprisoned state. When the "silver cord" is broken, which connects mind and matter together, vitality ceases. The body then, with all its artful and numerous vessels, fibres and nerves, and other exquisite machinery, undergoes decomposition, and is turned into its original elements; but the immortal soul, having shaken off this coil, is destined for a new residence; to flourish in eternal youth; to outlive the wrerk of elements, and the crush of worlds. It is embodied even in its residence in another world. "Thou fool," says the Philosopher and Apostle, "that seed which thou sow- est is not quickened except it die."—"And that which thou sowest is not that body which shall be; but God giv- eth it a body as it hath pleased him, and to every seed its own body. So also is the resurrection of the dead.— The body is sown in the earth in dishonour, it is raised in glory; it is sown in weakness, it is raised in power; it is sown a natural body, it is raised a spiritual. Beh »ld I show you a mystery. We shall not all sleep, but we shall all be changed. In a moment, in the twinkling of an eye, at the last trump; for the trumpet shall sound, and the dead shall be raised incorruptible, and we shall be changed. For this corruptible must put on incorruption, and this mortal must put on immortality." Man therefore is not the Human Machine. 43 what he will hereafter be. What we discover of him here below, is only the gross foldage, under which he crawls upon the earth, and which he must shortly cast off. The animal body has no other relation than to this earth. The spiritual body will have enjoyments which ((ear hath not heard, nor hath it entered into the heart of man to conceive." New senses will be disclosed, multi- plying perfections in an almost infinite degree. Man's sphere will he aggrandised, and he will become equal to superior intelligences. Revelation informs us it will be so; and the parable of the seed is the most expressive and philosophic emblem of this wonderful pre-ordination. The senses, as they are brought into subjection to the soul, will no longer rule over her. Separated from flesh and blood, there will remain in her none of those earthly affections resulting from them.—Transported in- to the regions of light, the human understanding will present no ideas to the will, but those of highest good. It will then have no other than lawful desires, and God will be their constant and ultimate end. It will love him from gratitude; fear him from a principle of love; and adore him as the supremely amiable being, the eternal source of life, perfection, and happiness. The Thorax, or breast, is situated between the belly and neck. The front part is commonly called the breast; the posterior part the back, and the lateral parts the right and left sides. Before we take notice of the internal parts, it may be proper to speak of the mamma? or breasts. These are two glandular bodies, of a round oval figure, most remarkable in women. The period of their grow- ing full in the female is about the age of fourteen or fifteen, and that of their decreasing, fifty. The breasts are com- posed of a vast multitude of minute vessels to secrete the milk from the blood. These vessels, as they approach the nipple, fall into, and form eight or ten larger pipes, connected together with admirable skill, that, "in case of any obstruction or accident in any one or more of them, the milk might not be obstructed. The swelling of the breasts, during the time of gesta- tion, is owing to the consent between them and the womb. The cavity of the breast is lined by a fine smooth mem - 46 Of the Structure of brane, named pleura, and contains those two grand or- gans, the heart and lungs. The Lungs are divided into two larger portions, called lobes; the one on the right, and the other on the left side. The vessels which enter the lungs, are the trachea or wind-pipe, by which we draw in the air, the pulmonary artery, which comes from the right ventricle of the heart, and the pulmonary vein, whose trunk opens into the left ventricle of the heart: Each of these divides into two branches. The lungs differ from every other part of the body in this respect; the wind-pipe, in its minutest ramifications, passes through all parts of its substance, terminating eve- ry where in air vesicles forthe grand purpose of respira- tion, which keeps it in a continued state of action and re- action. Hence, when the lungs are diseased, their mo- tion is not only increased by the respiration being quick- ened, but they suffer violent concussion by the means of coughing. This circumstance renders disorders of the lungs more peculiarly difficult to cure. The Heart is a strong, active, indefatigable, muscular body, of a conical figure, included in an exceedingly strong membranous bag, called the pericardium or heart- purse, and situated in the cavity of the chest. It has two separate cavities, called ventricles, out of which issue the two large arteries of the human body, one called pulmo- nary, or artery of the lungs, the other aorta, or large arte- ry of the body, from which all the other arteries go off, as branches of a tree from its trunk, dividing themselves into minute ramifications in their progress. Near the mouths of these two ventricles are two other hollows, which, from their similitude to dog's ears, are called auricles, into which the veins, returning from all parts of the body with the blood, empty themselves, through two large trunks or channels. It has two motions called systole and dias- tole; the former is when it contracts itself, and thereby forces the blood into the arteries. The diastole is when it relaxes itself, and receives the blood from the veins.— The ventricles of the heart are each capable of receiving an ounce of blood or more, and therefore, being full in their diastole, we may suppose that they throw out at least one ounce of blood each systole. The heart con- the Human Machine. 47 tracts about four thousand times in an hour, more or less, according to the different temperaments, sexes and ages; and, therefore, there pass through the heart every hour, four thousand ounces, or two hundred and fifty pounds weight of blood. Now the common opinion is, that the whole mass of blood does not exceed twenty-five pounds, and, therefore, according to this allowance, a quantity of blood equal to the whole mass, passes through the heart ten times in an hour, that is about an ounce every second. If the heart contract eighty times in a minute, then twenty- five pounds weight of blood pass through its ventricles once in five minutes, or twelve times in an hour. The far- ther the blood moves from the heart, its velocity decreases as the artery divides into more branches, so much so, that the blood moves 5233 times slower in some capillary arte- ries than it does in the aorta or great artery. The blood is received from the arteries into the veins, where it still moves more slowly as it returns to the heart again. The arteries are to the veins as 324 to 441, and consequently the blood moves in the veins above 7116 times slower than it does in the aorta. The heart is the grand organ of the circulation of the blood, and, consequently, of life. Impelled by this beat- ing engine, part of the blood shoots upward; and sweeps, with a bounding impetus, into the head. There it im- pregnates the prolific fields of the brain; and forms those subtile spiritous dews, which impart sense to every nerve, and communicate motion to every limb.—Part flows down- ward; rolls the recking current through all the lower quar- ters; and dispenses the nutrimental stores, even to the meanest member, and the minutest vessel. Observe, how the stately Thames, and the lordly Poto- mac, refresh the forest and groves; water the towns which crowd their banks; and make the meadows they intersect, laugh and sing. So, only with an incomparably richer fluid, and with infinitely more numerous streams, this hu- man river laves the several regions of the body, transfus- ing vigour, and propagating health through the whole.— The living flood never discontinues its interchangeable tide; but, night and day, whether we sleep or wake, still perseveres to sally briskly through the arteries, and return softly through the veins. Such astonishing expedients are used to elaborate the 48 Of the Structure of chyle, to blend it with the blood, and to distribute both through the body, that the animal constitution is perfectly maintained. In youth, its bulk is increased; in age, its decays are repaired; and it is kept in tenantable condition for the soul, during the space of seventy or eighty years. The doctrine, taught by the immortal Harvey, the dis- coverer of the circulation of the blood, is, that all the veins of the body falling into two trunks, viz. the ascending and descending cava, empty themselves into the riglit auricle of the heart. The right auricle unloads into the right ventricle of the heart, which throws the blood through the pulmonary artery, into the lungs, by its two branches, which go to the right and left lobes. From the lungs the blood is brought back by the pul- monary veins, into the left auricle, and thence it passes into the left ventricle, from which it is distributed through the body by the aorta, or large artery and its branches. These terminate in the veins of the body, which collect the blood and bring it back to the heart, by the two cava, or large veins. In other words, the blood is conveyed from the left ven- tricle of the heart by the aorta and its branches, to the minutest and most remote parts of the body, and then, passing from the extremities of the smallest arteries into the incipient veins, circulates through them into their larger branches, and so on into the right auricle of the heart, thence into the right ventricle, whence it is forced, with the fresh supplies that it receives from the chyle in passing through the subclavian vein, into the pulmonary artery, and after circulating through, and being acted upon by the lungs, in its passage through them, is return- ed by the pulmonary vein, into the left auricle, and thence into the left ventricle, and so on, the same round, until death concludes the progress. There is in the consideration of the organs performing the circulation of the blood, an air of grandeur that seizes forcibly on the mind, and penetrates it with the highest admiration. We perceive that the blood, every time it is returned to the right ventricle of the heart, is directly dispersed through the lungs, and immediately reconveyed to the heart, before it is permitted to begin anew circulation.__ In the study of nature throughout all her work, however the Human Machine. 49 complex the machine, the utility of each part ever claims the admiration of the speculative mind. The observation is beautifully illustrated on the present occasion, and "I believe it will be admitted by every one," says the ingenious author of the Medical Extracts, "that the blood, after having performed one round, throughout the animal economy, undergoes some new and important change in its transit through the lungs, especially requisite to support a second circulation. This change is certainly the oxygenation of the blood, and we should expect if oxygen be the natural stimulus to the heart, and arteries, that their pulsation would be in proportion as the blood had access to this principle." That animal beat depends upon the action of the arte- ries, and the circulation of the blood in general, is very natural to imagine; because whatever increases the velocity of the circulation, whether exercise, friction, or disease, also increases the internal heat; whereas faint- ing, hemorrhage, and whatever produces a weak and lan- guid circulation, also diminish the heat of the body. When a ligature is put around an artery, so as to pre- vent the blood from being carried to any particular limb, that limb becomes colder than it was, and does not re- cover its natural heat, until by removal of the ligature, or the expansion of the branches, wiiich go off from above the ligature, the usual quantity of blood is circulated through the limb. With a new-born infant, the first thing is to infuse into its nostrils "the breath of life;" for until the lungs be ex- panded, and the venal or purple blood changed into arte- rial or crimson, in that organ, the heart does not con- tract, nor the arteries vibrate; like a clock, not wound up, though sound in all its parts, remaining en- tirely at rest. In the clock, if we wind it up, the main- spring applying its powers, all the wheels are immediate- ly put into motion, and it marks its hours and minutes; so, likewise, in the animal machine, the blood in the lungs having imbibed the vital principle from the air, the heart acquires its actions, the brain its energy, the nerves their sensibility, and the other subordinate springs of life presently resume their respective functions. No organ can be severely affected without affecting the heart, and disturbing its functions; nor can the heart be 7 50 Of the Structure of in the smallest degree affected, without disturbing every function of the animal economy. But the heart is not only affected by what injures the body, but also by what ruffles the mind. Rage occasions frequent and forcible contractions; sorrow, slow and lan- guid ones; and there are instances of violent passions sus- pending the contractions of the heart altogether, and oc- casioning death. The heart is not only affected by what- ever hurts the body or mind of the person, to whom it be- longs, but also by what hurts the bodies or minds of others.. But the extent of this kind of sympathy differs greatly in different persons. In some it embraces chil- dren, friends, relations, countrymen, and in a certain de- gree, the whole human race; in others, it seems to be en- tirely confined within the limits of their own bodies, or at most, reaches with a blunted sensibility, no farther than to those whom they conceive to be their own offspring. While the blood is in circulation, various liquors are separated from it by a process called secretion, all these secretions being necessary for the health and preservation of animal life. When it is taken from the vein by the usual mode of bleeding, and left to itself, it soon congeals, and appears to be composed of two distinct parts, called crassa- mentum, or solid, and serum, or liquid. In a mass of healthy human blood, about one half is crassainentum, which hath the red colour to itself. The serum in a healthy state is almost colourless; at other times it is yel- lowish, or of a greenish hue, while the top of the crassa- mentum has different degrees of firmness, and puts on different appearances, w ith respect to colour, according to the constitution and health of the subject, from which it is taken. A due proportion of the respective parts of the blood is necessary to perfect health. The Diaphragm, or Midriff, is a large, thin, broad muscle, that divides the breast from the belly. The uses of the midriff are, first, to assist in respira- tion; for, in taking in the breath, it is pressed downwards, and in expiration, it rises upwards into the cavity of the breast: secondly, to assist the necessary motions of the stomach, intestines, liver and spleen; and for assisting the expulsion of the fseces, the urine, the foetus in parturi- tion, and of the secundines or after birth. It marks our the Human Machine. 5i passions by its irregular actions, as sighing, yawning, coughing, laughing. It is affected by spasms as in hic- cough. The Abdomen, or Belly, lies between the breast and pel- vis, which is formed by the juncture of the haunch bones. The belly contains many of the principal parts of the human body, as the stomach, the intestines, liver, spleen, pancreas, kidneys, bladder, &c.—On its inside it is lined with a membrane called peritoneum, which is capable of a very great extension; and afterwards can contract itself to its ordinary size, as we see in pregnancy, dropsy, cor- pulency, and repletion. The Stomach may be considered a dilatation of the oesophagus or gullet, as it is a continuation of the same tube. Its figure nearly resembles thepouch of a bag-pipe, and has two orifices, the one above from the gullet, through which it receives the crude aliment, the other below, whereby it conveys the partially digested food or chyme into the duodenum. Before the food enters the gullet, it must of necessity pass over the orifice of the wind-pipe; consequently must be in very imminent danger of falling upon the lungs, which would, if not entirely obstruct the breath, yet occa- sion violent coughing, and great inconveniencies. To obviate this evil, the all foreseeing contriver has placed a moveable lid, or hung a cartilaginous drawbridge; which, when any of the smallest particle of food advances to en- ter the stomach, is pulled down, and shut close; but the very moment the morsel is swallowed, it is set loose and stands open. By this two-fold artifice, the important passage is always barred and made sure against any noxi- ous approaches; yet is always left free for the necessary accession of air, and commodious for the purpose of res- piration. When the malster prepares his grain for the transmu- tation of the brew-house, he suffers it to lie several hours steeping in the cistern, before it is fit to be spread upon the floor, or dried on the kiln. The meat and drink like- wise must remain a considerable time in the stomach be- fore they are of a proper consistence and temperature, either for the tender coats, or the delicate operation of 52 Of the Structure of the bowels. For which purpose that great receive* is made strong to bear, capacious to hold, and st curiously contrived, as to lay a temporary embargo upon its contents. Here they are lodged in the very centre of warmth, and concocted by the most kindly combination of heat and hu- midity. Here they are saturated with other fermenting or diluting juices; and are kneaded, as it were, by the mo- tion of the stomach, and compression of the neighbouring parts. So that every the minutest fragment is separated; the whole is reduced to a tenuity abundantly finer than the exactest grinding could effect; and all is worked up into the smoothest, most nicely mixed pulp imaginable.— From hence it is dislodged by a gentle acting force, and passes by a gradual transition into the cavity of the in- testines. The Intestines form one continued canal from the stomach to the anus, wliich is usually five or six times the length of the individual. It is curiously convoluted in the abdo- men, and is extremely irritable. Although one entire tube, anatomists have divided it into the small and great intestines. The small intestines are called duodenum, jejunum, and ilium; the larger are the csecum, colon, and rectum. The Duodenum, so called, because it is generally twelve inches long in adults, is the widest and shortest of the small intestines. At a short distance from where it joins the stomach, it receives two ducts, the one from the liver, bringing the bile, and the other from the pancreas, or sweet bread, bringing its liquor to complete the digestion of the food. The second gut is the Jejunum, so called, frmi its being usually found empty, its numerous lacteal vessels having absorbed the chyle. The Iliu n is the third and last of the small intestines.— The great length of the small guts is evidently for the convenience of a greater number of lacteals, that the chyle which misses their orifices in one place may not escape them in another. The Caecum,or blind gut, is a pouch, as itwere,ofthe Colon, about three inches long, and called blind, from its being out of the direction of the passage of the food. The Colon is the greatest and widest of all the intestines, about eight or nine hands' breadth long, and by lying so the Human Machine. 53 contiguous to all the bowels, it communicates all the bene- fits of the injections thrown into it. When the Colon is affected, there is a sense of weight, though the pain is not very acute; whereas, in the small guts there is not any sense of weight, but an acute pain. Sometimes a pain in the colon attended with fever, the pain extending to the ribs, gives a suspicion of pleurisy, though the colon only is affected. The colon is narrower on the right side than elsewhere, whence colic pains arise more frequently, and are more severe in this part. The excre- ments are long retained here, and often are much indurat- ed before they pass farther on. The Rectum or straight gut, is about a hand's breadth and a half long. It begins where the last curvature of the colon ends, and is terminated at the fundament. At its termination it is surrounded by circular muscular fibres, called the sphincter ani, to retain the faeces. The intestines are not left to move at random in the cavity of the abdomen, but are artfully tied down by a mem- branous web, which prevents their circumvolutions from being entangled in each other, at the same time allowing a gentle, but animated motion. That part of it connect- ed with the small intestines is called mesentery, the other part fastened to the colon, mesocolon:—All the intestines have in their inner membrane an almost infinite number of very small glands, whose office it is to discharge into the intestines a liquor for the attenuation of the chyle, for lubricating the intestines, and in the large guts to soften the faeces, that they may be evacuated without pain. The intestinal canal serves to complete the first digestion, strain off the chyle, and carry off the faeces. Had the intestine been straight and short, the food might have gone through them, without resigning a sufficient quantity of its nourishing particles. Therefore this grand- est of all the vital ducts is artfully convolved, and greatly extended, to afford an opportunity of sifting more tho- roughly whatever passes, and of detaining whatever may serve its purposes. Though the alimentary substance can never mistake its way, yet it may, through some acciden- tal impediment, attempt to return backward. In this case a valve intervenes, and renders what would be extremely pernicious almost impractible. Upon a survey of the use of the stomach and intestines, we 54 Of the Structure of cannot avoid being struck with wonder at its apparent simplicity, answering so many salutary purposes. As soon as we take our food, it is received into a place in all points calculated to render it fit for yielding its nutri- tious contents. At first, the food taken into the stomach, retaining its peculiar properties, irritates the coat of that organ, and occasions a contraction of its two orifices.— The food thus confined then undergoes a constant agita- tion by means of the abdominal muscles, and of the dia- phragm, and by the motion of the fibres of the stomach it- self. By these movements every part of the food is expos- ed to the action of a fluid secreted in the stomach, called the gastric juice, which gradually dissolves and attenu- ates the food, and prepares it for its passage into and farther change in the intestines. The painful sensation of hunger, which is the irrita- tion of the gastric juice on the coat of the stomach, or a sensation of a defective supply of chyle in the arterial sys- tem, being removed by the food, we soon feel a mild and undescribable delight, first, from the stimulus of the ali- ment, and secondly, from the distension of this, and the increased action of other parts. The aliment having remained during two or more hours in the stomach, is converted first into a greyish pulp, which is called chyle. This fluid passes out of the right orifice, the fibres of which relax to allow it to escape; while the grosser and less altered particles remain in the stomach till they acquire a sufficient fluidity to pass into the intestinal canal. As the digested food enters the duodenum, it stimulates the common duct of the gall- bladder, from which it receives a full supply of bile and of saliva, secreted from the pancreas. The Chyle, drawn off by all the secretory orifices, is carried along millions of the finest ducts, and lodged in several commodious cells. As a traveller, by taking pro- per refreshments on the road, is better qualified to pursue his journey; so the chyle, diverted to those little inns, is mixed with a thin, diluting, watery substance, which renders it more apt to flow, and more fit for use. Hence it is conveyed to one common receptacle, and mounts through a perpendicular tube. When provision or am- munition is transmitted to an army, it generally passes the Human Machine. 55 under an escort of able troops. As this is the immediate support and principal nourishment of the whole system, its conveyance is guarded with peculiar caution. The perpendicular vessel that conveys it, not having sufficient force of its own, is laid contiguous to the great artery, whose strong pulsation drives on the creeping fluid, ena- bles it to overcome the steep ascent, and unload its pre- cious treasure at the very door of the heart. Here it en- ters the trunk of a large vein, secured by a valve, ad- mirably constructed to prevent the refluent blood in case it should offer to return, and opening a free, safe and easy avenue to introduce this milk, this manna of nature. The Blood, through every stage of its simple circuit, having sustained great expenses; being laid under con- tribution by every gland in the whole system; and having supplied myriads of the capillary vessels with matter for insensible perspiration, must be very much impoverished; but is most opportunely recruited by this accession of chyle. Besides the uses above specified, appropriated to the stomach and intestines, there is another very considera- ble bestowed, particularly on the former, by which im- pressions are diffused to almost every part of the machine, and from which all the sensible parts receive very pecu- liar and extraordinary advantages; namely, conveying action to different parts, and feeling the effect from these sympathetically and instantaneously. For instance, a glass of wine or brandy, received into the stomach of a person exhausted with fatigue and ready to faint, gives instantaneous spirits and fresh vigour. This must pro- ceed from the affection of the nerves of the stomach, and their sympathy with the rest of the body, as there is not time for the liquor to be conveyed into the blood in the usual manner. The Stomach universally sympathises with other parts of the body. A blow on the head occasions vomiting. A disordered stomach often excites a head-ache. The head- ache, which is apt to come after drinking too much wine, or other strong liquors, certainly proceeds from the sto- mach, and sometimes is diminished or entirely removed by a dram. A stomach disordered by indigestion is of- ten accompanied with flushings in the face, palpitations 56 Of the Structure of at the heart, difficult breathing, dejection of spirits, un- common sensibility, and with giddiness. The Omentum, or Caul, is a fine membrane like net- work, larded with fat. It is situated under the perito- neum, and immediately above the intestines, on the sur- face, resembling an apron tucked up. It serves to lubri- cate the intestines, that they may the easier perform their peristaltic motion, to cherish and defend them from cold, and to assist in the formation of the bile. It serves also to temper the acrimony of the humours, and probably, to give nourishment to the body, as all the other fat is sup- posed to do, when it is incapable of being nourished any other way. The Liver, situated immediately below the diaphragm or midriff, on the right side, reaches as far back almost as the spine or back-bone, and rests upon the right kidney. It is the largest gland in the body, and is divided into two unequal parts, called lobes. Except forthe vessels, which* arc very numerous, the liver would be very soft, and like a piece of congealed blood. The great use of the liver is to secrete the bile. It is the scat of various disorders, inflammation, abscess, scirr- hus, &c. and in most of them, the countenance hath a pale colour, or a yellowish one, with a green cast. There is one circumstance not much attended to with respect to the situation of the liver; its large or right lobe occupies the whole half of the belly, where it lies from the spine to the inside of the ribs, laying over the upper part of the kid- neys. Now, this position of the liver is not often consid- ered, for when one has a pain in the small of the back, it is said to be in the kidneys; but if it be a little higher up in the back, it is seldom, if ever, thought to be in the liver, though it most undoubtedly may, as its posterior edge lays on that part, on the right side. The Gall Bladder, or receptacle of bile, is fixed to the under side of the liver. Punctual as a porter in his lodge, it waits, ready to pour its acrimonious, but salutary juices on the aliment, as it advances from the stomach; wliich dissolve its remaining viscidities, support the peristaltic motion of the intestines, and greatly assist in completing the digestion. the Human Machine. &J Such is the importance of the bile in our constitution, and the ill consequence of an error in it, that every aid is desirable, by which our knowledge of its nature can be promoted. When there is a defect of bile, it disposes the body to various diseases; as melancholy, indigestion, and obstruction of the viscera, &c. When there is a redun- dancy of bile, or it offends the stomach by its acrimony, it causes chilliness, shivering, and great anxiety. It is certain, that in fevers the bile is not only plentifully gene- rated, but peccant in its quality; and if not duly evacuated, must be productive of many disagreeable symptoms; hence the importance of a soluble belly in febrile disorders. The Pancreas or Sweet Bread, a large gland, situated near the stomach, serves to secrete a liquor like the sali- va, which is discharged, by a short duct, into the duode- num. The Spleen is situated under the cartilages of the left short ribs. In its natural and sound state, it is about six or seven inches long, about three in breadth, and one in thickness. It often becomes scirrhous and considerably enlarged in persons who have been frequently attacked with intermittent fever. Its use is not precisely known. The Kidneys are two oval bodies, situated in the loins, contiguous to the two last short ribs; the right under the liver, and the left under the spleen. They separate the urine from the blood. The Ureters are tubes about the size of goose quills, and about a foot long; rising from the kidneys, and en- tering the bladder near its neck. They form to them- selves, as it were, valves, so that, upon the contraction of the bladder, the urine is ejected through the urethra, its proper passage. The Bladder is a membranous and fleshy sack or bag, capable of contraction and dilatation, situated in the low- er part of the belly. Around its neck, which is longer in men than in women, there goes a small sphincter mus- cle, to contract the orifice, that the urine may not be in- voluntarily discharged. The use of the bladder is to re- 8 58 Of the Structure of ceivethe urine, perpetually secreted into it from the kid- neys. The Uterus, or Womb, between the urinary bladder and the rectum, or straight gut, is placed, by Divine Wisdom, in a situation of great security, called the pelvis or basin, being guarded on all sides by the strong bones that form the basis of the trunk. In figure, it very much resembles a pear, its broadest extremity, whirh is called its bottom, is uppermost, and its small part, the neck, is downwards. The womb, when impregnated, hath a very small cavity, but becomes larger as pregnancy advances, and, in the time of delivery, has its mouth wonderfully dilated, so as to give passage to the child. About the age of puberty, the blood vessels of the uterus become distended, and secrete monthly a fluid called menses, catamenia, and vulgarly, flowers, courses. The Vagina, or Neck of the Womb, extends from the mouth of the uterus to the pudendum or external parts. In women it enlarges, and, like the uterus, in the time of birth dilates very much. Just within the vagina is the orifice of the urethra, which is shorter, wider and straight- er than in men. Besides the womb and vagina, there are two other con- trivances supposed to perform particular functions, in the propagation and formation of our species, the one called ovaria, from their retaining small round substances of the nature of eggs, the other fallopian tubes, from their discoverer, Fallopius. The Fallopian Tubes are situated on the right and left sides of the womb. They rise from its bottom by a nar- row beginning, and dilate in the form of a trumpet to their extremities at the ovaria. Their cavity, where they open into the womb, will scarcely admit of a hog's bristle-but at its widest part, it will take in the end'of one's little finger. The tubes are about four or five fingers' breadth long. They serve to convey from the ovaries the rudiments ot the tcetus to the womb, where they are further deve- loped and perfected. the Human Machine. 59 The Ovaria, or Ovaries, are two small bodies, situated on each side of the fundus uteri, or bottom of the womb, behind the fallopian tubes. At the age of puberty they are full and plump, and continue so until the menses are about to depart. They contain from ten to twenty or more pellucid eggs, supposed to contain the primordiaof the foetus. The Testes, or Testicles, are two oval glandular bodies seated in the scrotum, which serve to secrete the semen from the blood. The scrotum, or external covering, is made up of the scarf skin, true skin, and immediately un- der the latter, is a thick cellular texture closely adhering to it. It is likewise composed of many fleshy, or muscu- lar fibres, by means of which the scrotum is contracted, and is reckoned a sign of health. The Prostate Gland is situated at the neck of the blad- der; and is about the bigness of a walnut. By some it is snpposed to secrete a fluid merely to lubricate the urethra, and by others it is deemed subservient to the process of generation. The Urethra is a canal or pipe of the thickness of a goose quill, and about twelve or thirteen inches long, which begins at the neck of the bladder, and terminates at the end of the penis. Its inner membrane furnishes a mucilaginous liquor, serving to defend it against the acrimony of the urine. The Penis is composed of two spongious bodies, part of the urethra, the glands or nut at its extremity, and its integuments. The spongious bodies take their name from being porous like sponge, and capable of being distended and enlarged by the blood penetrating their substance, as in cases of erection. The integuments of the penis make a hood to the glands or nut of the yard, called prepuce or foreskin. The small ligament, by which it is tied to the underside of the nut, is called frsenum. The use of the prepuce, or foreskin, is to keep the nut soft and moist, and to preserve its sensibility. The amputation of it con- stitutes circumcision, a practice recommended by Moses to the Jews. 60 Of the Structure of We shall now conclude the anatomical part of the hu- man body, and trust enough has been said, concise as it is. to give to the uniformed readers just conceptions of the most important parts of the human machine, and its nat- ural action. We see the greatest multiplicity of parts, yet the most perfect, harmony subsists between them all. No one hin- ders, but each assists the operation of another, and all conspire to the benefit and preservation of the whole. Most judiciously has the great apostle touched this sub- ject; and most happily applied it to illustrate the reason- ableness, and enforce the practice, both of personal and social duties, of private content, and public concord. The body, he observes, is not one member, but many, to each of which some peculiar and needful office is assigned; so that the foot, though placed in the lowest order, and destined to serve on the very ground, has no reason to reckon itself a worthless outcast; or to say, Because I am not the head, I am not of the body. Neither has the head, in its exalted station, and amidst its honourable functions, any cause to despise the inferior limbs; or to say, with contempt and self-sufficiency, I have no need of you.—If there were no feet, what would become of the locomotive faculty? or how could the body convey itself from one place to another? If there were no hands, what should we do for the instruments of action? or how could the animal frame be defended and accommodated? Nay, the parts which seem to be less hoihiurable, are necessary. Even those which form the sediments, or throw oft* the dregs, are of importance to life and its comforts. Should those be obstructed in their action, the most raging tor- ment ensues; and should the obstruction continue, death is the inevitable consequence.—By this wise adjustment, there is no schism in the body, no separate or interfering ends pursued by the members, but the safety and support of each are the one undivided care of all. Wise, wonderfully wise and eminently gracious, is the regulation both of spontaneous and involuntary motion. Were this regulation reversed, what deplorable incon- veniencies would take place; nay, what unavoidable ruin must ensue! Deplorable inconveniencies; if the discharges of the bowels, or evacuations of the bladder, were quite independent of our leave. Unavoidable ruin; if the action the Human Machine. 61 of the heart required the co-operation of our thoughts, or the business of respiration waited for the concurrence of our will. The will, in some cases, has not so much as a single vote. In others, she determines and commands like an absolute sovereign; nor is there a monarch upon earth so punctually obeyed, as this queen of the human system. If she but intimate her pleasure, the spirits run, they fly to execute her orders; to stretch the arm, or close the hand; to furrow the brow with frowns, or dimple the cheek with smiles. How easily, as well as punctually9 are these orders carried into execution! To turn the screw, or work the lever, is laborious and wearisome: but we move the vertebrae, with all their apparent chambers; we advance the leg, with the whole incumbent body; we rise from our seat; we spring from the ground; and, though much force is exerted, though a very considerable weight is raised, we meet with no difficulty, we complain of no fatigue. That all this should be effected without any toil, and by a bare act of the will, is very surprising: but that these motions should be made, renewed, continued, even while we remain entirely ignorant of the manner in which they are performed, is beyond measure astonishing. Who can play even a single tune upon the piano, without learning the difference of the keys, or studying the rudiments of music? Impossible! Yet the mind of man touches every string of the human machine with the most masterly skill, though she knows nothing at all concerning the nature of her implements, or the process of her operations. Wc walk, we run, we leap, we throw ourselves into a variety of postures, and perform a multitude of motions, yet are utterly unable to say which nerve should be active; what muscles should swell, or what tendons approximate. Put a German flute into the hand even of a sensible person; without a master to instruct him, he is at a loss to make the instrument speak; much less is he able to sink and soften the sound, to exalt and extend it just as he pleases. Yet we are self-taught in the method of form- ing, regulating, and varying the voice. Naturally, and with unpremeditated fluency, we give it the languishing- cadence of sorrow, or the sprightly airs of joy; the low faltering accents of fear, or the elated tone, and rapid 62 Of the Structure of sallies of anger. We can never sufficiently admire this multiplicity of animated organs; their finished form, and their faultless order. Yet I mustconfess myself struck with greater admiration at the power, the truly mysterious pow- er and sway which the soul exercises over them. Ten thousand reins are put into her hand; she is not acquaint- ed with their office, their use, or their name; she has not learned so much as to distinguish one from another, nev- ertheless she manages all, conducts all, without the least perplexity, or the leastirregularity; rather with a prompt- itude, a consistency, and a speed, which nothing else can equal! Since health depends upon such a numerous as- semblage of moving organs: since a single secretion stop- ped, may destroy the salutary state of" the fluids, or a single wheel clogged may put an end to the vital motion of the solids; with what holy fear should we pass the time of our sojourning here below! trusting lor continual preservation, not merely to our own care, but to that omnipotent hand wliich formed the admirable machine: that the same hand which formed it, may superintend its agency and support its being. When we consider the extensive contrivance and deli- cate mechanism—what plans of geometry have been laid; what operations of chymistry are performed; in a word, what miracles of art and elegance are ex- ecuted, in order to furnish us with the necessary recruits and the several delights of life—is there not abundant rea- son to cry out with the inspired writer, "How dear are thy counsels unto me, 0 God!" thy counsels of creating wisdom! Thou hast not been sparing, but even lavish of thy indulgent designs! Thou hast omitted no expedient which might establish my ease, enlarge my comforts, and promote, yea complete, my bodily happiness!—and is not this a most endearing obligation to glorify the blessed God with our bodies, as well as with our spir ts? The mechanism of our body; the connexion and sub- serviency of all its parts to a common purpose; the ex- quisite contrivance of its organs, consisting of such vari- ous minute vessels, interwoven with wonderful art, have led anatomists, in all ages, to acknowledge an infinite, wise and powerful Maker. Among the most precious remains of antiquity, are those commentaries of Galen, written on the uses of the several parts ol the human bo- the Human Machine. 63 dy, as hymns and offerings of praise to the great Crea- tor. Is it, indeed, otherwise conceivable how such consis- tency and harmony could have taken place in the differ- ent parts of our wonderful frame? How they could have been so exactly fitted to each other, and to the exterior objects which have an evident relation to them, and the system they compose? Could the bones, which in all amount to four hundred, and the muscles still more nu- merous, and each so well disposed for motion, be adjust- ed without a superior knowledge in mechanics? The eye, so admirably adapted to light, and appropriated to vision, was it formed without a knowledge of optics? or the ear without the science of sounds? Even our incli- nations and passions, those sources of so much apparent ill, are by the Deity providentially rendered the means of our preservation, both as individuals and a race; and the selfish and social affections, like centripetal and centrifugal forces, conduct us with proper force, to the end intended by our Maker to be produced by them. Yet the love of life and all its enjoyments, the fear of death and all its dreadful harbingers, and the social affections and all their endearments, would not have been sufficient security for our carrying on the vital motions with that constancy and uniformi- ty necessary to the preservation of life, if thus en- gaged these motions had depended upon our will and choice. Reason would have deliberated concerning them with too much slowness, and volition would have execut- ed often with a dangerous and fatal caprice. For, if the heart had been subject to the soul's authority, as much as the voluntary muscles are; if its motions could have been suspended or stopped with the same facility, death would then have cost us no painful pang; and, whenever the body was tortured with disease, and the mind in an- guish from grief or disappointment, a remedy so easily applied might have been too frequently resorted to, and yet more unfortunate beings might have rushed uncalled into the presence of Him who stationed us for the wisest reasons here on earth. The preservation of life, there- fore, greatly depends on our vital motions being entirely subject to the wise government of the Author of our lives, who charges Himself with the immediate care of them 64 Of the Structure of and of us. All this, when attentively considered, must affect us with a sense of God's goodness; who, respecting the imbecility of man's nature,'hath been pleased, by ap- petites and passions, to excite him to acts of self-preser- vation; where the violence of these might have been hurtful, no less than the slowness and instability of rea- son, hath taken our safety under his more immediate di- rection. To attribute contrivances like these, and even understanding itself, to unintelligent causes, rather than to the all-wise Parent of Nature, seems an incompre- hensible perversion of reason and philosophy. That mind must be strongly prepossessed and bewildered with false science, which rather seeks for the cause of these involuntary motions in dead matter, organization, chance, necessity, something that, without knowledge or power, acts wisely and powerfully, than in the great fountain of power, wisdom and animation. If chance could be supposed to produce a regular de- terminate action, yet it is beyond the highest degree of credulity, to suppose it could continue this regularity for any time. But we find it remains through life, independ- ent of our will; and the same incessant vital actions have been carried on from the commencement of the world. It is thus that the sun's influence upon the earth hath ever been regular. The production of trees, plants and herbs ever uniform. Every seed produces now the same fruit itever did. Every species of animal life is still the same. Could chance continue this regular arrangement? Could any thing continue it, but the hand of an Omnipotent Creator? The human body is exalted to a most intimate and personal union with the eternal Son of Gon. He who decorated the heaven with stars, and crowned the stars with lustre; He vouchsafed to be made flesh, and was found in fashion as a man. Nay, this is even now the apparel of that divine and adorable person. He is clothed with our nature; he wears our very limbs; and appears in the dress of humanity, even at the right hand of God, and at the head of all the heavenly hosts. What think you of another privilege mentioned by the Apostle? "Vour bodies are the temple cfthe Holy Ghost." Not your souls only, but your very bodies are the shrine in which the high and holy one, that inhabiteth eternity, the Human Machine. 65 condescends to dwell. He, who sitteth between the die- rubim and walketh in t.ic circuit of the skies, is pleased to sanctify these earthly tenements for his own habitation. And is not this a much grander embellishment, than all their matchless contrivance and masterly workmanship? Nor must I omit the dignity—the transcendant dignity, which is reserved for these systems of flesh at the resur- rection of the just. They will then be refined and im- proved into the most perfect state, and the most beaute- ous form; surpassing whatever is resplendent and amia- ble in the most ornamental appearances of material na- ture. They will he purer than the unspotted firmament; brighter than the lustre of the stars; and, which exceeds all parallel, wliich comprehends all perfection, they will be made like unto Christ's glorious body; like that in- comparably glorious body which the blessed Jesus wears in his celestial kingdom, and on his triumphant throne. When we add all these magnificent prerogatives which are revealed in scripture, to all those inimitable niceties which are displayed by anatomists, what thankfulness, what admiration can equal such a profusion of favours? Say, why was man so eminently rais'd Amid the vast creation, why ordain'd Through life and death to dart his piercing eye, With thoughts beyond the limit of his frame? But that the Omnipotent might send him forth, In sight of mortal and immortal powers, As on a boundless theatre, to run The great career of justice; to exalt His generous aim to all diviner deeds; To chase each partial purpose from his breast, And through the tossing tide of chance and pain, To hold his course unfaltering, while the voice Of Truth and Virtue up the steep ascent Of nature, call him to his high reward, The applauding smile of Heaven. Akenside. 9 ON anroniBiiHiBs OR, THE ART (DV IPIBSBSlSIBTaSV® SUSAILVIIIo Reason's whole pleasure, all the joys of sense, Lie in three words —Health, Peace and Competence. But Health consists of temperance alone, And Peace, O Virtue, Peace is all thy own. Pope. In the preceding chapter I have treated of the struc- ture of the Human Body. I shall now show, that by due attention to the "Non-Naturals," air, food, exercise, sleep, evacuations, and passions, we may go far to pre- serve this fabric in good health from the cradle to the grave. Nay, so wonderful is the body in its resources, its powers of renovation; and so sovereign are the vir- tues of the Non-Naturals, that thousands are the in- stances of persons who, after having their health appa- rently ruined by an abuse of them, have on returning to a wise and temperate use, entirely recovered their health, and attained to a most active and happy old age. Hence the reason mankind are so often sick, is because they so often err in the use of these the appointed preser- vatives of life and health. To inculcate thi9 truth more universally, I have intro- 68 Of the Structure of duced these disquisitions on the art of preserving health, and, to render them more acceptable to my readers, have enlivened them with appropriate illustrations, hoping thereby to make impressions as lasting as they are im- portant, Thou cheerful guardian of the ruling year, Whether thou wanton'st on the Western gale, Or shak'sl the rigid-pinions of the Xorth, DifFusest life and vigour through the tracts Of air, thro' earth and ocean's deep domain. Without thy cheerful active energy No rapture, swells the breast; no poet sings; No more the Maids of Helicon delight. Come theti with trie, 0\ Goddess heavenly gay! Begin the song; and let it sweetly flow, And let it sweetly teach thy wholesome laws; "How best the fickle fabric to support Of mortal man; in healthy body how A healthful mind the longest to maintain." Armstrong;. As soon as an infant enters the world, the air rushes into its lungs, the circulation of the blood through that organ commences, and its life from that moment de- pends "ore the breath that is in its nostrils," which is in- cessantly taken in and thrown out of the lungs. While the child remained in the womb, it required no external air, because it existed in the blood wliich was received from its mother through the umbilical cord, or navel string. But as soon as the infant is born, the air is in- haled, and the circulation is determined through the lungs, which ever after continues in that way—and hence the necessity of breathing, which cau never cease but with life. Since then air is the main instrument of vitality, both to man and ail creatures, it certainly must be a most pleasing and profitable study to acquire correct ideas of this great element. By the unlettered part of mankind, the vast atmos- phere which surrounds our globe, to the depth of two and thirty miles, is supposed to be one simple, colourless, invisible mass, without any essential difference of quali- the Human Machine. 69 ties, and without weight. But it is a gross mistake; for instead of being a simple uniform.element, it is compos- ed of several parts, some of which are widely different from each other. We have, too, numberless proofs of its weight; like other bodies falling to the earth, and be- coming more dense as it approaches its centre. Every one knows that air on the tops of high mountains is much thinner than it is below in the valleys, but the weight of air is susceptible of demonstration by positive experi- ment. Having exhausted a thin glass flask, and suspended it at one end of a balance, which being nicely counterpois- ed by weights in the other.scale; this done, admit the air into the flask, into which it will rush with a noise, and though the flask was balanced before, it will now, upon admission of the air, preponderate. If the flask hold a quart, it will be found that the weight of the air it now contains is about seventeen grains, so that a quart of air weighs about seventeen grains. We will mention another experiment, easily put into practice. Some water being poured into a saucer, burn a bit of paper in a tea-cup, which by rarifying, will ex- haust and make a vacuum in the cup. Then while the paper is yet burning, turn it hastily down, paper and all, into the saucer, and the air without will press the water up from the saucer into the ciip. The water will stand within the cup in a column; and if the cup were thirty-two feet high, and the air within it perfectly exhausted, the water would rise to that height in it, as we havesaU before. This satisfactorily accounts for the rising of \fater in pumps, or the standing of the quicksilver in the barome- ter. If further proof be necessary to show the veight oi that great ocean of air, which constantly surrounds us let a man take a thick glass tube, such as is kit ove lamps, and place it upright on a table having a sma' hole in it for an air pump. Then let him placejiis han closely over the top of the tube, while a friendwith th pump extracts the air, and be shall find that jfe the a on the inside is removed, the air on the outside vill pre; his hand down with much violence. Nor will je be su prised at this pressure of the air, when he come) to leai that a column or pillar of air, of only one inch kiamete 70 Of the Structure of and thirty-two miles high, which is the depth of the at- mosphere from its top above the clouds to the ground, Weighs about fourteen pounds. If the hand of the person, which covers the top of the tube, measure ten inches square, the pressure on it will be about one hundred and i forty pounds—sufficient in all conscience to crush every ! bone in the hand. By the same token, a square foot of ; such a column of air would weigh near two thousand pounds, and as a common sized man measures about four- teen square feet, it is- a fact, as curious as it is awful, that i every such person bears constantly on his body a weight ! of fourteen tons, or twenty-eight thousand pounds of air. I Some persons may doubt this, from the conclusion that such a wreight would crush every man to pieces. So it would, if it were to press solely on any particular part. ', But this conclusion instantly falls to the ground, when it is recollected, that this pressure of the air is uniform and equal all around him, the air pressing as strongly from below as from above; from one side as from ano- ther; thus causing the various pressures most exactly and (admirably to counterpoise each other; of this we. see a iwondeiful instance in the case of fishes in the ocean.— One of these animals at a great depth under water, would be crushed to atoms, if all that heavy element pressed pnly on his back. But the God who made him has so kindly attended to his safety, as to cause the water that Surrounds him from below to press upwards as strongly is that from above to press downwards. There is ano- ther reason why our bodies are not so sensible of the tre- hendois weight of air, which thirty-two miles deep Iresses upon us; it is simply this, all bodies are full of ir; ant the air within pressing against that without, pre- ferves iven the most delicate bodies uninjured. A blad- er, or even a bag of oiled paper, if filled with water, re- tains perfectly unhurt, though a hundred.fathoms below je surhce of the sea; because the water within furnishes full reistance to the water without. But take away is resistance from within, and you shall find that the aghtesipressure will bring the two sides together. Accorling to the late discoveries in Chemistry, the anosplere consists of three different species of air— miely,iure, respirable. or dephlogisticated air; azotic, fjphlogsticated air; and fixed, or carbonic acid air. the Human Machine. 71 The proportion of the first, namely, pure or vital air, consists according to the French Chemists, who have given it the name of Oxygen, of 27 or 28 in the hundred parts; the second, the A%ote of the French, of 72 or 73 in the hundred; and the third, namely, the Carbonic acid air, of about one part only in the hundred. Oxygen is much better adapted to the respiration of animals than common atmospheric air. If two animals be enclosed in vessels, one of which contains pure Oxygen, and the other common atmospheric air, in proportions equal to the size of the animals, the former in the Oxygen will be found to live six or seven times as long as the latter in common air. It is properly this Oxygen which we in- spire, and which is the grand support of animal life. Per- sons apparently dead, or in a state of suffocation, have been instantly restored to life, by its influence; and from the corresponding testimony of several respectable physi- cians, it appears to have been employed with advantage in many obstinate diseases. The celebrated Ingenhouz, therefore, gave it the name of vital air. It promotes com- bustion in a very high degree. A candle will burn in it from six to seven times longerthan in common air, with a much greater degree of heat, and a more brilliant flame. Bodies in a glowing state are immediately inflamed, when put into Oxygen gas; and even metals, which are not ve- ry fusible, are melted in it with the greatest facility. Azote, by others called phlogisticated, mcphitic, cor- rupted, or suffocative air, is absolutely unrespirable, and not miscible with water. It arises from the change which atmospherical air undergoes in every process of combus- tion, putrefaction and respiration, whether produced by natuie or art. Azote enters into no combination with water, but may be rendered less hurtful by shaking it with that fluid.— This accounts in some measure for the salubrity of the sea-air. It greatly promotes the growth of plants, and readily accumulates in apartments filled with people, or containing articles fresh painted with oil colours, or in which strongly fragrant flowers are kept without having any accession of fresh air. We should be extremely cau- tious in entering such places, as diseases of the breast and 73 Of the Structure of tuners are too frequently the consequence of neglect, or ig- norance. The Carbonic acid air, or fixed air, is miscible with water, but in its pure state is equally unrespirable as the Azote. It derives its origin, partly from the vinous fer-v mentation of vegetables and some animal substances, and partly from the mild alkaline salts and earths combined with acid. Much of this air abounds in mines, where it frequently distresses the workmen by its suffocating effect. It is also observed in most mineral waters, where a stra- tum of it sometimes floats upon the surface of the well.— These waters, as well as fermented liquors which contain a considerable portion of fixed air, receive from it that well known pungency so agreeable to the palate. Hence flat and spoiled beer or wine, may be corrected and restor- ed to its former briskness, by the addition of fixed air evolved from chalk and vitriolic acid; or by mixing it with new beer, or wine in a state of fermentation. As this species of air quickly extinguishes fire, animals cannot live in it. These three aerial bodies, though blended together, ar- range themselves, in some degree, according to their specific gravities; that is, the proportion of azotic air, which is the lighter body of the three, will be found most in the upper part, the oxygen air in the middle, and the-fixed air will be found, most in the lower part of the apartment. This occasions a circulation in the air, the rarified air will ascend, tUe fixed air sink, and the colder and purer air rush into the apartment through every crevice. , To render the circulation of the air plain to sense, if the air of a room be heated by a tire, whilst the air in the next room is cold, and the door between open- ed, the hot air of one room being rarified, will pass through the upper part of the opening of the door into the cold room; and on the contrary, tiie cold air of the other room being heavier, will pass into the former through the lower part of the opening. This may l)e proved by applying a candle at the upper and lower openings be- tween the two rooms. The direction of the flame of the candle will point out the contrary currents of air. It is for this reason, that when a fire is lighted in a chimney, a strong current of air enters the room, which may be felt of Preserving Health. 73 by applying the hand near the key-hole, or other small openings, if the door and windows be shut. A fire is said to purify a room; but this it does partly by drying the dampness of the room, and chiefly by promoting the cir- culution of the air. The fire does not perform such ser- vice by purifying the bad air, but by removing it, and substituting that which is fresh and wholesome. Hence it appears that those persons are mistaken, who are over anxious to keep air from the apartments of convalescent persons, studiously sto ping, by list, linings and sand bags, all the smallest openings that admit freh air. Unless the air were constantly renewed, persons would be exposed to the most fatal accidents in large assemblies or crowded rooms. A rout was lately given at a celebrated bathing- place, or spring. The room was small and the com- pany very numerous. They had not been long seated at the card-tables, before a young gentleman and lady, both in delicate health, fell into a swoon. The doors and windows were immediately thrown open, to afford fresh air, which quickly dissipated the alarm, by reviving the young invalids. A physician present, telling one of his medical companions how severely he himself had suffered from the air of that vile oven, and that he had made up his mind to write a bitter phillippic against Routs, was archly answered by his friend: "Let them alone doctor, how otherwise should twenty-six physicians subsist i* this place?" A further illustration: Take a room thirty feet by twenty-five, and thirty feet high, capable of containing one hundred persons. Now, since each person consumes about five cubic feet of air in an hour, that is, deprives such a quantity of air of its oxygen, or vital principle, it would follow, that, as such a room could contain only twenty-two thousand live hundred cubic feet of air, un- less the air was constantly renewed, it would be render- ed completely mephitic or noxious in about four hours and a haf, and it is probable that the greater part of the company would be seriously incommoded, or even perish long before that time. The following affecting narrative is a melancholy con- firmation of this fact. In the summer of 1756, the Bri- tish settlement of Calcutta, in India, was attacked by 10 7-1 On Hygicine, or the art the natives under the viceroy Rajah Doulah, a young man of the most violent passions, and without the Irasf sense of honour or humanity. After a most obstinate resistance, the little garrison surrendered themselves pri- soners of war, on a solemn promise from the Rajah of the most honourable treatment. But no sooner had the mon- ster got them in his power, than, utterly regardless of that due to honour, humanity, and a brave enemy, he barbarously drove them all into a dark shallow vault under ground, called the black hole, only eighteen feet square. The number of the unfortunate men, thus cruel- ly immured, was one hundred and forty-six, with their gallant commander, Colonel Holwell, the historian of the following tragedy. The humane reader may form some idea of one hundred and forty-six poor fellows, many of them badly wounded and bleeding, and all worn out with the fatigue, and covered with the dust and sweat of a hard day's fighting, crammed together, on a hot sultry eve- ning, into a small dirty hole, eighteen feet square, with only two little windows, and those obstructed by strong iron bars. A profuse sweat quickly broke out on every individual, attended with an insatiable thirst, which became the more intolerable as the body was drained of its moisture. It was in vain they stripped off their clothes, or fanned themselves With their hats. A difficulty in breathing was next observed, and every one panted for breath. Colonel Holwell, who was placed at one of the windows, called to the sergeant of the guard, and after striving to excite his compassion by drawing a pathetic picture of their sufferings, promised him a thou- sand rupees in the morning, provided he could find means to remove some of his people into another place of con- finement. The sergeant, allured by the promise of so mighty a reward, assured him he would use his utmost endeavours, and retired for that purpose. What must have been the impatience at this time of these unfortunate objects? In a few moments the sergeant returned, with the wo- ful tidings, that the viceroy was asleep and no man durst disturb his repose! The despair of the prisoners now became outrageous. They endeavored to force open the door, that they might rush on the swords of the monsters, of Preserving Health. 75 by whom they were surrounded, and who derided their sufferings; but all their efforts proved ineffectual. They then used execrations and abuse to provoke the guard to fire upon them. The captain of the guard was at length moved to com- passion. He ordered his soldiers to bringsome skins con- taining water, which, by enraging the appetite, only served to increase the general agitation. There was no other way of conveying it through the windows, but by hats; and this mode proved ineffectual, from the eager- ness of the wretched prisoners, who struggled for it in fits of delirium. The cry of water! water: issued from every mouth. The consequence of this eagerness was, that very little fell to the lot even of those who stood nearest the window; and the most fortunate, instead of finding their thirst assuaged, grew more impatient. The confusion soon became general and horrid; all was clamour and contest; those who were at a distance, en- deavoured to force their passage to the window, and the weak were pressed down to the ground, never to rise again. Colonel Holwell, observing now his dearest friends in the agonies of death, or dead, and inhumanly trampled on by the living, finding himself wedged up so closely as to be deprived of all motion, begged, as the last mark of their regard, that they would for one moment remove the pressure; and allow hiin to retire from the window, and die in quiet. Even in such dreadful circumstances, which might be supposed to have levelled all distinction, the poor deliri- ous wretches, manifesting a respect to his rank and character, immediately gave way, and he forced his pas- sage into the centre of the place, which was less crowded, because, by this time, about one third of the number had perished, while the rest still pressed to both windows. He retired to a platform at the farther end of the room, and lying down upon some of his dead friends, recom- mended his soul to the mercy of its Creator. Here his thirst grew insupportable; his difficulty in breathing increased; and he was seized with a strong palpitation at the heart. These violent symptoms, which he could not bear, urged him to make another effort. He forced his way back 76 On Hygicine, or the art to the window, and cried aloud, "Water! for God's sake, a little water!" He had been supposed already dead by his wretched companions, but finding him still alive, they exhibited another extraordinary proof of regard to his person. "Give him water," they cried: nor would one off hem at- tempt to touch it, until he had drunk. He now breathed more freely, and the palpitation ceased; but finding him- self still more thirsty after drinking, he abstained from water, and moistened his mouth, from time to thne, by sucking the perspiration from his shirt sleeves, which tasted soft, pleasant, and refreshing. The miserable prisoners now began to perceive that it was air, and not water that they Wanted. They dropt fast on all sides, and a strong steam arose from the bodies of the living and the dead, as pungent and volatile as hartshorn. Colonel Holwell being weary of life, retired once more to the platform, and stretched himself by the Rev. Mr. Bellamy, who, together with his son, a young lieutenant^ lay dead, locked in each other's arms. In this situation he was soon deprived of sense, and seemed to all appearance dead, when he was removed by his surviving friends to one of the windows, where the fresh air brought him back to life. The Rajah being at last informed that the greater part of the prisoners were suffocated, enquired if the chief were alive, and being answered in the affirmative, sent an order for their release* when no more than twenty-three survived, of one hundred and forty-six, who entered into this prison. How many melancholy instances of a similar kind have occurred on board vessels engaged in that most abomina- ble and diabolical traffir, the slave trade. My soul is sick with every day's report Of wrong and outrage with which earth is filled: There is no yielding flesh in man's hard heart, It does not feel for man. The natYal bond Of brotherhood is sever'd, as the flax That fails asunder at the touch of fire. He finds his fellow gni'tu of a skin Not coloured like his own; and having power To enforce the wrong, for such a worthy cause. of Preserving Health. 77 Dooms and devotes him as a lawful prey. Thus man devotes his brother; And, worse than all, and most to be deplored, As human nature's broadest, foulest blot, Chains him, and tasks him, and exacts his sweat With stripes, that mercy with a bleeding heart Weeps when she sees inflicted on a beast. Then what is man? and what man seeing this, And having human feelings, does not blush And hang his head, to think himself a man? I would not have a slave to till my ground, To carry me, to fan me while I sleep, And tremble when I wake, for all the wealth That sinews bought and sold have ever earned. CoWPEK. To mention no other fact, a strong proof of the neces- sity of the frequent renewal of air may be found in the re- cords of the Dublin lying-in hospital. In this hospital two thousand nine hundred and forty- four infants out of seven thousand six hundred and fifty, died in the year 1782, within the first fortnight after their birth, which is nearly every third child! They al- most all died in convulsions, or what the nurses call ninth day fits, because they came on nine days after their birth. Many of these children foamed at their mouths, their- thumbs drawn into the palms of their hands, jaws locked, and faces swelled and blue, as though they were choaked. The last circumstance led Dr. Clark to conclude that the rooms were too close and crowded. That benevolent physician contrived therefore air-pipes, by which the rooms were completely ventilated. The consequence was, a prodigious decrease in the mortality. It is almost un- necessary to mention the frequent and sudden deaths that have taken place from entering deep wells, cellars,, and other confined places. Three poor men at Denton, Maryland, having nearly completed a deep well, quitted their work to go home to keep the holy-days. However, before they left the well, they covered the mouth of it closely. Carbonic acid gas settled at the bottom of it. After some time the unlucky well-diggers returned, and opening the well, very unsus- 78 On Hygieine, or the art piciously let themselves down to their work. Two out of the three perished at the bottom; the other notgoing down escaped. Lime-kilns, throwing off large quantities of fixed air, are extremely dangerous. Two disorderly young women, after rambling a greater part of the night, crept, early in the morning, into a lit- tle hovel, contiguous to a lime-kiln, and fell asleep. The kiln being in high blast, diffused a portion of vapour through the crevices into the hovel; but the poor wretches were too sound asleep to be awaked. After some hours, the man, who had the care of the kiln, coming to look al- ter his work, finding these women asleep, endeavoured to awake them, but in vain! They were taken immediately to the hospital. The one first conveyed recovered, but the other perished. There is another species of mephitic air, which burns with a bright flame, and, if mixed with common air, in- stantly catches fire and explodes; hence it has received the name of "inflammable air." Mines and coal-pits are frequently infested with this gas, which, being ten times lighter than common air, as- cends to the upper region of the mine; and is called Fire- damp. To discharge this, the miners arc in the habit of crawling on their hands and feet, and, with a taper affix- ed to a long stick, set fire to it, which is succeeded by a terrible, and sometimes fatal explosion. This air is of- ten generated in the stomach and bowels of animals both living and dead. A lighted candle held near, has often caused it to take fire. The inflammable woman of Coventry, as described by Mr. Wilmcr, appears to have reduced herself by dram drinking, to such a state, as to be capable of being set on fire, and burning away like a match: so eager, says the learned Dr. Beddoes, were the principles of which she was composed to combine with oxygen. The Russians and Germans are frequently exposed to fainting during their cold season, from the noxious air of of Preserving Health. 79 their stoves, and want of due ventilation. As soon as a person is discovered in this state, without sense and mo- tion, he is instantly carried into the open air, and being stript, is rubbed very briskly with snow, or cold water, wliich generally recovers him, if breathing have not been suspended above an hour. Faintings, qr suffocations from the fumes of charcoal, are commonly cured by cold water thrown on the patient. As the mass of atmospheric air is incessantly corrupted by the respiration of men and animals, by the burning of so many natural and artificial fires, by the dissolution and putrefaction of innumerable substances, and by various other phlogistic or dis-oxygenating processes, it would at length become altogether incompetent for its original de- signation, if the all benevolent Creator had not provided effectual means for its improvement and renovation.— Among the most powerful of these is the vegetation of plants. For this very important discovery, we are in- debted to Dr. Priestly, who was so fortunate as to make it after he had long employed many fruitless attempts to correct impure air by artificial means. He found that air rendered deleterious by the breathing of animals, which had died in it, was again so completely restored by the vegetation of plants, that after the lapse of some days, an animal could live in it with equal ease, and for the same length of time, as before. The ingenious philosopher. Dr. Ingenhouz, remarked, first, that most plants have the property of correcting bad air within a few hours, when exposed to the light of the sun; but that, on the contrary, during the night, or in the shade', they corrupt the air: second, that plants from their own substance afford a very pure air, or oxygen, when expos- ed to the rays of the sun; but a very impure air, or azote, at night, or in the shade: third, that not all parts ofplants' but only the green stalks of leaves, produce this beneficial effect: fourth, that the disengagement of pure or vital air does not commence until the sun has been some time above the horizon, that it ceases altogether with the termination of day-light; and that the disadvantage arising from the impure exhalations ofplants, during the night) is far ex- ceeded by the great advantage they afford during the day; insomuch, that the impure air generated by a plant during 80 On Hygicine, or the art the whole night, scarcely amounts to a hundredth part of the pure vital air, or oxygen, exhaled from the same plant in two hours of a serene day. Thus, the atmosphere is constantly preserved in that state of purity, wliich is the most salutary both to animals and vegetables. As the vegetable kingdom is renewed in spring, and as vegetation in general is most lively in that season, there can be httle doubt, that the pure vital air is then most co- piously evolved by means of the light and heat, of the sun. Hence it follows that the air Of spring is more wholesome than that of autumn, which is saturated with impure par- ticles. The cold, however, and the frequent winds wliich prevail at a more advanced period, prove extrcmelj effi- cacious in counteracting the baneful effects of corruption and putrefaction. AH strongly scented bodies are. more or less pernicious: not only those of a foetid, hut even those of a fragrant smell. The latter, if too strong, are particularly danger- ous, as a sense of disgust does not naturally incline us to avoid them. Hence people who carry large nosegays in the hot days of summer, or sleep in rooms decorated with flowers, are apt to feel themselves affected with head- achs, vertigoes, fainting fits; and even apoplexies have been produced in persons of a plethoric habit. Thesmell of roses, how pleasing soever to most persons, is not only odious, but almost deadly to others. Warm air relaxes the body, and occasions a quicker circulation of the fluids: hence the tender and infirm suf- fer severely in hot weather; hence arise hysteric and hy- pochondriac complaints, convulsions and diarrhoeas. Cold renders bodies more compact, the appetite stronger, and digestion easier and quicker. On the contrary, the resistance of the fluid parts becomes so great, that even the increased powers of the solids cannot overcome it, if the cold be too violent. In winter the blood is much dis- posed to inflammations: hence stitches in the side, inflam- matory sore throats, rheumatism, &c. In persons who take little exercise, the fluids are apt to stagnate, and the solids to chill during the winter. Upon the whole, how- ever, the effects of cold weather may be rendered less hurtful, and even salutary to the body, if proper exercise be not neglected. of Preserving Health. 81 Damp or Moist Air suddenly relaxes and debilitates, retarding the circulation, checking the perspiration, and depressing the spirits. If damp air be accompanied with cold, it tends, by obstructing the perspiration, to throw the retained humours on the breast, throat, stomach, bowels, &c. occasioning sore throats, pleurisies, sick stomach, diarrhoeas, &c. If damp air be accompanied with heat, it is still worse, by opening the pores, through which the moisture penetrates into the body, and predis- poses every part of it to putrefaction and dissolution. This accounts for the great mortality prevalent during the hot season at Batavia, and some of the West-India islands. Dry and Cool Air, from its elasticity, promotes, in an extraordinary manner, the serenity and alertness of mind and body; and is therefore most agreeable and salubrious both to the healthy and infirm. Too sudden a transition from warm to cold air, or the reverse, is pernicious. But none have ever complained on leaving, however suddenly, the sickly air of the town, for the dry, pure, temperate air of the country. After all, the surest sign of good air in any place, is the lon- gevity of its inhabitants. The most certain marks, by which to distinguish whe- ther the air in rooms be damp or not, are the following: the walls or tapestry change their colour; bread acquires a mouldy surface; sponges in the rooms retain their mois- ture; loaf-sugar turns soft; iron rusts; brass and copper acquire a green colour, and wooden furniture moulders and crumbles to pieces. In cities the sitting rooms ought if possible to be above the ground floor, or on the second story, well ventilated by convenient doors and windows. And as to the bed- rooms, they ought assuredly to be in the most elevated stories of the house, that they may be as far removed as possible from that mass of azote, or deadly air, which is so copiously generated in large towns, and which natural- ly settles near the ground. Dr. Caldwell, lecturing on this subject, states that it was on this principle he was induced, contrary to the re- monstrances of his family and friends, to keep his son in the third story of his house, during a very sickly season 83 On Hygieine, or the art in Philadelphia, and adds that he, could not avoid being sensibly snick with its happy effects in preserving his health. And I am convinced the excellent health my family enjoyed, during eight or nine year's residence in Savannah, was greatly owing to sleeping in large well aired chambers, three stories from the ground. The airing of apartments should not be neglected, even in winter, as fires alone are not sufficient to carry off the corrupted air. If possible, we should not sit through the day in a room in which we have slept; as the bed clothes, and particularly feather beds, very slowly part with the exhalations they have imbibed during the night. It far- ther deserves to be remarked, that all damp vapours are prejudicial; hence keeping wet clothes in dwelling rooms, should by all means be carefully avoided. mw wmwm* For this the watchful appetite was given, Daily with fresh materials to repair This unavoidable expense of life, This necessary waste of flesh and blood. Hence the concoctive powers, with various art.. Subdue the cruder aliments to chyle; The chyle to blood: the foamy purple tide To liquors, which through finer arteries To different parts their winding course pursue; To try new changes, and new forms put on, Or for the public, or some private use. Armstrong, Nature not only points out the/ood fit for infancy, but kindly prepares it. When the babe, just born into this cold world, is applied to its mother's bosom, it is first agreeably affected by warmth; next it is delighted with the odour of the milk; then gratified by the flavour of it; afterwards the appetites of hunger and of thirst afford pleasure by the possession of their objects, and by the sub- sequent digestion of the aliment; and lastly, the sense of of Preserving Health. 83 touch is delighted by the softness and smoothness of the milky fountain, which the innocent embraces with its hands, presses with its lips, and watches with its eyes___ Satisfied, it smiles at the enjoyment of such a variety of pleasures. It feels an animal attraction, which is love; a gratification when the object is present, a desire when it is absent, which constitutes the purest source of human fe- licity, the cordial drop in the otherwise vapid cup of life, overpaying the fond mother for all her solicitudes and cares. Lo! at the couch where infant beauty sleeps, Her silent watch the mournful mother keeps; She, white the lovely babe unconscious lies, Smiles on her slumb'ring child with pensive eyes, And weaves a song of melancholy joy. Campbell A mother who abandons the fruit of her Womb as soon as it is born, to the sole care of an hireling, hardly de- serves that tender appellation. Nothing can be so pre- posterous and unnatural, as a mother abandoning the care of her child. If we search Nature throughout, we can- not find a parallel Every other animal is the nurse of its own offspring, which thrives accordingly. Connubial fair! whom no fond transport warms, To lull your infant in maternal arms; Who, blest in vain with tumid bosom, hear His tender wailing with unfeeling ear; The soothing kiss, and milky rill deny To the sweet pouting lip, and glist'ning eye! Ah! what avails the cradle's damask roof, The eider bolster, and embroider'd woof! Oft hears the gilded coach, unpity'd plains; And many a tear the tasseled cushion sta ns! No voice so sweet attunes his cares to rest, So soft no pillow, as his mother's breast! Darwiw. It is in infancy and early age, that the foundation is laid for the many diseases arising from indigestion, found in almost every family. If children be fed immoderately, 84 On Hygicine, or the art the first passages become too much distended, and the stomach by degrees acquires an unnatural craving for food, which must he satisfied, whatever be the, conse- quence. These excessive supplies are not only unneces- sary, but produce the most serious and fatal disorders.— There is a certain relation subsisting between what is taken in, and what is lost by the body. If we eat and drink ;nuch, we likewise lose much, without gaining any more by it than we might do by moderate meals. Eat- ing too much retards the growth, and eventually dimin- ishes tin- digestive power of the stomach. Nature is easily satisfied, and is always best provided if we do not obtrude upon her more than she is accustomed to. If we have for some time taken little nourishment, nature becomes so habituated to it, that we feel indisposed as soon as the usual measure is transgressed; and both the stomach and its digestive powers are thereby impaired. It would lie impossible to lay down fixed rules, where- by to determine the salubrity or insalubrity of aliments, With respect to the individual. Experience is indeed our chief guide upon this subject; for such is the peculiarity of constitutions, that the same article which will nourish and perfectly agree with one person, would prove highly pernicious to another. Let us, therefore, in the selection of our food, adopt that which long and careful observation has confirmed to be saluta- ry, and avoid those things, however tempting to the pa- late, which we know to be injurious. There are, however, articles of diet obviously impro- per to every one, which though they may not manifest their ill effects immediately, yet, nevertheless, undermine and break down by gradual operation, the vigour of our systems, and entail upon us with certainty a train of chron- ic disorders, of all others the most troublesome and diffi- cult to cure. The articles of this description are all high seas >ned dishes, and those which are composed of a great variety of ingredients. People in health require no excite- ment to the relish of good and wholesome meat, and to those in the opposite state, the luxuries of the table are poison. The sad effects of Luxury are these; We drink our poison, and we eat disease. of Preserving Health. 85 Not so, O Temperance bland; when ruled by thee, The brute's obedient, and the man is free: Soft are his slumbers, balmy is his rest, His veins not boiling from the midnight feast. 'Tis to thy rules, bright Temperance! weowe All pleasures wliich from strength and health can flowj Vigour of body, purity of mind, Unclouded reason, sentiments refined; Unmix'd, untainted joys, without remorse, The intemperate sensualist's never failing curse; DoDD. There are three kinds of appetite: first, the natural ap- petite, which is equally stimulated and satisfied with the most simple dish as with the most palatable: second, the artificial appetite, or that excited by bitters, spirits, pic- kles, and other condiments, which remain only as long as the operation of these stimulants continues: third, the habitual appetite, or that by which we accustom ourselves to take victuals at certain hours, and frequently witiiout any appetite. Longing for a particular food is likewise a kind of false appetite. By the true and healthy appetite alone, can we ascer- tain the quantity of aliment proper for the individual.— If in that state we no longer relish a common dish, it is a certain evidence of its disagreeing with our digestive or- gans, if after dinner we feel ourselves as cheerful as be- fore it, we may be assured that we have taken a proper meal; for if the proper measure be exceeded, torpor will ensue, with indigestion, and a variety of unpleasant com- plaints. When the tir'd glutton labours through a treat, He finds no relish in the sweetest meat. Then hear what blessings Temperance can bring, Those blessings, only, form my cause to sing; First Health—the stomach cramm'd from every dish, A tomb of roast and boil'd, of flesh and fish, Where bile and wind, and phlegm and acid jar, And all the man is one intestine war, Remember's well the school-boy's simple fare, The temperate sleeps, and spirits light as air. Pope. 86 On Hygicine. or the art A decent, well-furnished and hospitable table, is very commendable in those who can afford it. It speaks the greatness of their minds, the goodness of their natures, and gains the blessing of the poor and needy, where they are charitably allowed to come in for a share; but, when feasting runs into excessive luxury and vain expense, it reproaches the author of it with prodigality and folly; for no money can he so truly said to be thrown away, as that which is superfluously spent upon the belly. It was a maxim of Socrates, "that we ought to eat and drink to live, and not to live in order to eat and drink." Temperance is the preservation of the dominion of soul over sense, of reason over passion. The want of it des- troys health, fortune and conscience. Chremes, of Greece, though a young man, was very in- firm and sickly, through a course of luxury and intem- perance; and subject to those strange sorts of fits which are called trances. In one of these, he thought that a philosopher came to sup with him; who out of all the dishes served up at the table, would only eat of one, and that the most simple; yet his conversation was sprightly, his knowledge great, his countenance cheerful, and his constitution strong. When the philosopher took his leave, he invited Chremes to sup with him at a house in the neighbourhood; which also took place in his imagination; and he thought he wTas received with the most polite and affectionate tokens of friendship; but was greatly surprised when supper came up, to find nothing but milk and honey, and a few roots dressed up in the plainest manner, to which cheerfulness and good sense were the only sauces. As Chremes was unused to this kind of diet, and could not eat, the philosopher ordered another table to be spread more to his taste; and immediately there succeeded a ban- quet composed of the most artificial dishes that luxury could invent, with great plenty and variety of the richest and most intoxicating wines. These, too, were accompanied by damsels of the most bewitching beauty. And now Chremes gave a loose to his appetites; and every thing he tasted raised extacies beyond what he had ever known. During the repast, the damsels sung and danced to enter- tain him. Their charms enchanted the enraptured guest, of Preserving Health. 87 already heated with what he had drunk. His senses were lost in extatic confusion. Every thing around him seemed Elysium, and he was upon the point of indulging the most boundless freedom: when lo! on a sudden, their beauty, which was but a visor, fell off, and discovered to his view forms the most hideous and forbidding imagina- ble. Lust, revenge, folly, murder, meagre poverty, and frantic despair now appeared in their most odious shapes, and the place instantly became the direct scene of mise- ry and desolation. How often did Chremes wish him- self far distant from such diabolical company!, and how dread the fatal consequences which threatened him on every side! His blood ran chill to his heart; his knees smote against each other with fear; and joy and rapture were turned into astonishment and horror. When the philosopher perceived that this scene had made a suffi- cient impression on his guest, he thus addressed him: "Know, Chremes, it is I, it is ./Esrulapius, who has thus entertained you; and what you have here beheld is the true image of the deceitfulness and misery inseparable from luxury and intemperance. Would yon be happy, be tem- perate. Temperance is the parent of health, virtue, wis- dom, plenty, and of every thing that can render you hap- py in this world, or the world to come. It is, indeed, the true luxury of life; for, without it, life cannot be en- joyed." This said, he disappeared; and Chremes awak- ing, and instructed by the vision, altered his course of life, became frugal, temperate, industrious; and by that means so mended his health and estate, that he lived without pain, to a very old age, and was esteemed one of the richest, best, and wisest men in Greece. Such is the beautiful moral drawn by the pen of ele- gant and instructive fiction; with which, if there be any mind so insensible as not to be properly affected, let us only turn to that striking reality presented to us in the case of Lewis Cornaro. This gentleman was a Venitian of noble extraction, and memorable for having lived to an extreme old age; for he was above a hundred years old at the time of his death, which happened at Padua, in the year 1565. Amongst other little performances, he left behind him a piece entitled, "Of the advantages of a tem- perate life," of which we will here give our readers some 88 On Hygicine, or the art account; not only because it will very well illustrate the life and character of the author, but may possibly he of use to those who take the summim bonum, or chief good of life, to consist in good eating: He was moved, it seems, to compose this little piece at the request, and for the benefit of some, ingenuous young men, for whom he had a regard; and who, having long since lost their pa- rents, and seeing him, then eighty-one years old, in a fine florid state of health, were desirous to know of him what had enabled him to preserve, as he did, a sound mind in a sound body, to so extreme an age. He describes to them, therefore, his whole manner of living, and the reg- imen he had always pursued, and was then pursuing. He tells them that, when he was young, he was very intempe- rate; that his intemperance had brought upon him many and grievous disorders; that, from the thirty-fifth to the fortieth year of his age, he spent his nights and days in the utmost anxiety and pain; and that in short, his life was grown a burthen to him. The physicians, however, as he relates, notwithstanding all the vain and fruitless efforts which they had made to restore his health, told him that there was one method still remaining, which hid never been tried, but which, if they could but prevail with him to use with perseverence, might free him, in time, from all his complaints; and that wras a temperate and regular way of living. They added, moreover, that unless he resolved to apply instantly to it, his case would soon become desperate, and there would be no hopes at all of his recovery. Upon this, he immediately prepared himself for his new regimen; and now began to eat and drink nothing but what was proper for one in his weak habit of body: but this was at first very disagreeable to him. He often wanted to live again in his old manner; and did, indeed, indulge himself in a freedom of diet sometimes, without the knowledge of his physician; but, as he informs us, much to his own detri- ment and uneasiness. Driven, in the mean time, by the necessity of the thing, and resolutely exerting all the pow- ers of his understanding, he at last grew confirmed in a settled and uninterrupted course of temperance; by virtue of which, as he assures us, all his disorders had left him in less than a year: and he had been a firm and healthy man, from thenceforward, till the time in which he wrote his .treatise. of Preserving Health. 89 Some sensualists, as it appears, had objected to his abstemious manner of living; and, in order to evince the reasonableness of their own, had urged that it was not worth while to mortify one's appetites at such a rate for the sake of being old, since all that was life, after the age of sixty-five, could not properly be called a living lite, but a dead life. "Now," says he, "to show these gentle- men how much they are mistaken, I will briefly run over the satisfactions and pleasures which I myself enjoy in this eighty-third year of my age. In the first place, I am always well, and so active, withal, that I can, with ease, mount a horse upon a flat, or walk upon the tops of very high mountains. In the next place, I am always cheerful, pleasant, perfectly contented, and free from all perturbation, and every uneasy thought. I have none of that fastidium vitoe, taat satiety of life, so often to be met with in persons of my age. I take a view of palaces, gardens, antiquities, public buildings, temples, fortifica- tions, and endeavour to let nothing escape me which may afford the least amusement to a rational mind. Nor are these pleasures at all blunted by the usual imperfections of great age; for I enjoy all my senses in perfect vigour; my taste especially, in so high a degree, that I have a better relish for the plainest food now, than I had forthe choicest delicacies formerly, when immersed in a life of luxury." As a principal rule of diet, we ought to take food with an easy and serene mind, and to eat slowly. The stomach suffering in this case a very gradual distension, as the food has sufficient time to be duly prepared by mastication. To eat of one dish only seems most conformable to na- ture, and is, doubtless, the means of procuring the most healthy fluids. The diet ought not only to be such as is best adapted to the constitution, but likewise to be taken at regular periods; for long fasting is hurtful at any stage of life. All great and sudden changes of diet are universally dan- gerous, particularly from a rich and full diet to a low and sparing one. When, therefore, a change becomes necessary, it ought always to be made by degrees. When a person has suffered so much from extreme hunger, much food must not be given him at once. By 12 90 On Hygieine, or the art full feeding, thousands long starved at sea have been de- stroyed at once. Such persons should be supplied with liquid food, and that sparingly. As soon as the food has entered the stomach, the im- portant office of digestion begins. The vigour of the or- gans exerted on this occasion, ought certainly not to be abridged by violent exercise; but muscular and robust people feel no inconvenience from gentle motion about one hour after the heaviest meal. But as the whole pro- cess of digestion is <>f much longer duration than is gen- erally imagined, the afternoon hours cannot be employed so advantageously to health in any labour requiring strong exertions. In violent exercise, or an increased state of perspira- tion, the fluids are propelled to the external parts, and withdrawn from the stomach, where they are indispensa- ble to assist the proper concoction. Exclusive of the quantity and quality of food, great at- tention is due to the kind of it in particular constitutions. Animal food in general is more nourishing than vegeta- ble, and, when fresh, is likewise more easy of digestion. On this account, it generally agrees best with delicate and weak constitutions. But the flesh of young animals, with a proportionate quantity of well boiled and wholesome vegetables, is the best diet adapted to our system. In summer it is advisa- ble to increase the proportion of vegetable food, and to make use of ripe fruits. With regard to our food, how- ever, in quantity and quality, it should be properly pro- portioned to our exercise. The labourer, who is perpetu- ally toiling from morning till night, could not subsist on food appropriated to those who pursue not the severer exercises of the body. His diet must be of the coarser kind; such as salted meats or fish, cheese, corn bread, potatoes, onions and peas, and these in pretty large quan- tities. On the whole, it will be found to be the safest, both in health and sickness, to regulate our diet with simplicity; ever bearing in mind that a preference is to be given to such articles as oui personal knowledge has demonstra- ted to be the most congenial to our constitutions and hab- its. of Preserving Health. 91 In our aliment, an essential part is drink, the use of which is indispensable to the digestion of food. Water, the basis of our drinks, should be carefully ob- tained in its highest purity. The best water is that which is pure, light, and without any particular colour, taste or smell. Where water cannot be obtained pure from springs, wells, rivers or lakes, care should be taken to deprive it of its pernicious qualities, by boiling and fil- tering, but most effectually by distillation. Any putrid substances in the water may be corrected by the addition of an acid. Thus half an ounce of alum, in powder, will make twelve gallons of corrupted water pure and trans- parent in two hours, without imparting a sensible degree of astringency. Charcoal powder has also been found of great efficacy in checking the putrid tendency of wa- ter. To the same purpose, vinegar and other strong acids, are well adapted. Whatever kind of drink is used, it ought to be taken always in a moderate quantity. Too much drink, even of water, innocent as it is, tends to oppress and weaken the stomach, of course to generate acidities and flatulence. Some advise us never to drink without eating some- thing, but he who drinks only when nature requires it, has no occasion to eat every time he drinks. Persons, on the contrary, once accustomed to drink more than is necessary, or to make use of hot, stimulating, and intoxi- cating liquors, would do well always to eat some bread, or other solid food, along with them. An undue proportion of drink renders the mass of blood too thin and watery, and occasions a general de- bility of the body. On the other hand, too little drink renders the blood thick and viscid, and weakens the di- gestive powers. Light and well fermented beer, is a wholesome, and, at the same time, diluent species of nour- ishment. Cider, when properly fermented and pure, is also a pleasant and wholesome liquor. On the contrary, when it is new or tart, we cannot recommend it as a salubrious beverage. Wine, when pure, and used in moderation, certainly 92 On Hygieine. or the art conduces to health, especially in weak and languid hab- its. See Vine. Mat. Med. Ardent Spires, when properly diluted, are likewise an excellent beverage and antiseptic. These liquors are of considerable service in preventing the bad effects of a moist and cold atmosphere, pestilential vapours, damp military camps, unclean occupations, and, occasionally too, of a temporary abstinence from food. But as the infusion of too great a quantity of oil imme- diately extinguishes the lamp, the light of reason, and the lamp of life itself, are frequently suffocated, and put out forever, by an imprudent use of either wine or spirits. Tea is considered by some as being highly injurious, while others have either asserted its innocence, or even ascribed to it extraordinary virtues. When taken in a large quantity, or very strong, and at a late hour, it often produces watchfulness; but if used in moderation, it greatly relieves an oppressed stomach, and pains of the head. It ought, however, to be made of a moderate strength, otherwise it certainly affects the nerves. Hypo- chondriac and hysteric people are much deceived in their opinions of the efficacy of tea; for all the evils arising from weak stomachs and flatulency, of which they com- plain, are certainly increased by tea, especially if taken in large and strong quantities. The cold stomach which they propose to warm by it, is a mere phantom of the brain; for this sensation of cold, is nothing but relaxa- tion, which, instead of being removed by hot liquors, is assuredly increased by them. Coffee promotes digestion, and exhilarates the animal spirits; but an excessive use of it, like tea, affects the nerves, occasions watchfulness, and trembling of the hands. As possessing excellent antispasmodic virtues, it is a favourite beverage with the hypochondriac and hysteric. Chocolate is nutritious and wholesome, if taken in small quantity; but to the corpulent and weak, particularly those with whom a vegetable diet disagrees, it is gener- ally hurtfuli of Preserving Health. 93 mw w^mmmmM* -----------------By health the peasant's toil Is well repaid; if exercise were pain Indeed, and temperance pain. By arts like these Laconia nursed of old her hardy sons; And Rome's unconquered legions urged their wav Unhurt, through every toil in every clime. Toil and be strong. By toil the flaccid nerves Grow firm, and gain a more compacted tone; The greener juices are by toil subdu'd. Mellowed, and subtilis'd; the vapid old Expell'd, and all the rancour of the blood. Begin with gentle toils, and, as your nerves Grow firm, to hardier by just steps aspire. The prudent, even in every moderate walk, At.first but saunter; and, by slow degrees, Increase theirpace. This doctrine of the wise, Well knows the master of the flying steed. Akmstrosg. It was a common saying among the ancients, that acute diseases are from heaven and chronic from ourselves. To die, says Dr. Johnson, is the fate of man; but to die with lingering anguish, is generally his own folly. Inactivity never fails to induce an universal relaxation of the contractile fibres. When these fibres are relaxed neither the digestion, the circulation, nor the peristaltic motion can be duly performed. It is absolutely impossible to enjoy health where the perspiration also is not duly carried on; and that can never be the case, where exercise is neglected. Indolence often originates from a mistaken education, in which pleasure or flattery is made the immediate mo- tive of action, and not future advantage, or what is term- ed duty. This observation is of great value to those who attend to the education of their own children. I have seen, says Dr. Darwin, one or two young married ladies ol fortune, who perpetually became uneasy, and believed themselves ill, a week after their arrival in the country, and continued so uniformly during their stay; yet, on their return to London or Bath, immediately lost all their complaints. I was led to ascribe this to their being sur- 9* On Hygicine, or the art rounded in infancy with menial attendants, who had flat- tered them into the exertions they then used; and that, in riper years, they became torpid for want of this stimulus, and could not amuse themselves by any voluntary em- ployment; requiring ever after either to be amused by other people, or to be flattered into activity. Dr. Johnson says, "Whenever chance brings within my observation a knot of young ladies, busy at their nee- dles, I consider myself as in the school of virtue; and though I have no extraordinary skill in plain work or embroidery, I look upon their operations with as much satisfaction as their governess, because I regard them as providing a security against the most dangerous ensnarers of the soul, by enabling themselves to exclude idleness from their solitary moments, and with idleness, its at- tendant train of passions, fancies, chimeras, fears, sor- rows and desires." If sedentary employments be intermixed with a due quantity of exercise, they will never injure health. Weak fibres are the constant companions of inactivity. Nothing but daily exercise in the open air can brace and strengthen the powers of the stomach, and prevent an endless train of diseases, which proceed from a relaxed state of that organ. We seldom hear the active and la- borious complain of nervous diseases; which are reserved for the sons of idleness. -----------------How happy he whose toil Has o'er his languid powerless limbs diffused A pleasing lassitude. He not in vain Invokes the gentle deity of dreams. By toil subdued, the warrior and the bind Sleep fast and deep.—Their active functions soon With generous streams their subtle tubes supply Ere morn, the tonic irritable nerves Feel the fresh impulse, and awake the soul. Armstrong. Idleness is a servile, weak and degenerate habit; that of the mind being worse than that of the body. of Preserving Health. %5 A gentleman states, that, as be was sitting with some I'rcuds before the door of the Caiitol, a beggar presented himstif, who, with si lis, tears and lamentable gestures, expressed his miserable poverty, saying withal, that "he hud about him a private disorder, wbich shame prevented him from discovering to the eyes of men. They, pitying the case of the, poor man, gave each of them something, and he departed. One amongst them sent his servant af- ter him, to enquire what his private infirmity might be, which he was so loth to discover? The servant overtook him; and desired that satisfaction; and having diligently viewed his face, breast, arms, &c. and finding all his limbs in good plight, "I see nothing," said he, "whereof you have any such reason to complain." "Alas!" said the beggar, "the disease that afflicts me is far different from what you conceive of, and is such as you cannot see. It is an evil that has crept over my whole body; passing through the very \eins and marrow of me, in such a man- ner, that no one member of my body is able to take pro- per exercise, or do any work. This disease by some is called idleness." The servant having left him, returned with this account; which not a little amused his master and friends. As idleness is the rust and bane of all human virtues, so, on the contrary, industry and diligence in business are conquerors of all difficulties; sweetening labour and pains, and giving satisfaction as well as profit, in the accomplishment of what is undertaken. When men work at their play, and play with their work, they invert the order of nature, as well as the divine command, and must expect in the sequel to come home by Weeping Cross, be- cause they have laboured in vain, and played the fool with themselves in neglecting to secure to themselves a comfortable subsistence. Among the Athenians and an- cient Romans, there was a law exacting an account from every man how he maintained himself and family; and if unable to give a satisfactory answer, he was imme- diately banished with reproach, as a vermin that de- voured what he had no right to, in being an unprofitable excrescence, contributing nothing towards the tranquillity Of the public. 96 On Hygieine, or the art A gentleman possessed of an estate of about two hun- dred pounds per annum, in land, kept the whole a great while in his own hands; but finding, notwithstanding all his care and industry, that he still run behind hand, and at length obliged to sell half his estate to pay his debts, let the rest to a farmer by lease for twenty-one years, at an annual rent. His tenant thriving, and* coming before the expiration of the lease, to pay bis rent, he asked his landlord, "if he would sell the land he rented of him?" "Why," said he, "wouldst thou buy it?" "Yes," says the farmer, -'if you will part with it." "That is very strange," said the landlord. "Prithee tell me how it is, that I could not live upon twice so much, being my own, and you upon half of it, though you pay rent for it, are able in less than twenty years to buy it?" "0 Sir," said the farmer, "a few words make the difference. When any thing was to be done, you said, 'Go and do it,' and lay in bed, or took your pleasure; but I always said, 'Come, let us go and do it,' and bath assisted and saw my business done myself." To show the absolute necessity of exercise in cold cli- mates, we cannot omit relating the botanical excursion of Sir Joseph Banks, Dr. Solander. and others, on the heights of Terra-del-Fuego. Dr. Solander, who had more than once crossed the mountains dividing Sweden from Norway, well knowing that extreme cold produced a tor- por and sleepiness almost irresistible, conjured the compa- ny to keep always in motion, whatever pain it might cost them, and whatever relief they might be promised by rest: "Whoever sits down," said he, "will sleep, and whoever sleeps will w ke no more." Thus at once admonished and alarmed, they set forward, but while they were still upon the naked rock, and before they got among the bushes, the cold was so intense, as to produce the effects that had been most dreaded. Dr. Solander, himself, was the first who found the inclination, against which he had warned others, irresistible; and insisted upon being suf- fered to lie down. Sir Joseph Banks entreated and re- monstrated with him in vain; down he lay upon the ground, though it was covered with snow; and it was with great difficulty that his friends kept him from sleeping. * One of his black servants also began to linger. Partly by of Preserving Health. 97 persuasion, and partly by force, the company made them go forward. Soon, however, they both declared, "they wouM go no farther." Sir Joseph Banks had recourse again to expostulation, but this produced no effect. When the black was told that if he did not go on, he would in a short time be frozen to death, he answered that he de- sired nothing so much as to lie down and die. The Doc- tor did not so explicitly renounce his life; saying, he could go on. but that he must first take "some sleep," though he had before told the company, that "to sleep, was to per- ish." Both in a few minutes fell into a profound sleep. After considerable exertions they happily succeeded in waking the doctor, who had almost lost the use of his limbs, and the muscles were so shrunk, that his shoes fell from his feet; but every attempt to relieve the unfortunate black proved unsuccessful. Since we have touched upon the subject of cold, we can- not forbear inserting the observations of the immortal Darwin. Animal bodies resist the power of cold probably by their exertions: but if these increased exertions be too violent, so as to exhaust the power of the brain, the animal will probably sooner perish. Thus, a moderate quantity of wine or spirit, repeated at proper intervals of time, might be of service to those who are long exposed to excessive cold, both by increasing the action of the capillary ves- sels, and thus producing heat, and perhaps by increasing in some degree the secretion of aensorial power in the brain. But the contrary must happen when taken im- mediately, and not at due intervals. A well attested story was once related to me of two men, who set out on foot to travel in the snow, one of whom drank two or three glasses of brandy before they began their journey, the other contented himself with his usual diet and potation: the one perished, in spite of every assistance his compan- ion could afford him, and the other performed his jour- ney with safety. In this case the power of the brain was exhausted by the unnecessary motions of incipient intoxi- cation by the stimulus of the brandy, as well as by the exertions of walking, which so weakened the dram-drink- er, that the cold sooner destroyed him; not having power 13 88 On Hygieine, or thv. art to produce sufficient muscular or arterial action, and in consequence sufficient heat to supply the great expendi- ture of it. Hence the capillaries or smaller vessels of the skin, first ceased to act, and became pale and empty; next those which are immediately associated with them, as the extremities of the pulmonary artery, as happens on going into the cold bath. By the continued inaction of these parts of the vascular svstem, the blood bee. mes accumulated in the internal arteries, and the brain is sup- posed to be affected by its compression; because these pa- tients are said to sleep, or to become apoplectic, before they die. Travellers, benighted in deep snow, might frequently save themselves by lying down on the dry ground, and suffering themselves to be entirely covered with the snow, except a small hole for air. The ground being usually at the 40th degree of cold, that is, eight degrees above freezing, and the snow in contact with their clothes, thawing and contracting into the snow next to it, would form above them a close dry cover-lid, that would perfect- ly exclude the external cold, and place them in a situa- tion almost as warm as a bed! My reverend and worthy friend, Dr. Andrew Hunter, of Washington, overcome with the fatigues of a long day's march, during the revolutionary war, threw him- self down with the rest of the army, on the cold frozen ground. His only cover was a blanket, and a saddle his pillow. Instantly his wearied senses were locked up in sleep so sound, that he never felt the cold snow, wliich presently began to fall in heavy Hakes upon him. Next morning when he awoke, he was astonished at his situa- tion—a heavy fall of snow a foot deep had completely covered him, through which the heat of his breath, melt- ing the snow as it fell, had formed a nice opening. Hav- ing raised his head, and seeing his comrades still asleep, he laid himself down to enjoy a little longer his singular bed, which he declared was very pleasant. If these facts were more generally known, they might save the lives of many valuable citizens. of Preserving Health. 99 mw m^mmM1* The shades descend, and midnight o'er the world Expands her sable wings. OJreat Nature droops Through all her works. Now happy he whose tofl Has o'er his languid powerless limbs diffused A p easing lassitude, he not in vain Invokes the gentle Deity of dreams. His powers the mo.s' voluptuously dissolve In soft repose: on him the balmy dews Of sleep with double nutriment descend. ARMSTRONG. "Tired nature's sweet restorer, balmy sleep," cannot be dispensed with. It introduces a most welcome vaca- tion, both for the soul and the body. The exercises of the brain and the labours of the hands, are at once discontin- ued; so that the weary limbs repair their exhausted vi- gour, while the pensive thoughts drop their load of sor- rows, and the busy ones rest from the fatigue of applica- tion. Most reviving cordial! equally beneficial to our animal and intellectual powers. Since sleep is so absolutely necessary, so inestimably valuable, observe what a fine apparatus Almighty Good- ness has made to accommodate us with the balmy blessing. With how kind a precaution he removes whatever might obstruct its access, or impede its influence! He draws around us the curtain of darkness, which inclines to drow- siness, and conceals every object that might too strongly agitate the senses. He conveys peace into our apartments, and imposes silence on the whole creation. Hviay we not discern in this gracious disposition of things, the tender cares of an affectionate Mother, who hushes every noise, and excludes every disturbance, where she has laid the child of her love to rest? So, by such soothing circum- stances, and gentle working opiates, He giveth to his be- loved, sleep. No sooner does the morning dawn, and day-light enter the room, than this strange enchantment vanishes. The man awakes, and finds himself possessed of all the valua- ble endowments which for several hours were suspended 100 On Hygicine, or the art or lost. His sinews are braced, and fit for action. His senses are alert and keen. The romantic visionary heightens into the master of reason, and the frozen or be- numed affections melt into tenderness, and glow with be- nevolence. ---------------------O sacred rest! Sweet pleasing sleep! of all the powers the best: O peace of mind! repairer of decay! Whose balms renew the limbs to labours of the day, Care shuns thy soft approach, and sullen flies away. DllYDEN. If sleep do not pay the accustomed visit, the whole frame of man will in a short time be thrown into disor- der; his appetite cease, his spirits dejected, and his mind, abridged of its slumbering visions, begin to adopt waking dreams. It is in vain that all light is excluded, all sound removed, and books of entertainment read, the restless and busy mind still retains its former activity, and Reason, that wishes to lay down the reins, in spite of herself, is obliged to maintain them. This is strongly instanced by Shakspeare, in the soliloquy of King Henry. How many thousands of my poorest subjects Are at this hour asleep! 0! gentle sleep, Nature's soft nurse, how have I frighted thee, That thou no more wilt weigh my eye-lids down, And steep my senses in forgetfulness? Why, rather, sleep, ly'st thou on smoky cribs, Upon uneasy pallets stretching thee, And hush'd with buzzing night-flies to thy slumbers; Than in the perfum'd chambers of the great, And lull'd with sounds of sweetest melody? O thou dull god, why ly'st thou with the vile ' In loathsome beds, and leav'st the kingly couch, A watch-case or a common larum bell? Wilt thou upon the high and giddy mast Seal up the ship-boy's eyes, and rock his brains In cradle of the ■ ild imperious surge; And in the visitation of the winds, Who take the ruffian billows by the top, Curling their monstrous heads, and hanging them of Preserving Health. 101 With deaf'ning clamours in the slipp'ry shrouds, Tiiat, with the hurley, death itself awakes? Canst thou, O partial sleep! give thy repose To the wet sea-boy in an hour so rude; And, in the calmest, and most stillest night, With all appliances and means to boot, Deny it to a King? Then, happy low, lie down! Uneasy lies the head that wears a crown. Excess of sleep is not less prejudicial to health than the want of it. The whole body sinking gradually into a complete state of inactivity, the solid parts become re- laxed, the blood circulates slowly, and remain particular- ly long in the head; perspiration is disordered, the body increases in fat, and rendered incapable of being the me- dium of mental exertion, the memory is enfeebled, and the unhappy sleeper falls into a lethargic state, by which his sensibility is, in a great measure, destroyed. Sleep, immediately after supper, is apt to occasion the night-mare, or a stagnation of the blood, which, by its pressure, produces tbe sensation or idea of this trouble- some bed fellow. It is principally the nervous, the de- bilitated, and those of an impaired digestion, who are visit- ed by such terrific dreams. The proper duration of sleep, in youth and adults, is usually settled at six or seven hours; in children and the aged, from eight to nine hours. The more bodily weak- ness we feel, the more we may indulge in sleep; provided it be refreshing. If people in a state of health be per- fectly cheerful in mind and body, when they awake, this is the most certain criterion that they have slept suffi- ciently. Though weakly persons may have a disposition to sleep duringthe day, they ought not to sleep long, since it tends to increase their langour and relaxation. Whe- ther to sleep after dinner be advisable, must be decided by a variety of concurrent circumstances; age, climate, and the like. However, a sleep after dinner ought never to exceed a half, or one hour at most; and it is also much better sitting than lying horizontally; for, in the latter case, we are subject to determinations of the blood to- wards the head- and consequently to head-ach, and risk apoplexy. In the evening we should eat light food, and 102 On Hygieine,or the art not retire to rest till two or three hours after supper.— The mind ought to be serene and cheerful previous to go- ing to rest, and we should then avoid gloomy thoughts; so that we may as mu"h as possible guard against dreams, which always interfere with the refreshing influences of sleep. Sleep accompanied either with talking or walking, » called somniloquism and somnambulism, is a transient paroxysm and delirium. When they are induced by an increase of stimuli, whether corporeal or mental, blood- letting, gentle cathartics, vegetable diet, with moderate exercise, are the best remedies; but when they arise from a diminution of customary stimuli, a glass or two of wine, a draught of porter, or a dose of laudanum at bed- time, and a change of air, will generally succeed. The Feather-beds, in which we usually sleep, are cer- tainly not as healthy as mattresses in summer. But, as many individuals have not sufficient resolution to use these, they ought to be particular in having their feather-beds frequently shaken sfnd aired. Farther, it is highly improper to sleep in beds overloaded with clothes; they heat the blood more than is consistent with health, and produce an immoderate and enervating perspiration, which still more weakens the organs already relaxed by sleep. The custom of sleeping with the curtains drawn close, is pernicious to health, because the copious exhala- tions, which then take place, cannot be properly dissipat- ed, and are consequently re-absorbed. It is also very imprudent to rover the head with the bed-clothes. The old and abominable custom of warming the bed, likewise deserves to be condemned; as it has a direct tendeney to produce debility. A spacious and lofty room should always be chosen, if practicable, for a bed-chamber, and attention paid to the admission of fresh air, even during the night, in warm weather. Lastly, no candle or fire should be kept burn- ing during the night in a bed-room. of Preserving Health. 103 ■®m MWMm&Tmm. By subtle fluids pour'd thro' subtle tubes The natural, vita!, functions are performed; By these the stubborn aliments are tamed, The toiling heart distributes life and strength; These the still crumbling frame rebuild. AuMSTUOKft. The evacuations of the body, from its superfluous, im- pure, and noxious particles, are no less necessary than its nourishment. The same power which changes and assimilates our food and drink, likewise affects the due and timely evacuation of the secretions. It is an object of the first consequence, that nothing remain in the body which ought to be evacuated; and that nothing be ejected, which may be of use to its preservation. How many persons do we find who complain of bad health, notwith- standing every attention they pay to air, aliment, exer- cise, and sleep; while others enjoy a good state of health, though totally careless with regard to these particulars, and all owing to a difference in the state of evacuations. If these be disordered, the most rigorous observance of dietetic rules is insufficient to insure our health; while on the contrary, most of those rules may be neglected, for some time, without any injurious consequences, if the evacuations be regular. Nature removes not only nox- ious matter, or such as is in a state of corruption, but likewise the useful fluids, if they become superabundant; for instance, the milk, semen, and blood. In such cases, therefore, these must be considered as objects of evacua- tion, equally natural and salutary. Nature expels all crude and acrid substances by those three grand emunctories, the kidneys, bowels, and skin, and accordingly as they are disordered, diseases of differ- ent degrees of malignity and duration will necessarily ensue. Nature also frequently relieves herself by more unusual channels; such arc the bleeding of the nose, in plethoric young men; the hemorrhoids, with which per- sons of a middle age are sometimes troubled; the various 104 On Hygieine, or the art ulcers common to those whose fluids are in an impure state; the excretions of saliva, and the expectoration of others, &c. By a premature suppression of the trouble- some, but salutary efforts of nature, great mischief may be produced to the individual. Many persons perspire much under the arm-pits; others in the hands or feet; others again are subject to eruptions in the face, or different parts of the body: such canals, however, if nature be once accustomed to eject by them certain ill humours, cannot be suddenly stopped without considerable danger—cleanliness, in the strictest sense of the word, is almost the only safe remedy to counteract their fatal effects. ®W WBM maiSMl Passions, like aliments, though born to fight. Yet mix'd and soften'd, in his work unite. Love, Hope, and Joy, fair Pleasure's smiling train. Hate, Fear, and Grief, the family of Pain; These mix'd with art, and in due bounds confin'd, Make, and maintain the balance of the mind, The lights and shades, whose well accorded strife, Gives all the strength and colour of our life. Pope. Passions are the active forces of the soul: They are its highest powers, brought into movement and exertion. Like wind and fire, which are instrumental in carrying on many of the beneficent operations of nature, where they rise to undue violence, or deviate from their proper course, their path is marked with ruin; so are the pas- sions either useful or destructive, according to their di- rection and degree. Yes, yes, dear stoic! hide it as you can, The sphere of pleasure is the sphere of man: This warms our wishes, animates our toil, And forms alike a Newton, or a Hoyle; of Preserving Health. 105 Gives all the soul to all the soul regards, Whether she deals in planets, or in cards. Caw thorn. Love is a passion by no rules confin'd, The great first mover of the human mind; Spring of our fate! it lifts the climbing will, Or sinks the soften'd soul in seas of ill; Science, truth, virtue sweetness, glory, grace, All are love's influence, and adorn his race; Love too, gives fear, despair, grief, anger, strife, And all the unnumber'd woes which tempest life. Hill. Love, the most universal and grateful passion of the heart, is not only conducive to health, but contributes greatly to the happiness of every society in which it is introduced. A warm and reciprocal affection, between two virtuous lovers, may be considered the sweetest charm of life. Where friendship full exerts her softest power, Perfect esteem enlivened by desire Ineffable, and sympathy of soul; Thought meeting thought, and will preventing will, With boundless confidence: for nought but love Can answer love, and render bliss secure. ----------What is the world to them, Its pomp, its pleasure, and its nonsense all! Something than beauty dearer, should they look Or on the mind, or mind-illumin'd face; Truth, goodness, honour, harmony, and love, The richest bounty of indulgent Heaven, Meantime a smiling offspring rises round, And mingles both their graces. By degrees, The human blossom blows; and every day, Soft as it rolls along, shows some new charm, The father's lustre, and the mother's bloom. Thomson. 14 106 On Hygicine, or the an Love arises from a desire of what is beautiful and fair, and is defined to be an action of the mind, desiring that which is good. No one loves before he is delighted with the object, let it be what it will, by which means it be- comes pleasing in our eyes, and begets a value and es- teem in our affections. This amiable passion in many respects is very wonderful and unaccountable; it is of such power in its operation that it has often taken the diadem from kings and queens, and made them stoop to those of obscure birth and mean fortune. It wrests the sword out of the conqueror's hand, and makes him a cap- tive to his slave. It has such a variety of snares to en- tangle the most wary, that few have at one time or other escaped them. Eginardus was secretary of state to Charlemain, and having placed his affections much higher than bis condi- tion admitted, made love to one of his daughters, who seeing this man of a brave spirit, and a suitable grace, thought him not too low for her, seeing merit had so em- inently raised him above his birth. She loved him, and gave him free access, so far as to suffer him to laugh and sport in her chamber on evenings, which ought to have been kept as a sanctuary where reliques are preserved. It happened on a winter's night, Eginardus, ever hast}7 in his approaches, but negligent about returning, had somewhat too long continued his visit; and in the mean time a snow had fallen, which troubled them both. He feared to be betrayed by his feet, and the lady was un- willing that such prints should be found at her door. Be- ing much perplexed, she did an act for her lover, very unusual for the daughter of one of the greatest men upon earth. She took the gentleman upon her shoulders, and Carried him all the length of the court to his chamber, he never setting a foot to the ground, so that the next day no impression might be seen of his footing. It happened that Charlemain watched at his study this night, and hearing a noise, opened the window and perceived this pretty prank, at which he could not tell whether it were pest to be angry or to laugh. The next day, in a great as-; sembly of lords, and in the presence of his daughter and Eginardus, he asked what punishment that servant was worthy of, who made use of a king's daughter as a mule, and caused himself to be carried on her shoulders in the midst of winter, through night, snow, and all the of Preserving Health. 107 Sharpness of the season. Every one gave his opinion, and not one but condemned that insolent man to death.__ The princess and secretary changed Colour, thinking no- thing remained for them but to be flayed alive. But the emperor looking on his secretary with a smooth brow, said, "Eginardus, hadst thou loved the princess my daugh- ter, thou oughtestto have come to her father, the disposer of her liberty; thou art worthy of death, but I give thee two lives at present; take thy fair portress in marriage, fear God, and love one another." Though the female be the weaker sex, yet some have so repaid the weakness of their nature by an incredible strength of affection, that they have often times perform- ed as great things as we could expect from the courage and constancy of the most generous amongst men. They have despised death, in whatever shape, and made all sorts of difficulties give way before its invincible force, which seemed proud to show itself most strong, in the greatest extremity of their husbands. Arria, the wife of Cecinna Psetus, understanding that her husband was condemned to die, and that he was per- mitted to choose the mannerof his death, went to him, and having exhorted him to depart this life courageously, and bidding him farewell, gave herself a stab into the breast with a knife she had hid for that purpose under her clothes; then drawing the knife out of the wound, and reaching it to Partus, she said, "Vulnus quod feci, Psete, non dolet, sed quod tu fades:" The wound I have made, Partus, smarts not; but that only which thou art about to give thyself." Whereupon Martial wrote the following epigram. When Arria to her husband gave the knife, Which made the wound whereby she lost her life, "This wound, dear Partus, grieves me not," quoth she, "But that which thou must give thyself grieves me." Happy they! the happiest of their kind, Whom gentler stars unite, and in one fate Their hearts, their fortunes, and their beings blend. 'Tis not the coarser tie of human laws Unnat'ral oft, and foreign to the mind, That binds their peace, but harmony itself Attuning all their passions into Love. Thomson. 108 On Hygicine, or the art "It is this," says Lavatar, "wliich has sweetened eve- ry bitter of my life; this has alone supported me, when the sorrows of a wounded heart wanted vent. When my best endeavours were rejected, when the sacred impulse of conscious truth was ridiculed, hissed at and despised, the tear of sorrow was ever wiped away by the gentle, tender, and affectionate address of a female mind, who has an aspect like that of unpractised virginity, which felt, and was able to efface each emotion, each passion in the most concealed feature of her husband's countenance, and by endearing means, without what the world would call beauty, always shone forth in countenance heavenly as an angel." Serene in virgin modesty she shines, And unobserved the glorious orb declines. Oh blest with temper, whose unclouded ray Can make to-morrow cheerful as to-day: She who ne'er answers till a husband cools, Or if she rules him, never shows she rules; Charms by accepting, by submitting sways, Yet has her humour most when she obeys. Pope. How delightful that sentiment, which, even in advanc- ed life, inspires a passion perhaps more profound than it excites even in youth; a passion which collects into the soul all that time has robbed from the senses, and strip- ping life, in its last stages, of all gloom, unsociability and indifference, secures us the happiness of meeting death in those arms which sustained our youth, and entwined us in the ardent embraces of love. 0 the sweet powerful influences of love! It is this that unites the interests as well as the hearts of lovers, and gives to each the joys and felicities of the other. And it is this which induces the delicate lady to forget better days, and to smile in poverty, and toil with the husband whom she loves. What charm then under Heaven can excel this noble passion? No pleasures are comparable to those that affect the heart, and there are none that affect it w ith such exquisite delight, as loving and being beloved by a worthy object. Ask the husband who is blest with an amiable wife, and he will tell you that the most delicious of Preserving Health. 109 feeling his heart ever experienced were those of virtuous love. Go gentle gales and bear my sighs along! The birds shall cease to tune their evening song; The winds to breathe, the waving woods to move, And streams to murmur, ere I cease to love. Pope. Some angry poets spit all their venom against loving husbands; but it no way depreciates virtue. Virtue, the strength and beauty of the soul, It pleases and it lasts; a happiness That even above the smiles and frowns of fate Exalts great nature's favourite;—a wealth That ne'er^nrumbers, nor to baser hands Can be transferred; it is the only good Man justly boasts of, or can call Ms own. Armstrong. A Neapolitan, being at work in a field bordering upon the sea side, his wife being at some distance from him, was seized by some corsairs of Tunis, and carried on board their vessel. Missing his wife, and seeing a ship at anchor, he soon conjectured what the matter was, and throwing himself into the sea, swam to the ship, telling the captain, "He was come to take the same fate with his wife, for though he understood the hardship and misery he must undergo in slavery, his love had conquered all difficulties, he neither could nor would live but with her." The Turks, admiring the man's unaccountable affection, at their return told it to the King of Tunis, who pleasing himself with so singular an example of love and constan- cy, gave them both their liberties. Bless'd is the maid, and worthy to be blessed, Whose soul, entire by him she loves possess'd, Feels every vanity in fondness lost, And asks no power but that of pleasing most: Her's is the bliss, in just return, to prove The honest warmth of undissembled love; For her inconstant man might cease to range, And gratitude forbid desire to change. 110 On Ilygieine, or the art Love is a vice only in vicious hearts. Fire, though the purest of all substances, will yet emit unwholesome and noxious vapours when it is fed by tainted matter; so love, if it grow in a vicious mind, produces nothing but shame- ful desires and criminal designs, and is followed with pain, vexation, and misery. But let it rise in an upright heart, and be kindled by an object adorned with virtue, it ia safe from censure. Love, studious how to please, improves our parts With polished manners, and adorned with arts. It kindles all the soul with Honour's fire; "j Curbs and restrains extravagant desire, s. And to be chaste and kind does still conspire. J A just heroic passion that can find, No room in any base degenerate mind. Drtpen. In propitious love the heart beats with joy; vivacity cheers the countenance, the eye is brilliant, society is courted, and all the benevolent affections are indulged. But disappointed love, on the other hand, is extremely de- trimental. It depresses the spirits, enfeebles digestion, takes away the appetite, banishes sleep, and not unfre- quently produces insanity. History affords many in- stances of mental derangement from disappointed love.— The follow ing affecting cases deserve to be mentioned. A German lady, of great beauty and accomplishments, having married a Hessian officer ordered to America, and not being able to acquire an} tidings of him in her own country, came over to England. Here, she could only learn the destiny of her husband from those ships which had either transported troops to the continent or were bringing back the wounded. Day after day she wander- ed on the beach at Portsmouth, and hour after hour she wearied her eyes, bedewed with tears, in the vain expecta- tion of seeing him. She was observed at the same spot, ere it was light, and watched each motion of the waves un- til the setting sun.—Then her haunted imagination pre- sented him mangled with wounds, and the smallest gust of wind seemed to threaten her with an eternal separa- tion. After eight months spent in this anxious manner, she learned that a vessel bringing some wounded Hessian of Preserving Health. ill officers bad arrived. She kept at some distance, for fear of giving too great a shock to her husband's feelings, should he be among them. He was landed with others: she followed to the tavern. When she entered the room, he burst into a flood of tears. A lady was supporting him in her arms. What words or painter could represent the tragedy that followed! He had married in America, and this person was also his wife. He intreated for "pardon," was past reproach, for in a few minutes after he sunk in- to the arms of death. The lady, whose melancholy his- tory we are recording, rushed from the room, and leaving her clothes and money at her lodging, wandered, she knew not whither, vowing, "that she would never enter house more, or trust man." She stopped at last near Bristol, and begged the refreshment of a little milk.— There was something so attractive in her whole appear- ance, as soon produced her whatever she requested. She was young, and extremely beautiful; her manners grace- ful and elegant, and her countenance interesting to the last degree. She was alone, a stranger, and in extreme distress; she asked only for a little milk, but uttered no complaint, and used no art to excite compassion. Her dress and accentbore visible marks thatshe was a foreign- er of superior birth. All the day she was seen wander- ing in search of a place to lay her wretched head; she scooped towards night a lodging for hersejf in an old hay stack. Multitudes soon flocked around her, in this new habitation, attracted by the novelty of the circumstance, her singular beauty, but, above all, the suddenness of her arrival. French and Italian were spoken to her, but she appeared not to understand these languages; however, when she was accosted in German, she evidently appear- ed confused, the emotion was too great to be suppressed, she uttered some faint exclamations in that tongue, and then, as if hurried into an imprudence, she attempted to be also without knowledge of this language. Various con- jectures were instantly formed, but what seemed passing strange, was, her acceptance of no food, except bread or milk, and that only from the hands of females. On the men shelooked with anger and disdain, butsweetly smiled, as she accepted any present from the other sex. The neighbouring ladies remonstated with her on the danger of so exposed a situation, but in vain; for neither prayers nor menaces could induce her to sleep in a house. US On Hygicine, or the art Beneath a stack Louisa's dwelling rose, Here the fair maniac bore four winter's snows; Here long she shiver'd, stiffening in the blast, And lightnings round her head their horrors cast, Dishevell'd, lo! her beauteous tresses fly, Anil the wild glance now fills the staring eye, The balls fierce glaring in their orbits move, Bright spheres, where beam'd the sparkling fires ofJove. It may gratify the reader to learn, that it has been as- certained since her death, that this fair sufferer was the natural daughter of the Emperor Francis of Germany. In W----, a small village in Saxony, there lived a poor, but honest and upright curate, who for many years had enjoyed, without alloy, the tranquil pleasures of do- mestic happiness. He bad a wife, and an only child, a daughter. Content in the sphere wherein they were placed, and unacquainted with the turbulent passions of the fashionable wpidd, theiu days flowed quietly on in an uniform course ofundisturbed felicity. The mother and daughter took a joint care of all the domestic concerns, and strove, by every act of attention and love, to diminish the burden which the duties of the good old man imposed on him. Harriet, this was the name of his daughter, was, in the strict sen^e of the word, the child after his own heart. He was unhappy if she were absent even for a few hours; she was, therefore, his constant attendant.— She was about eighteen years old, but had not yet experi- enced the inquietudes of that passion, which often exhib- its itself in very early life in the great world; and her principles and mode of thinking were too noble and good to inspire her parents with even the slightest apprehen- sions as to the wanderings of her heart. But hear her history. Far different from the condition of the Ameri- cans, the Saxons are obliged, in time of peace, to receive the king's cavalry, which are quartered in different vil- lages, where it is maintained at the expense of the poor peasantry. Most of the soldiers are riotous young men, who, by virtue of their profession and uniform, obtain en- trance into the houses of all the peasantry, and even to the curates, to the great corruption of the innocent and virtuous manners of the country people. One of them, a handsome, but giddy young man, was quartered at of Preserving Health. 113 W*----where he soon made the acquaintance of the good old parson. The young soldier had more culture of mind than is usually met with in such a class of men. He pleased the curate, who often invited him to the parson- age, and listened with pleasure to the histories of his bat- tles, and warlike achievements. The tender-hearted Harriet found great entertain- ment in the company of the young warrior, and, like Othello's mistress, the story of his life, the battles, sieges, fortunes that he thad passed, the hair breadth 'scapes, the moving accidents by flood and field, won her heart.— Love had taken possession of her bosom, before she was aware of its approach. She blushed when he took her by < he hand, and was unhappy when he left her. The sol- dier could not resist the beautiful girl, for his heart was formed for love. They therefore soon came to an explana- tion of their mutual passion, which, for the present, they agreed to conceal from their parents, for fear that pruden- tial motives would cause them to oppose it. They bound themselves to each other, however, by an oath, which, at the same time that it showed the strength of their affection, exhibited the most romantic turn of mind. They promised to marry as soon as he could attain the rank of sergeant-ma- jor, and agreed that the one should destroy the other, who first jailed in the engagement. Thus matters stood, when, contrary to the wishes of the lovers, a lawyer from a neighbouring town applied to the father of Harriet for the hand of his daughter. He was well received, and his views promoted by the old people; but when his intention was declared to the unfortunate girl, she fell into the arms of her father, as if struck with lightning, and, on her re- covery, wept bitterly, entreating them not to encourage the addresses of this new lover. Her parents, being ig- norant of the true cause of her aversion, thought that time would soon overcome it, and therefore gave their solemn promise to the lawyer to second his wishes. Harriet, however, resisted every argument, and remained true to her promise; but her parents, at length growing tired of her opposition, determined to employ their authority, which at last prevailed. The young soldier soon received the intelligence, and instantly formed his desperate resolu- tion, for without his lovely Harriet he could not live. A short time before the marriage-day, a dance was given in 15 111 On Hygieine, or the an W----, in honour of the pair. To this he resorted, una- ble any longer to resist the desire of seeing once more his beloved. He concealed himself among the spectators until he saw her dance; which roused him to a state of fury. He ran home, took a pair of loaded pistols, and waited until tiie party broke up. It was a dark night, but he discerned the unhappy bride intended, and her bridegroom, walking hand in hand. He stepped up to her, and in alow voice, requested that she would indulge him with a moment's conversation. She disengaged her arm from that of the lawyer, intreated him to walk on, assuringhim she would immediately return: but, alas! she was to return no more! A pistol was heard, and when her trembling friends reach- ed the place, they found her weltering in blood, at the feet of her murderer. "Now art thou mine again." cried the soldier, in tones of horrid joy. and fled, but not to escape. He delivered himself to the officers of justice, and begged to be instantly executed, which event, indeed, soon followed. Learn parents, from this story, the danger of interfer- ing with your children's affections in so serious an affair as marriage: for as Shakspeare observes: Marriage is sure a matter of more worth Than to be subject for attorneyship; For what is wedlock forced, but a hell, An age of discord and continual strife? Whereas the contrary bringeth forth bliss, And is a pattern of celestial peace. The most dangerous effect of love is jealousy. It is the most vain, idle, foolish, and turbulent disease that ever assaulted and oppressed the mind of mankind. Of all the diseases of the mind, it is that which most things serve for aliment and fewest for remedy. Bonavcntur, sitting at a table, and looking earnestly upon a beautiful woman present, was asked by her hus- band, why he so gazed? He answered: "That he admir- ed the excellency of the Creator by contemplating the beauty of the creature: and that if mortals w ere so amia- of Preserving Health. 115 hie, bow lovely should we be at the resurrection." This was an example, saitii Boschier, that was rather to be ad- mired than imitated; suitable to the golden age, and not this present iron age of the world, wherein jealousy may he compared to the Indian arrows, so envenomed, that if they prick the skirt it is very dangerous; but if they draw blood, it is irrecoverably death: the first motions that rise from this root of bitterness have their evil effects; but where the disease is improved, it empoisons all our com- forts, and throws us headlong into the most tragical re- solutions. The Marquis of Astorgas, of the family of Osorio, in- dulged himself in an illicit intercourse with a most beau- tiful young woman. His wife, on being informed of his intrigue, went immediately to the, house where her hus- band's mistress lived, and murdered her in the most cruel manner. She tore her heart from her bosom, and took it home, ordering it to be hashed and served up to her hus- band for dinner. After he bad eaten of it, she asked him if it were good? and, on his answering yes, she said, she was not in the least surprised, for it was the heart of his mistress, whom he so dearly loved. At the same time, she drew from a cupboard the bleeding head of his murdered favorite, and rolled it on the table at which this unhappy lover was sit- ting with his friends. His wife immediately departed, and took refuge in a convent, where she soon afterwards went mad with rage and jealousy. Earth has no rage like love to hatred turn'd, Nor hell a fury like a woman scorn'd. Dryden. The power of beauty is universally acknowledged, hav- ing been the object of love and admiration in all times and among all nations. But, alas! what is beauty without the graces of virtue! In Italy there grows an herb called the Basilisco; it is sweet-scented enough, hut, withal, hath this strange pro- perty, that being laid under a stone in a moist place, in a I Hi On Hygieine, or the art few days it produces a scorpion. Thus, though the wo- man, in her first creation, was intended as a help for man, the partner of his joys and cares, the sweet perfume and relish of his days throughout his whol-,pilgrimage; yet there are some so far degenerated fru>m their primitive institution, though otherwise of exterior beauty and per- fection enough, that they have proved more intolerable than scorpions, not only tormenting the life, but hastening the death of their too indulgent husbands. Not that my verse would blemish all the fair, But yet, if some be bad, 'tis wisdom to beware; And better shun the bait, than struggle in the snare. Drtden. Joan, grand-child to Robert, king of Naples, succeeded her grand-father in the kingdom of Naples and Sicily; a woman of beautiful person, and rare endowments of na- ture. She was first married to her cousin Andrew, a prince of royal extraction and of sweet disposition; but, being lasciviously disposed, she grew weary of him, and caused him to be strangled in the night, and then threw out bis corpse into a garden, where it lay some days un- buried. It is said her husband, on seeing her twisting a thick string of silk and silver, asked for what purpose she made it; she answered, "to hang you in!" which he then little believed; the rather, because those who intend such mischief use not to speak of it before-hand; but it seems she was as good as her word. 0 fairest of creation! last and best Of all God's works! creature in whom excelled Whatever can to sight or thought be formed, Holy, divine, good, amiable, or sweet! How art thou lost. Milton. Love is never more abused than by those men who do not design to marry. It will generally be found, that li- bertines will single out from among the herd of females, a raw, innocent, young creature, who thinks all the world as sincere as herself, to whom they design to make their addresses. They take every opportunity to be in their of Preserving Health. 117 company, and pretend to zeal in love, when it is nothing but lust that fires them. When men's desires and lusts once sated are, For oaths and promises they little care. The female, who yields her virtue to the brutal desires of a false lover, degrades herself in his estimation by the in- fidelity she commits, aud the surrender of so precious a jewel inspires a remorse and shame, when she ceases to be beloved, that constitutes the bitterest woe of life. It is surely matter of wonder, that these destroyers of innocence, though dead to all the higher sentiments of vir- tue and honour, are not restrained by compassion and hu- manity. To bring sorrow, confusion, and infamy into a family; to wound the heart of a tender parent, and stain the life of a poor deluded young woman, with a dishonour which never can be wiped off, are circumstances one would think sufficient to check the most violent passion, in a heart the least susceptible of feeling. w mmmm •'.'Hope springs immortal in the human breast, Man never is, but always to be blest O Happiness, our being's end and aim, Good, Pleasure, Ease, Content, whate'er thy name: That something still, which prompts the eternal sigh, For which we bear to live, or dare to die." Pope. Hope is the anticipation of joy, or the presentiment of an expected good. It is attended with all the favourable effects of a fortunate event, without possessing any of its physical advantages; because the expectation of happiness does not affect us so excessively as its enjoyment. Be- sides, it is not liable to those interruptions, from wliich no human pleasure is exempt; it is en,ployed principally with ideal or imaginary objects, and generally keeys 118 On Hygicine, or the art within the bounds of moderation; lastly, the sense of hap* piness contained in hope, far exceeds the satisfaction re- ceived from immcliate enjoyment, consequently it has a more beneficial influence on health, than good fortune re- alize I. Although hope is in itsell only ideal, and presents its flattering images to the fancy in a borrowed light, yet it is nevertheless the only genuine source of human happi- ness. With thee, sweet Hope! resides the Heav'nly light, That pours remotest rapture on the sight: Thine is the charm of life's bewilder'd way, That calls each slumb'ring passion into play. Wak'd by thy touch, I see the sister band, On tiptoe watching, start at thy command, And fly where'er thy mandate bids them steer, To Pleasure's path, or Glory's bright career. Campbell. The poet Hesiod tells us, that the miseries and calami ties of mankind were included in a great tun; that Pandora took off the. lid of it, sent them abroad, and they spread themselves in great quantities over all lands and seas; but at this time, Hope only did remain behind, and flew not all abroad, But underneath the utmost brim and ledge it still abode. And this is that which is our principal antidote, which keeps our hearts from bursting under the pressure of evils; and that flattering mirror that gives us a prospect of greater good. Hence some call it the manna from Heaven, that comforts us in all extremities; others, the pleasant and honest flatterer, that caresses tiie unhappy with ex- pectation of happiness in the bosom of futurity. Primeval Hope, the Aonian Muses say, When Man and Nature mourn'd their first decay; When every form of death, and every wo, Shot from malignant stars to earth below; When Murder bared her arm, and rampant War Yok'd the red dragons of her iron car; of Preserving Health. lig When Peace and Mercy, banish'd from the plain, Sprung on the viewless winds to Heav'n again; All, all forsook the friendless guilty mind, But Hope, the charmer, linger'd still behind. Campbell. A very notable case of the influence of Hope on the hu- man body, and its maladies, is recorded in the history of the long siege of Breda, in 1625, by a physician, eye- witness to the fact. The garrison, depressed by fatigue, poisoned by bad provisions, and dying rapidly of the scurvy, were on the point of giving up" the town. The Prince of Orange, anx- ious to prevent its loss, contrived letters to the garrison, promising them speedy assistance. These were accom- panied with newly discovered medicines against the scur- vy, of a most extraordinary price, hut still more extraor- dinary efficacy. To each physician were given three small vials, filled with drops of such sovereign power, that four drops were sufficient to impart a healing virtue to a gallon of liquor. We now, says the physician, who was one of the eye-witnesses of this curious fact, began to dis- play our wonder-working balsams. Nor were even the commanders let into the secret of the cheat upon the sol- diers. All who had the scurvy crowded around us to take their doses. Cheerfulness again appears in every coun- tenance, and the universal faith prevails in the sovereign virtues of the remedy. The effect of this delusion was truly astonishing. Many who had not moved their limbs for a month before, were seen walking the streets erect and perfectly cured. Many, who declared they had been rendered worse by all former remedies, recovered in a few days, to their inexpressible joy, and the no less general sur- prise, by their taking, what we affirm to be, their gracious Prince's cure. "This curious relation," adds Dr. Lind, "would hardly perhaps gain credit, were it not in every respect conso- nant to the most accurate observations, and best attested description of that disease. It is given us by an eye-wit- ness, an author of great candour and veracity, who as he informs us, wrote down every dav the state of his patients, and seems more to be surprised with their unexpected re- 120 On Hygicine. or the art eovery, than he probably would have been, had he been acquainted with the nature of this surprising malady. An important lesson in physic," adds this excellent writer, "is hence to be learned; the wonderful influenre of the pas- sions of the mind on the state and disorders of the body. This is too often overlooked in the cure of disorders, ma- ny of which aresometimes attempted by the sole mechani- cal operation of drugs, without calling into our assistance the strong powers of tiie imagination, or the concurring influences of the soul. Hence it is, that the same remedy will not always produce the same effect, even in the same person; and that common remedies often prove wonder- fully successful in the hands of men not of the faculty, which do not answer the purpose in a timorous and dis- trustful patient." A certain Rhodian, for his over freedom in speech, was cast by a tyrant into a cage, and there kept as a wild beast, to his great pain and shame: for his hands were cut off, his nostrils slit, and his face deformed by several wounds upon it. In this extremity, he was advised by some of his friends to shorten his life by a voluntary abstinence from all food. But he rejected their counsel with great indignation; and told them, "While a man is alive, all things are to be hoped for by him." Cease, every joy, to glimmer on my mind, But leave—oh! leave the light of Hope behind! What, though my winged hours of bliss have been, Like angel-visits, few and far between! Her musing mood shall every pang appease, And charm—when pleasures lose the power to please! Campbell. But Hope ill-grounded does often trick and bubble the owner, as it did the Spanish woman that, coming with three of her sons a begging to a French shoemaker that lived in Spain, he said to her one day, "Good woman, I will ease thee of some part of thy charge; for if thou leave one of thy sons with me, I will breed him up in my trade, and make him capable of living like a man, and to be help- ful to bis parents also." "God forbid," said the woman, "that I should cast away my child to a stranger, and of Preserving Health. 121 bring him up to so pitiful a mechanic trade as a shoemaker, since I live in hopes that the eldest will be viceroy of Na- ples, the second of Mexico, and the youngest of Sardinia* Hope, Fortune's cheating lottery! Where, for one prize, a hundred blanks there be. Fond archer, Hope! who tak'st thy aim so far, That still, or short or wide, thy arrows are. Thin empty cloud! wliich th' eye deceives With shapes that our own fancy gives: A cloud, which gilt and painted, now appears, But must drop presently in tears. Brother of Fear! more gaily clad! The merrier fool o' tl»e two, but quite as mad. Drxden. IW 4 Pleasures are ever in our hands or eyes; And when, in act, they cease, in prospect, rise; Present to grasp, and future still to find, The whole employ of body and of mind. All spread their charms, but charm not all alike; On diff'rent senses, dift'rent objects strike; Hence different Passions more or less inflame, As strong or weak, the organs of the frame; And hence one masteh passion in the breast, Like Aaron's serpent, swallows up the rest. Pope. Jot is that state of mind, in which it feels extraordi- nary pleasure. The activity of the whole machine is en- livened; the action of the heart and arteries is increased; the circulation of all the fluids is more vigorous and uni- form; preventing the formation of disease, and facilitating the cure of such as are formed. There are several degrees of joy, as various eircum* stances may intervene; and so may we distinguish various differences of the passion itself; for there is no pleasure 16 132 On Hygieine, or the art or good that may not be mixed with some ill or incon- venience. Our extremest pleasure has still some air of groaning and complaining in it, unless it be discreetly moderated. Ptolemeus Philadelphus had received the sacred vo- lumes of the law of God, newly brought out of Judca; and, while he held them with great reverence in his hands, praising God upon that account, all that were present made a joyful exclamation; and the king himself was so overjoyed, that he broke out into tears. Nature having so ordered it, that the expression of sorrow should also be the follower of extraordinary joys. Askew, a wealthy and facetious farmer of Cornwall, was afflicted with a most alarming imposthnmation, of which he appeared to be on the very point of suffocation. Concluding, from his agonies, that he had but a few mo- ments to live, his servants, an ungrateful crew to such a generous master, began to plunder. One seized his gold watch, another laid violent hands on his plate, and the third, more daring still, broke his bureau, and began to finger his gold. A monkey, who was present, seeing what they were about, and thinking he might as well take a hand in the game, laid hold of his master's wig, and with his gold-headed cane, made him a low bow, and be- gan to walk about the room as a man of great conse- quence. The stately steppings and self-assumed dignity of Jacko, so tickled the fancy of Mr. Askew, as to excite a most immoderate fit of laughter. The imposthnmation burst, the purulent matter was thrown up—and, to the eternal confusion of his servants, Mr. Askew perfectly recovered his health. Philemon, a comic poet, beholding an ass eating some figs that a boy had laid down; when the boy returned, "Go now," said he, "and fetch the ass some drink;" the old man was so tickled with the fancy of his own jest, that he died laughing. In the same manner, and much upon the same occasion, died Crysippus. If we have anticipated any joyful event, the body i' of Preserving Health. 123 gradually prepared to undergo the emotions connected with it. For this reason we ought to fortify ourselves with the necessary share of firmness, to meet joyful as well as disastrous tidings. It is, the great art of life to manage Welt The restless mind. Tor ever on pursuit Of knowledge bent, it starves the grosser powei-s Quite unemployed, against its own repose It turns its fatal edge, and sharper pangs Than what the body knows,' embitter life. Chiefly were solitude, the nurse of care, To sickly musing gives tiie pensive mind, There madness enters; and the dim eyed fiend, Sour melancholy; night an. I day provokes Her own eternal wound.------------- Aumstroho. Grief, like a poison, corrodes the powers of the mind and body; it enfeebles the whole nervous system; the heart beats slower; the circulation of the blftod, and other fluids, become more inert; the appetite and digestion be- come vitiated, and thus arise obstructions and other dis- tressing complaints. Tears are the anodynes of grief, and ought, therefore not to be restrained. They have a tendency to prevent the danger to be apprehended from grief, by diminishing the spasmodic motions in the breast and head; and by restoring regularity in respiration, as well as in the circulation of the blood. A widow lady was left in narrow circumstances with a boy and girl, two beautiful and lovely children, the one six, and the other seven years of age. As her circumstan- ces allowed her to keep but one maid servant, these two children were the sole attention, employment, and conso- lation of her life. She fed them, dressed them, slept w:th them, and taught them herself. They were both snatched from her by the gangrenous sore throat, in one week; so 134 On Hygicine, or the art that she lost at once all that employed her, as well as all that was dear to her. For the first three or four days after their death, when any friend visited her, she sat up- right with her eyes wide open, without shedding tears, and affected to speak of indifferent things. Afterwards she began to weep much, and for some weeks talked to her friends of nothing else but her dear children; but did not for many years, even to her dying hour, get quite over a gloom which was left upon her countenance. When any cause of deep grief is presented to the mind, it frequently gains such a force as almost totally to ex- clude all thoughts, except those that are connected with it. Hence the whole imagination is, by degrees, obscur- ed, and the most usual consequences of it are tbe deepest melancholy, succeeded by insanity—and sometimes, that speedier dissolution, "a broken heart." When the Turks came to raise the siege of Buda, there was amongst the German captains a nobleman called Rayschachius, whose son, a valiant young gentleman, having got out of the army without his father's know- ledge, he behaved so gallantly in fight against the enemy, in the sight of his father and of the army, that he was highly commended of all men, and especially of his father, who did not know he was his son; yet before he could clear himself he was compassed in by the enemy, and, valiantly fighting, was slain. Rayschachius, exceeding- ly moved by the death of a brave man, ignorant how near it touched himself, turning about to the other captains, said, "This worthy gentleman, whosoever he be, deserves eternal commendation, and to be honourably buried by the whole army." As the rest of the captains were with like compassion approving his speech, the dead body of the unfortunate son was presented to the most miserable father, which caused all who were present to shed tears; but such a sudden and inward grief surprised the aged father, and struck so to his heart, that after he had stood awhile speechless, with his eyes fixed, he fell down dead. The melioration of grief by time, and its being at length even attended by pleasure, depends on our retain- ing any distinct idea of the last object, and forgetting for ef Preserving Health. i£i> a time, the idea of the loss of it. This pleasure of grief is beautifully described by Akenside. --------Ask the faithful youth Why the cold urn of her whom long he lov'd So often fills his arms: so often draws His lonely footsteps at the silent hour To pay the mournful tribute of his tears? Oh! he will tell thee, that the wealth of worlds Should ne'er seduce his bosom to forego That sacred hour; when stealing from the noise Of care and envy, sweet remembrance sooths With Virtue's kindest looks, his aching breast, And turns his tears to rapture. Whilst the great genius of physic, Hippocrates, drove away maladies by his precepts, and almost snatched bo- dies out of the hands of death, one Antiphon arose in Greece, who, envious of his glory, promised to do upon souls, what the other did on bodies; and proposed the sub- lime invention, which Plutarch calls the art of curing grief, where we may truly say, he used more vanity, pro- mises, and show of words, than he wrought effects. Cer- tainly it were to be wished that all ages, which are abun- dant in misery, should likewise produce great comforts to soften the calamities of human life. 0! canst thou minister to a mind diseased, Pluck from the memory a rooted sorrow, Rase out the written troubles of the brain; And, with some sweet oblivious antidote, Cleanse the stuff'd bosom of that perilous stuff Wliich weighs upon the heart? SlIAKSPEAEE. In the Pagan religion, the power of dying was the great consolation in irremediable distress. Seneca says, "No one need be unhappy, unless by his own fault."— And the author of Telemachus begins his work by saying, that Calypso could not console herself for the loss of Ulysses, and found herself unhappy in being immortal. But to the Christian, this one suggestion, I know that my Redeemer livcth, affords a richer cordial to the 126 On Hygieine, or the art fainting soul, than all the volumes of Heathen Philoso- phy. Many are the sayings of the wise In ancient and in modern books enroll'd, Extolling patience as the truest fortitude: And to the bearing well of all calamities, All chances incident to man's frail life. Many are the consolatory writs form'd "With studied argument, and much persuasion; But with th' afflicted in his pangs such sounds •* Little prevail, or rather seem a tune Harsh, and of dissonant mood from his complaint: Unless he feel within Some source of consolation from above, Secret refreshings, that repair his strength, And fainting spirits uphold. Milton. In the midst of all distresses, there remains to every sin- cere Christian, that mixture of pure and genuine conso- lation, which springs from the promises and hopes of a future life. Consider what a singular distinction this makes in your situation, beyond the state of those who, under the various troubles of life, are left without hope; without any thing to look up to, but a train of unknown causes tind accidents, in which they see no light nor coin- fort. Thank the Father of Merciks, that into all the evil he sends, he infuses j yful hope, that the sufferings of the present time are not worthy to be compared with the glory that shall be revealed in the end to the virtuous and good. Have we. sustained the greatest of all losses? It is his gain that, he yet liveth. that this life is but the thres- hold, the portal, the entrance to a better place, and that his happiness is as complete as our misery is great. Let us turn our eyes from earth to heaven, from the perishable body to that which endureth forever; and, even whilst we are heavy with affliction, let us smile with our eyes turned upwards, and say, "It is thy will, I submit.—He is hap- py. I would not wish him back to a troublesome world. I soon shall follow after him. The mortal hath put on immortality—We shall then meet, never, never, to be separated more." of Preserving Health. 12/ Think, then, ye mourning parents, nor complain For breathless children, as ye weep in vain. W liv should you be in lamentations drown'd, While your young babes with victory are crown'd, Before the sword was drawn, or cruel strife ^ Had shed its venom on the ills of life? / Perhaps Almighty God foresaw some vile, Some tempting evil that should them beguile; Ol sore adversity, a dreadful storm, Or of dire wickedness, a monstrous form. How then in words which nothing can avail, Against that kind precaution dare you rail? Remember, that of them you're notbereav'd, But from "the coming evil they are sav'd." Anketell. Timorous self-love, with sick'ning fancy's aid, Presents the danger that you dread the most, And ever galls you in your tender part. Hence, some for love, and some for jealousy, Have lost their reason: some for fear of want, Want all their lives; and others every day, For fear of dying, suffer worse than death. Is there an evil worse than fear itself? And what avails it, that indulgent Heaven From mortal eyes has wrapt the woes to come, If we, ingenious to-torment our selves, Grow pale at hideous fictions of our own? AnMsraoirc. Fear has its origin in the apprehension of danger, and is kindly placed in man as a sentinel for self-preservation. But, like every other passion, the excess of it is pernici- ous. O Fear, I know thee by my throbbing heart; Thy withering power inspir'd each mournful line: Though gentle Pity claim her mingled part, Yet all the thunders of the scene are thine. Collins. 128 On Mygie i n e, o r th e a rt Don Diego Osorius, a Spaniard of a noble family, be- ing in love with a young lady of the court, had prevailed with her for a private conference under the shady boughs of a tree, that grew within the gardens of the king of Spain: but, by the unfortunate barking of a little dog, their privacy was betrayed, and the young gentleman seized by some of the king's guard, was imprisoned. It was a capital crime to be found in that place, and, there- fore, he was condemned to die. He was so terrified at the hearing of his sentence, that one and the same night saw the same person young, and all turned grey, as in age. The jailor, moved at the sight, related the accident to king Ferdinand, as a prodigy; who, thereupon, par- doned him; saying, "He had been sufficiently punished for his fault, seeing he had exchanged the flower of his youth into the hoary hairs of age." I knew a surgeon, says Dr. Darwin, who was always rather of a parsimonious disposition, had a large house, with a fortune of forty thousand pounds left him; and in a few weeks became insane from the fear of poverty; la- menting that he would die in a jail or a work-house. He had left off a laborious country practice and the daily per- ception of profit in his books; he also now saw greater ex- penses going on in his new house than he had been accus- tomed to observe, and did not so distinctly see the source of supply; which seems to have occasioned the maniacal hallucination. The fear of hell, continues he, has also, in some instances, been attended with fatal effects. In this kind of madness, the poor patients frequently commit suicide; although they believe they run headlong into the very hell which they dread! It is said of Epicurus, a profane teacher, that never was a school boy more afraid of a rod, than he was of the thought of a God and death. No man more feared the tilings which he taught should be despised, than himself. For whatever there is in the air, there is certainly an clastical power in the conscience, that will bear itself up, notwithstanding all the weight that is laid upon it. Conscience, the torturer of the soul, unseen, Does fiercely brandish a sharp scourge within. of Preserving Health. 189 Severe decrees may keep our tongues in awe, But to our thoughts what edict can give law? Even you, yourself, to your own breast shall tell Your crimes, and your own conscience be your hell. Drtdex. The wretched state of Richard the Third, after he had murdered his nephews, is thus described by Sir Thomas More: "I have heard," saith he, "by credible re- ports, that after this abominable deed he never had quiet in his mind, and never thought himself safe. When he went abroad, his eyes whirled about, his body was pri- vily fenced, his hand ever on his dagger, his counte- nance and manner like one who was ever ready to strike: he took no rest in the night, lay long waking and musing, sore wrearied with care and watching, and rather slumbered than slept, troubled with fearful dreams: he sometimes started suddenly up, leaped out of his bed, and ran about the chamber: his restless heart was continually tossed and tumbled with the tedious impression and stormy remem- brance of his horrid and abominable deeds." Conscience, what art thou? thou mysterious pow'r, That dost inhabit us without our leave, And art within ourselves another self, A master self, that loves to domineer, And treat the monarch frankly as the slave; How dost thou light a torch to distant deeds, Make the past, present, and the future frown: How, ever and anon, awake the soul, As with a peal of thunder, to strange horrors! Shakspeare. The rich Cardinal of Winchester, Henry Beaufort, who procured the death of the good Duke of Gloucester, was soon after struck with an incurable disease; and, un- derstanding by his physicians, that he could not live, he expressed himself thus; "Fy, will notdeath be hired? Will money do nothing? Must I die who have such great riches? If the whole realm of England would save my life, I am able, either by policy to get it, or by riches to buy it." But the king of terrors is not to be bribed by gold. It is a pleasure to him to mix the brains of princes and politi- 17 130 On Ilygieine, or the art cians with common dust; and how loth soever he was to depart, yet grim death would seize upon him. How shocking must thy summons be, O death! To him that is at ease in his possessions; Who, counting on long years of pleasure here, Is quite unfurnish'd for the world to come? In that dread moment, how the frantic soul Raves round the walls of her clay tenement, Rushes to each avenue, and shrieks for help, But shrieks in vain----------------- ----------------------------------The foe, Like a staunch murderer, steady to his purpose, Pursues him close through every lane of life, Nor misses once the track, but presses^on, Till forc'd at last to the tremendous verge, At once he sinks to everlasting ruin. Blair. The best remedy against this torturing state of the mind is a good conscience, which is to the soul what health is to the body. It preserves a constant ease and serenity within us, and more than countervails all the ca- lamities and afflictions that can befal us. When the mind has been under the influence of sudden surprise, or vehement attention to some interesting ob- ject, it has frequently suspended, and even entirely cured ague and fever, asthma, and other chronic diseases. An officer, of great courage, w ho had contracted the asthma by long service in India, declares, that during a most severe attack of that complaint, when he could scarcely breathe in an erect posture, and without power to move, as he thought, six yards to save his life, the alarm guns were fired for the whole line to turn out, be- cause the Mahrattas broke into the camp. Knowing that certain death would be his portion if he remained in his tent, he sprung out with an alacrity that amazed his atten- dants, instantly mounted his horse, and with great ease drew his sword, which the day before he could not move from its scabbard, though he had used his whole strengthin the attempt. From the instant of the alarm, the debility left him, together with the asthma, nor did the disorder return for some time after. of Preserving Health. 13J I have frequently observed, says the ingenious author of the Medical Extracts, delicate hysterical women, who, for many months, had seldom enjoyed one day's health, sud- denly relieved from every complaint, when a favourite child was attacked with a disease, in wliich danger was apprehended: and they continued in appearance, to be in perfect health during the whole course of the illness, and exhibited an unusual alertness in discharging their duty as nurses and parents. But when they understood that the danger was over, their former complaint gradually returned, to their great surprise; for from the health they had lately enjoyed, and for so considerable a time, they believed themselves perfectly cured. Through a most criminal inattention to children in the nursery, a foundation is sometimes laid in their tender minds for those superstitions terrors, from wliich not all their efforts in subsequent life can entirely relieve them. I allude to those dismal stories about Witches, Spirits, Hobgoblins, Raw head and Bloody-bones, wherewith silly nurses, especially poor blacks, are so fond of frightening infants. Considering the importance of deep impressions made during those tender years, parents cannot too strict- ly forbid every thing of this sort; neither can they ever exceed in their generous labours to illuminate the minds of their children with lofty ideas of their Creator, and that mighty power which he will never fail to exert in their favour, if they will but be good. Timorous persons are more readily infected by conta- gious disorders, than those possessed of fortitude. Hence it is we find nurses most frequently escape contagion, while persons of a fearful disposition contract the dis- ease on entering the chamber of the sick only once or twice. Persons under a violent fit of fear, should be treated like those who suffer from any other spasmodic contraction. Tea, a little wine, or spirits and water may be given to them; vinegar, lavender-drops, or spirits of hartshorn may be held to the nostrils; warm bathing of the feet, and emollient injections may be of advantage; but above all, the mind ought to be duly composed.—Excessive bashfnl- ness borders on fear; it may be corrected by social inter- course with persons of a cheerful disposition. 132 On Hygieine, or the art ®w mm ©^m* Whf.it reason like a skilful charioteer, Can break the fiery passions to the bit, And, spite of their licentious sallies, keep The radiant track of glory; passions, then, Are aids and ornaments.----------------- Younc. Resentment of wrong is a useful principle in human na- ture; and for the wisest purposes was implanted in our frame. It is the necessary guard of private rights; and the great restraint on the insolence of the violent, who, if no resistance were made, would trample on the gentle and peaceable. But in the fulness of self-estimation, we are too apt to forget what we are. We are rigorous to offen- ces, as if we did not daily entreat heaven for mercy. It is a vice that few persons are able to conceal; for if it do not betray itself by extei nal signs, such as sudden pale- ness of the countenance, and trembling of the joints, it is more impetuous within. Pale and trembling Anger rushes in, With falt'ring speech, and eyes that wildly stare; Fierce as the tiger, madder than the seas, Desperate, and arm'd with more than human strength. He whom Anger stings, drops, if he dies, At once, and rushes apoplectic down; Or a fierce fever hurries him to hell. Armstrong. Those who feel the approach of anger in their mind, should, as much as possible, divert their attention from the object of provocation, and remain silent. They should never use loud oaths, violent upbraidings, or strong ex- pressions of countenance, or gesticulations of the arms, or clenched fists; as these, by their former associations with anger, will contribute to increase it. I have been told, says Dr. Darwin, of a sergeant or corporal, who be- gan moderately to cane his soldiers, when they were awk- ward in their exercise; but being addicted to swearing of Preserving Health. 133 and coarse language, he used soon to enrage himself by his own expressions of anger, till, toward the end, he was liable to beat the delinquents unmercifully. Is this not applicable to some of us, in the treatment of our slaves? A gentleman in New-Castle county, Delaware, was so enraged with a neighbouring slave, for persevering, con- trary to his orders, to visit a female servant in his family, that he bought him of his master at a high price, for the express purpose of getting satisfaction; that is, to give him a severe flogging, and then to sell him to a negro-buyer. What with the bitter curses and blows he inflicted upon the poor fellow, tied hands andfeet,his anger rose at length to a flame he could not controul, and, by the time the master had lost the power to inflict, the poor slave had lost the power to suffer—having literally expired under his cruel hands. A sea captain, in Charleston, South Carolina, naviga- ted his vessel with the help of three slaves. On some pro- vocation from one of them, he laid hold of the offender, who was so alarmed at his master's looks, that he jerked away^from him. Roused to fury by such an act of treason, as this appeared to him, the master caught up a broad axe, and with the looks and voice of a demon, ordered his other slaves "to seize the d----d villain." Frightened out of their wits, they seized their fellow-servant, and the master, black with rage, and regardless of his prayers and supplications, had him dragged to a block, and in a most barbarous manner struck off his head. Although the laws of the land did notsentence these in- human masters to death, yet neither of them long surviv- ed their infernal acts. The gnawings of a blood-stained conscience soon brought them down to the grave. Cruelty is the extreme of all vices, an offence to God, abhorrence to nature, the grief of good men, and a plea- sure only to devils and monsters divested of humanity.— Justice may take away a man's life, to punish his offences, and to deter others by his example, from the commission of the same crimes; but to do it by racks and other tor- ments, favours little of humanity, less of Christianity. 134 On Hygieim>, or the art How many millions of men have the Spaniards butcher- ed in South America? Bartholomew Casa affirms, that in forty-five years they destroyed about ten millions of hu- man souls; an unaccountable way of converting these poor savages to Christianity. These millions were butchered outright, and if we add those who died labouring in the mines, doing the drudgery of asses, oxen, and mules, to what a vast number would they amount? Some of them carry burdens upon their backs of a hundred and sixty pounds weight, above three hundred miles. How many of these poor wretches have perished by water as well as by land, by diving fathoms deep, fishing for pearl, who stay there sometimes half an hour under water, panting and drawing the same breath all the while, and are fed on purpose with coarse biscuit and dry things, to make them long winded. And if what is reported be true, they hunt the poor Indians with dogs to make themselves sport. There is a story of Hathir Cacica, a stout Indian, who, being to die, was persuaded by a Franciscan friar to turn Chris- tian, and then he should goto heaven; Cacica asked him "Whether there were any Spaniards in heaven?" "Yes," says the friar, "it is full of them." "Stay, then," said the Indian, "I had rather go to hell than have any more of their company." A young gentleman in Augusta, Georgia, going to a party in the neighbourhood, in a gig, had not got out of the street, before his horse balked. The youth, leaping from his gig, and angrily catching his horse by the bridle, led him off. Having mounted his gig, he cracked his whip for a second start; but his horse had not gone many steps, before he unfortunately fell back again. Leaping from the gig in a violent rage, he struck his horse over the head with his loaded whip, and then attempted to lead him off once more. Frighted by such violence, the ani- mal, in place of moving forward, drew back. Enrnged by such obstinacy, the young man repeated his blows with the whip until it broke, which rather increased the pertur- bation of his mind. By this time, finding himself sur- rounded by unwelcome spectators of his brutal conduct, he became more furious; and snatching a large club, con- tinued his unmerciful blows, until he brought the horse to the ground; when, after a few struggles, bis blood and brains flowing copiously, the poor animal expired. of Preserving Health. 185 As anger is a short madness, so patience is a recollec- tion of all requisite virtues, that enables us to withstand the assaults of the former, and to behave ourselves like sober and prudent men. When Xenocrates came one time to the house of Plato to visit him, be prayed him, "that he would beat his ser- vant for him, in regard he himself was not at present so fit to do it, because he was in a passion." Another time he said to one of his servants, "that he would beat him sufficiently, but that he was angry." Forgiveness of injuries, and a merciful disposition to- wards those who have offended us, are not only infallible marks of a great and noble mind, but are our indispensa- ble duties as reasonable creatures, and peculiarly so as Christians. Sir Walter Raleigh, a man of known courage and hon- our, being very injuriously treated by a hot-headed, rash youth, who next proceeded to challenge him, and, on his refusal to accept, spit upon him, and that too in public, the knight, taking out his handkerchief, with great calm- ness, made him only this reply: "Young man, if I could as easily wipe your blood from my conscience, as I can this injury from my face, I would this moment take away your life." The consequence was, that the youth, struck with a sudden and strong sense of his misbehaviour, fell upon his knees, and begged forgiveness. Clinias, the Pythagorean, was a person very different both in his life and manners from other men. If it chanced at any time that he was influenced with anger, he would take his harp, play upon and sing to it; saying, as oft as he was asked the cause of his so doing, "that by this means he found himself reduced to the temper of his for- mer mildness." There is a charm, a power that sways the breast, Bids every passion revel or be still; Inspires with rage, or all your cares dissolves; Can soothe distraction, and almost despair. That power is Music.--------- Armstrong. 136 On Hygieine, or the an So great is the empire of music over all the faculties of human nature, and so loud have been the ingenious in celebrating its power and praises, that they have left no- thing scarcely in heaven, not at all in the air, sea, or on the earth, but what, in excess of fancy or merit, they have subjected to its dominion for the better. Music exalts each joy, allays each grief, Expels diseases, softens every pain, Subdues the rage of poison, and the plague; And hence the wise of ancient days ador'd One power of Physic—Melody and Song. Armstrong. While the physician prescribes draughts for curing bodily diseases, an able musician might prescribe an air for rooting out a vicious passion. When the tyrant Eugenius raised that perilous war in the East, and money grew short with the emperor Theo- dosius, he determined to raise subsidies, and to gather from all parts more than before he had ever done. The citi- zens of Antioch bore this exaction with so ill a will, that, after they had uttered many outrageous words against the emperor, they pulled down his statues and those also of the empress his wife. A while afterwards, when the heat of their fury was past, they began to repent themselves of their folly, and considered into what danger they had cast themselves and their city. Then did they curse their rashness, confess their fault, implore the goodness of God, and with tears, "that it would please him to calm the em- peror's heart." Their supplications and prayers were solemnlysung, with sorrowful tunes and lamenting voices. Their bishop, Flavianus, employed himself valiantly, in this needful time, in behalf of the city; made a journey to Theodosius, and did his utmost to appease him: but find- ing himself rejected, and knowing that the emperor was devising some grievous punishment; and on the other side, not having the boldness to speak again, and yet much troubled in his thoughts because of his people, then came this device into his head. At such time as the emperor sat at meat, certain young boys were wont to sing musi- cally unto him. Flavianus wrought so, that he obtained of Preserving Health. iSj of those that had charge of the boys, that they would suffer them to sing the supplications and prayer of the city of Antioch. Theodosius* listening to that grave music, was so moved with it, and so touched with compassion, that having then the cup in his hand, he with his warm tears watered the wine that was in it. and forgetting all his con- ceived displeasure against the Antiochans, freely pardon- ed them and their city. "Man may most justly tuneful strains admire, His soul is music, and his breast a lyre; A lyre which, while its various notes agree, Enjoys the sweet of its own harmony. What ravishes the soul? What charms the ear? 'Tis music, though a various dress it wrear. Beauty is music too, though in disguise, Too fine to touch the ear, it strikes the eyes, And thro' 'em to the soul, the silent stroke conveys," lNTEiiif.4L Malice, only pining Hate, And Envy grieving at another's state; When these are in the human bosom nurst, Can peace reside in dwellings so accurst? Hamilton;.; Hatred is a Fury that never sleeps; ulcerates the soul; and tortures it throughout. Hence it never fails to injure the body. As admiration, the first of the passions, rises in the soul before she has considered whether the thing represented to her be good, or convenient to her, or not; so, after she has judged it to be good, there is raised in her the most agreeable and complacent of all passions, Love; and when she hath conceived the same to be evil, she is quickly moved to Hatred, which is nothing but the soul's aversion to that which threatens pain or grief, and may be defined 18 138 On Hygienic, or the art to be "a commotion produced by the spirits, that incite the soul to be willing to be separated from objects repre- sented to her as ungrateful and hurtful;" which definition only respects pure nature; but through the. corruption of men and manners, it may be said to arise from an imbibed prejudice, or envy aggravated by continuance, and height- ened by a malicipus intention of malignancy, and injur- ing the persons to whom we have a disaffection, and that too without any reason but what proceeds from a self-con- tracted wickedness. Anger is sometimes allowable, and when excessive, is still called but the vice of men; but ha- tred is said to be the sin of devils, being not confined at home, but roves abroad, seeking whom it may devour. "Cruel revenge, Which still We find, The weakest frailty of a feeble mind. Degenerous passion, and for man too base, It seats its empire in the savage race." A certain Italian, having his enemy in his power, told him there was no possible way for him to save his life, un- less he would immediately deny and renounce his Saviour. The timorous wretch, in hope of mercy, did it; when the other, forthwith, stabbed him to the heart, saying that now he had a full revenge, for he had killed at once both his body and soul. In the reign of Edward VI. upon the alteration of re- ligion, there was an insurrection in Cornwall and divers other counties, wherein many were taken and executed by martial law. The chief leaders were sent to London, and there executed. The sedition being thus suppressed, it is memoralile what cruel revenge or sport Sir W illiam Kington, provost-martial, made by virtue of his office, upon men in misery. One Boyer, mayor of Bodmin in Cornwall, had been amongst the rebels, not willingly, but enforced. To him the provost sent word that he would come and dine with him, for whom the mayor made great provision. A little before dinner, the provost took the mayor aside, and whispered him in the ear, "That an execution must that day be done in the town, and there- fore required that a gallows should be set up against din- ner should be over." The mayor failed not of his charge. of Preserving Health. 139 Presently after dinner, the provost, taking the mayor by the hand, desired him to lead him to the place were the gallows was; which, when he beheld, he asked the mayor, "If he thought it to be strong enough?" "Yes," said the mayor, "doubtless, it is." "Well, then," said the pro- vost, "get you up speedily, for it is provided for you." "I hope," answered the mayor, "you mean not as you speak!" "In faith," said the provost, "there is no reme- dy, for you have been a busy rebel:" and so, without re- spite or defence, he was hanged. Near the said place dwelt a miller, who had been a busy actor in that rebel- lion, who, fearing the approach of the marshal, told a stur- dy fellow, his servant, that he had occasion to go from home, and, therefore, if any came to inquire for the mil- ler, he should not speak of him, but say that he was the miller, and had been so for three years before. So, the provost came, and called for the miller, when out comes the servant, and said, "he was the man." The provost demanded, how long he had kept the mill? "These three years," answered the servant. Then the provost command- ed his men to lay hold of him, and hang him on the next tree. At this the fellow cried out, "that he was not the miller, but the miller's man." "Nay, Sir, said the pro- vost, "I will take you at your word. If thou beest the miller thou art a busy knave; if thou art not, thou art a false lying knave; and, howsoever, thou canst never do thy master better service than to hang for him;" and so, with- out more ado,, he was despatched. Revenge is but a frailty, incident To craz'd and sickly minds; the poor content Of little souls, unable to surmount An injury, too weak to bear affront. Drtden. Revenge is a great sign of cowardice, when an enemy is at one's mercy. There is more bravery and disdain in slighting a private enemy, and despising revenge, than in cutting his throat: not that a man should be insensible of an injury or affront, but that he should not carry his resentments too far, where a gentle revenge is sufficient. Excellent was the advice that was given to the Romans 140 On Hygieine, or the art by the ambassadors of some cities in Etruria, "That since they were men, they should not resent any thing be- yond human nature; and that in mortal bodies they should not carry immortal feuds." Light injuries are made none by disregarding them; which, if revenged, grow grievous and burthensoine, and live to hurt us, when they might die to secure us. It is princely to disdain a wrong; and they say, princes, when ambassadors have offered indecencies, used not to chide, but deny them audience; as if silence were the royal way to revenge a wrong. When the duke of Alva was in Brussels, about the he- ginning of the tumults in the Netherlands, he had sat down before Hulst, in Flanders; and there was a provost-mar- shal in his army who was a favourite of his, and this pro- vost had put some to death by secret commission from the duke. There was one captain Bolea in the array, who was an intimate friend of the provost's; and one evening late he went to the captain's tent, and brought with him a confessor and an executioner, as it was his custom. He told the captain he was come to execute his excellency's commission and martial law upon him. The captain started up suddenly, his hair standing upright, and being struck with amazement, asked him, "Wherein have 1 of- fended the duke?" The provost answered, "Sir, I am not to expostulate the business with you, but to execute my commission; therefore, I pray prepare yourself, for there is your ghostly father and executioner." So he fell on his knees before the priest, and having done, and the hang- man going to put the halter about his neck, the provost threw it away, and breaking into a laughter, told him, "there was no such thing, and that he had done this to try his courage, how he would bear the terror of death." The captain, looking ghastly at him, said, "Then, Sir, get you out of my tent, for you have done me a very ill office." The next morning, the said captain Bolea, though a young man of about thirty, had his hair all turned grey, to the admiration of all the world, and the duke of Alva himself, who questioned him about it; but he would con- fess nothing. The next year the duke was recalled, and in his joHrney to the court of Spain, he was to pass by Saragossa, and this captain Bolea and the provost went along with him as his domestics. The duke being to re- of Preserving Health. 141 pose some days in Saragossa, the young old captain Bolea told him, "that there was a thing in that town worthy to be seen by his excellency, which was a casa de loco,n bed- lam house, such a one as there was not the like in Chris- tendom." "Well," said the duke, "go and tell the war- den I will be there to-morrow in the afternoon." The cap- tain having obtained this, went to the warden, and told him the duke's intention; and that the chief occasion that moved him to it was, that he had an unruly provost about him, who was subject often times to fits of frenzy; and, be- cause he wished him well, he had tried divers meaiV^to cure him, but all would not do,- therefore, he would try whether keeping him close in bedlam for some days would do him any good. The next day the duke came with a great train of captains after him, amongst whom was the said provost, very shining and fine. Being entered into the house about the duke's person, captain Bolea told the warden, pointing at the provost, "that's the man:" the warden took him aside into a dark lobby, where he had placed some of his men, who muffled him in his cloak, seized upon his sword, and hurried him into a dungeon. The provost had lain there two nights and a day; and af- terwards it happened that a gentleman, coming out of curiosity to see the house^peeped into a small grate where the provost was. The provost conjured him, as he was a Christian, to go and tell the-duke of Alva his provost was there confined, nor could he imagine why. The gentle- man did his errand; and the duke, being astonished, sent for the warden with his prisoner. The warden brought the provost in cnerpo, full of straws and feathers, madman- like, before the duke; who, at the sight of him, burst into laughter, asking the warden why he had made him pris- oner? "Sir," said the warden, "it was by virtue of your excellency's commission, brought me by captain Bolea." Bolea stepped forth, and told the duke, "Sir, you have asked me oft how these hairs of mine grew so suddenly grey; 1 have not revealed it to any soul breathing; but now I'll tell your excellency;" and so related the passage in Flanders; and added—"I have been ever since beating my brains to know how to get an equal revenge of him, for making me old before my time." The duke was so well pleased with the story, and the wittiness of the re- venge, that he made them both friends. 14S On Hygieine, o\r the art m —Malicious Envy rode Upon a ravenous wolf, and still did chew Between his canker'd teeth, a ven'mous toad, That all the poison ran about his jaw: But, inwardly, he chewed hisown maw At neighbour's wealth, that made him ever.sad: ^ For death it was when any good he saw, *' And wept, that cause of weeping none he had, But when he heard of harm, he wax'd wond'rous glad. He hated all good works, and virtuous deeds, And him no less that any like did use; And who with gracious bread the hungry feeds, >■ His alms for want of faith", he doth accuse; So every good to bad he doth abuse; And eke the verse of famous poets' wit, He does backbite, and spiteful poison spews From lep'rous mouth on all that ever writ: Such one, vile Envy was. SPEHSEH. To repine at the superior happiness of others, is the nature of Envy. It arises from self-love or self-interest, particularly in such individuals whom nature has denied certain qualifications of body or mind, which they cannot avoid seeing in others. It is almost the only vice which is practicable at all times. and in every place; the only passion which can never lie quiet for want of irritation; its effects are, therefore, every way discoverable, and its, attempts always to be dreaded. Envy commands a secret band, With sword and poison in her hand. Around her haggard eye-balls roll, A thousand fiends possess her soul. The artful, unsuspected spright, With fatal aim attacks by night. Her troops advance with silent tread, And stab the hero in his bed; Or shoot thewing'd malignant lie, And female honours pine or die. Cotton. of Preserving Health, 143 Solomon emphatically styles "Envy, a rotteness of the bones." and we too often witness its baneful effects on those who cherish the fatal poison. It shows itself in hor- rors even on the face of young females, who, it might be supposed, could not possess so odious a passion. Observe an envious girl, while pleased with herself, appears quite beautiful and pleasing in her manners; but on the appear- ance of one of her sex, a school-mate, of superior beauty and endowments, her countenance becomes stangely al- tered. In like manner the spirits become depressed; and, as the body cannot remain undisturbed, when the mind, to wliich it is so nearly attached, is in such misery, the person who is tormented with it cannot enjoy good health: For it is the passion of the damned; and, as it richly de- serves punishment, it never escapes it. A French lady of quality that was well married, and lived in plenty, hearing her husband's brother had mar- ried a very handsome lady with a great fortune, was mightily out of humour, insomuch, that she perfectly hated all that spoke in the commendation of her new sister-in- law, and hearing her husband also commend her as a ve- ry beautiful woman, she bribed a servant in that lady's family to poison her; but he, discovering the design, and the lady being reproached for it by the husband, she pois- oned herself and died. Envy's the worst of fiends, procurer of sad events, And only good when she herself torments. Cowley. Plutarch compares envious persons to cupping-glasses, which ever draw the worst humours of the body to them. Like flies, they resort only to the raw and corrupt parts of the body; or, if they light on a sound part, never leave blowing upon it till they have disposed it to putrefaction. When Momus could find no fault with the face in the pic- ture of Venus, he picked a quarrel with her slippers; and so malevolent persons, when they cannot blame the sub- stance, will yet represent the circumstance of men's best actions with prejudice. The black shadow is still observ- ed to wait upon those that have been the most illustrious l4l On Hygieine, or the art for virtue, or remarkable for some kind of perfection: and to excel in either has been an unpardonable crime. "The man who envies, must behold with pain Another's joys, and sicken at his gain." When Aristides, so remarkable for his inviolable attach- ment to justice, was tried by the people at Athens, and condemned to banishment; a peasant, unacquainted with the person of Aristides, applied to him to vote against Aristides. "Has he done you any wrong," said Aristides, "that you are for punishing him in this manner?" "No," replied the countryman, "I don't even know him; but I am tired and angry with hearing every one call him the just." Mutius, a citizen of Rome, was noted to be of such an envious and malevolent disposition, that Publius, one day observing him to be very sad, said, "Either some great evil has happened to Mutius, or some great good to another." Medicines cannot cure a disease so odious. Educa- tion and improvement of morals are its only antidotes.— Envious persons commonly give too much importance to trifles; hence they ought to be instructed to employ them- selves in more useful pursuits; to judge of things accord- ing to their true value, and to accustom themselves to a philosophic calmness, learning how to overcome, or at least to moderate, their selfishness; to counterbalance their expectations with their deserts; and to equal or sur- pass others in their merits, rather than in their preten- sions. of Preserving Health. 145 ®W MfWMMWmb Asd, Oh! what man's condition can be worse Than his, whom plenty starves and blessings curse* The beggars but a common fate deplore; The rich poor man's emphatically poor. If cares and troubles, envy, grief, and fear. The bitter fruits be what fair riches bear, It'a new poverty grows out of store, The old plain way, ye gods! let me be poor. Cowxr.i. This vile passion, which frowns at the approach of the stranger, clinches the hand against the poor, denies all encouragement of public good, and can pinch and starve wife and children, is hardly more detestable in a moral point of view, than it is pernicious in a physical. It is true, that by his unwillingness to part with his money, the miser is generally a temperate, and even an abstemi- ous character, and so far his vice is beneficial to his health; but, in many other respects, this detestable vice operates very hurtfully to the health of him who is cursed with it. By the extreme eagerness to make money, by the distress- ing fears about keeping it, by the inconsolable grief for losing it; besides the heart-achs, the envies and jealousies, the sleepless nights, wearisome days, and numberless other ills which it inflicts on its slaves, it often ruins their health, and brings them down to the grave by some lingering disease, or more horrible suicide. History tells us of illustrious villains; but there never was an il- lustrious miser in nature. Can wealth give happiness? Look round, and see What gay distress! what splendid misery! Whatever Fortune lavishly can pour, The mind annihilates, and calls far more. Young. To declaim against riches, is like an hungry man in- reigning against wholesome food, and a naked man rail- ing at warm clothing; it is spending breath to no purpose, 19 146 On Hygieine, or the art and one should sooner be stigmatised with the character of a fool or a madman, than gain belief that the harangue is more than a copy of one's countenance, or like the fox cursing the grapes that were out of his reach; for there are so many good uses to which riches may be employed, that to inveigh against them is to satirise upon acts of piety, beneficence, and charity. But to be poor in the midst of riches is the most insupportable kind of pov- erty. In vain our fields and flocks increase our store, If our abundance makes us wish for more. Rose. Thegreatand learned Hippocrates wished a consultation of all the physicians in the world, that they might advise together upon the means how to cure covetousness. It is now above two thousand years ago since he had this de- sire; and after him a thousand and a thousand philoso- phers, have employed their endeavours to cure this insa- tiable dropsy. All of them have lost their labours. The evil rather increases than declines under the multitude of remedies. There have been a number in former ages sick of it; and this wide hospital of the world is still as full of such patients as ever it was. A rich cotton planter in Georgia, in consequence of losing two cents in the pound on a crop of cotton, was seized with such a sadness of heart, that he took to his bed, and refusing to be shaved, shirted, or to take suit- able nourishment, died miserable. He was a bachelor, and his estate, on appraisement, amounted to nearly one hundred thousand dollars! In York county, Pennsylvania, a farmer, so wealthy as to raise one hundred bushels of clover seed on his own lands, in consequence of losing five dollars per bushel on his clover seed, that is, only getting seven dollars in Phi- ladelphia, after he had been offered twelve for it at home, was struck with such a deadly heart anguish, that be went into a fit of despondence, and hung himself. After bis of Preserving Health. 147 death, silver to the amount of two hundred thousand dol- lars was found barrelled up in bis cellar. Vain man! 'tis heaven's prerogative To take, what it first design'd to give, Thy tributary breath: In awful expectation plac'd, Await thy doom, nor impious haste To pluck from God's right hand his instruments of death. Warton. Hippocrates, in his epistle to Crateva the herbalist, gives him this advice for the cure of some rich patients, that if it were possible he should cut up that weed of Covet- ousness by tiie roots, that there might be no remainder left, then he might be certain, that, together with their bodies, he might cure all the diseases of their minds. ®T SifS^MIaM^^W^ We curse not wine—the vile excess we blame; More fruitful than the accumulated board, Of pain and misery For the subtle draught Faster and surer swells the vital tide; And with more active poison than the floods Of grosser crudity convey, pervades The far remote meanders of our frame. _________________For know whate'er Beyond its natural fervour hurries on The sanguine tide; whether the frequent bowl, High seasoned fare, or exercise to toil Protracted, spurs to its last stage tir'd life, And sows the temples with untimely snow. Abmstbono. Temperance, by fortifying the mind and body, leads to happiness. Intemperance, by enervating them, ends in misery. And those who destroy a healthy constitution of body by intemperance, do as manifestly kill themselves, as those who hang, poison, or drown themselves. Virtue 148 On Hygieine, or the art is no enemy to pleasure; but, on the contrary, is its most eertain friend. Her office is to regulate our desires, that we may enjoy every pleasure with moderation; and then our relish for them will continue. Pleasure, my friend! on this side folly lies; It may be vig'rous, but it must be wise: And when our organs once that end attain, Each step beyond it is a step to pain. Cawtiiorn. Anacharsis, the Scythian, in order to deter young men from that voluptuousness ever attended with ill effects, applied his discourse to them in a parable, telling them that the vine of youthful gratification had three branches, producing three clusters. "On the first," says he, "grows pleasure; on the second, sottishness; on the third, sadness.*' Struck by the powerful charm the gloom dissolves In empty air: Elysium opens round. A pleasing frenzy buoys the lighten'd soul, And sanguine hopes dispell your fleeting cares: And what are difficult, and what was dire, Yields to your prowess and superior stars; The happiest you, of all that e'er were mad, Or are, or shall be, could this folly last. But soon your heaven is gone; a heavier gloom Shuts o'er your head; and, as the thund'ring stream Swoln o'er its banks with sudden mountain rain, Sinks from its tumult to a silent brook; So, when thefrantic raptures in your breast Subside, you languish into mortal man: You sleep,----and waking, find yourself undone; For, prodigal of life, in one rash night You lavish'd more than might support three days. A heavy morning comes; your cares return With tenfold rage. Armstrong. Drinking is undoubtedly the most miserable refuge from misfortune. It is the most broken of all reeds. This so- lace is truly short-lived; when over, the spirits commonly of Preserving Health. 149 sinking as much below their usual tone, as they had been before raised above it. Hence a repetition of the dose be- comes necessary, and every fresh dose makes way for another, till the miserable man is rendered a slave to the bottle; and at length falls a sacrifice to what at first, per- haps, was taken only as a medicine. Unhappy man, whom sorrow thus and rage, Two different ills, alternately engage. Who drinks, alas! but to forget; nor sees That melancholy, sloth, severe disease, Memory confused, and interrupted thought, Death's harbingers, lie latent in the draught, And in the flowers that wreathe the sparklingbowl, Fell adders hiss, and poisonous serpents roll. Prior. Were the pleasures of the palate lasting, says Cornaro, there would be some excuse for inebriety; but it is so tran- sitory, that there is scarce any distinguishing between the beginning and the ending; whereas, the diseases it produces are very durable. O'er the dread feast malignant Chemia scowls, And mingles poison in the nectar'd bowls; Fell Gout peeps grinning through the flimsy scene, And bloated Dropsy pants behind unseen: Wrapp'd in his robe, white Lepra hides his stains, And silent Frenzy, writhing, bites his chains. Darwin. The story of Prometheus seems to have been invented by physicians in those ancient times when all things were clothed in hieroglyphic, or in fable. Prometheus was painted stealing^e from heaven, which might well repre- sent the inflammable spirit produced by fermentation, that may be said to animate and enliven the man of clay: whence the conquest of Bacchus, and the heedless mirth and noise of his devotees. But the after punishment of those who steal this accursed fire, is a vulture gnawing the liver; which well allegorises the poor inebriate, la- *50 On Hygieine, or the art bouring under painful hepatic diseases. It is thus beau- tifully described by Darwin. So when Prometheus braved the Thunderer's ire, Stole from his blazing throne ethereal fire, And lai tem'd in his breast, from realms of day, Bore the bright treasure to his man of clay:— High on cold Caucasus, by Vulcan bound, The lean, impatient vulture flutt'ring round; His writhing limbs in vain he twists and strains, To break or loose the adamantine chains: The gluttonous bird, exulting in his pangs, Tears hisswoln liver with remorseless fangs. Let those who have been enticed frequently to taste spirituous liquors, till at length they begin to have a fond- ness for them, reflect a moment on the danger of their situation; and resolve to make a speedy and honourable retreat. Remember, that custom soon changes into ha! it; that habit is a second nature, more stubborn than the first; and, of all things, most difficult to be subdued. Remem- ber, that it is by little unsuspecting beginnings, that this unfortunate vice is generally contracted; and, when once confirmed, scarcely terminates but with life! Learn, then, in time, to resist this bewitching spirit, whenever it tempts you. Then will you find yourself so perfectly easy with- out it, as at length never to regret its absence; nay, pecu- liarly happy in having escaped the allurements of such a dangerous and insidious enemy. Those who pride themselves in living fast, and are bent upon "a short and merry life," though, in truth, it is a short and miserable one, will, doubtless, spurn at these admonitions, and run headlong to their own destruction. Strange infatuation! Can you submit to such despicable bondage, and tamely give up your freedom without one generous struggle? The present conflict, remember, is not for the fading laurel or tinselled wreath, for which others so earnestly cont'iid. but for those more blooming, more substantial honours, which Health, the daughter of Temperance, only can bestow. For it is thine, O Health! and thine alone, to diffuse through the human breast that genial warmth, that serene sunshine which glows in the cheek, shines in the eye, and animates the whole frame! of Preserving Health. 151 But, if still you have no regard for this blessing, let me remind you of an hereafter! "To die—to sleep—to sleep! perchance to dream— Ay, there's the rub!" If death was nothing, and nought after death; If, when mei died, at once they ceas'd to be, Returning to the barren womb of Nothing, Whence they sprung—then might the wretch That's weary of the world, and tired of life, At once give each inquietude the slip, By stealing out of being when he pleased, And by what way; whether by hemp or steel, Death's thousand doors are open. Who could force The ill-pleased guest to sit out his fuil time, Or blame him if he goes? Sure, he does Well That helps himself as timely as he can, When able. But if there's an hereafter, And that there is, Conscience uninfluenced, And suffer'd to speak out, tells every man; Then must it be an awful thing to die: More horrid yet to die by one's own hand. Self-Murder! dreadful deed! our island's shame, That makes her the reproach of neigbb'ring states: Shall Nature, swerving from her earliest dictates, Self-preservation, fall by her own act? Forbid it Heaven! Let not, upon disgust, The shameless hand be foully crimson'd o'er With blood of its own lord. Dreadful attempt! Just reeking from self-slaughter, in a rage To rush into the presence of our Judge; As if we challenged him to do his worst, And heeded not his wrath. Blair. It is an invariable law of our present condition, that every pleasure, which is pursued to excess, converts itself to a pois >n. Could we expose to view the monuments of death, they would read a lecture on moderation much more powerful than any that the most eloquent writers can give. You would behold the graves, peopled with the victims of intemperance. You would behold those chambers of dark- 15S On Hygicine, or the art ness, hung round, on every side, with the trophies of luxu- ry, drunkenness, and sensuality. So numerous would you find those victims to iniquity, that it may be safely assert- ed, where war or pestilence have slain their thousands, intemperate pleasure has slain its ten thousands. By unhappy excesses, how many amiable dispositions have been corrupted or destroyed! how many rising ca- pacities and powers have been suppressed! how many flat- tering hopes of parents and friends have been totally ex- tinguished! Who, but must drop a tear over human nature, when he beholds that morning, which arose so bright, overcast with such untimely darkness; that good humour, which once captivated all hearts; that vivacity, which sparkled in every company; those abilities, which were fitted for adorning the highest station, all sacrificed at the shrine of low sensuality; and one who was formed for running the fair career of life in the midst of public es- teem, cut off by his vices at the beginning of his course, or sunk, for the whole of it, into insignificancy and con- tempt. Would you extend your narrow span, And make the most of life you can; Would you, when med'cines cannot save, Descend with ease into the grave; Calmly retire like evening light, And cheerful bid the w orld good night? Let temperance constantly preside Our best physician, friend, and guide! The Father justly describes the nature of this beastly vice, when he saith of it, that "It is a flattering devil; a sweet poison; a delightful sin; which he that hath, possess- eth not himself; and he that acts it, doth not only commit a sin, but is wholly converted into sin, being deserted of his reason, which is at once his counsellor and guardian." A young gentleman of the most respectable parentage, being rather intemperate, was urged by his parents to marry, thinking that might produce a change of his habits. He paid his addresses to a most amiable young lady, of of Preserving Health. ±52 a fair estate, to whom he was soon united in wedlock — It was not many months after marriage, before he resum- ed his former habits, and what with drinking and gam- bling, he very soon exhausted the whole of her fortune. Executions being out against him, he was compelled to keep at home, where he did nothing but get drunk and abuse his amiable wife. One nighCfilled with rage, he re- solved to destroy her, and going at a late hour into the kitchen, where she had been constrained to retire fivin his abuse, he continued hi* opprobrious language to her, and notwithstanding she gave him only hiving and kind words, yet he struck her over the head with a large stick, which she bore patiently, although it much injured her face. He still continuing to rage ait her, wearied, and in great fear, she rose up and went to the door. Here he followed her, with a chopping-knife in his hand, with which he struck at her wrist, and cut her very much; no help being near but an old woman, who durst not in- terpose, fearing for her own life, who prayed her mistress to stay and be quiet, hoping all would be well, and so get- ting a napkin, bound up her hand with it. After this, stiil railing and raging at his wife, he struck her on the forehead with an iron cleaver, whereupon she fell down bleeding; but recovering herself, upon her knees she prayed unto God for the pardon of her own and her hus- band's sins, praying God to forgive him as she did. But as she was thus praying, the infernal demon, her hus- band, split her skull open with the cleaver, so that she died immediately: for which he was apprehended, con- demned, and hanged. But so callous was the wretch, that even under the gallows he did not exhibijt any marks of repentance. It is a lamentable fact, so great is the infatuation of this vice, that few, once deluded, have ever after recover- ed their freedom. Some, glorious instances, however, have occurred, wliich is surely fine encouragement to others. We also have the pleasure to find none are greater enemies to vice, than those who formerly were the slaves of it, and have been so fortunate as to break their chain and recover their liberty. 20 154 On Hygicine, or the art A medical gentleman in Virginia, who was married to a most amiable lady, by associating with dissipated char- acters, became at length intemperate himself. As soon as lie acquired habits of intemperance, his disposition was altered, and from an affectionate husband he proved very turbulent, and treated his wife so ill that she was con- strained to separate from him. After living a disorderly life for some time, he was brought to a sense of reflection, and with an entire change of mind and manners, he re- nounced all vicious habits, plead guilty before his amiable wife, who was ready to forgive, and they have since lived in the utmost harmony. So sensible is he of the danger of using spirituous and vinous liquors to excess, that he will not taste them, lest he should be enticed to exceed the bounds of moderation; and whenever he sees a person so inclined, never fails to caution him against so insidious an enemy. A gentleman in Maryland, addicted to drunkenness, hearing a considerable uproar in his kitchen one night, felt the curiosity to step without noise to the door, to know what was the matter; when, behold, they were all indulging in the most unbounded roars of laughter, at a couple of his negro boys, who were mimicking himself in his drunken fits!—as, how he reeled and staggered! how he looked and nodded, and hickupped and tumbled! The pictures which these children of nature drew of him, and which had filled the rest with such inexhaustible mer- riment, struck him with so salutary a disgust, that from that night he became perfectly a sober man, to the in- expressible joy pf his wife and children. A very respectable gentleman in Philadelphia, had a wife who, by her fondness for strong drink, had almost broken his heart. At length he was advised, "as a des- perate remedy in a desperate disease," to place a barrel of spirits in her closet, and let her kill herself as soon as possible, since every persuasive means had been used in vain to break her of this beastly vice. At the sight of so extraordinary a visitant in her closet, she was struck with such horror at the idea of the dreadful design on which it was placed there, that she was immediately reclaimed. of Preserving Health. 555 .ind recovered all the purity and lustre of her former character, to the infinite joy of her husband, children, and numerous friends. O Temperance! support and attendant of other virtues! Preserver and restorer of health! Maintainer of the dig- nity and liberty of rational beings, from the wretched, in- human slavery of Sensuality, Taste, Custom and Exam- ple! Brightener of the understanding and memory! Sweetener of life and all its comforts! Companion of rea- son, and guardian of the passions! Bountiful rewarder of thy admirers and followers! how do thine excellencies ex- tort tiie unwilling commendations of thine enemies! and with what rapturous delight can thy friends raise up a panegyric in thy praise! ®3F <&jyBQ!2£TOt The love of gaming is the worst of ills: With ceaseless storms the blacken'd soul it fills; Inveighs at Heaven, neglects the ties of blood; Destroys the power and will of doing good; Kills health, pawns honour, plunges in disgrace, And, what is still more dreadful—spoils her face. Youxo. While gaming keeps within the bounds of innocent diversion, to recreate the body, or compose the mind, and is not tainted with covetousness or passion, the most strait-laced casuist will not censure or condemn it as a crime; but, when it breaks the limits of moderation, and transports men into heats, swearing, cursing, reproach- ing, and lying; or is taken up as a trade to live by, and pushed on by a covetous desire to enrich ourselves by the loss and ruin of one's neighbour, it is absolutely unlaw- ful, carefully to be avoided, and utterly abominated, as the certain procurer of repentance, sorrow, grief, disease, derision, beggary, and contempt. To play sometimes to 156 On Hygieine, or the an entertain company, says the Marquis of Halifax, or to divert yourself, is not to be disallowed; but, to do it so often as to be called a gamester, is to be avoided, next to the things that are most criminal. It has consequences of several kinds not to be endured; it will engage you in- to a habit of idleness and ill hours, draw you into bad company, make you neglect your business, bring you to poverty and, disgrace, cause sleepless nights, and destroy health. What fool would trouble Fortune more. When she has been too kind before; Or tempt her to take back again What she had thrown away in vain, By idly venturing her good graces To be dispos'd of by umes-aces; Or settling it in trust, to uses Out of his power, on trays and deuces; To put it to the chance, and try, l' th' ballot of a box and die, Whether his money be his own, And lose it, if he be o'erthrown; As if he were betray'd, and set By his own stars to every cheat, Or wretchedly condemn'd by Fate To throw dice for his own estate. Butler. It is true, as it is lamentable, in the age we live, there are too many of all qualities and conditions excessively addicted to this abominable vice; by which many respecta- ble families have been reduced from affluence to extreme poverty. But the evil docs not stop here; it must be fresh in every memory, of the most diabolical acts having been perpetrated by persons who enlisted under the banners of a gambler, and squandered away their estate. Let the following melancholy catastrophe, which I have from the best authority, not long since took place prove a warning to others. Mr. A. S----, who had a very comfortable support, was enticed to associate himself with gamblers, and in a of Preserving Health. 157 short time lost all that he possessed, at cards and dice, which ought to have been treasured up for the subsist- ence of his family. Reflecting on the foolish manner in which he had thrown away his money, and beholding his children cry about him for victuals, so diseased his mind, that, taking advantage of his wife's absence, he cut the throats of his three children, and then hung himself. His wife, on returning home, being so much affrighted at the sight of so barbarous a tragedy, fell dead upon the spot. An old ruined gamester, in hopes to make a bubble or prey of a young gentleman that came to town with his pockets full of money, took him to a gaming-house, and there, to encourage him to play, shewed him several top- ping sparks that were born to no fortune, who by play had purchased great estates, and lived in pomp and splendour, by success in shaking their elbows. "You shew me," says the young gentleman, "the winners, but I pray what has become of the losers?" To which the old prig making no reply, a third person, overhearing their conversation, told the young gentleman, that since the other was silent and confounded with shame at the question, he would oblige him with an answer—"Many of the losers," saith he, "taking the highway to repair their losses, have been hanged; others have gone to sea to earn their bread; some have taken up the trade of being bullies to bawdy- houses; others that have not hid themselves as servants under a livery, are begging or mumping about the streets, or starving in jails for debt, where you will be ere long, if you follow that rascal's counsel." "The punishment," says the young gentleman, "is fit for the sin, when men, possessed with great sums of their own money, will play the fool to make it another man's; and, if this be the hu- mour of the town, I will return again to the country, and spend my estate among my neighbours and tenants, where you, Sir," speaking to the gentleman that dealt so plainly with him, "shall be very welcome." 153 On Hygieine, or the art So W"eak are human kind by Nature made, Or to such weakness by their vice betray'd; Almighty Vakity! to thee they owe Their zest of pleasure, and their balm of wo. You.vg. Vanity consists of an agreeable reverie; and is well ridiculed in the story of Narcissus, who so long contem- plated his own beautiful image in the water, that he died from neglect of taking sustenance. On the green margin sits the youth, and laves His floating train of tresses in the waves; Sees his fair features paint the streams that pass, And bends for ever o'er the watery glass. Darwin. As the vain found their claims on qualities which they do not possess, they frequently meet with mortifications; while their extreme solicitude for distinctions they are not entitled to, can never allow them any repose; hence vani- ty is an enemy to health. Observe a lady at a ball, anxious to be thought the fin- est woman in the assembly, and doubtful of success. The pleasure, which it is the purpose of the assembly to enjoy, is lo.st to her. She does not for a moment experience such a sensation; for it is totally absorbed by the prevail- ing sentiment, and the pains that she takes to conceal it. She watches the looks, the most trivial marks of the opin- ion of the company, with the attention of a moralist, and the anxiety of a politician; and wishing to conceal from every eye the torments she feels, her affectation of gaiety at the triumph of a rival; the turbulence of her conversa- tion when that rival is applauded; the over-acted regard wliich she expresses for her; and the unnecessary efforts which she makes, betray her sufferings and constraint.— Grace, that supreme charm of beauty, never displays it- self hut when the mind is perfectly at ease, and when con- fidence prevails. of Preserving Health. 159 If we take the whole sex together, we shall find those who have the strongest possession of men's hearts, are not always eminent for their beauty. As pride destroys all symmetry and grace, so affectation is a more terrible enemy to fine faces than the small-pox. And it will al- ways be found, that the lady who has an humble opinion of herself, will have every body's applause, because she does not expect it; while the vain creature loses approba- tion through too great a sense of deserving it by her own affectation. If a beautiful, proud, and gay woman, would but seri- ously reflect on what a loathsome carcass she must ere long' become in the grave, amidst worms and corruption, it would tend to mortify her pride, lessen her vanity, and teach her to be humble. Ye proud, ambitious, wealthy, young, and gay, Who drink the spirit of the golden day, And triumph in existence, come with me, And in the mould'ring corpse your picture see, What you, and all, must soon or later be. Solitary Walks. Pride, well placed and rightly defined, is of ambiguous signification, says the late incomparable Marquis of Hali- fax: one kind being as much a virtue as the other a vice. But we are naturally so apt to choose the worst, that it has become dangerous to commend the best side of it. Pride is a sly, insensible enemy, that wounds the soul unseen. and many, who have resisted other formidable vices, have been ruined by this subtle invader; for, though we smile to ourselves, at least ironically, when flatterers bedaub us with false encomiums; though we seem many times an- gry, and blush at our praises; yet our souls inwardly re- joice; we are pleased with it, and forget ourselves. Some are proud of their quality, and despise all below it; first, set it up for the idol of a vain imagination, and then their reason must fall down and worship it. They would have the world think, that no amends can be made for the want of a great title. They imagine, that with this advantage, they stand upon the higher ground, which makes thera 160 On Hygicine, or the art look down upon merit and virtue as things inferior to them. Some, and most commonly women, are proud of their fine clothes; and when they have less wit and sense than the rest of their neighbours, comfort themselves with the reflection that they have more lace. Some ladies put so much weight upon ornaments, that if one could see into their hearts, it would be found that even the thought of death was made less heavy to them, by the contemplation of their being laid out in state, and honourably attended to the grave. The man of letters is proud of the esteem the world gives him for his knowledge; but he might easi- ly cure himself of that disease, by considering how much learning he wants. The military man is proud of some great action performed by him, when possibly it was more owing to fortune than his own valour or conduct: and some are proud of their ignorance, and have as much rea- son to be so as any of the rest; for they being also com- pared with others in the same character and condition, will find their defects exceed their acquisitions. O, sons of earth! attempt ye still to rise, By mountains pil'd on mountains to the skies? Heaven still with laughter the vain toil surveys, And buries madmen in the heaps they raise. Pope. A person of infinite wit, speaking of what might precisely be calleYfea proud and vain man, once said, "When I see him, I feel something like the pleasure of seeing a happy couple; his sdflove and he lives so happily together." Pride was not made for men: a conscious sense Of guilt, and folly, and their consequence, Destroys the claim, and to beholders tells, Here nothing but the shape of Manhood dwells. I once saw, says Dr. Darwin, a handsome young man, who had been so much flattered by his parents, that his vanity rose so near to insanity, that one might discern, by his perpetual attention to himself, and the difficulty with which he arranged his conversation, that the idea of himself intruded itself at every comma, or pause of his discourse. of Preserving Health. 161 I dreamt that, buried with my fellow clay, Close by a common beggar's side I lay; And as so mean an object shock'd my pride, Thus like a corpse of consequence I cried: "Scoundrel, begone! and henceforth touch me not, More manners learn, and at a distance rot." "Scoundrel, then," with haughtier tone, cried he, "Proud lump of earth, I scorn thy words and thee; Here all are equal, now thy case is mine, This is my rotting place, and that is thine." Dood. The cure of vanity may be attempted by excess of flat- tery, which will at length appear ridiculous, or, by its familiarity, will cease to be desired. 1 remember, says Dr. Darwin, to have heard a story of a nobleman, in the court of France, who was so disagreeably vain in conver- sation, that the king was pleased to direct his cure, which was thus performed. Two gentlemen were directed al- ways to attend him; one was to stand behind his chair, and the other at a respectful distance before him: when- ever his lordship began to speak, one of them always pro- nounced, "Lord Gallimaufre is going to say the best thing in the world." And, as soon as his lordship had done speaking, the other attendant pronounced. "Lord Gallimaufre has spoken the best thing in the world." Till, in a few weeks, this noble lord was so disgusted with praise, that he ceased to be vain, and his majesty dis- missed his keepers. 21 162 On Hygieinef or the art Hail, Modesty! fair female honour hail! Beauty's chief ornament, without whose charms Beauty disgusts, or gives but vulgar joys. Thou giv'st the smile its grace; the heightened kiss Its balmy essence sweet! AnirsTnoNo. Modesty is to virtue, what a fine veil is to beauty.— It is one of the most distinguishing and attractive char- acteristics of the female sex. It comprises the beauties of the mind, as well as those of the body; and it not only heightens the desire of the male, but deters him from rude- ness and improper behaviour. It is, therefore, the in- terest of the men to cherish, and not to injure, by indeli- cacy, a quality from which they derive so much pleasure and advantage. Naked in nothing should a woman be, But veil her very wit with modesty: Let man discover, let not her display, But yield her charms of mind with delay. Young. I remember, says a female author of great distinction, the count M----, one of the most accomplished young men in Vienna, when I was there; he was passionately in love with a girl of peerless beauty. She was the daugh- ter of a man ol great rank and influence at court; and, on these considerations, as well as in regard to her charms, she was followed by a multitude of suitors. She was live- ly and amiable, and treated them all with an affability which still kept them in her train, although it was gene- rally known that she had avowed a predilection for the count, and that preparations were making for their nup- tials. The count was of a refined mind and delicate sen- sibility; and loved her for herself alone; for the virtues which he believed dwelt in her beautiful form; t»id, like a lover of such perfections, he never approached her with- of Preserving Health. 163 out timidity; and when he touched her, a fire shot through his veins that warned him not to invade the vermillion sanctuary of her lips. Such were his feelings, when, one night, at his intended father-in-law's, a party of young people were met to celebrate a certain festival; several of the young lady's rejected suitors being present. Forfeits were one of the pastimes, and all went on with a grateful merriment, til) the count was commanded, by some witty mademoiselle, to redeem his glove by saluting the cheek of his intended bride. The count blushed, treinbled, ad- vanced to his mistress, retreated, advanced again—and at last, with a tremor that shook every fibre in his frame, with a modest grace, he put the soft ringlets, wliich play- ed upon her cheek, to his lips, and retired to demand his redeemed pledge, in evident confusion. His mistress gaily smiled, and the game went on. One of her rejected suitors, but who was of a merry, unthinking disposition, was adjudged by the same indiscreet crier of the forfeits, to snatch a kiss from the lips of the object of his recent vows. A lively contest between the lady and gentleman lasted for a minute! but the lady yielded, though in the midst of a convulsive laugh. And the count had the mor- tification, the agony, to see the lips, which his passionate and delicate love would not allow him to touch, kissed with roughness by another man, and one whom he des- pised. Without a word, he rose from his chair, and left the room, and the house—and never saw her more! Thus, by that good-nutured kiss, the fair boast of Vienna lost a husband and her lover. Although I consider this act of the count as ridiculously fastidious, yet I cannot but think it may prove a good hint to my fair readers. Certainly the sensitive plant cannot* shrink more coyly than should the lovely virgin from the slightest touch of the immodest. "Learn, then, ye fair, to keep the person sacredj ----------------------like the pure mind, Be that array'din modest dignity: Nor e'en its beauties flauntingly expose— Thus may ye keep the heart your charms have won." 164 On Hygieine, or the art The attractive grace and powerful charm of Modesty, cannot be better illustrated, than by relating the follow- ing interesting narrative. Charlotte Corday was tall and well-shaped, of the most graceful manners and modest demeanour. There was in her countenance, which was beautiful and engaging, and in all her movements, a mixture of softness and dignity, which were evident indications of a heavenly mind. She came to Paris, and under a feigned pretext gained admis- sion t<> that republican tyrant, Marat, in whose breast she plunged a dagger, acknowledged the dped, and justified it, by asserting that it was a duty she owed her country and mankind, to rid the world of such a monster. Her deportment during her trial was modest and dignified.— There was a softness so engaging in her countenance, that it was difficult to conceive how she could have armed her- self with sufficient intrepidity to execute the deed. Her answers to the questions of the tribunal, were full of point and energy. Site sometimes surprised the audience by her wit. and excited their admiration by her eloquence.— Her face sometimes beamed with sublimity, and was some- times covered with smv.es. She retired while the jury de- liberated on their verdict; and when she again entered the tribunal, there was a majestic solemnity in her demeanour, which perfectly became her situation. She beard her sentence with attention and composure, and left the court with serenity, her mind being long before prepared even for the last scene. It is difficult to conceive the heroism which she displayed in the way to execution. There was such an air of chastened exultation thrown over her coun- tenance, that she inspired sentiments of love, rather than pity. The spectators, as she passed, uncovered their heads before her, and others gave loud tokens of applause. She ascended the scaffold with undaunted firmness. When the executioner informed her that her feet must be tied to th" fatal plank, slit* submitted with a smile. When he took off her handkerchief, the moment before she bent un- der the fatal stroke, she blushed deeply; and her head, which was held up to the multitude the moment after, ex- hibited the last impression of offended modesty. Such an instance of a young female, given up to des- truction, and yet so tremblingly alive to modesty, that of Preserving Health. 165 even in her last moments she resents the slightest insult to that, more than she dreads the executioner's axe, is a dis- play of the charm, as well as the force of virtue triumphant over death, that deserves to be preserved in everlasting remembrance. Its effects on the crowd beggared all des- cription. Admiration held the gazing thousands mute. And though, while gazing on her cheeks yet divinely en- riched with the blush of deathless modesty, they shed their tears over her untimely fate; still their joy-glistening eyes seemed to thank her for such a proof of the divinity of virtue, and the birth-right of innocence to Heaven. One of the spectators, a young man, by the name of Lux, had his feelings wrought to such an adoration of her virtues, that he proposed, in a pamphlet published the day after, to erect a monument to her honoi.r, and to inscribe it with these words:—GREATER THAN BRUTUS. He was instantly sentenced to the guillotine. He received the news with joy, and died exulting that he had the honour of being offered up at the same altar with the immaculate Charlotte Corday. As lamps burn silent, with unconscious light, So modest ease, in beauty, shines most bright: Unaiming charms with edge resistless fall, And she who means no mischief, does it all. Hill. Plutarch observes, that as thistles, though noxious things in themselves, are usually signs of an excellent ground wherein they grow; so bashfulness, though many times a weakness and betrayer of the mind, is yet gene- rally an argument of a soul ingenuously and virtuously inclined. We read of many, who, through modesty and fear, when they were to speak publicly, have been so disap- pointed, that they were forced to bold their tongue. Thus Cicero writes of Cario, that being to plead in a cause be- fore the senate, he was not able to speak what he had pre- meditated. Also, Theophrastus being to speak before the people of Athens, was on a sudden so deprived of memory, that he remained silent. The same happened 166 On Hygicine, or the art to the famous Demosthenes in the presence of king Philip. Nor are we ignorant that the like misfortunes have be- fallen many excellent persons in our times. Get that great gift and talent, Impudence; Accomplish'd mankind's highest excellence; 'Tis that alone prefers, alone makes great, Confers alone, wealth, titles, and estate; Gains place at court, can make a fool a peer, An ass a bishop, can vil'st blockhead rear To wear red bats, and sit in porph'ry chair. Oldham. When once men have bid adieu to Modesty, there is nothing so unmanly, indecent, or reprehensible, but the brazen brow will venture upon; and nothing so high or great that his impudence does not pretend a title too. A gentleman being asked how it came to pass that he, being a man of extraordinary natural parts, and those improved by an University education, foreign travel, diligent study, and the knowledge of most European languages; besides, being well born, and having many friends to recommend him, missed a considerable employ- ment in the government, at a time when there were so many vacancies? The gentleman answered, The reason is plain; I have too much modesty, and too little impu- dence, to be preferred, where a higher value is put upon the latter than the former. For he that has but impudence, To all things has a fair pretence; And put among his wants but shame, To all the world may lay his claim. HuniBRAs. An Athenian, of decrepid age, came into the theatre at Athens, on a public night, when it was xery much crowd- ed. He went to that part of the house where his young countrymen were sitting, but instead of making room for him, they closed their ranks. By chance he came to the place where sat some young Lacedemonians of the first of Preserving Health. 167 distinction, who, moved with the age of the man, in rever- ence to his years and hoary hairs, rose up, and placed him in an honourable seat amongst them; which, when the people beheld, with a loud applause, they approved the modesty of another city. At which one of the Lacede- monians said, "It appears that the Athenians do under- stand what is to be done, but they neglect the practice of it." These young Lacedemonians were Heathens. How de- voutly were it to be wished, that all young Christians would copy so fair an example, and learn to treat seniori ty with a respect equally amiable and endearing. tf5S If the rude verse that now detains your ear, Should to one female heart conviction hear; Recal one gentler mind from Fashion's crew. To give to Nature what is Nature's due; —Whilst others mount the arduous heights of fame, To wake your feelings be my nobler aim: Nor yet unblest, if, whilst I fail to move, The fond attempt my kind intention prove. Rosuoa, Pliny, one of the most celebrated naturalists of anti- quity, pathetically laments, "that whilst Nature has giv- en various clothing to the brute creation, and even fenced plants and trees with bark against the injuries of the cold and heat, she should have cast man into this world naked, unprovided against the inclemency of different climates and seasons." But, instead of agreeing with that philo- sopher, that Nature has, in this particular, acted more like a cruel step-mother, than a kind and indulgent parent to man, we cannot sufficiently extol her providence and wisdom. It was no more than consistent with equity to provide the irrational part of her works with clothing 168 On Hygicine,or the art suitable to their circumstances; but man. whom she en- dued with the transcendent faculty of reason, she hath very wisely left to accommodate himself to the difference of season and climate, and to clothe himself, accordingly, with the fleeces and skins of animals, and the producls of various plants and trees. Midwifery was first practised by women. Hence the dressing of children became an art which few could attain: Each midwife strove to out do all others in this pretended knowledge. These attempts were seconded by the vanity of parents, who, too often desirous of making a show of the infant as soon as it was born, were ambitious to have as muchfinery heaped upon it as possible. Thus it came to be thought as necessary for a midwife to excel in brac- ing and dressing an infant, as for a surgeon to be expert in applying bandages to a broken limb; and the poor child, as soon as it came into the world, had as many rollers and wrappers applied to the throat and body, as if every bone had been fractured in the birth; and these often so tight, as not only to gall and wound its tender frame, but even to obstruct the motion of the organs necessary for life. Nature knows no other use of clothes but to keep the body warm. And the pressure of the abdomen by rollers or laceci jackets, impedes the action of the stomach and bowels, and the motion necessary for respiration; and con- sequently the just circulation of the blood. Hence a train of dreadful disorders ensues. The shape God has given, is too often attempted to be mended by dress, and those who know no better, believe that mankind would be frights without its assistance.— The bones of growing persons are so cartilaginous, that they readily yield to the slightest pressure, and easily as- sume the mould in which they are confined. Hence it is that so many girls, in proportion to boys, are mis-shapen. A lady, whose girls were all mis-shapen, though her family was numerous, consulted the celebrated anato- mist, Mr. Cline, on the prevention. " To have no stays,— and to let the next girl run about like 'he boys," was the excellent advice of this gentleman; which being complied with, none of the future children were afterwards marred by the ill-placed attention of the ignorant mother. bf Preserving Health. 169 It has been said, observes a celebrated female author, that the love of dress is natural to the sex; and we see no reason why any female should be offended with the asser- tion. Dress however must be subject to certain rules, be consistent with the graces, and with nature. By attend- ing to these particulars is produced that agreeable exteriop which pleases, we know not why; which charms, even Without that first and powerful attraction, beauty. "A beauty, carelessly array'd Enamours more, than if display'd. AH woman's charms were given* And o'er the bosom's vestal white, The gauze appears a robe of light, That veils, yet opens, Heaven." Fashion, in her various flights, frequently soars be- yond the reach of propriety. Good sense, taste, and deli- cacy, then make their appeal in vain. Her despotic and arbitrary sway levels and confounds. Where is delicacy? where is policy? we mentally exclaim, when we see the fair inconsiderate votary of fashion exposing, unseemly, that bosom which good men delight to imagine the abode of innocence and truth. Can the gaze of the voluptuous, the unlicensed admiration of the profligate, compensate the woman of sentiment and purity, for what she loses in the estimation of the moral and just? But, delicacy apart, what shall we say to the blind Conceit of the robust, the coarse, the wanton fair one, wrho thus obtrudes the ravages of time upon the public eye? Nature having maintained a harmony between the figure of a woman, and her years, it is decorous that the consistency should extend to the materials and fashion of her apparel. For youth to dress like age, is an instance of bad taste seldom seen. But age affecting the airy gar- ment of youth, the transparent drapery of Cos, and the sportiveness of a girl, is an anachronism, as frequent as it is ridiculous. Virgin, bridal Beauty, when she arrays herself with taster obeys an end of her creation; that of increasing her charms in the eyes of some virtuous lover, or the husband of her bosom. She is approved. But when the wrinkled fair, 22 170 On Hygicine, or the art the hoary-headed matron, attempts to equip herself for con- quest, to awaken sentiments w hich, the bloom of her cheek gone, her rouge can never arouse; then we cannot but de- ride her folly. There is a mediocrity which bounds all things, and even fixes the standard which di\ides virtue from bombast. --------------------------Loveliness . Needs not the foreign aid of ornament; But is, when unadorn'd, adorn'd the most. It is worthy of remark, an unaffected beauty carries with it a respect and superiority that proceeds from the impulse of nature, and not from the artifice of those that have it. "Taste." says Dr. Knox, "requires acongruity between the internal character, and the external appearance."— Another author, the discriminating Chesterfield, observ- ed, that "a prepossessing exterior is a perpetual letter of recommendation." Hence we see that the desire of exhibiting an amiable exterior is essentially requisite in women. It is to be re- ceived as an unequivocal symbol of those qualities, which we seek in a wife; it indicates cleanliness, sweetness, a love of order, and universal propriety. What, then, is there to censure in a moderate consideration of dress? Nothing. We may blame, when we find extravagance, profusion, misappropriation; the tyranny of fashion; slavery to vanity; in short, bad taste! Fashions like manners, still from courts descend, And what the great begin, the vulgar end. Honour's a mistress all mankind pursue; Yet most mistake the false one for the true: Lur'd by the trappings, dazzled by the paint, We worship oft the idol for the saint. Courted by all, by few the fair is won; Those lose who seek her, and those gain who shun, Naked she flies to merit in distress, And leaves to courts the garnish of her dress. of Preserving Health. 171 Although we cannot suppose prodigality in dress would recommend the wearers to persons of sense; yet we con- sider that a decent habit, proportioned to one's quality and business, is essentially necessary. Philupsemon, commonly called the Great, was a person of a very mean aspect, and one that took no care to set himself off With decent apparel, by wliich means he was often affronted by such people as could not distinguish the man from his clothes. He sent notice to one of his friends in M gara that he would take a supper with him, who went immediately to market to provide an entertainment, and requested his w ife, in the mean time, to right up the louse that it might be fit. to entertain so noble a guest.— Philopsemon, it seems, made greater haste than his atten- dants; and the wife of the house, by the meanness of his dress, taking him to be a servant, emplo^d him in cleav- ing wood for the fire, which he was busyat when his friend returned from the market, who bc'-'g astonished at the sight, said, "Why does my great friend Pliilopeemon dis- honour himself and me, by stoo.n'ngto so mean an office?" The great man, with a checr&f »ntl smiling countenance, answered, "I am taking prance for my homely face and bad apparel." Though we cann-'t hope entirely to escape the unplea- sant sensations ji* altogether to ward off the fatal effects, occasioned ly the sudden changes of our climate; yet, considering properly the nature of clothing, we may avoid much of (lie danger. If ladies are subject to catch cold more frequently than men, it is not alone their delicacy of constitution, or their being more confined within doors; but the frequent changes they make in the quality and quantity of their garments, and sometimes, however fear- ful of a partial current of air, because they expose those parts of the body that little before had been warmly clad. If a greater proportion of females fall victims to consump- tion, is it not because, losing sight more than men of its primary purpose, says Dr. Beddoes, they regulate their dress solely by fantastic ideas of elegance? After the high encomiums bestowed upon flannel by so many respectable authors, both ancient and modern, and i7% On Hygicine, or the art by persons who, from long experience, have ascertained its beneficial effects, it is surprising that any individual should be whimsical or hardy enough to dispute its general salu- brity, merely with a view to establish a favourite hypo- thesis. It has been objected, that flannel worn next the skin is debilitating, because it too much increases perspira- tion; but this is not founded on truth, since perspiration, as long as the skin remains dry, never can be hurtful. In answer to another objection against the wearing of flan- nel, it is certain that a flannel shirt may preserve the body as clean, and much cleaner, than linen, if as frequent- ly changed. To cold or phlegmatic temperaments; to all who lead a sedentary li|e; to individuals subject to catarrhs, or fre- quent colds, gout, diarrhoea, and partial congestions of the blood; to ah nervous patients and convalescents from severe chronic disorders; to persons who are too suscep- tible of the impressions of the atmosphere; and, lastly, in such climates and pursuits of life, as are exposed to fre- quent and sudden change of air, the wearing of flannel next to the skin is certainly a salutary dress. It will also be found a better preventive contagion than any other; because, while it encourages peiSpiration, it at the same time removes the inhaled poisonous particles. It is a mis- taken notion that flannel is too warm ■*. clothing for sum- mer. I have never found the least im>nvenience from wearing it during the hottest weather; but, -*n the contra- ry, have experienced the greatest advantage. A cele- brated author's favourite recipe for health was, *to leave off flannel on mid-summer day, to resume it the day fol- lowing." To keep an animal in health, beside the retaining of a due degree of animal heat, there must be a continual gene- ration of new juices, and a perpetual dircharge of the old. Without the due quantity of perspiration, which, with us, depends very much on our clothing, neither the vegetable nor animal can continue in health. A plant, whose perspi- ration is stopt, becomes sickly and dies. Even an egg, whose shell has been covered with a varnish, and the per- spiration stopt, will produce no animal. of Preserving Health. iy$> The grand discharge, the effusion of the skin, Slowly impair'd, the languid maladies Creep on, and through the sick'ning functions steal; As, when the chilling east invades the spring, The delicate Narcissus pines away In hectic langour; and a slow disease Taints all the family of flowers, condemned To cruel heav'ns. But why, already prone 1 o fade, should beauty cherish its own bane! O shame.1 O pity! nipt with pale quadrille, And midnight cares, the bloom of Albion dies. AHMSTnON-U. Cle anline ss may be considered the grand secret of pre- serving beauty, as well as promoting health; and, there- fore, is applicable to all ages and sexes. It maintains the limbs in their pliancy; the skin in its softness; the complex- ion in its lustre; the eyes in their brightness; the teeth in their purity; and the constitution in its fairest vigour. The frequent use of tepid baths is not more grateful to the sense, than it is salutary to health, and to beauty.— By such ablution, all impurities are thrown off; cutaneous obstruction removed; and, while the surface of the body is preserved in its original brightness, many threatening disorders are put to the rout. Indeed, so important is this regimen, that every family shouhl make a bathing vessel as indispensable an article in the house as a table. Against the rigours of a damp, cold Heaven, To fortify their bodies, some frequent The gelid cistern; and, where nought forbids., 1 praise their dauntless heart.--------- With us, the man of no complaint demands The warm ablution, just enough to clear The sluices of the skin; enough to keep The body sacred from indecent soil. Still to be pure, ev'n did it not conduce, As much it does, to health, were greatly worth Your daily pains. »Tis this adorns the rich; The want of this is poverty's worst wo; 17^ On Hypeine, or the art With this external virtue, age maintains A decent grace; without it, youth and charms Are loathsome. This the venal graces know; So, doubtless, do your wives; for married sires, As'well as lovers, still pretend to ta^te; Nor is it less, all prudent wives can tell, To lose a husband's than a lover's heart. Armstrong. Cleanliness is certainly agreeable to our nature. It sooner attracts our regard than even finery itself, and often gains esteem where that fails. It is an ornament to the highest, as well as the lowest situation, and can not be dispensed with in either. I had occasion, says the author of the Spectator, to go a few miles out of town, some days since, in a stage-coach, where I had for my fellow-travellers,a dirty beau, and a pretty young quakcr woman. Having no inclination to talk much, 1 placed myself backward, with a design to survey them, and to pick a speculation out of my two com- panions. Their different figures were sufficient to draw my attention. The gentleman was dressed in a suit, the ground whereof had been black, as I perceived from some few spaces that had escaped the powder which was incor- porated with the greatest part of his coat; his periwig, which cost no small sum, was after so slovenly a manner cast over his shoulders, that it seemed not to have been combed since the year 1682; hislinen, which was not much concealed, was daubed with plain Spanish, from the chin to the lowest button, and the diamond upon his finger, which naturally dreaded the water, put me in mind bow it sparkled amidst the rubbish of the mine where it was first discovered. On the other hand, the pretty quaker appeared in all the elegance of cleanliness. Not a speck was to be found upon her. A clean, oval face, just edged about with little thin plaits of the purest cambric, received great advan- tage from the shade of her black hood; as did the white- ness of her arms from that sober coloured stuff in wliich she had clothed herself. The plainness of her dress was very well suited to the simplicity of her phrases; all which, of Preserving Health. 175 put together, gave me an exalted sense both of her good taste and her pure innocence. This adventure occasioned my throwing together a few hi'its upon cleanliness, which 1 shall consider as one of the half-virtues, as Aristotle calls them, and shall recommend it under the three following heads. As it is a mark of politeness; as it produces regard; and as it bears analogy to purity of mind. First, it is a mark of politeness. It is universally agreed upon, that no one unadorned with this virtue can go into company without giving a manifest offence. The easier or higher any one's fortune is, this duty arises propor- tionally. The different nations of the world are as much distinguished by their cleanliness, as by their arts and sciences. The more any country is civilized, the more they consult this part of politeness. We need but compare our ideas of a female Hottentot and an English beauty, to be satisfied of what has h^en advanced. In thenextplaee, cleanliness may be said to be the roster- mother of love. Beauty, indeed, most commonly pro- duces that passion in the mind, but cleanliness preserves it. An indiff-rent face and person, kept in perpetual neat- ness, has won many a heart from a pretty slattern. Age itself is not unamiable, while it is preserved clean and un- sullied; like a piece of marble constantly kept clean and bright, we look on it writh more pleasure than a new ves- sel that is cankered with rust. We might observe farther, that as cleanliness renders ns agreeable to others, so it makes us easy to ourselves; thatit is an excellent preservative of health, and that seve- ral vices, destructive both to mind and body, are incon- sistent with the habit of it. We find, from experience, that through the prevalence of custom, the most vicious actions lose, their horror, by being made familiar to us.— On the contrary, those who live in the neighbourhood of good example, fly from the first appearance of what is shocking. It fares with us much after the same manner as to our ideas. Our senses, which are the inlets of all the images conveyed to the mind, can only transmit the impressions of such things as usually surround them. So that pure and unsullied thoughts are naturally suggested to the mind by those objects that perpetually encompass us, when they are beautiful and elegant in their kind. 176 On Hygicine, or the art Man, through all ages of revolving time. Unchanging man, in every varying clime, Deems his own land, of every land the pride, Belov'd by Heaven o'er all the world beside; His home a spot of earth supremely blest, A dearer, sweeter spot than all the rest. MONTOOITEBT. Patriotism, properly defined, is the love of the laws and of the commonwealth. It is a sentiment which makes us prefer the interest of the public to our own.— At the very name of country, the wise and brave feel an enthusiasm which renders them invincible. Patriotism also contributes greatly to the promotion of good morals; and hence to health, and every other blessing, both private and public. Rome, Athens, and Lacedeemon, owed all their glory to patriotism; and their npthingness to their forgetfulness of their country, their laws, and morals. Happy if these awful lessons, read to us in the examples of the great republic of antiquity, could but avail to kin- dle among ourselves that divine patriotism which once ex- alted them to such glory among the nations. Among in- numerable other blessings, health would then be promoted. For the noble virtues of the soul constituting patriotism, as magnanimity, disinterestedness, valour, and consci- ousness of doing our duty, would diffuse through the heart that habitual complacency and joy most friendly to health; which would be still further promoted by that sim- plicity of manners, and activity of life, which belongs to Republicans. Whereas, on the contrary, in proportion as national patriotism decays, health becomes enervated by luxury and other vices, which are sure to overspread a nation that has lost the animating fire of patriotism. John II. king of Portugal, who, for the nobleness of his mind was worthy of a greater kingdom, when he heard there was a bird called a pelican, that tears and wounds her breast with her bill, that with her own blood she may of Preserving Health. fff restore her young ones to life, when left as dead by the bitings of serpents, this excellent prince took care that the figure of this bird, engaged in this action, should be added to his other royal devices; that he might hereby show, that he was ready, upon occasion, to part with his own blood for the welfare and preservation of his people and country. Pity it is to conceal their names, whose minds have been, in this.respect, as pious and princely as his, not fearing to redeem the lives of their fellow-citizens at the price of their own. Themistocles, the Athenian general, after his many famous exploits, was banished the country, and sought after to be slain. He chose, therefore, to put himself rather into the power of the Persian king, his enemy, than to expose himself to the malice of his fellow-citizens. He was by him received with great joy; insomuch, that the king, in the midst of his sleep, was heard to cry out thrice aloud, "1 have with me Themistocles, the Athenian."— He also did him great honour, for be allotted him three cities for his table-provisions, and two others for the fur- niture of his wardrobe and bed. While he remained in that court with such splendour and dignity, the Egyp- tians rebelled, encouraged, and also assisted by the Athe- nians. The Grecian navy had come as far as Cyprus and Cilicia; and Cimon, the Athenian admiral, rode mas- ter at sea. This caused the Persian king to levy sol- diers, and appoint commanders, to repress them. He also sent letters to Themistocles, then at Magnesia, importing that he had given him the supreme command in that affair, and that he should now be mindful of his promise to him, and undertake this war against Greece. But Themistocles was no way moved with anger against his ur.grateful countrymen, nor incited to wage war with them by the gift of all his honour and power; for, after having sacrificed, he called about him his friends, and, having embraced them, he drank a strong poison, and chose rather to close his own life, than to be an instru- ment of evil to bis native country, wliich yet had deserv- ed so ill at his hands. Thus died Themistocles, in the sixty-fifth year of his age, most of wliich time he had spent in the management of the republic at home, or as the chief commander abroad. 23 178 On Hygieine, or the art At the siege of Turin by the French army in 1640, a sergeant of the Piedmontcse guards signalized himself by a singular example of patriotism; this sergeant guarded with some soldiers, the subterraneous parts of a work of the citadel. The mine was charged, andnothing was want- ing but what is called a sausage or pudding, to blow up several companies of grenadiers who served in the work, and posted themselves in it. The loss of the work would have accelerated the surrender of the place. The sergeant. with great resolution, ordered the soldiers he commanded to retire, begging them to desire the king his master to protect his wife and children. He then set fire to the powder, and perished for his country. On the surrenderor Lord Cornwallis, in the American war, the Loyalist of 22 guns, then in the Chesapeake, be- came a party in that disastrous event; her crew were con- veyed to the Count de Grasse's fleet—of that fleet the Ar- dent, captured off Plymouth, made one, but was then in a very leaky condition. The Count being informed that the carpenter of the Loyalist was a man of talents, and perfectly acquainted with the nature of the chain pump, of which the French were ignorant, ordered him on board the Ville de Paris, and addressed him thus: "Sir, you are to go on board the Ardent directly; use your utmost skill, and save her from sinking, for which service you shall have a premium, and the encouragement due to the car- penter of an equal rate in the British navy; to this I pledge my honour; on refusal, you will, during your captivity, be fed on bread and water only." The tar, surprised at being thus addressed in his owrn language, boldly answer- ed; "Noble Count, I am your prisoner. It is in your power to confine me; but never let it be said that a British sailor forgot his duty to his king and his country, and entered voluntarily into the service of the enemy; your promises are no inducement for me, and your threats shall not force me to injure my country." There is a land, of ev'ry land the pride, Belov'd by Heaven o'er all the world beside; Where brighter suns dispense serener light, And milder moons emparadise the night; A land of beauty, virtue, valour, truth, of Preserving Health. 17<) Time-tutor'd age, and love-exalted youth. 'Where shall that land, that spot of earth be found?' Art thou a man?—a.patriot?—look round; 0 thou shaltfind, howe'er thy footsteps roam, That land thy country, and that spot thy home! Montgomery. As Americans, we feel the love of country, not merely because it is the land where we were born, but the land where we enjoy/reedom, equal rights, ami every blessing that can sweeten life, and gild it over with glory. Hence we need not have gone back to ancient times to show what men have dared from patriotism. No, thank God! we have, in our own country, and in our own days, names as bright as ever adorned the annals of time. The memo- ry of my exulting reader is already flying before me to a host of heroes, who even courted wounds and death for their country; to Lawrence, whose last words were "Don't give up the ship!"—to Burrows, who, when despe- rately wounded on thedeck, said,"Iwon'tbecarried below; prop me up, that I may see my brave men at their guns!" —to Lowry Donaldson, who cried, "My gallant country- men, I die, but don't let the cause of freedom die with me!" —to Daviess, who, on the field of Tippecanoe, smiling in the arms of fate exclaimed, "Thank God, 1 die in the best of causes!"—to a common sailor, who, while below, dress- ing for a mortal wound, and hearing his companions on deck shouting for victory, snatched away the shattered stump of his arm saying, "Let me go doctor: I know lam dying, but I must give one huzza more for my country!" —to Pike, Covington, Gibson, Wood, Holmes, Stoddard, Beasley, Mead, Spencer, Wattles, Hoppuck, Jack, Brad- ford, Armistead, Vanhorn, Omstead, Middleton, Wool- folk, Smith, M'Donough, Blaney, Legate, Yates, Jack- son, O'Fling, of the army—to Allen, Ludlow, Wilmer, Funk, Babbit, Hamilton, Howell, Stansbury, Gamble, Cowell, Williams, Brookes, Bush, Broome, of the navy —to Davis, Allen, Lauderdale, Henderson, Graves, Hick- man, Hart, M'Cracken, Hooper, Pace, Bucl, Hamilton, E\ans, Quarles, Brown, Belknap, Blakesley, Clagget, Clemm, Rosevelt, Poe, of the miliha—and a thousand other Martyrs of Liberty, who all rushed into tha 180 On Hygieine, or the art battle as if animated by the immortal Washington's in- junction,—"Remember, that you are going to fight for liberty!" and who all died rejoicing that they had shed their blood to cement her Holy Fabric " To livewithfame the gods allow to many; but to die with equal lustre, is a gift which Heaven selects from all the choicest boons of fate, and with a sparing hand on few be- stows." Yet, though kind Heav'n points out th' unerring roadj That leads through nature up to bliss and God; Spite of that God, and all his voice divine, Speaks to the heart, or. teaches from'the shrine, Man, feebly vain, andimpotently wise, Disdains the manna sent him from the skies; Tasteless of all that virtue gives to please, _, For thought too active, and too mad for ease, From wish to wish in life's mad vortex tost, For ever struggling, and for ever lost; He scorns Religion, though her seraphs call, And lives in rapture, or not lives at all. Cawthoit. Some of my readers may perhaps be surprised, that in a book which professes to treat of Health, I should so far forget the text as to introduce the subject of Religion.— But I trust they Will cease to wonder when they consider that health is the physical result of nicely balanced appe- tites and passions, and that there exists nopower on earth, that can so attune these into harmony, as Religion. Cast your eye around you, and say whence have sprung most of the diseases, both mental and corporal, but from Jack of this divine guardian of man, Religion. By this great of Preserving Healfh. 181 name, I do not mean that hypocrisy which consists in gloomy faces, nor that narrow bigotry which rests on par- ticular forms; the one only shows that religion is very galling to their feeling; the other is but too often false and treacherous, deluding those who behold them, into the opinion of their superior sanctity and virtue. >ior can 1 entertain a more favourable opinion of those who make a profession of religion and exhibit too much levity. It is a maxim among politicians, "that those who know not how to dissemble, know not how to rule." But this will not hold in religion, where virtue is at all times to be the guide of our actions. There are some sectarians who are so illiberal as to ex- press a belief, that those only of their persuasion are in the right road to Heaven! Strange infatuation! Can this be consistent with the Scriptures or reason? The pure spirit of the gospel of Christ breathes forth a holy reli- gion, founded on meekness, cbarity,kindness, and brother- ly love. Could we forbear dispute, and practise love, We should agree as angels do above. Where love presides, not vice alone does find No entrance there, but virtues stay behind: Both faith, and hope, and all the meaner train Of mortal virtues, at the door remain. Love only enters as a native there, For, born in Heaven, it does but sojourn here. Waller. It is of the utmost importance to guard against extremes ef every kind in religion, lest by seeking to avoid one rock we split upon another. It has been long the subject of re- mark, that Superstition and Enthusiasm are two capital sources of delusion. Superstition, on the one hand, attaching men with immoderate zeal to the ritual and ex- ternal points of religion, and enthusiasm, on the other, directing their whole attention to internal emotions and mystical communications with the spiritual world; while neither the one nor the other has paid sufficient regard to the great moral duties of the Christian life. 18# On Hygieine, or the art Blest is the man, as far as earth can bless, Whose measur'd passions reach no wild excesss; Who, urg'd by Nature's voice, her gifts enjoys, Nor other means than Nature's force employs. ZlMM HUMAN. In mental illusion, Imagination, when she first begins to exercise her powers, seizes on some fact, of the real nature of which the mind has but an obscure idea, and, for want of tracing it through all its connexions and de- pendencies, misleads reason into the darkest paths of er- ror. The wild conjectures, and extravagant opinions which have issued from this source, are innumerable.— The voice of the calm inquirer, Reason, is incapable of being heard amidst the tumult; and the favourite image is animated and enlarged by the glowing fire of the Passions. No power remains to controul or regulate, much less to subdue, this mental ray, which inflames the wmole soul, and exalts it into the fervour of Enthusiasm, hurries it into the extravagance of Superstition, or precipitates it into the furious frenzies of Fanaticism. The fire of fanaticism is so subtilely powerful, that it is capable of inflaming the coldest minds. The rapidity of its progress certainly depends, in a great degree, on the nature of the materials on which it acts; but, like eve- ry dangerous conflagration, its first appearances should be watched, and every means taken to extinguish its flame. In the course of my practice as a physician, says Dr. Zimmerman, I was called upon to attend a young lady, whose natural disposition had been extremely cheerful, until a severe fit of sickness damped her spirits, and ren- dered her averse to all those lively pleasures which fasci- nate the youthful mind. The debility of her frame, and the change of her temper, were not sufficiently attended to in the early stages of her convalescence. The anxiety of her mind was visible in the altered features of her face; and she was frequently heard to express a melancholy re- gret, that she had consumed so many hours in the frivo- lous, though innocent, amusements of the age. Time in- creased, by almost imperceptible degrees, these symp- toms of approaching melancholy; and at length exhibited of Preserving Health. 183 themselves by penitential lamentations of the sin she had committed with respect to the most trifling actions of her life, and in wliich no shadow of offence could possibly be found. At the time I was called in, this superstitious mel- ancholy was attended with certain indications of mental derangement. The distemper clearly originated in the indisposition of the body, and the gloomy apprehensions which disease and pain had introduced into the mind dur- ing a period of many months. This once lively, hand- some, but now almost insane female, was daily attacked with such violent paroxysms of her com idaint, that she lost all sense of her situation, and exclaimed, in horrid distrac- tion and deep despair, that her perdition was already ac- complished, and that the fiends were waiting to receive her soul and plunge it into the bitterest torments of hell. Her constitution, however, still fortunately retained sufficient strength to enable me, by the power of medicine, gradually to change its temperament, and to reduce the violence of the fever wliich had been long preying on her life. Her mind became more calm in proportion as her nerves re- covered their former tone; and when her intellectual pow- ers were in a condition to be acted on with effect, I success- fully counteracted the baleful effects of Superstition by the wholesome infusion of real Religion, and restored, by de- grees, a lovely, young, and virtuous woman to her fami- ly and herself. Oh! would mankind but make fair Truth their guide, And force the helm from Prejudice and Pride, Were once these maxims fix'd, that God's our friend, Virtue our good, and Happiness our end, How soon must, reason o'er the world prevail, And Error, Fraud, and Superstition fail! None would hereafter, then, with groundless fear, Describe The Almighty cruel and severe; Predestinating some, without pretence, To Heaven; and some to hell for no offence; Inflicting endless pains for transient crimes, And favouring sects or nations, men or times. Zimmerman. It is that fervent love of God and man, constituting the heart-gladdening religion of Christ, which I mean. This 184 On Hygieim, or the an teaches us to deny ourselves, and follow' in the exercise of all virtues, wherein consists the life of religion, laying aside all idle quarrels, self-interest, and needless debates about circumstantials; fortius religion is not in words but in works; not in opinions but in assurances; not in specu- lation but in practice. It is this religion all men ought to love for their own sakes, because a holy life, which it teaches, gives a comfortable death and a happy eternity. He that alone would wise and mighty he, Commands that others love as well as he. Love as helov'd—How can wc soar so high? He can add wings when he commands to fly. Nor should we be with this command dismay'dj He that examples give will give his aid. For he took flesh, that when his precepts fail, His practice, as a pattern, may prevail. Waller. The man who loves God, enjoys that first of felicities, the consciousness of having placed his affections on the on- ly object that truly deserves them. O! how amiable is gratitude; especially when directed to the Supreme Bene- factor. It is the most exalted principle that can actuate the heart of man. When a good man looks around him on this vast world, where beauty and goodness are reflected from every ob- ject, and where he beholds millions of creatures in their different ranks, enjoying the blessings of existence, be looks up to the Universal Fathkr, and his heart glows within him. And in every comfort which sweetens his own life, he discerns the same indulgent hand. Thus it is that gratitude prepares a good man for the enjoyment of prosperity; for not only has he as full a relish as others of the innocent pleasures of life, hut, moreover, in these lie holds communion with God. *In all that is good or fair he traces his hand. From the beauties of nature, from the improvements of art, from the blessings of pub- lic or private life, he raises his affections to the great Fountain of all the happiness which surrounds him, and this widens the sphere of his enjoyments, by adding to the pleasures of sense, the far more exquisite joys of the heart. of Preserving Health. 185 If this goodness of God is so admirably seen in the works of Nature, and the favours of Providence, with what a noble superiority does it even triumph in the min- istry of redemption. Redemption is the brightest mirror in which to contemplate the most lovely attribute of the Deity. Redemption! oh thou beauteous mystic plan, Thou salutary source of life to man! What tongue can speak thy comprehensive grace? What thought thy depths unfathomable trace? 0! blest Redeemer, from thy sacred throne, Where saints and angels sing thy triumphs won! From that exalted height of bliss supreme, Look down on those who bear thy sacred name; Restore their ways, inspire them by thy grace, Thy laws to follow, and thy steps to trace; Thy bright example to thy doctrine join, And by their morals prove their faith divine! BoYSE. Religion is so far from debarring us of any innocent pleasure or comfort of human life, that it purines our en- joyments, and renders them more grateful and generous; and thus makes us habitually cheerful. Thou, Cheerfulness, by Heaven design'd To sway the movements of the mind; Whatever fretful passion springs, Whatever wayward fortune brings To disarrange the power within, And strain the musical machine: Thou, goddess, thy attempering hand Doth each discordant string command, Refines the soft and swells the strong, And, joining Nature's general song, Through many a varying tone unfolds The harmony of human souls. Akensioe. Cheerfulness is consistent with every species of virtue and practice of religion. It bears the same friendly re- 24 180 On Hygleinc, or the art gard to the mind as to the body; it banishes all anxious care and discontent, soothes and composes the passions, and keeps the soul in a perpetual calm. Providence did not design this world should be filled with murmurs and repinings, and that the heart of man should be involved in perpetual gloom and melancholy. As I was betwixt sleeping and waking, says a sublime author, I perceived one of the most shocking figures imagination can frame, advancing towards me. She was dressed in black, her eyes deep sunk in her head, and her complexion pale and livid as the countenance of death. Her looks were filled with terror and unrelenting se- verity, and her hands armed with whips and scorpions. As soon as she came near, with a horrid frown, and a voice that chilled my very blood, she bade me follow her. I obeyed, and she led me through ragged paths, beset with briers and thorns, and a deep solitary valley.— Wherever she passed, the fading verdure withered be- neath her steps; her pestilential breath infected the air with malignant vapours, obscured the lustre of the sun, and involved the fair face of Heaven in universal gloom. Dismal howlings resounded through the forests; from eve- ry baleful tree the night raven croaked his dreadful note; and the prospect was filled with desolation and horror. In the midst of this tremendous scene, she addressed me in the following manner: "Retire with me, O rash, unthinking mortal, from the vain allurements of a deceitful world, and learn that plea- sure was not designed the portion of human life. Man was born to mourn, and to be wretched; this is the condi- tion of all below the stars, and whoever endeavours to op- pose it, acts in contradiction to the will of Heaven. Fly then from the fatal enchantments of youth and social de- light, and here consecrate the solitary hours to lamenta- tion and wo. Misery is the duty of all sublunary beings, and every enjoyment is an offence to the Deity, who is to be worshipped only by the mortification of every sense of pleasure, and the everlasting exercise of sighs and tears," This melancholy picture of life quite sunk my spirits, and seemed to annihilate every principle of happiness within me. I threw myself beneath a blasted yew, where the winds blew cold and dismal round my head, and dread- of Preserving Health. 187 ful apprehensions chilled my heart. Here I resolved to lie till the hand of death, which I impatiently invoked, should put an end to the miseries of a life, so deplorably wretched. In this sad situation, I espied on one hand of me a deep muddy river, whose heavy waves rolled on in slow and sullen murmurs, when I found mj self suddenly surprised by the sight of the loveliest object I ever be- held. The most engaging charms of youth and beaut) appeared in all her form; effulgent glories sparkled in her eyes, and their awful splendours were softened by the gentlest looks of complacency and peace. At'her ap- proach, the frightful spectre, who had before tormented me, vanished away, and with her all the horrors she had caused. The gloomy clouds brightened in cheerful sun- shine; the groves recovered their verdure; and the whole region looked gay and blooming as the garden of Eden. 1 was quite transported at the unexpected change, and re- viving hope began to glad my thoughts, when, with a look of inexpressible sweetness, my beauteous deliverer thus uttered her divine instructions: "My name is Religion. I am the offspring of Truth and Love, and the parent of Benevolence, Hope, and Joy. That monster, from whose power I have freed you, is called Superstition; she is the child of Discontent, and her followers are Fear and Sorrow. Thus, different as we are, she has often the insolence to assume my name «and character, and seduces unhappy mortals to think us the same, till she at length drives them to the borders of de- spair; that dreadful abyss, into which you were just go- ing to sink. "Look around, and survey the various beauties of the globe, which Heaven has destined for the seat of the hu- man race, and consider whether a world thus exquisitely framed, could be meant forthe abode of misery and pain. For what end has the lavish hand of Providence diffu- sed such innumerable objects of delight, but that all might rejoice in the privilege of existence, and be filled with gratitude to the beneficent Author of it? Thus, to enjoy the blessings he has sent, is virtue and obedience; and to reject them merely as means of pleasure, is pitiable igno- rance, or absurd perverseness. Infinite goodness is the source of created existence; the proper tendency of every 188 On Ttygieine,or the art rational being, from the highest order of raptured se- raphs, to the meanest rank of men, is to rise incessantly from lower degrees of happiness to higher. They have each faculties assigned them for various orders of de- lights." "What!" cried I, "is this the language of Religion? Does she lead her votaries through flowery paths, and bid them pass an unlaborious life!" "The true enjoyments of a reasonable being," answered she, mildly, "do not consist in unbounded indulgence, or luxurious ease, the tumult of passions, the languor of indulgence, or the fiut- ter of light amusements. Those are often raised into the greatest transports of joy, who are subject to the greatest depressions of melancholy: on the contrary, Cheerfulness, though it does not give the mind such an exquisite glad- ness, prevents us from falling into depths of sorrow. Mirth is like a flash of lightning, that breaks through a gloom of clouds, and glitters for a moment. Cheerful- ness keeps up a kind of day-light in the mind, and fills it with a steady and perpetual serenity." It was the daily practice of that eminent physician, Dr. Boerliaave, throughout his whole life, as soon as he arose in the morning, which was generally very early, to retire for an hour to private prayer and meditation on some part of the Scriptures. He often told his friends, whch they asked him how it was possible for him to go through so much fatigue, that it was this which gave him spirit and vigour in the business of the day. This, there- fore, he recommended, as the best rule he could give: for nothing, he said, could tend more to the health of the bo- dy, than the tranquillity of the mind; and that he knew nothing which could support himself or his fellow-crea- tures, amidst the various distresses of life, but a well grounded confidence in the Supreme Being upon the prin- ciples of Christianity. Were men sensible of the happiness that results from true religion, the voluptuous man would there seek his pleasure, the covetous man his wealth, and the ambitious man his glory. Ah! what is life? with ills encompass'd round, Amidst our hopes, fate strikes the sudden wound: of Preserving Health. 189 To-day the statesman of new honour dreams, To-morrow death destroys his airy schemes; Is mouldy treasure in thy chest confin'd? Think all that treasure thou must leave behind; Thy heir with smiles shall view thy blazon'd hearse, And all thy hoards with lavish hand disperse. Should certain fate th' impending blow delay, Thy mirth will sicken, and thy bloom decay; Then feeble age will all thy nerves disarm, No more thy blood its narrow channels warm. Gay. Let the affections of a man be once softened and dulci- fied with Divine love, and he is ever secure from the sud- den apoplexies of the passionate, the poisonous cups of the drunkard—the murdering pistol of the duellist—the as- sassinating dagger of the jealous—the loathsome diseases of the harlot—and the wasting hectics of the gambler. In vain we seek a Heaven below the sky; The world has false, butflatt'ring charms: Its distant joys show big in our esteem, But lessen still as they draw near the eye; In our embrace the visions die! And when we grasp the airy forms, We lose the pleasing dream. Watts. There are many wicked men who will speak unbecom- ing things of God, in a humour of bravado amidst com- pany, but will tremble before him in solitude, and shud- der at the approach of death. Man makes a death which nature never made, Then on the point of his own fancy falls, And feels a thousand deaths in fearing one. Young. Voltaire, aman who, after havinglong and too justly been consideredthepatronof infidelity, and after having shown himself equally the enemy to every religious establish- ment, at length, to the astonishment of all serious minds, 190 On Hygicine, or the art and at the close of a long life of near eighty years, em braced the Christian religion. If a veteran in the cause of infidelity thus closes his life and his works, does it not greatly behoove those who have been deluded and misled by his writings, seriously to look to themselves, and bring home this striking example to their hearts. 0 then, while penitence can fate disarm, While ling'ring justice yet withholds its arm; While heavenly patience grants the precious time, Let the lost sinner think him of his crime; Immediate, to the seat of mercy fly, Nor wait to-morrow—lest to-night he die! Boyse. If men, so prodigal in scattering imprecations and curses upon all they are displeased at, would take time to consider what they are about before they disgorge them, they would certainly be ashamed of the folly of such a practice, because nobody is hurt by it but themselves; for curses, like arrows shot against Heaven, fall upon the heads of those that throw them out, but can never injure the persons or things levelled at. Again, what can be more foolish than for men, in common discourse, to make imprecations upon themselves, to confirm the truth of their assertions, which does no more than give a handle to their auditors, suspicion; for good men will be believed without them, and scorn to use them; and bad men can never gain credit, but disparage themselves, by so fre- quently venting them; because, by such bitter assevera- tions they seem to suspect their own reputations. It is also for want of consideration, and too easy a compliance with a scandalous and vicious custom, that men of sense in other matters, upon very slight, and sometimes no oc- casion in the world, expose themselves to the wrath of Heaven, by calling upon God to damn them if what they say be false, when, at the same time, they know there is no truth in it, and wish they may perish eternally, if they don't do what they never intend when they speak it. What use of oaths, of promise, or of test, Where men regard no God but interest? of Preserving Health. 191 What endless war would jealous nations tear, If none above did witness what they swear? Sad fate of unbelievers, and yet just, Among themselves to find so little trust! Were Scripture silent, Nature would proclaim, Without a God, our falsehood and our shame. Boyse. Amongst all the nations, there are none so barbarous and cruel, none so utterly lost to all the sentiments of hu- manity and civility, but have embraced and continued amongst them the notion of a Deity, or some Being enti- tled to their adoration. This is a principle so deeply en- graven in the very nature of man, that no time, nor change, nor chance, hath ever been able to obliterate it; so, that rather than have nothing to worship, men have often been contented to adore as gods, even the works of their own hands. And, indeed, herein their ignorance and folly is chiefly to be lamented, that they have still made choice of any thing, rather than the true God, to pay their homage and veneration. In the mean time, they shame some of us, in having been more zealous in their superstition, than we are in the true religion. The Athenians consulted the oracle of Apollo, demand- ing what rites they should make use of in matters of their religion. The answer was, "The rights of their ances- tors." Returning thither again, they said, "The man- ner of their forefathers had been often changed;" they, therefore, inquired, "what custom they should make choice of in so great a variety?" Apollo replied, "The best." First to the gods thy humble homage pay; The greatest this, and first of laws obey. Perform thy vows, observe thy plighted troth, And let religion bind thee to thy oath. The heroes next demand thy just regard, Renown'd on earth, and to the stars preferr'd, To light, and endless life, their virtue's sure reward. Due rites perforin, and honours to the dead, To every wise, to every pious shade. With lowly duty to thy parents bow, 19-3 On Hygicine, or the art And grace and favour to thy kindred show: For what concerns the rest of human kind, Choose out the man to virtue best inclin'd; Him to thy arms receive; him to thy bosom bind. Pythagoras. The great Lord Burleigh used to say, "I will never trust any man not of sound religion; for he that is false to God can never be true to man." Oh man! degenerate man! offend no more! Go, learn of brutes thy Maker to adore! Shall these through every tribe his bounty own, Of all his works ungrateful thou alone! Mark bow the wretch his awful name blasphemes, His pity spares—his clemency reclaims! Observe his patience with the guilty strive, And bid the criminal repent and live; Recal the fugitive with gentle eye, Beseech the obstinate he would not die! Amazing tenderness—amazing most The soul on whom such mercy should be lost! Boyle. From the very respectful mention which I have so fre- quently made of Religion, some of my readers may be charitable enough to conclude, that I am religious in a high degree. Would to God I were. From my soul I wish that my devotedness to religion bad all my life been equal to the exalted opinion which I entertain of it. But, though like most of the human race, I have too often neg- lected my duty in this respect, yet can I say, before my God, that I look upon religion as the only true glory and happiness of man; and though worlds were thrown into the opposite scale, yet would I not relinquish the joys, imperfect as they are, which, I derive from it. And from this circumstance I have often been led to think, that if I derive so much comfort from the little religion which I possess, how truly enviable, how superlatively happy must they be, whose whole lives are devoted to her service, and whose hearts are perpetually enjoying those sublime plea- sures which her unclouded smiles can impart. of Preserving Health. 193 Arise, my soul, on wings seraphic rise, And praise th' Almighty Sovereign of the skies; In whom alone essential glory shines, Which not the heaven of heav'ns, nor boundles space confines. While this immortal spark of heavenly flame Distends my breast, and animates my frame; To thee my ardent praises shall be borne On the first breeze that wakes the blushing morn: The latest star shall hear the pleasing sound, And nature in full choir shall join around. When full of thee my soul excursive flies Through air, earth, ocean, or thy regal skies; From world to world new wonders still I find, Aud all the Godhead flashes on my mind. When wing'd with whirlwinds, vice shall take its flight To the deep bosom of eternal night, To thee my soul shall endless praises pay; Join, men and angels, join th' exalted lay! BljACKLOCK. 35 or UNDER this head are comprehended all fevers what- ever, by which the human frame is affected; but, as they arise from a great variety of causes, and affect persons of very dissimilar constitutions, they must of course differ in their nature, and require a very distinct treatment. Two very opposite states of the human body are sup- posed to give rise to fevers, and to form their great and fundamental distinctions. The one is called the phlogis- tic diathesis, or inflammatory disposition; wherein the heart is excited to rapid and strenuous exertions, manifest- ed by great strength in the action of the vessels, while the blood itself exhibits a more florid hue and denser tex- ture than usual. In the other, the brain and nervous system are more directly affected, their energy seems impaired, the force of the heart and vessels is diminished, the blood is of a looser texture, and the fluids tend to dissolution. In the first state, when the inflammation originates from external causes, as wounds, contusions, or burns, the fever follows the local affection, and is in proportion to the degree of inflammation in the part affected. Such fevers are called symptomatic. 196 Of Fevers in general. This is also the case in certain disorders of the lungs, and other viscera, which arise, not from external injuries, but from some vice in the part, which gradually brings on inflammation and fever. If the local inflammation be removed, the fever is removed also; if it cannot be sub- dued, but increase gradually, destroying the organization of the part, the patient dies sometimes by the violence of the fever, and sometimes merely because an organ essen- tial to life is destroyed. Cold is found, by universal experience, to give a dis- position to inflammatory disorders; and heat to those call- ed putrid.* During the winter, and early in the spring, pleurisies, peripneumonies, quinsies, rheumatisms, and in- flammatory fevers prevail. Towards the end of summer, and particularly in autumn, fevers of a different nature, with dysenteries and putrid ulcerous sore throats, make their appearance. Although it is true in general, that cold occasions a dis- position to diseases of an inflammatory nature, and heat to those supposed putrescent, yet, persons who take vio- lent exercise in sultry weather, or who accidentally fall asleep on the ground, exposed to the beams of the mid-day sun, are sometimes seized with fevers of a highly inflam- matory and dangerous quality; the inflammation directly affecting the brain itself, or its membranes. The time, in which intermittents and remittents are most prevalent, is the end of summer and beginning of autumn, when heat and moisture combine to hasten the corruption of animal and vegetable substances, and fill the atmosphere with miasmata. These considerations reduce it next to a certainty, that something essentially connect- ed with a marshy soil produces fever, and we can suppose nothing with so much probability, as the effluvia of stag- nant water and corrupting animal and vegetable sub- stances. And if a sudden stoppage of perspiration, from the + We continue this term in obedience to custom, only. For it con- veys a false view of what really happens in those fevers. Recent expe- riment and more accurate observation, have demonstrated, that putre- faction never takes place in a living body. The process which sometimes goes on in these malignant fevers, has ;ome of the appearances of putrefaction; but it is, in fact, totally distinct, Of Fevers in general. 197 cold of autumn, after the body is relaxed by the heat of summer, be sufficient of itself to produce fever in dry and well ventilated countries, where there is no reason to think that marsh miasmata prevail, we cannot be sur- prised to find them far more universal and more obsti- nate in low and marshy soils, where the first cause con- curs with the second. A still more active source of fevers is the effluvia from the living human body, which, when long confined, be- comes in the highest degree acrimonious, and gives rise to diseases the most dangerous and malignant. When- ever numbers of people are crowded together, the air must soon he deprived of its vital ingredient, by repeated respiration, hence this infectious matter will be formed, but with most rapidity in gaols, in hospitals, in the holds of ships, and in dirty dwellings, where its virulent ten- dency is hastened by nastiness, by unwholesome food, by desponding thoughts, or by the effluvia coming from bo- dies in a diseased state. It communicates its infection not only to those who approach the places in which it is generated, and the human body from which it flows, but also will remain long entangled in beds, blankets, and other articles, having been in contact with the patient's body, retaining its activity, and capable of infecting others at a considerable distance of time and place, if, unhappily, those contaminated materials are carried abroad. In this manner, one person who is not himself infected, may in- fect another: the first person, in such cases, being less predisposed to the disease than the second. Although the infection arising from the living human body, is not perceived to act at a great distance from its direct source; yet it seems most probable that it does not immediately lose its virulency; but after it is diffused in the atmosphere, continues in some degree to act in con- junction with the miasmata of marshes, with heat, ob- structed perspiration, and the other causes of fever, and, according to the various proportions of those causes, com- bined with the circumstances of season, climate, and th« constitution of the patient, the nature of the fever is deter- mined. 193 Intermittent, or INTERMITTENT, OR AGUE AND FEVER. Symptoms. Is that fever which has, periodically, a clear intermission alternating with a return of its pa- roxysms. From the length of time between the fits, the species of the fever are distinguished and named. Thus, if the fit returns every day, it is termed a quotidian; if eve- ry third, a tertian; if every fourth, a quartan. The ague commences with weakness, frequent stretching, and yawn- ings, succeeded by sensations of cold in the back and ex- tremities, which increase, until the limbs as well as the body become agitated with frequent and violent shivering. This continues for some time, during which a violent pain of the head and back, and a sensation reseinhling a stricture across the stomach, frequently distress the patient; and the sense of coldness is so great, that no endeavours to obtain warmth are ofthe least avail. These, symptoms, subsiding by degrees, give way finally to warm flushings, which increase, until redness and heat, much greater than natural, are extended over the whole body; the patient at length burning with such extreme heat, as to be now as solicitous for the refreshing sensation of cold, as he was before anxious to mitigate its violence. After these symp- toms have existed for sometime, they gradually decline; the thirst goes off, the skin is relaxed, and a moisture breaks out on the head, which soon becomes general and profuse; then it slowly abates, till it entirely ceases. This is the general progress of a regular paroxysm of a well formed intermittent; the patient is often left, apparent- ly, free of disease, until the next attack. Causes. The remote causes of ague or autumnal fe- ver are, first, the effluvia which arises from marshes or moist grounds acted on by heat. Secondly, cold, espe- cially when accompanied by moisture, which will neces- sarily act with more certainty, if a predisposition to the disease exists. This predisposition may be induced by living too sparingly, or on trashy food, excessive fatigue, impeded perspiration, preceding disease, indulgence in spirituous liquors, and in fine, by whatever tends to weak- rn the system and impoverish the blood. Hence the poor are more subject to the disease than the rich; Ague and Fever. 199 For health consists of spirits and of blood, And these proceed from generous wine and food. Pope. Treatment. In the cure of an ague, whether quoti- dian, tertian, or quartan, much the same plan may be fol- lowed, which is, a9 far as possible, to prevent the disease from being habitual; for the longer it continues, the more it weakens the constitution, and disposes the glandular viscera, as the liver, spleen, &c. to obstructions, and oft- en prepares the habit for dropsies and other chronic dis- eases. So that although this disease be not very alarm- ing in its appearance, yet, if injudiciously treated, or neglected, it often draws after it the most serious conse- quences; and hence merits particular attention. The cure of the disease therefore calls for an emetic, or a dose of calomel and jalap, or salts, senna and man- na, to free the bowels of their offending contents; and if the patient be of a full habit, with head-ach and flushed countenance, the pulse hard and quick, showing an in- flammatory disposition, blood-letting will be highly ne- cessary. Having by these means prepared the system, strength- ening remedies should next be employed. Of these, the Peruvian bark is the most celebrated, and may be used with safety in the time of intermission, provided there exists no swelling or hardness of the viscera. In that event the bark must be withheld, until these symptoms are rendered milder by the administration of gentle laxatives, blisters, and diaphoretic medicines, as the cathartic and saline mixtures,* whose good effects will be greatly aided by diluent drinks and abstinence from solid food. As soon as the system is properly prepared forthe use of the bark, it may then be given in such doses as the stomach will bear, and at such intervals, that six or eight doses may be taken during the intermission. Should it disagree with the patient in substance, give it in some other form, as the cold infusion, decoction or tincture.* In the mean time, strict attention must be paid to the habit of body: for in vain shall we expect to cure intermit- tents, if the bowels be not kept open and the skin moist. • See Dispensatory 200 Intermittent, or When, therefore, the Peruvian bark produces costive* ness, five or six grains of rhubarb, or some mild purgative, should be added to each dose; and in case of cold phlegma- tic habits, with a dry skin, the addition often or fifteen grains of Virginia snake-root is peculiarly proper. In some constitutions the bark produces severe and co- pious purging. This debilitating effect may be prevent- ed by adding five or six drops of laudanum to each dose.— And when the patient is troubled with sourness on the stomach, flatulence and pain, take the bark in lime water, or conjoin with each dose, eight or ten grains of salt of tartar, or magnesia. Notwithstanding every precaution, the bark will not sometimes remain on the stomach, and with children it is often difficult for them to swallow this medicine. With such patients it should be employed externally as directed below.f Some patients are subject to profuse sweats, from de- bility. In such cases the bark should be united with a few grains of the rust of steel, or ten or fifteen drops of elixir vitriol, and taken in wine. But when these evacuations proceed, as they often do, from an imperfect cure, accom- panied with great and intense heat, during their preva- lence, we must immediately resort to the preparatory re- medies, as blood-letting, cathartic and diaphoretic. Some- times the fever will not yield to the bark, even when all the usual preparatory medicines have been employed. In such cases we may justly suspect the liver to be diseased, particnlarly if the countenance be either livd, or pale, or of a yellowish cast; and in that event, the use of the bark should be suspended until those obstructions be removed. For this purpose one of the mercurial pills* should be given night and morning, until ptyalism, that is, a sore- ness of the mouth with increased spitting, is produced, ■}• Take a piece of Holland, cut in form of a waistcoat, and for the lining, get humhums of an open texture. Between these cloths, from three to six ounces of bark must be closely quilted, and then the waistcoat ap- plied on the naked skin. Every two'or three days, it will be necessary to rub the jacket between the hands. It is sometimes proper to unite snakeroot with the bark, in proportion pf one ounce of the former to four of the latter. * See Dispensatorv 0 Ague and fever. 201 which will generally succeed; and when it fails, the ni- tric acid diluted, and given in its usual doses* may be depended on. After a ptyalism is effected, recourse must be had to one or other of the strengthening remedies, to give tone to the system. From the tenor of these observations it follows, that the Peruvian bark is not a remedy to be employed in every case of intermittent fevers, but that much caution is necessary in the use of it, lest it be turned into abuse. For unless the system be properly prepared by suitable remedies, the administration of bark, or any other tonic, is an error fraught with the most serious mischief. The Peruvian bark being so costly and not always to be had pure, it must afford much pleasure to the benevo- lent, to learn that the black oak bark of America possess- es the same virtues of the Peruvian, as has been verified by repeated experiments, not only in the cuie of inter- mittents, but other diseases hitherto treated with the Pe- ruvian bark alone. It may be taken in the same manner, only in rather larger doses. In substance it is most effi- cacious, and if well pulverised it will be found more pala- table than the Peruvian bark, and not so apt to excite vomiting. Another mode in which this remedy may be employed to great advantage, from its abundance in our country, is by bathing twice or thrice a-day in a strong decoction of it; which to children, and patients whose stomachs will not retain medicine, will prove exceedingly beneficial.— When the black oak bark is not convenient, the red oak bark, though less efficacious, should be substituted, as I have often witnessed the happiest effects accruing to de- bilitated persons bathing in a strong decoction of it, about lukewarm, particularly in the last stage of fevers. Hence this remedy well deserves the attention of the planter. Professor Barton assures us that he has employed the bark of the Spanish oak in gangrene, with the happiest ef- fect, and that he considered it, in powder, equal to the best Peruvian bark. See Oak. Materia Medica. The common dog-wood bark, of our country, is also an excellent substitute for Peruvian, particularly in the cure • See Dispensatory. 26 * 20-2 Intermittent, or of intermittents; so is the bark of the wild cherry-tree, and of the lyriadendron tulipifera, or American poplar, all of which may be given in the same forms and doses, as the Peruvian bark. See Materia Medica. The columbo root, an admirable corrector of bile, is a most useful medicine, in this complaint, and will often be retained by the stomach, when the bark, in every form, has been rejected. It is likewise an excellent remedy, joined with steel, as in the form of the tonic powders or pills,* for patients disposed to be dropsical, or who have a swelling and hardness of the spleen, called ague cake; especially if a purge or two have been previously employed, and some mercurial action excited in the system, by one or two grains of calomel, taken every night and morning for a few weeks. Another valuable medicine in the cure of agues, and which has frequently succeeded when the bark failed, is white vitriol. But like other tonic medicines, it requires that the stomach and bowels should be freed of their mor- bid contents, before any good effects can result from its use. Therefore, some evacuating medicine is always ne- cessary; after which, one of the vitriolic pills* may be given every three or four hours during the intermission of fever, gradually repeating the dose, or increasing it, as the system becomes habituated to its action. Charcoal powder in doses, from a tea to a table spoon- ful given three or four times during the intermission, has often interrupted the expected paroxysm and cut short the disease. A scruple of the spider's web it has been said, in many instances hath proved successful, given an hour before the fit of an ague and an hour after it. But among the remedies of intermittents none is more infallible than the solution of arsenic, which may be givJ en with perfect safety to persons of every age, beginning with the smaller doses, and proportioning them to the age of the patient. Stimulants administered before the fit, by inducing a salutary change in the system, have frequently overcome the disease. It is in this way that emetics are consider. • See Dispensatory. Ague and Fever. §03 ed useful in the coming on of the fit, so is active exercise, and other stimulants. Cataplasms of mustard seed and garlic, or horse-radish, applied to the wrists and ankles an hour or two previous to the expected fit, will excite a degree of inflammation so great as to increase the heat as well as the circulation, and have often succeeded. I have frequently, in obstinate intermittents, prevented the recurrence of the fit, by giving a large dose of lauda- num or sether about an hour before the expected paroxysm. But when an inflammatory disposition prevails in the sys- tem, this remedy should not be resorted to, as it may con- vert the intermittent into a continued fever. An emetic given previous to the return, while the per- spiration is supported by the volatile alkali or Dover's powder* in their usual doses, with warm drinks, have also succeeded in obstinate cases. It should be observed how- ever, that when we attempt to prevent the paroxysm of an intermittent by sweating, this mode of relief must be con- tinued till the period of the paroxysm is at an end; or at least till the time when the sweating stage would have otherwise commenced. Those means which excite terror, suprise and horror, by producing a train of new emotions will prevent the re- turn of paroxysms. A man has been pushed into the water; fire haabcen cried; the most distressing tidings in- vented and communicated. All these remedies fill the mind with such dread as to counteract the impression of the cause; but in general they are dangerous, and when we wish to prevent the fit, we depend rather on tonics, the stimulants, and the sudorifics. Dr. Kellie, an ingenious surgeon of the British navy, states, that manv instances have occurred of the good ef- fects of compression by tourniquets or bandages applied so as to obstruct the circulation in two of the extremities. The plan pursued by him was to apply the instrument on one thigh, and on one arm, of opposite sides, at the same time. In two minutes after the application of the tourni- quets, the shaking and other symptoms of the cold stage entirely ceased, a mild hot stage was immediately induced, and the patient found himself quite relieved. After suffer- * See Dispensatory 201 Intermittent, or Ague and Fever. ing the instruments to remain on for about fifteen minutes, they were removed, and the cold symptoms did not return. He further states, that, if the tourniquets be applied previ- ous to the accession of the paroxysm, the cold stage will entirely be prevented; and that, where the cold stage of an ague is either thus shortened, or altogether prevented, the following hot stage will be rendered both milder and of shorter duration. As agues are liable to recur, one excellent mean of pre- vention, as well as cure, is to wear flannel next to the skin, and to exchange the situation where the disease was con- tracted, for another, even though not of a healthier air. This alone has often effected a cure. In like manner a change of medicines is as necessary as a change of air. thai the body may not become habituated to any one mode of treatment. Therefore, it ought to be remembered, that neither bark, nor any other tonic medicine, should be con- tinued longer than a fortnight at a time, but should be changed for another article whose virtues are nearly the same. After a week or two, the former may be resumed, in case the disease should prove obstinate; and to bring about the necessary changes in the constitution, larger doses should be given. Regimen. As to regimen in the cold fit, very little more is necessary than warm camomile tea. In the hot fit, the drink may be barley water, mint or balm tea, lemonade, toast and water, or cold spring water, taken often, but in small quantities at a time. When the sweat- ing begins, the drinks just enumerated may be enlivened with wine, and if the patient be able to take it, he may be allowed a little nourishment. During the intermission, the diet should be as nutritious as the patient's appetite and digestion will allow. Every thing that tends to keep up a gentle perspiration, and to give tone to the vessels, is useful; hence moderate exercise is singularly proper, since nothing more conduces to these beneficial effects.— The exercise should be of that kind to which the patient has been most accustomed: and taken in the open air, un- less wet weather, or a damp situation forbid. But the utmost care should be taken, that exercise he not pushed to fatigue, which, by inducing debility, carries thousands. particularly foreigners, to untimely graves. 205 REMITTENT, OR BILIOUS FEVER. S /.mptoms. In this fever there is a remission or abate- ment of its violence, but not a total cessation. Like other fevers, it commences with a sense of coldness and shiver- ing, accompanied by violent pains in the head and back, great dejection of spirits, sickness at the stomach, gid- diness, loss of strength, and difficulty of breathing. The cold stage is succeeded by a considerable degree of heat, the pulse, which in the cold fit was small and quick, be ■ comes full, but abates not of its quickness. The pain of the head and back increases, and the nausea is augmented, frequently terminating in copious vomitings of bile.— These symptoms continuing, the skin, which had hitherto been hot and dry, becomes moist. Soon after this, the symptoms abate, and sometimes cease entirely. The pa- tient flatters himself with the hopes of health speedily re- turning; but, alas! these pleasing illusions are soon dissi- pated by another attack, which comes on with increased violence. And if the fever be not opposed by means ear- ly employed and sufficiently powerful, a constant delirium and restlessness take place; the discharges become very offensive, succeeded by twitchinfgs of the tendons, profuse clammy sweats, and convulsions, which soon terminate in death. Causes. Remittents are produced from the same causes which induce intermittents, but acting here in a more powerful manner. Like these, they are most pre- valent in the months of August, September, and October, when heat and moisture combine to hasten the corruption of animal and vegetable substances, impregnate the air with noxious exhalations. Treatment. In the cure of this fever, all our efforts should be made to bring the remission to a complete inter- mission; and this is to be effected by bleeding, cathartics, emetics and diluents, with such medicines as have a ten- dency to solicit the circulation of "the fluids to the surface. Hence, on the commencement of the disease, bleeding will generally be found unnecessary, and should be often repeated, when there exists much pain in the head, with a 206 Remittent, or hard and quick puis?. But to evacuate the first passages of their impure contents is always necessary; and this is best done with calomel and jalap, or salts, senna and manna, and when circumstances do not prohibit the use of emetics, they may also be employed. The extent to which these means are to he carried, can only be direct- ed by the symptoms present, the habit of body, and other considerations. It will in many cases be proper to ex- hibit an emetic at the very first attack, but this may sometimes be forbidden, by great irritability of the sto- mach, or the appearance of inflammation. For frequent- ly in diseases of the same origin, and in persons very nearly similar, with respect to age. sex, and temperament, one will frequently be accompanied with an inflammatory diathesis, whilst another will be more ,of the low, irrita- ble species; and consequently the treatment must be va- ried, in proportion to the nature and violence of the dis- ease. For among fevers, we see all the intermediate de- grees and varieties, from common agues to those of the most violent and infectious kinds. If the patient be of a strong plethoric constitution, with a hard and quick pulse, a deep seated pain in the eyes, a burning heat at the stomach, and flushed countenance, in- dicative of a strong inflammatory disposition, bleeding is absolutely necessary, and should be repeated every ten or twelve hours, or oftener, until the inflammatory symp- toms subside. The necessity of diligently evacuating the intestinal canal, musj; be obvious to every person. And it is not al- ways by one or two brisk cathartics that this complaint is to be cured; but the operation must be continued until the whole of the bilious matter is evacuated, which may be known bjr the fseces changing their color, and putting on a natura| appearance. When the irritating matter is thoroughly evacuated, mild laxatives, as the cathartic mix- ture* or castor oil. answer very well in the course of the disease to keep the body gently open; but in desperate cases calomel is most to be depended on. And if a ptya- lism, or a slight salivation be excited by the calomel, the patient has no cause of alarm, but rather of joy, as this * Sec Disper.satory. Biliuus Fever. 207 is a certain indication of recovery. How desirable then must it he in high stages of bilious fever, to have this ef- fect produced as early as possible, by giving calomel, and rubbing in mercurial ointment, and dressing the blisters with the same. Besides the aforesaid evacuants, glysters of warm soap-suds, or molasses and water, to which may be added a little vinegar, should be employed; as they are not only useful in removing from the larger intestines any offend- ing matter present, but also in producing the good effects of fomentations. Attention having been paid to the state of the bowels, which is always necessary, because of the constant dis- position to accumulate bile, such medicines as tend to de- termine the fluids to the surface, are next to be regarded. Of this class are the diaphoretic drops, saline mixture, inindererus's spirit, febrifuge, and Dover's powder.*— Either of these may be exhibited in their usual doses, eve- ry two or three hours, but in desperate cases the antimo- nial powders with calomel, or calomel alone, in small doses, are most to be relied on. The warm bath also admirably promotes insensible per- spiration, by relaxing the skin, and taking off the stric- ture of the vessels; it consequently should always, when practicable, be used, and if a bathing vessel cannot be procured, the extremities should be immersed in warm water at least once a day. The temperature of the bath, should be regulated by the feelings of the patient, and that which effects these most agreeably, should be preferred. The cold affusion, by throwing cold water over the pa- tient, or sponging the body with vinegar and water, has been attended with the best effects in warm climates, par- ticularly if the application be made during the height of the paroxysm, when the head is generally affected. After the inflammatory disposition has ceased, bark will add considerably to the cure; but if incautiously used at the outset, as it frequently is, will render every symp- tom more violent. However, if the patient suddenly be- comes giddy, feeble and languid, the bark and wine must be had recourse to, and given freely on the remission; • See Dispensatory !, 208 Remittent, or otherwise, it will degenerate into a true nervous fever.— But you must not mistake the debility which arises from oppression, requiring evacuants, for an exhausted state of the system; as in that case the use of tonics would be but little better than butchery. Another medicine of great importance in this disease is the Colombo root, which readily checks the vomiting, so frequently an attendant, and supports the patient's strength during the use of such medicines as are requisite to abate the febrile heat, and to carry off the bile. After unloading the stomach and intestines, by two or three brisk purges, and diminishing the arterial action, by bleeding if requisite, a wine glass full of the infusion of columbo, or ten or fifteen grains of the powder may be given in a cup of mint tea, every two or three hours, either conjointly or alternately, with some gentle open- ing medicine, as rhubarb, magnesia, cream of tartar, or salts, to remove the redundant bile by keeping the bowels open. Salts, though a nauseous medicine, may be rendered much less so by adding a little sugar, acidulated with lemon juice or sharp vinegar, as in the form of the cathar- tic mixture; and this is an excellent aperient, to be ex- hibited in small doses after the vitiated bile has been re- moved by calomel. A solution of salts in seltzer water, is a form still more agreeable. During this general treatment, particular symptoms will require attention. The headach for example, which so frequently accompanies this fever, is to be treated by applying to the head cloths wrung out of cold water, or vinegar and water often repeated, until the malady is re- moved; besides which a blister should be applied between the shoulders. As to the vomiting, that depending on the peculiarities of habit, is to be variously treated. In some I have found the saline mixture or infusion of columbo, answer very well; in others a spoonful or two of new milk, or equal parts of milk and lime water, given every hoqr, have had the happiest effects. A spoonful of sweet oil and molasses has proved equally beneficial, when vomiting is accom- panied with a burning sensation at the pit of the stomach. To others, porter has afforded immediate relief. Never Bilious Fever. 209 was there a more welcome or wonderful illustration of this, than in the case of Mrs. Carroll, consort of Dan- iel Carroll, Esq. of Dudington. It was my good fortune to attend this very amiable lady under a most violent attack of the bilious fever, with in- cessant vomiting. All the usual remedies were employed, without any good effect, which excited considerable alarm. She being in a state of pregnancy, and recollecting that nature sometimes furnished a cure beyond the rules of our art, I asked her if there were any article of drink to which her appetite particularly led her. "Yes, Sir, replied she, I have been craving to drink some good London porter for two days past, but I would not mention it, being un- der the impression you would forbid my taking it."— Learning that Dr. Thornton had some of that description, I immediately obtained a few bottles, and giving her a glass of it, diluted with a little water, it acted like a charm, and, in a few weeks, I had the very great satisfaction of seeing my fair patient perfectly restored to health. The warm bath, or local applications, such as flannels wrung out of a warm decoction of camomile flowers, or mint leaves stewed in spirits, or equal parts of sweet oil and laudanum rubbed on the stomach, have done much good; and when these fail, a large blister, or a cataplasm of mustard-seed, ought instantly to be applied over the region of this organ. When the stomach is in a very ir- ritable state, the patient may frequently moisten his mouth and throat with cold water, but should drink as little as possible of any liquid. Wakefulness, or inability to sleep, will often yield to the warm bath and blisters, and when they fail, a glass or two of porter, or the camphorated julep may be given, which also failing, a dose of laudanum is proper at bed- time, provided there exists no considerable inflammatory [llft.til(*SlS The pain in the bowels is mostly relieved by the warm bath, or a moderate bleeding and emollient injections, to which occasionally may be added twenty or thirty drops of laudanum. If these produce not the desired ef- fect, and the fundament be scalled from the evacuations, give glisters of milk and lime water, composed of half a 27 210 Remittent, or pint of each. These failing, inject every hour with cold water, and apply cloths wrung out of it, to the belly. If a delirium come on in the first stage of the disease, it is to be treated by bleeding, purging, and the means prescribed above for violent headach; but should it occur at a later period, the pulse weak and irregular, with a great propensity to sleep, besides making cold applica- tions to the head, the body should be frequently sponged with cold vinegar and water, or equal parts of vinegar and spirits. And should not the recollection in a few hours become more improved, and the pulse fuller and more uniform from this mode of treatment, it will be pro- per to apply a blister to the head, and sinapisms or blis- ters to the extremities; besides which, wine or some cor- dial must be allowed; and if there be a cold sweat, or coldness of the extremities, flannels wrung out of hot spirits, or spirits of camphor, ought to be applied often around the arms, legs and thighs. On the decline of this fever, patients are sometimes troubled with night sweats, to relieve which, gentle ex- ercise in fresh air, and the tonic powder or pills, [See Dispensatory] or bark and elixir vitriol will be proper. The unusual fatality of this fever in Washington, as well as in many sections of our country, during the last summer and fall, was sufficient to create alarm, and to induce the benevolent to solicit through the medium of public prints, information, relative to the most successful mode of treatment. Although the practice I pursued last autumn, did not materially differ from that above recommended, yet, I am persuaded a brief sketch of the improvement, accom- panied with a few remarks, will be gratifying to most of my readers, particularly as I can state, an incontrover- tible fact, not a patient who was governed by my pre- scriptions died during the sickly season; nor was there a case of the disease degenerating into the nervous, when early application was made. This extraordinary success was the more remarkable, as the number of my patients were very considerable, in so much, that it was imprac- ticable to visit all of them daily, and many were attended principally by my students. Some of the indigent sick would doubtless have followed the fate of many of the Bilious Fever. 211 paupers who died, bad I not been sensible that exhibiting medicines, without payingdue attention to regimen, would not have the desired effect, and knowing tbis fact, I felt it my duty to those for whom I prescribed, to have them supplied with nourishment suitable to the case. In most instances, the lancet was resorted to; and with some patients of robust constitutions, and inflammatory dispositions, it was used freely in the early stage of the disease. Aperient medicines, being of the greatest importance, were frequently administered, and I found their salutary effects evidently increased by conjoining such as deter- mined to the surface. Twenty grains of calomel united with a grain of tartar emetic, or six or eight grains of ipecacuanha, were administered to an adult in the morn- ing, and followed in a few hours by an ounce of epsom salts, or an infusion of salts, senna and manna in broken doses. When a preference was given to medicine in the form of pills, I directed two of the aperient and diaphore- tic pills [-See Dispensatory] to be given every two hours, or two of them, to be taken at bed time and the dose repeat- ed every hour in the morning, until several copious evacua- tions were produced. With infants, calomel and ipecacu- anha in large doses, repeated occasionally, were often found sufficient. It should be observed with respect to aperient medi- cines, though active in their operation, they do not weaken the patientas generally supposed, for they take away the cause of, at least apparent, weakness, and we have often found patients in fevers taking bark and stimulants to support them under this apparent debility, who after the operation of some laxative medicine, required neither. In the employment of this remedy, however, it is necessary to attend to the discharges. The nurses will often report frequent evacuations, and if examined these may be found mucous and insufficient, or a watery fluid scarcely colour- ed. It is necessary that the stools should be truly fecu- lent, and be continued while the discharges shall be dark and offensive. We therefore ought not to be governed by the number of evacuations; but by the effects, and the patient's feelings. If he be relieved after each stool, and the pulse becomes softer, the hand more moist, and the 212 Tlemittent, or head less loaded, he need not be apprehensive, however violent the discharge. On the contrary, if the pulse be- come smaller and more frequent, the face sink, and faintness comes on, however little the discharge, it has been too much. In some cases, emetics were employed with very good effects. They greatly contributed to relieve congestion in the liver, and were also useful in determining to the skin as well as carrying off the bile. When purgatives were not requisite, the febrifuge mix- ture, diaphoretic drops, or antimonial powders were ad- ministered in their usual doses, every two hours, with the view of promoting a gentle diaphoresis, and to assist their effects, the patient being directed to take frequent small drinks of some tepid diluting liquor. Medicines of this class, by exciting perspiration, will be found to produce most beneficial effects, in those cases where the vital ener- gy is not diminished; but when considerable debility is present, they frequently fail of having the desired effect, and act on the bowels, producing a dangerous diarrhsea. When the fever manifested a disposition to yield, the in- fusion of columbo or camomile was given, particularly, after the immediate operation of laxatives; wliich had the effect of correcting the bile, restoring the tone of the sto- mach, and supporting the patient's strength. And so soon as there was an intermission of fever, or symptoms of the disease assuming the typhoid state, the bark conjoined with Virginia snakeroot, was given in such doses as the stomach would retain, which, together with the liberal use of porter and wine and nourishing diet, speedily arrest- ed the disease. In some instances the nitric acid diluted [See Dispensa- tory J was employed as a tonic with considerable advan- tage, particularly in delicate habits; or when there were symptoms indicating the liver to be diseased. With others again the solution of arsenic in the usual doses was ad- ministered with the most happy effects. The warm bath, in every instance in which it was em- ployed, produced beneficial effects; and when this luxury could not be procured, sponging the body and extremities with vinegar and water, or equal parts of vinegar and spirits, afforded great relief. Bilious Fever. 218 A few cases occurred of patients of robust constitutions, who not only neglected the proper remedies at the com- mencement, but aggravated the disease by taking stimu- lating drinks or active exercise, were at length attacked with great prostration of strength, accompanied with cold clammy sweats, coldness of extremities and impeded pulse. These symptoms indicated that considerable congestion had taken place, which would admit of no delay. I directed the warm bath, and w hen this could not be immediately obtained, friction and flannels wrung out of hot spirits, in which red pepper and mustard seed had been infused, were applied to the extremities, and renew- ed as often as they became the least cold. So soon as the natural warmth was restored, blood-letting with calomel and other aperient medicines were resorted to; and also blisters over the region of the liver and extremities.— It will frequently occur in such cases, that the ac- tion of the heart is so overpowered in the first instance, that the blood merely trickles or rather oozes from the punctured vessel for a considerable time, being much darker and thicker than natural. Yet when a few ounces have been drawn it usually flows with freedom, and be- comes finally of a brighter colour. The deficiency or irregularity of heat on the surface is among the first symptoms that indicate congestive dis- eases, and if the skin can be restored every where to its natural warmth, a cure may be expected. It is evident the warm bath, frictions of the skin, blood-letting, calo- mel with purgatives, and blisters, are the chief expedients to diminish congestion; but unless these be very early re- sorted to, they will not succeed, so rapidly does the stage of collapse supervene. Recovery very generally suc- ceeds if natural warmth be speedily restored, and an uni- versal perspiration excited. Upon this principle is to be explained the repeated success of the practice pursued by some practitioners in the plague; for immediately after persons were perceived to be affected, and consequently while there was yet no arterial excitement, they were subject to frictions by warm oil, in a close room, and over a brazier of hot coals, until a free perspiration took place. Some patients in the course of the disease, were afflict- ed with acid eructations and heart-burn, but were reliev- 214 Remittent, or ed by magnesia, the absorbent mixture or mucilage of gum arabic. These medicines were also useful in giving check to watery evacuations, which sometimes occurred on the exhibition of diaphoretic medicines; others again, on the decline of fever were troubled with pain, arising from flatulency, wliich required occasionally a little mint wa- ter, ginger tea, tincture of assafsetida or spirits of laven- der. This symptom, however, seldom came on when pro- per attention was paid to the discharge of the bowels. In a few cases the hiccough became exceedingly trou- blesome, but was relieved by taking in turns the syrup of damsons, a lump of loaf sugar m listened with brandy, tincture of assafoetida, or the camphorated mixture.— When these failed, a cataplasm of mustard seed and vine- gar applied over the region of the stomach generally suc- ceeded. Strangury was another spasmodic affection that requir- ed particular attention. Although the occurrence of this symptom was frequently the effects of blisters, [>ee suj)- pression of urine] yet in some cases, it evidently was pro- duced from a spasmodic irritation of the neck of the blad- der. And when arising from this cause, the camphorated powders, the warm bath, or injections of warm camomile tea or infusion of hops, with laudanum, proved to be tiie best remedies. Hemorrhages sometimes occurred, and when proceed- ed by head-ach, the pulse full and hard, indicating an in- flammatory disposition, recourse w as immediately had to blood-letting, followed by aperient and diaphoretic medi- cines; but when the discharge was attended with faintness, or happened at the conclusion of fever, the bark, elixir vitriol, or nitric acid, with cold drinks, were prescribed. Nitre in doses, often grains every hour or two, in a glass of cold water, as well as cold applications near the parts affected, were employed in both cases with evident advan- tage. Longings for improper food and drink, with some pa- tients, were exceedingly troublesome. On the decline of fever, when this symptom did not arise from the caprice of the moment, and the patient anxiously craved any particu- lar food or drink, it was allowed not only with impunity, hut considerable advantage. Bilious Fever. 219 Those cases in which I was consulted after the typhoid state of fever had come on, as manifested by a disturbed state of the brain and nervous system; showing itself in frequent sighings, wandering delirium, watchfulness or irregular and interrupted sleep; characterized also in the more advanced stage of fever by a deranged state of the secretions and excretions attended with a brown or black state of the tongue, and a cadaverous and offensive smell of the whole body, my attention was drawn to support the patient's strength by supplying him with nourishing diet, and giving stimulants both diffusable and permanent as recommended under the head of .Nervous Fever. Attention was also paid to the state of the bowels, and their offensive contents were evacuated daily, not by active purges which in this exhausted state of the system would destroy the patient, but by injections, and the occasional use of small doses of calcined magnesia alone, or conjoin- ed with a few grains of rheubarb. I was no less attentive in having the offensive materials, which were constantly excreted by the skin, removed by wiping the body and extremities twice a day with a cloth wetted with equal parts of vinegar and spirits. Care was also taken to have the sheets and linen of the patient fre- quently changed. By perseverance in the means above stated, several persons, whom I was called to visit at the latter stage of the disease, recovered under the most unpromising cir- cumstances. One case particularly deserves to be noticed, in order to show the impropriety of giving up a patient while there is life. Mrs. Lund Washington lingered under this disease, upwards of six weeks, before application was made to me, and learning she had been given up by her physicians as a hopeless case, I was unwilling to attend; but from the earnest solicitude of her son, Mr. Peter Washington, I consented provided the medical gentlemen who attend- ed her would meet me. From some cause or other, nei- ther of the physicians appeared at the hour appointed, and as there was no time to be lost, I took the liberty of prescribing in their absence. I found her in a state of excessive debility, and on examining her mouth, the tongue was covered with small white blisters, and gums with a foul 21o Remittent, or sordes, accompanied with a cadaverous breath. Her bowels were in a very irritable state, and from the acute - ness of pain she occasionally felt in them, caused her to scream out in a most lamentable manner. The state of her mouth readily induced me to ascribe the affection of her bowels to the swallowing of some putrid matter, and notwithstanding her extreme debilitated state, I deemed it necessary to direct a table spoonful of castor oil to be given, and its operation encouraged by injections of soap suds. At the same time, her strength was supported by arrow root, made pallatable by a plentiful addition of wine and nutmeg. I directed, also, fresh charcoal pow- der to be given in doses of a table spoonful every two or three hours, which produced most beneficial effects, as these distressing symptoms soon yielded. On further exa- mination I found one side of the hip and lower part of the back in a gangrenous state. To arrest this, poultices of charcoal and bark were frequently applied, and so soon as a bathing vessel could be procured, and a strong decoc- tion of red oak bark prepared, she was taken up in the sheet and bathed daily from thirty to sixty minutes at a time. The number of blisters which had been applied, together with the large ulcers in her back, occasioned great pain in bathing, as well as in moving her from one sheet to another: but notwithstanding this, as her stomach would not retain a sufficient quantity of either bark or nitric acid, I had the bath continued about three weeks, which, together with the most nutritious diet and a plentiful use of wine, porter, and other stimulants, her general health was so far improved as to require little or no attention except to the ulcers. These, after the mortified parts had sloughed off, were very deep and extensive, exposing the bone and requiring more attention than I was able to give. I therefore requested the surgical aid of Doctor Bailey Washington, and by the skill and attention of this gentleman, those ill-conditioned ulcers were healed in a few weeks. And I am happy to add, this most amiable lady is now restored to perfect health, to the exceedingly great joy of her affectionate family and numerous friends. Regimen. With respect to regimen, the food and drink should be varied, and adapted to the taste of the patient. Bilious fever. 21? Nature, perhaps, generally takes care that no error shall he committed in that way, during the continuance of this disease. The patient is seldom persuaded to swallow any thing but liquids, during the prevalence of the fever, and if by accident he should have an inclination for something more solid, arrow root, sago, corn, or rice, gruel, mush, panado, custards, roasted apples, oranges, grapes, or other mild ripe fruits arc all that should be allowed. To allay the thirst, barley or rice water, apple water, tamarind wa- ter, molasses and water, toast and water, or cold soring water, lemonade, raspberry or currant jelly, dissolved in water, mint or balm tea, acidulated with lemon hi ice, or other pleasant acids, may be given with gre >T Scnefit, in frequent, but small quantities. These cooling drinks not only quench thirst, but also tend to excite perspira- tion. Washing the face and hands of the patient from tin e to time with vinegar and water, is always refreshing. The room should be somewhat darkened, and kept mo- derately co«d, by a constant succession of fresh air; tak- ing care, however, that the current of the wind is not immediately directed on the patient. The covering of the bed ought to be such as is found most comfortable, and the body kept, as nearly as possible, at rest. When the fever subsides, and the patient regains a desire for food, it will be best, in addition to the mild articles of diet already mentioned, to begin with puddings of vari- ous kinds, new-laid eggs boiled soft, soups with vegeta- bles, raw oysters, &c. resuming his diet gradually, as he finds his health return. To koep up the tone of the system, a moderate use of genuine wine, or porter diluted, or branny, or rum and water made weak, will be proper, at the same time pay- ing due attention to air, cleanliness, and exercise. Thus have I detailed, in the clearest manner, accord- ing to my experience, the best curative means of this the most prevalent and dangerous of all our Southern maladies. It is however much easier to prevent than cure diseases; and in order to the first, I will point out the general means which have been found conducive to this great end, and which constant experience has sanctioned. 28 218 Remittent, or Prevention.—To obviate the attack of summer and autumnal fevers, we should intercqit their causes, or guard the habit as much as possible against their influence. Therefore, on visiting a warm climate where any epi- demic prevails, the first step is to prepare the system as much as possible, for the unavoidable change it is about to undergo; and this preparation consists in living tem- perately, and taking every other night, or oftener, one or two grains of calomel, or chewing rhubarb, or drinking molasses and water, or using sulphur in such doses as to increase the discharge by the bowels, without debilitating the system. If there prevail a fulness of habit the loss of ten or twelve ounces of blood will also be a useful precau- tion. In the mean time, an imprudent exposure to the heat of the sun, or night air, should be strictly avoided. Hard drinking is another cause of disease, which should be carefully guarded against in warm climates, particu- larly by seamen, who of all others are, perhaps, the most inattentive to health. The same admonition applies to their sleeping on deck during the night, and cold bathing when overheated, or in a state of intoxication, which, by suddenly checking the copious perspiration, seldom fails to bring on disease. Cold moist air is a frequent cause of disease in warm climates; hence too much attention cannot be paid to com- fortable fires, and suiting the dress to the changes of the weather. Flannel worn next to the skin is one of the chief pre- servatives of health. Many people, indeed, clamour against it as tending to debilitate, because it creates per- spiration. But this is altogether a silly prejudice; as mild perspiration, or a soft skin, so far from being hurtful, is the very habit of health. It preserves a proper medium of temperature, by absorbing the excessive moisture from the body during the day, and by preventing the effects of the cold damp air at night. Cleanliness, both in our persons and apartments, is so essential to health, as to form a leading consideration in all our views to that first of blessings. The neglect of this not only renders a man loathsome and offensive to himself, but gives rise to many of our most inveterate and fatal diseases. Bilious Fever. 219 Among the various means used for the prevention of diseases, and for the preservation of health in general, none is perhaps more beneficial in warm climates, than good wine prudently used. It increases the circulation of the fluids, promotes both the secretions and excretions, and invigorates all the functions of the body. How much is it then to be lamented, that so valuable a cordial cannot always be got pure; from the avarice of selfish men, who at a low price purchase tart or half-spoiled wines, and, to render them saleable, adulterate them with the most poisonous ingredients; so that they become the most in- sidious foes to health. The common red wines are most generally adulterated, and artificially coloured, as manifested by a red sedi- ment in the glass, as well as in the bottle. But the most pernicious of all adulterations of wine, is that of sugar of lead, or lead itself, which gives it a sweet taste: and there- fore it ought to be remembered, that every wine of a sweetish taste, accompanied with astringent qualities, may justly he suspected to be adulterated with that noxi- ous mineral. [See Poison.] When genuine winecannotbe procured, good old spirits are of considerable service, especially when taken in small quantities, and much diluted. These pleasant preventives whether under the name of grog or toddy, must, in con- sequence of their gentle stimulant qualities, be peculiarly beneficial to persons whose lot is cast in low situations and moist air. But they should never forget, that no where is the great virtue of self-government more neces- sary, than in their use. For if indulged to excess, they seldom fail, whenever a pre-disposition to any particular disease lurks in the system, to rouse it to action. In like manner, we must have regard to a proper regu- lation of diet, which consists in preserving the happy mean between long fasting on the one hand, and immode- rate eating on the other. Vegetables are peculiarly adapt- ed to warm climates, and consequently should constitute the chief part of our diet. Sweet oil, when pure, is per- fectly wholesome; but rancid oil, butter, fat, or meat the least tainted, must be wholly rejected. To those of weak habit and bad digestion, much benefit will result from a glass of the infusion of columbo, or 220 J\"ervous Fever. camomile, or cold water, every morning, on an empty stmoach. Such are the general means for preserving health, and preventing diseases in a southern climate. The chief point is to avoid the exciting causes, and keep the bowels always moderately lax. NERVOUS FEVER. The fevers already described, and indeed all diseases attended with a considerable degree of morbid heat, affect in some measure the nervous system; but in this particular species, the nervous system is more immediately and more violently affected, than in any other. When a fever is once produced, from whatever cause, it seldom fails, by long continuance, to occasion all the symptoms which ap- pear in the nervous or malignant fever. This fever has been described by different authors nn- d^r various names; the typhus or nervous fever, the slow fever, the gaol fever, the hospital fever, the ship fever, the petechial fever, the putrid fever, and the malignant fever. The first appellation it receives from its attacking the brain and from the effects it produces on the nervous sys- tem. The second, from the slow and gradual manner in which it sometimes comes on. The third, fourth, and fifth, from their being apt to arise in gaols, hospitals, and ships, when numbers of men are crowded together, and when sufficient care is not taken to have such places well ven- tilated and cleansed. The sixth, from certain spots which sometimes appear on the skin of the patients, la- bouring under this disease. The seventh, from a putrid state, or tendency supposed to take place in the fluids; and the last, from the dangerous nature and malignity of the fever: but they are all one and the same disease; various- ly modified, according to the violence of the symptoms, and the different constitutions of the patients. Symptoms.—The symptoms are commonly more va- rious in this, than in any other fever. It sometimes creeps on in such a slow, insidious manner, that the pa- tient will have suffered the disease to make considerable Nervous fever. 221 progress, before he thinks it necessary to use any reme- dies. On other occasions it comes on with a great de- gree of rapidity, and with many of the symptoms com- mon to all fevers. Thus, it commences with alternate sensations of heat and cold, a want of appetite, a nausea, and occasional vo- miting. These are followed by some confusion of the head a sense of weakness, dejection of spirits, tremor of the hands, and frequent sighing without knowing the cause. At this stage the pulse is irregular, sometimes a little quicker, at other times about the natural standard. In so ne a dull and heavy pain, with a sense of coldness, possesses the back part of the head; in others, a pain in the orbit of one eye. These symptoms gradually increasing, the pulse be- comes smaller and at the same time quicker, while the arteries of the temples and neck beat with additional force. The patient is generally more restless towards night, the breathing is somewhat difficult, and very little refreshment is obtained, from his short and disturbed slumbers. This gradual increase of symptoms, with the peculiar pale, sunk countenance attending fever, will give the alarm, even when other nervous diseases with which the earlier symptoms have been confounded are present. In the progress of the disease, the system is unequally affected; for sometimes head-ach, restlessness, and unea- siness prevail in a high degree, while at the same time the tongue is clean and moist; and at other times, while there is no head-ach, or restlessness, the tongue will be dry and foul, and profuse sweats will break out. This fever, moreover, is not only thus irregular, in affecting various parts of the body differently, but it is also irre- gular in its exacerbations; and these, instead of taking place in the evening, will arise often in the morning. Again, sometimes the fever is very violent for the first three or four days; it then diminishes for a time, and then perhaps increases again. After or about the tenth day, the weakness increases considerably; the whole ner- vous system becomes affected With tremors and twitch- ings; the urine is commonly pale; the fingers are in con- stant motion; the tongue becomes dry, of a dark colour, 222 Nervous Fever. and trembles when attempted to be put out; and some- times the gums and lips are covered with a dark viscid substance. To these succeed stupor, cold clammy sweats, with a foetid smell, hiccough, and twitching of the tendons, together with an involuntary discharge of the excrements. In every malignant case, this fever tends fatally on or before the seventh day: but more frequently those who die, are carried off about the middle or towards the end of the second week. When the patient survives the twen- tieth day he usually recovers. When the fever termi- nates favourably before, or at the end of the second week, the crisis is generally obvious; but when that hap- pens at a later period, particularly if after the third week, the favourable turn is less evident; and sometimes several days pass, during which the disease goes off so gradually, that the most experienced are in doubts whe- ther it abates or not. At length, however, it becomes evident by a warm moisture on the skin, by the dark- coloured gluey substance which adheres to the gums and lips, growing less tenacious, and being more easily re- moved; by the stools regaining a natural colour; by the urine being made in greater quantity, and depositing a sediment; by a return of appetite, and by the pulse be- coming slower than it was before the commencement of the disease. Deafness ensuing, tumours appearing be- hind the ears, a red rash, and an inflamed scab below the nose, or about the lips, are also considered favoura- ble. The symptoms which point out the near approach of death, are a change of voice, a'wild stare, a constant inclination to uncover the breast, purple or livid spots on the skin, laborious respiration, profuse evacuations by sweating or purging, much watchfulness, sinking of the pulse, great incoherency of ideas, muttering, picking at the bed-clothes, considerable dilatation of the pupil of the eyes, involuntary discharges by urine and stool, starting of the tendons, hiccough, and convulsions. If many of these symptoms occur, little expectation of recovery can be entertained. Causes___This fever is occasioned by impure air, and putrid animal and vegetable effluvia. We are there- fore not surprised to find it often originate, in gaols, ships, Nervous Fever. 32^ and dirty dwellings, where numbers are crowded toge- ther, and where it is not possible to have sufficient venti- lation. Though human contagion', and the effluvia arising from putrid animal and vegetable substances, are the most fre- quent and active causes of this disease, yet they cannot be considered as the only ones; for we sometimes meet with instances in a country neighborhood, of persons be- ing seized with the disease in all its malignity; where it is not epidemic, nor can it be traced to any place where the human effluvia could be supposed to be confined in any uncommon degree. Hence nastiness, a moist atmosphere, much fatigue, cold, depressing passions, scanty diet, excessive stu- dy, too free use of mercury, immoderate venery, profuse hemorrhage, or whatever weakens the nervous system, may be enumerated among the causes. Treatment.—With regard to the cure, when the in- flammatory symptoms appear to run very high, the early use of the lancet will be required. It should be observ- ed, however, if blood letting be employed in all the vari- ous forms of typhus, without due regard to the period of the disease, the quantity of the blood drawn, the age, ha- bit and constitution of the patient, it will often be fol- lowed by fatal consequences. On the contrary, if it be cautiously used in the beginning of the inflammatory ty- phus it will be of the greatest utility, as it will render the other means more prompt and effectual, and thereby fa- cilitate the cure. When the lancet is resorted to, the blood should be taken away in small quantity and from a small orifice. And as the rising of the pulse, under bleeding, is a cer- tain indication of its propriety, so its sinking is as cer- tain ah indication of its impropriety; hence we have a criterion to guide us in the operation. Towards the close of most acute fevers of severity, there is some tendency to a change in the constitution of the fluids; and this may occur so soon as the second or third day, in the most malignant cases of typhus. The blood when drawn in this state, loses its florid colour, and as it flows from the arm exhibits a dirty, dark appearance, sometimes of a 224 Nervous Fever. muddy blue, and sometimes of a deep black. It does not coagulate, but continues in a dissolved state in the vessel, which induced the ancients to call it putrid. It is un- questionably very unfavorable, and indicates that deple- tion is improper. In general it will be safest to resort to the evacuation of the alimentary canal; therefore, on the first appearance of the symptoms, twenty or thirty grains of ipecacuan- ha, or four or five grains of tartar emetic, may be dis- solved in a pint or more of weak camomile tea; of wliich the patient may drink a gill every fifteen or twenty mi- nutes, until it excites vomiting, which ought to be assist- ed by drinking freely of warm water: or should any ms- tiveness prevail, give a dose of calomel alone or conjoin- ed with ipecacuanha, and in a few hours afterwards some rhubarb, epsom salts, or infusion of salts, senna and manna, in broken doses to evacuate the bowels of their morbid contents. Through the whole course of the dis- ease, the bowels must be kept in a soluble state either by some of the above medicines or acid laxatives, as cream tartar and tamarinds, by fruits, or by glysters. Two or three stools daily may be safely borne, though if so great an evacuation should appear to debilitate, even this so;m- ber should be curtailed. However, the patient should in no case be more than two days without a stool, for a great deal of feculent matter is produced in fe\er although lit- tle food is taken, and costiveness is apt to induce an in- crease of heat and affection of the bead as delirium, &c. In administering purgatives, care must be taken not to employ fliem in such doses as would operate very copi- ously, as great debility might thereby be produced. So long as the alvine evacuations continue of a dark colour or unnatural appearance, calomel should be given not on- ly as an aperient, but also with a view of producing ptya- lism. The alterative operation of this medicine in the early stage of the disease, is a circumstance highly to be desired, as it equalizes the circulation, and diminishes visceral congestions. In typhus proceeding from conla- gion, and of a malignant nature, very few hours should be lost in these preparatory steps; for the disease often hastens with rapidity, and the worst symptoms sometimes occur, so early as the fifth day. In the early period of the simple typhus giving an erne- Nervous Fever. £%5 tic and followed the next day by some active purgative medicine have frequently cut short the fever at*once; and when this desirable effect has not been produced, they have hardly ever failed to shorten its duration, and to lessen its danger. # Although medicines, which might excite profuse sweat- ing, would he highly improper in this fever, yet those possessed of a mild, diaphoretic power, as Dover's pow- ders, the camphorated powders or mixture, [See Dispen- satory] the spirits of nitre, or infusion of Virginia snake- root, may be occasionally employed with advantage. The saline mixture given in a state of effervescence, every two hours, readily abates thirst, and removes the increased irritability of the system. In like manner, a table spoonful of yeast, given every three or four hours, affords much relief, and has alone, often proved an effect- ual remedy. The Rev. Edward Cartwright, having read of the power of fixed air in preserving meat from putrefying, was induced to make trial of yeast on a boy of fourteen years of age who had been ill several days of a putrid fever, for which bark and wine had been exhibited with- out any apparent advantage, and where there was but lit- tle hope of recovery. He directed two table spoonfuls of yeast to be taken every three hours, wliich having been complied with, the boy found almost immediate relief, and recovered very quickly. Mr. Cartwright reports, that he gave the same remedy to above fifty patients in this fever, without losing one. Whatever may be the mode of action of yeast in typhus, the fact appears to be indisputable, that fixed air takes off that extreme debility of the stomach so conspicuously marked in disorders of this nature; and in proportion as that subsides, the pulse rises, becomes slower and fuller, the burning heat on the skin disappears, and a truce is gained for the reception of nourishing supplies. The most agreeable mode of administering yeast, is to add two ta- ble spoonfuls of it to a quart of beer or mild porter, of which a wine glassful may be taken every hour or two. According to the practiceof Drs. Thomas, Currie, and Jackson, as well as other eminent practitioners, the affu- sion of cold water is one of the most powerful and effica^ 29 226 Nervous Fever. cious means which we can make use of in typhus fever. Its effects will be more salutary, in proportion as it is early adopted, i. e. during the first stage of the disease.-— Such being an indisputable fact, established upon the firmest basis, we ought always to employ it, very soon af- ter we have evacuated the contents of the alimentary ca- nal. To the early stage of the disease, cold water may b< poured in considerable quantity from a height, or dashed forcibly from a pail on the patient. But aspersion or abh'tion of"the body, by means of a sponge, will be more eligible and safe in the advanced periods. The effects produced by both modes are grateful and refresh- ing to the patient, and they usually bring about an abate- ment of fever, followed by more or less of a diaphoresis, and this again by a refreshing sleep. Dr. Currie states, that the cold affusion may be used at any time of the day when there is no sense of chillness present; when the heat is steadily above what is natural; and when there is no general or profuse perspiration.— During the cold stage of the paroxysm of fever, while there is any considerable sense of chillness present, or where the body is under profuse sensible perspiration, this remedy ought never to be employed, as by so doing we might extinguish life. In the advanced stage of fever, when the heat is reduced, and the debility great, some cordial, such as wine warmed with an addition of spice, or even brandy, should be given immediately after it. When recourse is had to this remedy, every ar- rangement should be made for the affusion before the pa- tient is moved at all, and fatigue as well as disgust should be avoided as much as possible. In those cases where the delicacy of the system, or the apprehensions of the patient or of the by-standers, may prevent cold affusion from being employed, we may substitute tepid affusion for the more powerful remedy, or we may re- commend either ablution, or aspersion. The tepid affu- sion, the water being lukewarm, or from 87 to 97 de- grees of Fahrenheit, produces a coolipg effect equal to that of cold affusion, partly in consequence of a more speedy evaporation, and partly because so great a glow or reaction does not succeed. The important object of diminishing heat therefore may be obtained with great Nervous Fever. 227 certainty by the repeated employment of the tepid affu- sion, suffering the surface of the body to be exposed in the interval to the external air. A diminished frequency of the pulse, and respiration, and a tendency to repose and sleep immediately ensue, though its effects are not so permanent as those of the cold affusion. Doctor Currie reports, that a putrid fever having made its appearance in a regiment quartered in Liver- pool, he had the men drawn up and examined, seventeen of whom were found with symptoms of it upon them— these he subjected to the cold affusion once, and some- times twice a day. In fifteen of this number, the conta- gion was extinguished, and in the remaining two, the fever went through its course. The healthy part of the regiment bathed in the sea daily, and by these means, he effectually destroyed the contagion. He further relates, that of thirty-two who went through the disease, by its being too confirmed to be removed at the time of his first seeing them, only two died; and with these, recourse was not had to the cold affusion. The same remedy has likewise been successfully em- ployed by Dr. Currie, and many others in the more ad- vanced stage of the fever, so as seldom to fail of procur- ing a safe termination. He relates the case of a soldier who was in the ninth day of the disease when he first saw him: his pulse was 100 and feeble, his heat was 104, his thirst very great, his tongue foul and black, his mind much confused, and at times he was delirious, and pe- techia were dispersed over his whole body.—The mode of treatment was as follows: his strength was directed to be supported by administering a bottle of wine a day, with an equal quantity of gruel; every night he took an opiate draught, and his body was kept open by laxative clysters, and when these failed, by a few grains of calo- mel. A bucket-full of salt water was directed to be thrown over him immediately, which was to be repeated according to circumstances. The effect was, that in a few minutes after the affu- sion, the heat lessened to 98, the pulse moderated to 96, and his mind became more calm and collected. Two hours afterwards he had relapsed nearly into his former state, but the night was passed with greater tranquillity. 328 Nervous Fever. The whole of this practice was continued with nearly the same result, until the twelfth day of the disease, the affusion having been performed in the evening, and oc- casionally at noon. The fever continued its usual peri- od; but on the twelfth day, the heat having sunk to its natural standard, the cold affusion was thenceforth omit- ted, and instead of it, the body was sponged all over once or twice a day with vinegar. A memorable instance of the good effects of cold affu- sion came under my immediate knowledge some years ago, says Dr. Thomas, whilst I practiced in the West- Indies. A professional gentleman of my acquaintance, residing in the island of Nevis, was attacked with this fever; and it proceeded with such violence, that in a few days petechias appeared on different parts of his body, and a hemorrhage of blood issued from his nostrils, mouth, and other places. Under these unfavorable cir- cumstances he was freely exposed to the open air, and one or two buckets of cold water were thrown over him; he wras then wiped perfectly dry, and replaced in his bed; which plan of proceeding was repeated twice and some- times thrice a day. By means of this application, the administration of an opiate at night, and a liberal allow- ance of wine, his life was preserved to the great, but pleasing astonishment of all his friends. The affusion of cold water on the surface of the body, is considered by Dr. Jackson as a power which makes a strong and general impression on the system, and wliich arrests the disease, or changes its condition in virtue of that impression; but not by subtracting increased heat, as supposed by Dr. Currie. Indeed, the good effects of the re- medy in question, cannot, we think, be wholly owing to the mere subtraction of heat; for it has been used with great advantage in many cases of fever, where there has been no perceptible increase of temperature, and where, by affusion, ablution, or aspersion with cold water, the dis- ease has been cut short abruptly, as well as in those where it had risen to a high point. Therefore we may safely infer, that cold affusion, or the suddenly pouring cold water over the whole surface of the body, operates as a powerful stimulaut, although its effects probably are ol short duration, unless frequently repeated; they arc pro Nervous Fever. 2&9 duced by the suddenness of the application affecting the nervous energy, and by the shock rousing the dormant susceptibility, so as to induce a new action, as it were, of the nervous system, removing spasmodic contraction of the extreme vessels on the surface, carrying off a large portion of morbid heat by general evaporation, and the remainder by insensible perspiration; thence restoring the healthy action of the exhalents and capillaries. As the danger of this fever is in proportion to the debil- ity, tie great point is to support the patient's strength and spirits by a liberal use of tonics and cordials, which should be early employed. At the same time, a nourish- ing diet should be used, suited to the taste of the patient, and the most rigid attention paid to cleanliness, and to a free circulation of pure air. In having recourse to these means, with a view of supporting the vital energy, we must take care to prevent the feculent matter from being confined, by occasionally administering laxatives or clys- ters. As we have no other vegetable tonic of equal efficacy with the peruvian bark in this variety of fever, it should be given in frequent and as large doses as the stomach will retain. And its beneficial effects will be increased by conjoining it with the snake-root in proportion of one ounce of the former to two drachms of the latter, or by uniting to each ounce a scruple of camphor. When this valuable medicine is rejected in its various forms, as it frequently is, we should not despair of finding a succeda- nium so long as our country abounds with the red and black oak. From my own observations in practice, fre- quent bathing in a strong decoction of the bark of either will produce the same salutary effects, as could possibly be expected from a free exhibition of the peruvian bark inter- nally. [See Materia Medica—and also Bilious Fever.] The other tonics of most efficacy in typhus are the mineral acids. I have myself employed the nitric acid diluted [See Dispensatory.] in doses of a wine glassful every two or three hours with very beneficial effects. Dr. Thomas speaks highly of the muriatic acid in all febrile diseases of a malignant nature. In all such cases he says it will be found a powerful and efficacious medicine. His usual plan of administering it is nearly as follows; 230 Nervous Fever. Having relieved the stomach by a gentle emetic where nausea prevails, cleared the bowels of their feculent con- tents by a moderate dose of calomel and jalap or rhu- barb, and subjected the patient to cold affusion when the circumstances already noticed have admitted of it, he gave to adults ten or twelve drops of the muriatic acid. guarded with five drops of laudanum, in an infusion of columbo, Virginia snake-root, or bark, and repeated the dose every four hours, gradually increasing the quantity to eighteen or twenty drops, or more. U. says, from using it in this manner, his practice has been attended with the most decided success. Dr. Thatcher also bears testimony in favour of this remedy. He states a case of putrid fever, attended with extreme danger, in which he administered the muriatic acid in a strong decoction of tboroughwort, with a few drops of laudanum. Wnen it bad been taken freely for about twelve hours, a profuse sweat ensued, of a yellowish colour, and nauseous s^ell; afavourable change immediately appeared, and the recov- ery was rapid. Dr. Armstrong states, that he has employed the muri- atic acid in typhus, with beneficial effects, when it did not excite griping pains or diarrhsea. He has prescribed as much as two drachms of it, largely diluted with water, in twenty-four hours, so as to make it a sort of common drink. Another tonic of considerable efficacy in fevers of a ma- lignant nature, is the solution of arsenic. Dr. Ferrier found, in the last stage of typhus, when neither bark, wine, or brandy, cold bathing, or even occasional doses of cayenne pepper, had the effect of rousing the powers of life, or of lessening the thick crust which covered the tongue, that the most singular advantages were obtained by giving the arsenical solutions. As soon as the febrile paroxysms are stopped, he considers it best to suspend the use of the arsenical solutions, and to support the pa- tient with bark and different cordials. Dr. Thomas cor- roborates the efficacy of this medicine, in stating a severe case of typhus which fell under his care; the patient hav- ing suffered two relapses of the fever, and her life des- paired of, when he was induced to make use of this min- eral solution. Its effects exceeded his expectations, for Nervous Fever. 231 the woman's life was apparently preserved by it. The solution of arsenic may be given in its usual doses every three or four hours. Of every other medicine, cordials only would supersede the bark; and with these putrid fever is sometimes success- fully conducted, when the bark is disagreeable or reject- ed. The chief is wine, wliich it is necessary often to give in large quantities. It must be recollected, however, that wine is an indirect stimulant, followed by a narcotic effect; so that when we begin, we must continue its use until na» turecan exert herself. In this case, and in all instances of putrefaction, whether general or local, our remedies are intended to supply the powers of nature. When these are roused, our exertions may be safely remitted; and wc find that this effect is produced in general fever, when the pulse becomes fuller and softer, the eye more quick, the skin more clear, and the tongue more clean and moist; in partial gangrenes by a beginning separation of the mortified part. It is impossible to fix the precise quantity of wine that ought to be given, as it must be varied according to the nature of the existing symptoms, the age, constitution, and previous habits of the patient. Madeira is unques- tionably preferable to every other wine, but, unfortu- nately, it is seldom to be procured genuine from the retail stores; consequently, it is better to obtain the Sicily, dry Sherry, Lisbon, or Teneriffe wine. These should not only be given at first diluted, but in small portions at a time. A mixture of wine and milk, in proportion of one part of the former to three or four of the lat- ter, constitutes an excellent drink, as well as diet, in the advanced stage of typhus. When the stronger wines ex- cite too much, the weaker, such as claret, may be tried; and if these should not answer, small repeated draughts of brisk ale or porter, may be given, and in many cases with more salutary effects than wine; either being calcu- lated, in the last stage of typhus, to give that degree of vigour to the system, requisite to remove those partial congestions which often exist at that period in combina-. tion with general debility. Good cider is another sub- stitute for wine; and brandy, rum, or whiskey, may, though with less decided success, supply the place of ei- ther. 232 Nervous Fever. Although stimulants are indispensably necessary, where there is a loss of tone in the vascular system, and real de- bility existing, yet to employ them inconsiderately, will often be attended with bad consequences. Dr. Armstrong observes, that it would be quite as ra- tional to give a half intoxicated man a tolerably free al- lowance of ardent spirit, with a view to make him sober again, as to attempt to restore, while the stage of excite- ment continues, a typhus patient, by the administration of wine; for he may be said to be, in some degree, intoxica- ted by the stimulus of the fever, and he will therefore be more affected by every glass of cordial that is adminis- tered. Dr. Potter, also, judiciously remarks, that the prescribing diffusable stimuli in every fever that has the name of typhus attached to it, is one of the greatest ab- surdities and strongest infatuations, that infests the prac- tice of physic. There is no fever that will bear, much less require, such agents to remove it in its first stage. It should be remembered, that when strong stimulants are incautiously administered, they have a powerful ten- dency to produce inflammation or congestion in the vis- ceral organs, and thus to render the chance of recovery, at the best, very doubtful. Therefore it is important in administering wine, or any other stimulant, to give it at first sparingly, and notice its effects carefully. If on trial the patient sleeps well, breathes easily, and feels a uni- versal glow, we may safely go on with it; but if, on the contrary, it produces restlessness, difficulty of breathing, the tongue becoming drier, and the pulse more tense and rapid, its further use should be omitted until the inflamma- tory diathesis is removed. In habitual drunkards, the stage of collapse sometimes rapidly supervenes, and they should always have an earlier and a more liberal allow- ance of stimulus, than those who have lived in an abstemi- ous manner, otherwise they will sink under the evacua- tions which may be indispensably necessary to remove the disordered condition of certain organs. By this general plan, a cure will, for the most part, be effected; but in the progress of the disease, particular mor- bid symptoms will require especial treatment. Thus affec- tions of the head, with stupor and delirium, will sometimes be relieved by frequently washing the temples with cold Nervous Fever. 233 vinegar and water; and occasionally bathing the feet in warm water. But if these affections, notwithstanding, should continue, it will be necessary to shave the whole of the head, and apply cloths wrung out of cold vinegar and water, which should be frequently renewed; and if the delirium be accompanied with wildness of the eyes, a blister miist be applied to the head. Where there prevails any unusual coldness in the low- er extremities, recourse must immediately be had to the warm bath, or to some warm stimulating applications ex- ternally, as well as the exhibition of stimulants internally, in order to restore the circulation to the surface.^ Tbe efficacy of the bath will be greatly increased in such cases by having it strongly impregnated with salt, and the patient should remain in it, till his skin become warm, and on being removed to his bed, he should be well rubbed all over with hot flannels, and bottles of hot water, or heated bricks with vinegar poured upon them and enveloped in flannel applied to his feet, legs and under the armpits. When a bathing vessel cannot be procur- ed, use, as an embrocation, a strong solution of table salt in heated spirits, which admirably recalls the lan- guishing circulation to the surface. A depression of the animal heat will sometimes come on in the collapse of typhus without any apparent cause. The pulse becomes very small, and the extremities very cold; and if some warm cordial, as mulled wine, hot toddy, or ginger tea sweetened, with the addition of a little spirits, be not immediately administered internally, and warm stimulating applications applied externally, death will soon follow. Blisters, as well as sinapisms in such cases, have frequently been employed, and are servicable by their stimulating effects; but they should not be continued on long at a time; and when a blister is raised in this disease, the sore should be frequently washed with an infusion of red oak bark; and nothing ought to be ap- plied to the part which may tend to increase the discharge; for that, by debilitating the system, would prove injur- rious. If nausea or vomiting continue, apply flannels wrung out of hot spirits, in which red pepper or mustard seed has been steeped, to the stomach and lower extremities. 30 231 Nervous Fever. These failing, give the saline or camphorated mixture, and apoly a poultice of mint leaves or cloths moistened with laudanum and camphorated spirits to the stomach, and cataplasms of mustard seed and vinegar to the feet. A slight purging, attended with a gentle moisture of the skin, not unfreqietitly arises towards the close of this fever, and now and then assists in carrying it off: but where it does not seem to produce a critical effect, it ought to be stopped speedily as possible by giving char- coal or the absorbent mixture, with a few drops of lauda- num, or by glysters of starch or the decoction of red oak hprk, containing in each a tea-spoonful of laudanum. When the purging is not considerable, wine or brandy mulled up with spice, or a free use of arrow root, with plenty of nutmeg, or rice milk with cinnamon boiled in it, is often sufficient. If purging be produced from swallowing putrid mat- ter, give a small dose of castor oil or rhubarb and mag- nesia, and afterwards charcoal. [See Bilious Fever.] In the stage of excitement, a diarrhoea accompanied with bloody stools sometimes occurs, indicative of either a preternatural fulness of the liver, or inflammation of the mucous membrane of the bowels, in this" case we must resort to the warm bath, mucilageous drinks, and evacu- ants, as calomel, and castor oil. It not unfrequently occurs, that patients, kept in very close apartments, have, on the approach of the last stage, black, bloody stools without any offensive odour. About the same time petechial or purple spots begin to show themselves upon the extremities, which at first are only few in number, and appear-as if drops of black ink had been allowed to dry here and there upon the skin: but becoming numerous they soon spread over different parts of the body, and are generally accompanied by discharges of blood from the nostrils, mouth, bladder or bowels. When these symptoms are accompanied with a weak, quick, thready pulse, we may be sure the stage of col- lapse is at hand. In such cases, recourse must be had to the most powerful antiseptics, such as vegetable and mineral acids, yeast, liquors in a state of fermentation, wine and bark, and aromatics with very small doses of Nervous Fever. 235 laudanum. At this momentous crisis, bathing the pa- tient frequently in spirits, or in a bath composed of equal parts of whiskey and docoction of red oak bark, with a free admission of air, will not fail to produce good effects. In addition to this mode of treatment, when the hemorrh- age proceeds from the nose, mouth or ears, it is advisa- ble to make use of local applications, as lints dipped in a solution of alum or blue vitriol, or some powerful styp- tic. Miliary eruptions sometimes appear as the crisis to this fever, and ought, therefore, on no account to be checked by any kind of evacuations; nor should ite pa- tient, on the contrary, be kept too warm with aWcw of forcing them out. Profuse sweats are to be obviated by sponging the bo- dy and extremities daily with equal pacts of vinegar and spirits; by being lightly covered with bed-clothes; by admitting fresh air freely into the chamber, and by giv- ing whatever he drinks, cool, and agreeably acidulated with lemon juice or elixir vitriol. If hiccoughs or starting of the tendons supervene, it will be necessary to give camphor and volatile sal-ammo- niac in large doses, with the warmest cordials. In cases of retention of urine, the treatment must be varied according to circumstances. In some instances the kidneys become inflamed, and in this state very little urine is secreted, until the healthy action of the vessels be restored by administering calomel and mild purga- tives, swallowing freely of demulcent drinks, and, occa- sionally, using the warm bath. In the low typhus, the kidneys are rendered incapable of performing their func- tions from a loss of tone, and in such cases, stimulants and tonics, with cold applications over the region of the bladder, as cloths wrung out of spirits, or equal parts of vinegar and spirits, are the best remedies. When the bladder is over-distended, or inflamed, indicated by acute pain and some tumour, the catheter is indispensably ne- cessary to draw off the water. In febrile complaints, it will be found that, where a small quantity of urine is se- creted, the sediment is proportionably copious; and, on the contrary, where a large quantity is secreted, the sedi- 236 Nervous Fever. ment is proportion ably scanty. If attention be paid to keeping the bowels open from the commencement of fe- ver, a suppression of urine will hardly ever take place. In an advanced stage of the disease, it sometimes hap- pens that in addition to a profuse secretion of vicid sali- va, little white ulcers, or apthse, appear in the mouth. In such cases the detergent gargle [See Dispensatory,] should be frequently employed, and the mouth occasional- ly washed with a solution of alum in water, an ounce of the former to a pint of the latter, and this will quickly take away the stench that arises from them. The viscid phles^, which collects about the tongue and teeth, may be w^id away with flannel, dipped in vinegar or salt and water, or after washing the mouth with sharp vinegar or some austere acid, it may be scraped off with a knife, or a piece of whalebone bent. From the want of sleep, much rambling and low deliri- um sometimes occur, which will require an opiate at early bed-time. The most advisable way of giving it, to prevent any deleterious effects, is to conjoin laudanum, with the camphorated mixture, or the opium with a few grains of camphor, volatile sal ammoniac, or some mild diaphoretic, as Dover's powder. Opiates are more ad- missible in this fever than in any other, and, as it is of the utmost consequence to procure rest, they should, with this view, be employed every evening, where there is no great delirium. In all fevers where we wish to procure sleep, and cannot have recourse to opium, on account of delirium being present, a pillow of hops laid under the patient's head, has been used with singular advantage. In case of watchfulness, the camphorated julep or poi- ter and water will generally succeed. When, however, these means fail, and there is great prostration of strength, followed by stupor, and a train of the most distressing symptoms, wine should be exhibited in large quantities, and it will be found that the patient will show a relish for this valuable cordial, after refusing medicines and ev- ery kind of nourishment in a solid form. At first it is better relished mulled^but afterwards the patient will take it freely in its pure state, and in the quantity of one or two quarts a-day, without intoxication. The quanti- ty of wine should be regulated by the degree of debility Nervous Fever. 287 present, the age of the patient, and the effects produced by it. The proper rule to be observed in the use of wine is to give it until the pulse fills, the delirium abates, and a greater degree of warmth returns to the extremities. And upon the smallest appearance of the stupor return- ing, the pulse quickening, and sinking, for they usually go together, the wine must be resumed, and continued in that quantity which is found sufficient to keep up the pulse, and ward off the other bad symptoms. Wben wine cannot be had, rum or brandy diluted with milk, or water sweetened, will answer; and with snmMia. tients is better relished. The friends of the sick should never be disheartened too soon, for here, if any where, we may say, "while there is life, there is hope." And I can truly aver, that I have often seen the patient raised, as it were from the dead, by the determined use of generous wine a'one, especially old Madeira. As soon as the patient be able to take nourishment, such as panado, arrow-root, &c. the quantity of wine must be gradually diminished. For although it be ab- solutely necessary to take it so liberally, during the con- tinuance of this fever, yet, as soon as that shall have left the patient, much caution becomes necessary in the use of it: since the third part of what formerly had prov- ed a salutary cordial and restorative, would in this state of convalescence, occasion a dangerous intoxication. It sometimes happens at the close of typhus that the patient is affected with a slight degree of mania or tem- porary alienation of the mind. In such a case it will be necessary to support the patient with a generous, nutri- tive diet; to keep him as quiet as possible; and to give him tonic medicines as bark and elixir vitriol, nitric acid or tincture, or rust of steel, carefully avoiding evacua- tions. If the appetite does not readily return on the cessation of the fever, the mineral acids or stomachic bitters will be proper. Bathing daily in a strong decoction of red or black oak bark will be found an excellent remedy in re- moving the irritability and weakness which are left be- hind; and when there is no visceral obstruction, the shower bath will be attended with beneficial effects. 238 Nervous Fever. We repeat, it is of the utmost importance throughout the whole course of the disease, that the most rigid at- tention be paid to cleanliness, and the communication with the external air kept up in different degrees day and night, according to the state of the atmosphere. None but those whose business it is to attend the sick, ought to be allowed to go near the patient, except when there is little or no affection of the head. In such cases the presence of a friend may soothe the mind and help to dispel gloomy ideas; by comforting the patient with the hope of a speedy recovery, and diverting his thoughts froswthat anxiety and dread of danger which invariably attewls this complaint. Regimen.—In addition to the mild articles of diet enu- merated in the bilious fever, bread and milk, with a lit- tle water, sugar, and the pulp of a roasted apple, form a most grateful and nutritious food; and for the sake of va- riety, cider, porter, or any other drink which the patient covets, should always be allowed. It has been observed, that this fever often originates from corrupted air, and of course must be aggravated by it; great care should therefore be taken, to prevent the air from stagnating in the patient's chamber. When that is small, and cannot he well ventilated, the patient should be carried into the open air, and allowed to sit there two or three hours every day in mild weather. When this cannot be conveniently done, every meaus in our power to ventilate the room should be employed. Strong-scent- ed herbs ought every day to be strewed about the room, and vinegar frequently sprinkled about the bed-clothes, and some evaporated, by pouring it on a hot iron. The bed-clothes ought to be in no greater quantity than is agreeable to his feelings, and when he can sit up, with his clothes loosely put on, it is often a refreshing change of posture and situation. The patient should have his linen and bedding changed often, and the stools removed as early as possible; for nothing refreshes the sick more than cool air and cleanliness. In the early stage of this disease, when there is much preternatural heat, washing the face and hands often in cold vinegar and water, and wiping the body with wet Nervous Fever. 239 cloths, will be highly refreshing; and in the more ad- vanced stage of the disease, when there is less febrile heat, the vinegar should be united w ith an equal quantity of spirit. In all cases where the fever is unusually protract- ed, and lea\es the patient in excessive weakness, the re- covery is slow and precarious, and the greatest care is required to prevent any error in diet, during the conva- lescence, as a very smnll degree of excess at this time, will produce very troublesome consequences. Food of easy digestion, taken in small quantities and often re- peated; gentle exercise when the weather is favorable; attention to prevent costiveness, by some mild laxative; and the use of bitters to assist digestion, or the rust of steel, when there is any prevailing acid on the stomach, are the most certain means of re-instating health. Contagion.—Having in the preceding chapter enu- merated the different means for the prevention of diseases, I shall now point out such as are most suitable to arrest the progress of contagion when commenced. When a contagious fever makes it appearance, the first precaution is to separate the sick from the healthy, and thus to cut off, as much as possible, the intercourse between them. The next step should be, to purify both beds and clothes from every particle of filth. The cham- bers must be often fumigated, by burning good sharp vinegar or tar, and the floor washed daily with ley or the solution of pot-ashes, or strong soap-suds. A cloth wetted in lime water and hung up in the room, and re- placed as often as it becomes dry, is also a great mean of purifying infected air. When a contagio-is disease originates on ship-board, quicklime should always be added to the wrater which is used for common drink, in the proportion of one pound of quick-lime, to a hogshead of water; but if the water be impure, a larger quantity of lime will be necessary; and some of it should be put also into the ship's well, to pre- vent the putrid and foul air arising thence. When these means are ineffectual to stop the progress of any contagious disorder, fumigation with the nitrons vapour, will undoubtedly succeed: and the method of preparing it, is to put half an ounce of vitriolic acid int«r, 240 Nervous Fever. a cup, warm it over a shovel of coals, adding to it, by little and little, about the same quantity of powdered saltpetre, and stirring it occasionally with a slip of glass, as long as the vapour arises. The vessel is then to be carried about the room, the doors and windows being close shut, and put in every corner and place where it can be suspected there is any foul air; the fumigation to be continued for one or two hours every day, or oftener, until the contagion shall be destroyed. If the vapour should irritate the lungs, so as to excite much coughing, fresh air should be admitted, by opening the door or windows of the room. However, after a lit- tle familiarity with it, this vapour will not offend the lungs, but on the contrary will prove higiily grateful and refreshing. The vapour of muriatic acid has also been successfully employed in purifying infected air, and destroying con- tagion. It is made use of in the following manner. Put one pound of common salt into an earthen vessel, and pour over it, from time to time, a small quantity of sul- phuric acid, till the whole salt is moistened. If the air be foul, and peculiarly offensive, apply a gentle heat un- der the vessel, to extricate a larger quantity of vapour; but in general, the simple addition of the acid to the salt will be found sufficient, unless the apartment be very large. On the first appearance of typhus or any infectious disorder in a gaol, hospital, boarding school, or any other place where many persons are crowded together, one. of these gaseous fumigations should be employed in every room, in addition to a free ventilation and the greatest cleanliness. An eminent physician of the marine barracks of Brest, states, that previous to visiting the hospital, he was in the habit of introducing into his nostrils sponge cut into proper size and shape, and moistened with some essential oil. He also kept in his mouth a piece of orange-peel; and in this simple method, he escaped several putrid and pestilential diseases, wliich in one year killed eleven physicians and one hundred and thirteen students. Where any one is apprehensive of having caught infec- tion, which may be suspected by a bad taste of the mouth, and want of appetite, an emetic should be given towards Inflammatory Fever. 241 the evening, and on the patient going to bed he may be allowed a little mulled cider, or wine whey, with a small dose of the anodyne sudorific drops. [See Dispensa- tory.] The warm bath, if such a luxury can be commanded, would here be found exceedingly refreshing and benefi- cial.* INFLAMMATORY FEVER. When fever is attended with an inflammatory diathesis, or when actual inflammation affects any part during the existence of fever, the patient is said to labour under one of an inflammatory kind; but according to the different parts in which the inflammation is seated, different deno- minations are given to the disorder. This disease, how- ever, exists when there is no topical inflammation, and is distinguished by more considerable heat than usual, in- dicating an increased action of the arterial system. The fever continues for several days with nearly the same violence, the morning remissions being scarcely ever ob- servable. Symptoms.—A sense of lassitude and inactivity, suc- ceeded by vertigo, chilliness and pains over the whole body, but more particularly in the head and back; which symptoms are shortly followed by redness of the face, throbbing of the temples, great restlessness, intense heat, unquenchable thirst, oppression of breathing and nausea. The skin is dry and* parched, the eyes inflamed, and incapable of bearing the light, the pulse hard and quick, beating from ninety to one hundred and thirty in a min- ute. *To this disease, the philanthropic Dr. Benjamin Rush, of Phila- delphia, fell a victim, in the year 1S13; a man distinguished throughout a long and brilliant life, by his private and social virtues. He was ef- ficiently engaged in promoting the Independence of the United States in the war of the revolution; and contributed chiefly to the establish- ment of the Medical University of Pennsylvania, in which he fijjed suc- cessively the most important chairs. His memory is cherished with the greatest respect, not only by the members of the profession of which he was the ornament, but also by the people of the United States, 31 SM£ Inflammatory Fever. The disease usually goes through its course in about fourteen days, and terminates critically, either by a dia- phoresis, diarrhoea, hemorrhage from the nose, or a de- posite of copious sediment in the urine—otherwise it changes to a typhus. Caitsbs.—Sudden transitions from heat to cold, the application of cold to the body when warm, swallowing cold liquors when much heated by exercise; too free a use of spirituous liquors; violent passions ofthe mind; exposure to the rajs of the sun; topical inflammations; the suppres- sion of habitual evacuations, and the sudden repulsion of eruptions. Treatment.—The symptoms which attend this fever indicate most strongly the necessity of having an early recourse to the lancet, which should be freely used. In re- peating the operation we must, however, be governed by the effect it produces on the pulse, and by the appearance the blood puts on after standing sometime. If the for- mer continues full, strong and tense, and the latter exhib- its a buffy, sizy coat on its surface, the bleeding should be repeated by all means. The pulse in this fever is apt to become fuller and stronger after bleeding, which may easily be explained; for the plethora may be so great as to distend the vessels beyond their proper tone. In such cases, the vessels cannot act fully, and the pulse is contracted: but when the plethora is taken off by copious bleeding, and the vessels are allowed to contract properly, the pulse becomes fuller, which shows that the remedy is proper. When the fever has been of several days standing, and the bead is much affected, either with severe pain or de- lirium, topical bleeding, by the application of three or four leeches to each temple is advisable, should the pulse not justify the u^ ofthe lancet. Applying linen cloths, wetted in cold vinegar and wa- ter, to the forehead and temples, will often afford consid- erable relief. If nausea or sickness prevail at the commencement of •he disease, it should be relieved by a gentle emetic. But when the determination to the head is violent and the Inflammatory Fever. 94,S vessels have not been sufficiently depleted by blood-letting, the aperient and diaphoretic pills, or a dose of calomel, or infusion of salts, senna and manna will be most, pro- per. Cathartic medicine will not only relieve the head, but prevent determinations to the lungs and liver; and medicines of this class should be repeated every day or two during the continuance of much febrile action. Diaphoretics are remedies also of great utility in con- \ tinned fever. Therefore, with a view to determine the circulation to the surface of the body, give the febri- fuge powders or mixture, the saline mixture, spirit of Mindererus, diaphoretic drops, Dover's, or antimonial powders in their usual doses. [.S'ee Dispensatory.]— The warm bath will be found of considerable efficacy in encouraging the diaphoretic powers of these me- dicines. In many cases it will be sufficient to induce perspiration for the patient to bathe his feet in warm wa- ter, to lie in bed and drink plentifully of diluent liquors, as balm, ground ivy, or flaxseed tea with the addition of a little nitre; but should these simple means not prove efficacious, it will then be necessary to resort to more powerful agents. It ought to be remembered, in the whole ofthe inflam- matory cases, we should never have recourse to diaphor- etics, till arterial action and general excitement are con- siderably reduced by blood letting, and aperient medi- cines. And, it should also be laid down as a general rule, in every species of inflammatory fever, to solicit perspiration rather by simple means, than to force it by any violent measures. When the means employed have a tendency to allay heat, soften the skin, relieve deliri- um and induce sleep, we may be assured of their proprie- ty. But sweating, when excited in fevers by stim- ulant, heating and inflammatory medicines, is almost sure to prove hurtful. It likewise proves injurious when ex- cited by much external heat, or a load of bed clothes: as also where, instead of relieving, it rather increases the frequency and hardness of the pulse, the anxiety and dif- ficulty of breathing, the head-ach and delirium. When sweating is partial, and confined to the superior parts of the body, it will be more likely to prove hurtful than sal- utary. 244 Inflammatory Fever. The torpid state of the vessels of. the surface, ren- ders it, sometimes, necessary to have recourse to arti- ficial heat, in order to equalize the circulation and pro- duce perspiration. Therefore, when neither the warm or vapour bath can be procured, hot bricks, after being dipped in water, or vinegar poured upon them, and sur- rounded with flannels, should be applied to the feet, be- tween the thighs, the sides, or arm-pits, while the patient is moderately covered, so as to confine the steam or va- pours. Tliese means will very generally and speedily cause a relaxation of the surface, and produce an abun- dant perspiration. In having recourse to the warm bath, it is wor- thy of remark, that the natural temperature of the human species is about ninety-eight degrees, but owing to the cooling process constantly taking place on the sur- face, it is here considerably lower, and hence we feel the sensation of warmth, at several points below animal heat. It is this circumstance which renders it difficult to adjust a precise standard, though, perhaps, we may not err by fixing it from ninety to ninety-six degrees. However, it will be proper, from the different susceptibilities of per- sons, always to consult the feelings of the individual, and so to regulate the bath that it may impart a slight, but an agreeable sensation of warmth. But, though the appli- cation of heat to the surface, in the mode which we have described, will very generally excite sweating, it does not do so uniformly. There are cases attended by great heat of the surface, particularly in the early stage of the ner- vous and scarlet fever, which is aggravated by all the means we have enumerated, as designed to create perspi- ration. And in diseases of this nature, the effu- sion of cold water will be found more effectual in remov- ing the constitution of the cutaneous vessels, than warm applications. In the progress of this fever, it sometimes happens that particular parts of the body are much affected, and that there prevails either great oppression of breathing, or that violent pains in the head, stupor or delirium ensue: In all such cases, the application of a blister near the part affected, will be proper, and relief will often be quickly procured by it. Where there is any unusual coldness of Inflammatory Fever. 245 the extremities, with a sinking pulse, blisters to the in- side ofthe legs will likewise prove highly serviceable.— Their efficacy in such cases may be increased by the ap. plication of stimulating cataplasms, to the soles ofthe feet and palms ofthe hands. Blisters very powerfully restore the balance of the circulation, and diminish morbid con- gestions. In all cases of fever there is a fulness of the vessels; and we find the vessels ofthe eyes red, the face flushed, and the eye-ball itself apparently enlarged; but congestion produces also irritation, and often a less degree of phrensy. The usual wanderings ofthe mind are more rapid, the voice quick, the temper irritable, unreasonable, and occasionally violent. In each state, blisters are in- dicated, and often produce the happiest effects: sleep fre- quently coming on as soon as the plaster begins to stimu- late. The milder symptoms of congestion, yield frequent- ly to purgatives; and when these have been freely used, blisters are often necessary. In this fever, as in most others, sleep is much interrupt- ed; and from a want of this, delirium often arises. Opium here would be an uncertain medicine; for should it fail to procure rest, the delirium would be greatly increased by it. In such cases, a pillow of hops laid under the patient's head, or a strong tea of this herb, will generally have the desired effect of procuring refreshing sleep. The cam- phorated powders or julep are of considerable utility in fevers, and in many instances have procured sleep. The calmness which camphor often seems to inspire; the sere- nity and even the temporary ease, which are among its first effects, render it peculiarly valuable. Hemorrhages sometimes occur in this fever, and at times are difficult to be restrained. If the pulse be full and hard; if much headach has preceded, the bleeding must be continued. But if it happen at the conclusion of fever or be attended with faintness, antiseptics constitute the proper remedies. [See Bilious and Nervous Fevers.] Palpitation of the heart, is frequently a troublesome symptom in fevers. It is often produced by a redun- dancy of blood, as indicated by a florid countenance, in wliich case the lancet must be resorted to. It sometimes proceeds from the state of the stomach and bowrels, and may then be relieved by evacuants: but it arises also, in 246 Inflammateru Fever. many cases, from a diminution, or an irregular distribu- tion of the nervous power; and shows that the degree of debility is considerable when stimulants will be required. In some instances, the fever is continued and kept up solely by debility. In such cases, the bark may be em- ployed, provided on using this medicine, the patient sleeps well, breathes easily, and does not find any increased heat; but if, on the contrary, it produces difficulty of breat ling, and restlessness, its use should be omitted. If by a pru- dent and judicious use of the remedies pointed out, we can lessen the congestion in the head, preserve the strength by the due regulation of temperature, and support it after the first days by more nourishing diet, we shall find little occasion for administering bark or other tonics. Cordials are however often necessary; and of these, wine is the most efficacious. In this fever, partial evacuations, such as purging and sweating, which have no tendency to prove criti- cal, often arise. When these happen, we must put a stop to them, by resorting to the means recommended in such cases, under the head of Bilious and Nervous fever. Critical evacuations may be distinguished from those which are not so, by attending to the appear- ances which take place in other parts of the system. For instance, if a purging should arise, and the tongue continue foul, and the skin dry, without any abatement of heat and thirst, then we may regard it as by no means critical; but if, on its taking place, the tongue be- comes clean and moist, the pulse moderates, the febrile symptoms abate, and a gentle sweat is universally diffused over the skin, then a crisis may be expected. When this fever does not yield to the remedies pointed out, and assume the symptoms of typhus, it is then to be treated as advised under the head of Nervous fever. Among the sequels of fever are cough, night sweats, an irritable and irregular state of mind, a capricious and often an inordinate appetite. These are, in general, marks of debility only, and disappear with returning strength.— Bark and tonics are usually employed for a time with little effect. The constitutional powers are at last exerted, and the patient gains in hours the strength which, with the most powerful tonics, it did not attain in days. The pow- Inflammatory Fever. 247 :r-> of digestion, however, do not return in the same pro- (>o?-f ion as the appetite, and relapsesare not uncommon from 'unlimited indulgence. Rv < imen.—Throughout the whole course of the dis- cus* . the patient is to abstain from solid food and animal bro'Us. The diet should be chiefly gruel, barley or rice water, arrow root, subacid fruits, water acidulated with lemon, the jelly of currants, or similar sharp fruits. It may be drank warm or cold, as is most agreeable to the patient. Hid chamber is by no means to be kejjt warm, either by fires i*r by being closely shut up, as is too gene- rally the c*.se; on the contrary, it should r-e of a proper temperature, by allowing tiie admission oi cool air into it from time .<» time. His bed ought to be lightly cover- ed with clothes. The patient may sit up a little each day, according to his strength, for this will lessen the fever, headach and delirium; but when a salutary perspiration comes on, it should be indulged in bed. On his recovery, a strict attention should be paid to diet, scrupulously avoiding to overload the stomach, and partaking only of such things as are light, nutritive, and easy of digestion: all other causes likely to induce are- lapse, are also to be carefully shunned. Fresh air, gentle exercise on horseback or in a carriage, agreeable company, and a moderate use of wine, will greatly contribute to the recovery of convalescents.— Should the appetite not readily return, or the digestion prove weak, the tincture of bark, stomachic bitters, or nitric acid will be proper. Having pointed out in an intelligible manner, the most approved method of treating the intermittent, remittent, and continued fever, as well as the means of prevention, it seems advisable to give some useful hints with regard to the prognosis by which the attentive reader may also be instructed in the art of foretelling what may happen to the patient, with respect to the termination or change of a disease either by death or recovery. Prognosis of Fevers.—In treating the prognostics of fevers generally, we shall first present some useful admonitions which are given in the symptoms of impend- ing disease. 248 Inflammatory Fever. The prognostic of an impending disease may be drawn from the aspect of the countenance, the mode of living. the changes in habits or situations, and the critical pe- riod of life. If a person from a healthy state, becomes sallow, weak, with loss of appetite and spirits, or with disturbed sleep, we may reasonably suppose, that some disease threatens. If these indexes shall be gradually disclosed, with a countenance tinged lightly with yellow, obstructions in the liver have probably taken place; if more rapidly, with slight shiverings occasionally, a fever impends. A regular evening exacerbation, with cough. portends a hectic; a more violent shiver, with considera- ble heat, a continued fever, a deep redness in the face, with inflammation in the eyes, plainly point out accumu- lations in the head and chiefly venous ones; but these often arise from diseases impeding a free circulation through the lungs; so that the state of these organs must be considered in forming the prognosis. They often ex- ist together, and aggravate each other. Violent fixed pains in the head, recurring at irregular intervals, and usually excited by every cause of increased circulation, generally show that some fixed obstruction prevents the free course of the blood through the organ; and this is followed by convulsions and some times insanity, and frequently a sudden termination of life. A fulness in the stomach and abdomen are certain signs of accumula- tion, and it depends on the comparison of the other symp- toms, whither it be obstructions of the viscera, ac- cumulated contents, or merely flatulency, and the prog- . nostic must be regulated by comparing the symptoms of each disease. The mode of life will often lead us to form some prog- nostic of an impending disorder. Late hours cannot be borne with impunity, except by a very few7; and their principal effect is to induce obstructions in the abdominal viscera. If connected with drinking spirituous liquors, the effect is usually felt in the liver. The sedentary student has reason to apprehend biliary accumulations, with costive- ness, and a train of hypocondriac symptoms. Excess in eating or drinking will equally lead us to foretel diseases of the stomach, often of the head, connected with the sto ■ Inflammatory Fever. 34(1 mach; but retributive justice is frequently seen to pun- ish former error with the greatest severity, in the feelings of the patient by loss of appetite. Almost every situa- tion is apparently consistent with health, if free air be admitted; but its deficiency leads to a variety of diseases from debility, which may be easily foreseen, and only can be avoided by a change. Changes of habits and situations are frequently the source of different diseases, which we can often prognos- ticate, and sometimes guard against. Abstemiousness, suddenly adopted after free living, and the contrary, arc sources of disease, the former chiefly of complaints arising from insufficient stimulus, the latter from too great excitement. A sedentary, af- ter an active life, is often attended with languor, low spirits, and visceral accumulations; the contrary, at first with languor and fatigue, soon followed by increased tone and vigour. The critical periods of life merit attention also in our prognostics of various diseases. If scrofulous affections do not yield in the early period of life, there is little pros- pect of cure. The same may be said of epileptic fits, and of Saint Vitus's dance, though to the latter there are many exceptions. The critical period of the female life is that of the cessation rather than appearance of the catamenia, for unless hectic symptoms come en, the dis- charge though at a much later period than usual becomes regular. The period of cessation, if not preceded by free, often copious discharges of the menses, prognosti- cates a less healthy old age. Prognostics in diseases are usually drawn from the vi- tal, animal, or natural actions. The vital actions, which give the best information, are the states of the circula- tion and the respiration. The first is chiefly known by the pulse. But before we proceed further on this sub- ject, it may be proper to describe its action. The pulse consists in the reciprocal contraction and dilatation of the heart and arteries, by the former of which the blood is propelled through every part of the body. Much at- tention is required in feeling the pulse, since it often mis- leads, unless the practitioner is accustomed to its exami- nation. In estimating its strength or weakness, it is ne- 32 £50 Inflammatory Fever. cessary to consider the sex, temperament, and age of the patient. The pulse in women is quicker than in men; in the sanguine than in the melancholic temperament; in youth than in age. During the first year of an infant, its pulse is from one hundred and eight to one hundred and twenty; during the second from ninety to one hun- dred and eight; the third from ninety to one hundred. It varies little till the seventh year, when it is about sev- enty-five; and in the following year scarcely exceeds sev- enty. These numbers are subject to great variety. The pulse is quickened after a full meal, or taking any stim- ulus; after exercise or any agitation; it is also quicker when standing than sitting, and in the latter posture than when lying down. In hysteric patients it is excited to an inconceivable rapidity by the slightest circumstances without portending danger. A fat person has naturally a weak pulse; but it beats also to a disadvantage beneath a layer of fat. This circumstance should also be attend- ed to in our estimate. The size of the artery we can of- ten estimate, for we can feel, in thin persons, two thirds of its circumference, and errors can scarcely arise from this source. A natural pulse is from 60 to 80, more strictly from 65 to 75. On feeling the pulse the artery should be first felt gently, and if any doubt arises whe- ther the pulse is weak, it should be compressed strongly by three fingers, and the two uppermost slowly raised. If the pulse is strong, and seemingly weak only from compression, the blood, rapidly returning, will strike ful- ly the finger below. If really weak, it gradually reco- vers its former force. A strong, firm pulse is consistent with high health, but if it strikes the finger like a tense cord, it shows a ten- dency to disease, and if with this hardness, it is increas- ed in frequency, inflammatory fever is present. A throb- bing pulse which strikes the finger with apparent but not real fi rmncss, will sometimes be mistaken for what is styled the hard pulse. But this has not the same firm resist- ance which we have described. It strikes sharply but not strongly, and the relaxation is as rapid as the pulse is transitory. When there is internal irritation, the throbbing pulse will continue often to the last, show- ing, in every succeeding moment, its peculiar character Inflammatory Fever. 251 more strongly; but in the commencement of fevers it of- ten so nearly resembles the strong pulse as to deceive. A small pulse will also be mistaken for a weak one, un- less by a practitioner of experience; but the lightness of its strokes depends on the small size, sometimes the deoth of the artery. If a pulse is at 55 or 50, there is reason to apprehend some compression on the brain. A constant pulse of 90 in a minute, rising occasionally to 108, shows a considerable irritation in the system, and is not without danger. If, in the early stages of fever, it rises to 120 in a fe- male not peculiarly irritable, it portends considerable dan- ger either from debility or irritation. If, at any stage it exceeds 120 or considerably exceeds it, except for a short time, we have the greatest foundation for appre- hension. An intermitting pulse is a mark of considerable debili- ty, and prognosticates a dangerous disease. It is also a symptom of organic affections. This alarming view of the subject requires, however, some alleviation. An in- termitting pulse is frequently owing to fulness of the sto- mach and bowels, and often arises from agitation of mind. It is also habitual, a circumstance not uncommon. In such constitutions, the usual intermission, on the access of fever, often disappears, and the first symptom of amendment is the return of the intermission, wliich at the end of the long fever may appear alarming, if not connected with other favorable symptoms. In general, the favourable signs are pulses more soft, somewhat ful- ler, and in a slight degree more slow. The unfavorable signs are, more thready pulses, as if the artery was small- er, pulsations quick, weak and irregular. The state ofthe circulation is also known by the com- plexion. A sallowness, and a want of transparency show that the blood is not carried to the extreme vessels; and even when the cheeks are flushed, if the skin round the lips and nose is of an opaque sallow whiteness, the conclusion will be the same, and strength ofthe constitution is consid- erably impaired. The appearance ofthe eyes is equally in- dicatory of strength and weakness, and the character of the features is preserved in proportion to the remaining S52 Inflammatory Fever. strength: Each appearance depends on the State of the circulation. Respiration is a vital action connected with the state of circulation, and ofthe greatest importance as a prog- nostic. Respiration slow,full, and deep, shows the strength and all the vital organs to be unimpaired, and in every situation is highly favourable. The weak, slight and in- sufficient respiration is in general a mark of weakness; the suffocating of obstruction; the quick of considerable irritation, exciting rapid expiration. The stertorous shows insensibility, from compression on the brain; the stridulous, inflammation of the trachia; the rattling, ac- cumulations of phlegm often unconquerable; and the in- termittent, attends the last efforts of expiring life. The animal actions from which we may draw prognos- tics, are, the senses, muscular action, and sleep. Violent delirium is a symptom of active inflammation in the brain, and is dangerous only so far as it shows a violent acute disorder. The wandering delirium in fevers of a low kind, is a symptom of no great danger, unless it comes on early, and in a degree disproportioned to the state of the fever. In other complaints it will excite serious ap- prehensions, and shows that the inequality of excitement depends on debility. If it persist after the cessation of the fever, unless evidently in consequence of debility, there is reason to suspect an organic injury in the brain, and more so if violent delirium has occurred in the early part of the complaint. Delirium, arising from want of sleep, is said not to be dangerous, but the want of sleep itself is generally owing to a languid inflammation ofth« brain. General restlessness is a symptom ofthe same kind. Of the external senses, and their organs, the eye af- fords the most particular symptoms by which the event may be foretold. The sensation of black spots, which induces the patient to pick the clothes, as if he could re- move them, is a symptom of debility, and is attributed to a partial palsy in the retina. It is certainly a highly dangerous symptom, though by no means a desperate one, as it has been represented. A more dangerous symptom is double vision. It is in general an early symptom of hydrocephalus. When the eye-lids fall, and can scarce- ly be elevated by the exertion ofthe will, it shows con- Inflammatory Fever. S5S siderable weakness, and when the patient sleeps without closing them, great insensibility. The latter symptom is, however, often owing to an irregular contraction of the muscles of the eyes, for in such cases the pupil is drawn up under the lid. The symptom is not, however, on this account, less alarming. The clear natural ap- pearance ofthe eye is a favorable symptom; but too great brilliancy, or too quick motions of this organ, show ap- proaching delirium. A severe fixed look, without an ob- ject, is a similar symptom. The appearance of the eye- lids sometimes points out a weak state of the system, par- ticularly when there is a blackness in the lower lid, to- wards the inner corner ofthe eye. A noise in the ears in fevers is said to be a sign of ap- proaching delirium, though frequently a symptom of weak- ness only, and often occurs from this cause in weak and old people. If this noise occurs in the beginning of fe- vers, it is said to foretel a violent and a tedious disease. Hearing particularly acute is often a precurser of deliri- um, and witiiout fever, it is the effect of strong excitement in the brain. Deafness in fevers is said to be a favora- ble symptom: we can at least observe that we have not found it unfavorable. Depraved taste is very common and offers no particular prognostic. Lassitude on the attack of fevers, in so great a degree as to produce fainting, is always a very dangerous occur- rence. If attended with a considerable wandering, the danger is greater. It is a favourable sign if, in the beginning of a fever, the patient can sit erect with his head elevated. And, if the patient can support himself in bed, and occasionally turn on his side, about the tenth or twelfth day, circum- stances are favorable. Sleep, if calm and refreshing, is always a favourable symptom; but if interrupted, broken by terror, excited by dreadful images in dreams; if, instead of tranquil rest, the patient starts, catches, talks in a hurried manner, though not conscious of terror, it is unfavourable. Deep sleep is itself a disease, and shows considerable oppres- sion on the brain; yet, at the period of a crisis, if attend- ed with a soft pulse, moderately slow, and a soft moist skin, it is salutary. After a-crisis, the deepest, long con- ^54 Inflammatory Fever. tinued sleep is notdangerous, if not attended with a stertor (a sound like snoring) or with a pulse preternaf mally slow. The naturri actions which furnish prognostics are di- gestion and its consequences, and the various excretions. In fever the appetite is at once destroyed; nor is it a fa- vourable sign, in an acute disease, that it should remain or return too soon. The appearance of the tongue is of considerable impor- tance as a prognostic. Whiteness of its surface is a sign of fever; and if white and dry, it shows the fever to be more considerable. In the progress of a fever it be- comes brown, a darker brown, and even black; and these colours are usually seen when the tongue is dry and hard. While the edges continue clean, and of their natural speck- led appearance, there is little danger; and indeed fevers have terminated favourably, though the tongue has been, for many days dark, dry, and even black. The tongue sometimes in the course of fever becomes suddenly clean, and of a shining red. This, in general, shows that the fever will be of some continuance. The tongue some- times cleans slowly in elderly and debilitated constitutions. And, independent of fever, in such habits the tongue is often black at the back part. A heavy load in the stomach is an unfavorable symp- tom, unless it arise from indigestible food, since it shows either an accumulation of viscid mucus, or a want of energy in the organ. When the irritability of the stomach is ex- hausted by excessive stimuli, the effect is a heavy load. Vomiting is the connecting symptom between affections of the digestive organs, and those of the secretory ones. When violent and incessant, without previous accumula- tion of bile, it is an unfavourable symptom, as it general- ly arises from irritation on the brain. Even when from bile it is distressing, for the act of vomiting emulges the biliary duct, and the inverted motion ofthe duoderum car- ries the bilious fluid back into the stomach, thus furnishing new fuel for the flame. A frequent diarrhoea, independent of mucus inflamma- tion, is dangerous as it shows considerable debility, and a difficulty of retaining the food so long as is necessary for its assimilation. The other excretions, which have attracted attention as Inflammatory fever. &35 prognostics, are the perspiration, the urine and alvine evacuations. It is generally acknowledged, that the sa- lutary perspiration is not attended with heat, is not clam- my to the touch, is generally diffused, without any load, uneasiness, or anxiety. The sweat of an opposite kind does not relieve, but debilitate. Cold clammy sweats arise from a total relaxation of the exhaleiits, and are, in general, the preludes of death. The state ofthe urine has also afforded numerous prog- nostics, and the discrimination of its clouds, its sediment, &c. have been peculiarly minute. The greater number of these appearances may be disregarded. Urine must be examined only after it has been made for some time. It should be poured into a glass while yet warm, and kept in air moderately cold. With such precaution, some use- ful lessens may, perhaps be drawn from its appearance. The quantity of urine varies in different persons, and, in the same, at different periods. Hence, from this no conclusion can be drawn. In general where it is remarka- bly deficient, it is at other times equally redundant; and this chiefly occurs in hysterical constitutions. The ex- cess is also at no time dangerous, unless the quality ofthe urine is changed, since it only depends on irregular ac- tion ofthe renal vessels. When the urine is in small quan- tity its colour is necessarily high; and at the conclusion of a gouty paroxysm, as well as of a paroxysm of an inter- mittent, it throws down a brick coloured sediment. When highly red without depositing any sediment, it shows a violent and probably a long fever. In general, a scum on the top, in the early period of fevers, seems to show considerable debility; and we have usually found such fevers slow and tedious. A cloud, suspended at first near the top, and afterwards falling lower till in succession it reaches the bottom ofthe glass, are favourable signs; and a suspended cloud, previous to the fourteenth day, shows that the disease will terminate at that period. If it appear after the fourteenth day, the disease terminates at the twenty-first, gradually lessening on the intervening days. The progress of the cloud in the urine, in cases of fe- ver, is regular. It is at first suspended at the top, grad- ually falls, though for a day or two, often stationary near the middle of the glass, and at last reaches the bottom.— 256 Inflammatory Fever. It falls to the bottom often some days before it is accom- panied by any sediment; but when a white or redish se- diment also falls down, the crisis is nearly complete.— The urine is sometimes turpid, if not at the moment of discharging it, very soon afterwards; and this, accord- ing to tbe authors of prognostics, is said to show an in- sidious disease. Frothy urine, or which long retains the air bubbles, is said to show a tedious disease, or a slow consuming fever. In bilious fevers, the urine is some- times of a green or black colour, which shows a highly putrid state. The black is more dangerous, but, unless highly fetid, wc have frequently seen it without its being followed by a fatal event. In chronic diseases, red urine, depositing a copious, red, scaly, or branny sediment, is a mark of considerable debility. A mucous and viscid sediment is usually alarming from the apprehensions which it excites of abscess in the bladder. Mucus is, however, light and equable, Wholly free from foetor, and arises from an inflammation ofthe mucous membrane. It arises also from any irritation of the neck ofthe bladder; and is a frequent symptom of gravel and calculus. The nature of the alvine discharge is of considerable importance; and these should be frequently examined with attention. In acute diseases the discharge is often estimated by the number of motions rather than their appearance; and we have been told there has been a free discharge from the bowels, when the stools had not the slightest feculence. Liquid, frothy, watery motions, with little colour or smell, show, in general, a tedious fe- ver, for in every fever there seems to be an obstinate re- tention of the faeces, and motions of this kind show that the spasm is peculiarly violent. When the stools, in the beginning, are highly fetid and bilious, it has been ac- counted a dangerous symptom; but if the discbarge be free and copious, they are rather favourable. Calomel will, through the whole course of a fever, often bring off such motions by its superior power on the biliary secre- tion. Small black, pitch like motions, are always dan- gerous, and show equal weakness in the alimentary canal and the biliary system. On the contrary, hardened ex- crement, brought off with little straining or cholic, is fa- vourable. Inflammatory Fever. 257 From the remarks which have been offered, it will ap- pear that our prognostics of fever must be taken generally from the signs and degree of debility. This is obv\olls often to the sight. Every circumstance which regards a patient in a fever, will, by attentive observation at the bed-side, throw some light on this subject. The situation ofthe patient is dangerous, if the charac- ter of the countenance is soon lost; if the eyes apparently glare on vacancy; if the answers are rambling and incoher- ent; if slight, partial, involuntary contractions occur in the features; if the tongue trembles, or is soon dry and dark; if he soon declines turning on his sides, lies on his back, and sinks down on his bed; if the extremities are cold and be- numbed; if the tendons are particularly tense, and occasion- ally start; and if he appears to pick off or remove any dark spots on the bed clothes, or wishes some supposed dark object to be removed; each of these symptoms is a mark of debility; and the earlier they occur in fever, the greater is the danger. If, however, in a fever, the expression ofthe countenance is unchanged; if the mind is steady'and unruffled; the sleep, though short and interrupted, refreshing, and the patient is sensible of having slept; if the tongue is clean at the edges; the abdomen neither tense nor painful; if the patient lies on either side, and awakes without hurry or confusion, we may prognosticate a safe termination. In the more usual cases of fevers, if the disease is pro- perly managed in its earlier period, and the circumstances are on the whole favourable, there are few instances in which a salutary change does not take place on the tenth or fourteenth day. Where this is not observable, a gradual amendment takes place, which is clearly con- spicuous on the seventeenth, and the fever has disappeared before the twentieth. 33 ®W!Mfo Or, in the language of the Nosologists, Catarrh. i» a disease of the inflammatory kind, which occurs more frequently on sudden changes of the Weather, and attacks persons of all constitutions, but especially those of consumptive habits. It is also at times epidemic, when it is known by the name of influenza and has been erroneously considered as depending upon a specific contagion for its cause. The influenza generally pays us a visit every six or seven years. The season of its visitation is the middle or latter end of autumn, after a long spell of dry wea- ther. It would appear to be no respecter of persons, knocking equally at the door of the rich and the poor, and attacking the young no less than the aged. Symptoms.—Its first symptoms are a stoppage of the nose, dull pain, with a sense of weight in the forehead; stiffness in the motion ofthe eyes, and soon after cough, hoarseness, an increased secretion of mucus from the nose, and tears from the eyes, attended with more or less fever, and sometimes sore throat. Caus*.—This disease is generally the effect of cold, wliich by obstructing the perspiration, throws the redun- dant humours upon the nose, fauces and lungs; or to those great physical changes which give rise to epidemics. Treatment.—The treatment of this disease, as of all others of an inflammatory nature, consists of the an- tiphlogistic, or cooling remedies. Where it is slight, little else will be necessary than to pay attention to the state of the bowels; live abstemiously, avoid cold, and whatever may increase the feverish habit. Gold. 259 Bathing the feet in luke-warm water or bran and wa- ter, a little hotter than milk just taken from the cow, at the same time that something warm, as a glass of hot toddy, punch, or mulled wine, is taken internally, forms a remedy upon which many people place their sole reli- ance for the removal of their colds. But this unques- tionably is a hazardous practice; for it may be regarded as a general rule, in inflammatory diseases of whatever description, that all attempts to excite perspiration by stimulating and heating drinks, will be uniformly injuri- ous. Foot-bathing is certainly a simple, and often found to be a powerful, assistant of the operation of other reme- dies, by equalizing the circulation and promoting per- spiration. In this practice, however, much caution is necessary not to get fresh cold; the feet should be care- fully and speedily wiped dry, and afterwards wrapped up in a warm dry flannel, or the patient should immedi- ately go into a warm bed. When there exists any febrile action, the free use of cold water in the early stage ofthe disease, forms a safer and a much more efficacious remedy than the adminis- tration of warm or stimulating liquids. A glass or two of cold water taken upon going to bed is a very common and sometimes a successful remedy for cold. The impression of cold drink upon the stomach, inde- pendently of its general refrigerant operation, seems to have the effect of promoting the action of all the secreto- ry and excretory vessels. Taking a draught of cold wa- ter every hour or two with ten or fifteen grains of nitre dissolved in it, will be found a remedy as effectual as it is simple in almost every case of inflammatory catarrh. Should it be observed that the nitre has a tendency to increase the cough, nauseating doses of tartar emetic should be added to each draught of cold water which will promote expectoration as well as diaphoresis, without at the same time increasing arterial action. When recourse is had to this medicine, dissolve three grains of tartar emetic in a quart of pure cold water, of which solution a gill to a half pint may be given to an adult every three or four hours, or at such intervals as will produce a ve- ry gentle nausea, without creating any considerable de- 26,0 Gold. gree of uncomfortable sensation. The consent of the sto- mach with every part of the animal system is so generally acknowledged, that this organ is now admitted to be the medium through which almost all medicines, taken inter- nally, produce their effects upon every part ofthe frame. Hence cold applied to this viscus must be attended with more speedy and certain effects than to any other part whatever. Its operation in this case is simple; it produces its effects merely by the abstraction of the stimulus of heat. Although it will be admitted these two plans of cure, however contradictory, have both occasionally succeeded; yet the cool mode of treatment, when employed with a due degree of circumspection, is unquestionably the most advisable, forthe successful removal ofthe disease in its incipient state. Of all the improvements which have been made for many years, in the practice of medicine, the in- troduction of the use of external cold, in the treatment of acute diseases, may be regarded as one of the greatest importance. The theory upon which it is founded is ra- tional, and the practice it has led to, has b«en attended with the most happy effects. In fevers, inflammations, and eruptive disorders, it has restored thousands that would otherwise have perished; but its free and extensive use in catarrh, is inadmissible, as by exposing the body afresh to a low temperature, the original mischief would be often spread wider, or the foundation would be laid for other diseases more formidable. However, upon the accession ofthe symptoms indicating the commencement of the disease, the air which immediately surrounds the body, and which is inhaled in respiration, should be as cold as is consistent with comfortable feeling. Perhaps a temperature from forty to fifty degrees, will be most salutary. An approximation to this may always be ef- fected by the patient remaining, in cold weather, in a room warmed only by a small fire; and in the milder months, by a free exposure to the open air; in all cases carefully avoiding the causes which operate in rendering the cold air injurious. The covering ofthe body, both day and night, should be as light as the external tempera- ture will allow, and every thing taken in the stomach Cold. 261 should be perfectly cold. By pursuing the refrigerating plan, the activity of the whole arterial system is dimin- ished, the inflamed vessels are relieved from that redun- dancy of blood, and increased action, in which the disease consists, and finally recover their wanted healthy tone without any morbid relaxation of their »ver be injurious in cold weather. The use of flannel cannot he too highly recom- mended as a preventive of this disease; and if an objec- tion should be made to wearing it next to the skin, on account of the irritation it occasions, it may be worn over the linen. But while thus careful to guard against the morbid in- fluence of cold, by accommodating our dress to the wea- ther, we should be equally cautious not to run into the opposite extreme. Too much clothing produces a deli- cacy of frame that disposes no less to disease, than an imprudent disregard of necessary covering. There are two parts of the body more especially lia- ble to receive the ill impressions of cold, and communi- cate them to the rest—the feet and the chest, and with the delicate and susceptible, if fashion govern in all oth- er respects, these at least should be defended with the ut- most care. Whenever the whole or part of the body has been ex- posed to the long-continued action, or otherwise to the Cold. 26$ sedative influence of cold, it is said to be chilled; or in other words, it falls in a state of atony, in consequence of the reduction of its nervous energy, and is thereby de- prived of the faculty of duly supporting its natural heat. This state occurring universally, and to a great extent, usually proves destructive to life. When local or gene- ral in a less degree it proves the exciting cause to vari- ous diseases of the active kind, determined in their seat by the particular predisposition ofthe person; the weak- est part ofthe body invariably receiving the noxious im- pression, however generally applied. Thus those, whose pulmonary system is weak and irritable, will have ca- tarrh, or inflammation ofthe lungs; others, whose mus- cular fibres are most susceptible, will be attacked with rheumatism; and those addicted to drunkenness, will, per- haps, be afflicted with an inflammation ofthe liver; and «o of various other inflammatory affections. Colds, how- ever, are by far the most frequent, which, perhaps, may be accounted for, in a great measure, from the lungs be- ing so particularly exposed to all the varieties of atmos- pherical temperature. A person not particularly liable to catarrh, would probably seldom feel ill effects from being chilled by an exposure to the cold air, if he were careful to restore the natural warmth ofthe body by degrees; but if during the presence of that uncomfortable state of feeling produced by the diminished temperature, he either suddenly come into a warm room, or drink of warm stimulating liquids, he will seldom escape with impunity. It should be remembered that when any part ofthe bo- \ dy has been exposed to cold, it is liable to be much more affected by heat, than before the exposure. Of this, the method of treating frozen limbs in cold countries, affords a beautiful and decisive proof. Were a frozen limb to be brought before the fire, or immersed in warm water, a violent inflammation would come on, and speedily ter- minate in mortification. They therefore rub the parts benumbed with snow, and then very gradually expose them to a warm temperament. Hence it will evidently appear, that strong drinks, both before and after exposure to severe cold, must be highly dangerous; and it should always be remembered, that 270 Cold. when the body has been either chilled or much heated, hi must be brought back to its natural state by degrees. The common prudence of shunning, when heated, a torrent of cold air from the crevice of a door or window, or throwing off the clothing immediately after taking ex- ercise, are so obvious, as not to be required to be enlarg- ed upon. Putting on wet clothes, or lying in damp sheets, or sitting in wetted rooms, are also so well known to be injurious, that it is hardly necessary to admonish people against such obvious improprieties. The operation of moisture in producing catarrh, ap- pears to act in the same way as cold, by proving a seda- tive. The feet being most liable to receive the impres- sions of damp, as they are of cold, one of the most fre- quent causes of catarrh is getting them wet; to guard against which, is of importance to those liable to the com- plaint; and when a person has been exposed to the wet weather, the clothes should be changed as soon as pos- sible, after wiping the body and extremities with a cloth wetted in spirits, to wliich a little table salt has been added. The predisposing causes of catarrh are, 1st. Original peculiarity of constitution; secondly, an acquired morbid irritibility of the pulmonary system; thirdly, a morbid de- licacy of frame, induced by enervating indulgencies, or weakening occupations; or occasional and accidental de- bility. The exciting causes are those which when appli- ed to the body, under a state of predisposition, excite disease into action. It is worthy of remark, that however predisposed to disease the constitution may be, by carefully guarding against the causes which more immediately produce it, its dreaded incursions may usually be prevented, and health may often be preserved to old age. The import- ance, therefore, of avoiding the exciting causes of a dis- ease, so insidious in its nature, cannot be too strongly in- sisted upon, more particularly in the early periods of life, and in constitutions peculiarly obnoxious to its attacks. Some persons are so susceptible of cold, as to be una- ble to endure the least change of temperature, without having a violent fit of sneezing, coughing, and other symptoms of incipient catarrh. And these will recur so Cold. 271 frequently, and of so temporary a nature, as to justify the expression, that they are seldom free from cold.—. The means of obviating this susceptibility is, by gradual- ly and cautiously inuring the habit to the impressions of cold, by accommodating dress to season and personal feeling, and when changes from cold to heat, or the con- trary, are unavoidable, in guarding against the transi- tion being sudden and immediate. Nothing so much contributes to enervate the powers of the human frame, as an excess of artificial heat. The ruinous effect of this indulgence is, that our health and comfort are destroyed by the frequent recurrence of some one or other of thoge- disorders, which have their origin in cold. DebiIitatJ»y the perpetual stimulus of heat, we become sensible^Gevery, even the slightest, variation of atmospherical temperature. Few, indeed, of the re- finements of modern luxury are more prejudicial to health, by rendering the body susceptible of cold, than the living in rooms heated by stoves or enormous fires. Let those who have at heart the preservation of their health, and the vigour of whose frames is as yet entire, carefully avoid making this effeminate indulgence necessary to their com- fort. Let them, by gradually training themselves to bear the impressions of cold, endeavor to induce that enviable state of hardiness, that will enable them to brave, with impunity, the vicissitudes of the atmosphere of our cli- mate. It is in the power of every one, to render the apartments they occupy cool and airy; and there are none, perhaps, who have it not in their power, more or less fre- quently during the day, to breathe the open air without doors. In endeavouring, however, to habituate the sys- tem to two degrees of temperature, one caution is of the most essential importance to be attended to, namely, nev- er to remain inactive, either in the open air, or in cool apartments, long enough to induce a continued and un- pleasant sensation of actual cold. This, in all cases, would effectually counteract the design proposed, and by frequent repetition would, in all probability, ultimately be sufficient to injure the strongest constitution. By attention to these precautions, those inflammatory diseases, for which cold only prepares the system, may be easily avoided. liver, &c. Thus coughs attend pleurisies, wounds about the neck, inflam- mation of the liver, acrid matter in the stomach, or in the duodenum. Spasmodic disorders are often attended with a cough, the lungs suffering either by consent, from the source of the spasm, or becoming in their turn the seat of that which produced the spasm in some distant part. The most frequent cause, however,, is suppressed perspiration. Coughs are generally at first dry; but at last expecto- ration comes on, and a hectic fever is the consequence.— It sometimes happens, however, that a cough continues during a long life without inconvenience, and though it does not lead to consumption, induces at last asthma, or dropsy of the breast. So far as coughs are connected with the state of the lungs, they have already been considered under the head of cold, and will be further noticed in treating of con- sumption, so that we shall here chiefly notice the symp- tomatic coughs. The cure of the symptomatic coughs depends upon the removal of the original disease; hence the absolute neces- sity in all chronic coughs, of investigating the cause be- fore we can expect to find the appropriate remedy. Sometimes coughs have their origin in the stomach, af- fecting the lungs by sympathy, in which case recourse must be had to emetics, aperients, stimulants and tonics, with the view of cleansing and strengthening the organ primarily affected. Coughs. 273 Should the liver be the seat of the disease, calomel in small doses, together with the nitric lac ammoniac, [See Dispensatory] constitute the best remedies. It is very ev ident that coughs more frequently arise from N hepa'ic affections than is generally suspected. The coughs of those who have long resided in warm ^climates, very generally proceed from a diseased liver. And we are fully persuaded those cases of hectics which have been cured by salivation, originated from scirrhus of that .-■ viscus. Women, in the last months of pregnancy, are some- times afflicted with a troublesome cough, but which will readily yield to small bleedings, at the same time keeping the bowels in a soluble state, and avoiding food indigesti- ble and of a flatulent nature. With children a cough is occasionally produced by teething, as well ashy worms; in both of which cases, it is to be cured by such medicines as are adapted to those complaints. Coughs wliich attend the dyspeptic, chlorotic and hys- teric habits, are styled nervous. In this, as in other con- vulsions, increased irritability, with a less evident stimu- lus, or sometimes with a stimulus which escapes observa- tion, induces a violent degree ofthe complaint. It is sup- posed, cough of this kind proceeds from repelled erup- tion, gout, or the translation of some disease to the lungs. In such cases much benefit will be derived from the warm and vapour bath, and when the secretion ofthe chest is greatly lessened and debility alone remains, we must endeavour to give tone to the system, by substitut- ing the cold, for the warm bath; by administering the cold infusion or decoction of bark; by tranquillity of mind; by moderate exercise, together with a nourishing and generous diet. It is necessary, however, to observe in having recourse to the cold bath, should the patient feel chilly and uncomfortable, instead of feeling a universal glow over the system and being invigorated, it must not be repeated until the visceral obstructions arc removed. Neither will it be proper to continue the use ofthe bark or any other tonic if it be found to check expectoration, or produce a difficulty of breathing. In several instances of unconquerable coughs of this kind, which have come 35 274 Coughs. I undermy notice, calomel united with squills or given alone ' in small doses to produce ptyalism, has effected a cure. /The operation of calomel in the cure of obstinate coughs is, by producing a determination to the liver, and thus, by an increased secretion from that organ, securing more the vital parts and relieving those affected; and by excit- ing a new and general action in the arterial system, which shall transcend or supersede the existing morbid action. When the cough is kept up entirely by irritation, aris- ing from an increased secretion of mucus, under a weak- ened state of the lungs, a dose of paregoric at bed-time f will prove exceedingly beneficial; so the occasional use of some of the pectoral mixtures. [See Dispensatory.] In this state where inflammatory action has totally ceased, some ofthe balsamic medicines may also be employed with safety and advantage, and of these the tolu is the most valuable. It is a very grateful medicine, in consequence of its fragrant smell, and having a warm, sweetish taste. The dose of the tincture or sirup to adults is a tea spoon- ful, in some mucilage or sirup, three or four times a-day. Dr. Hill's balsam of honey is nothing more than the tinc- ture of tolu sweetened with honey. Tar united with bark, ' and formed in pills, have been administered in doses of six or eight three times a-day, with very good effects. In like manner tar water, taken to the quantity of a quart daily, has been found useful in coughs of long continu- ance. In coughs of aged people, or in all cases where the lungs are heavily oppressed, and expectoration difficult, gum ammoniac in doses of ten or fifteen grains dissolved in mint water or ginger tea, or administered in the shape of pills, or, which is preferable, given in the form ofthe nitric lac ammoniac, [fee Dispensatory] will not fail to produce expectoration and abate the distressing fatigue of cough. Fconi the variety of causes which produce coughs, it must be evident, the mode of treatment should vary, and here we would earnestly entreat every one who values the preservation of health, never to trust for the cure of any complaint, more especially affections of this kind, to patent medicines Let it be impressed upon their minds, that most of these advertised, as infallible remedies for the cure of colds and coughs, are either perfectly inert, or Epidemic. 275 really hurtful. And even supposing the medicine em- ployed to possess the virtues ascribed to it, by the pro- prietor, can it be applicable to all the various forms and stages of the complaint, for wliich it is recommended. If in one state of a disease, judiciously administered, it prove a successful remedy, in another it must of consequence be in the highest degree injurious. [See Preliminary Ob- servations.] By resorting to medicines of this description they fre- quently let slip the favourable opportunity, when, by more rational means their health might have been easily restor- ed, and their complaint thus gaining ground, under the use of an ineffectual remedy, will often become invete- rate in its nature, and set all human skill at defiance. How lamentable it is, that so many valuable lives are yearly sacrificed by persisting in the use of quack medi- cines. It is to the credulity ofthe lower class of society, that they are most liable to be taken in by the infamous ven- ders of poison, since they very generally prefer the use of a patent medicine to the advice of a practitioner. But how astonishing it is, to find this fatal prepossession ex- tend further; for we have frequently observed persons of higher order, and who it was expected would have bad better understanding, persist in their use, and become a sacrifice to the delusion. WHEDWENk The attention ofthe medical gentlemen of our country was drawn to a disease, which, during the three last win- ters, pervaded every state in the Union, and in most of them, according to the statements of the physicians, as- sumed every variety of shape, and required no little di- versity of treatment. In some places the lancet was used freely, and in others, remedies highly stimulant were ad- ministered* In spite, however, of the very different 276 Kj) identic. practice pursued, the disease continued its ravages, which in many places resembled those of the plague, sweeping whole families into the grave. Extreme debility appears to have been the character- istic feature of the disease, for all accounts agree, that in whatever form it commence !, there ensued a great, and sometimes a very sudden prostration of strength. This alarming pestilence did not appear in the city of Washington, until tiie winter of the year 1815, and even then not so destructively as in many other places. Most ofthe cases which I saw, resembled very much the bilious pleurisy of our country. They commenced with chill and fever, accompanied with pain in the side and chest, with a dry skin and rather laborious respiration. But the cough was by no means so frequent and distressing, as in pleurisy or peripneumony. The eyes were wild and red, and the countenance uniformly indicated great anx- iety and distress. In some instances, the throat and head were very much affected. The pulse was fill, though soft and readily compressible; indeed it sometimes indi- cated so much action that a practitioner not conversant with its peculiarity of type, would be very apt to treat the complaint as an inflammatory affection. This coun- terfeit character, however, did not continue long, for in a very short period, it assumed the typhoid form. Of the causes of the disease little has been ascertained. In common with other epidemics, its origin is involved in obscurity. As yet, we know only that it commences in cold weather, and is generally dissipated by the warmth of spring. In the treatment of those cases which came under my care, I generally commenced with an emetic, and if this had no effect on the bowels, it was followed by a dose of salts, or an infusion of salts, senna and manna. Dur- ing the operation of the cathartic, I sometimes found it necessary to support the patient, by having wine added to the gruel with which the medicine was to be worked off. As the cure of this formidable disease depended prin- cipally on exciting perspiration, I lost no time after the operation of the medicine, in having sudorifics adminis- tered; and of this class I found nothing superior to the Epidemic. 277 Seneka and Virginia snake-root. [See Materia Medica.] In the insipient stage of this disease, I directed a strong decoction of the former to be taken in doses of a tea-cup full every hour or two, and as the disease advanced, or the pulse began to sink, the latter was administered in the same manner. In addition to this, mulled wine or cider highly spiced, or hot toddy, was given very freely in those cases which indicated great prostration of power. It was also my uniform practice to have a blister applied as speedily as possible on the breast or side, over the pained part. If the head were most affected, the blister was put between the shoulders: and when the throat was complained of, a cataplasm of mustard or garlic [See Materia Medica] was applied around the neck. Flannels wrung out of hot spirits, in which mustard-seed or red pepper had been steeped, were constantly applied to the ext; cmities, and assisted greatly in producing the desired effect , As the disease advanced, bark, conjoined with Vir- ginia snake-root, proved a useful auxiliary in facilitating the cure. Dr. Cutbush pursued a very similar plan in the treat- ment of his patients, with the same fortunate result. Many other practitioners hear testimony in favour of this mode of practice. The ingenious and learned pro- fessor ; hapman, in his very interesting lecture on this epidemic, which 1 had the pleasure of hearing, stated that in no instance did any patient die under his care, after perspiration was induced. It was his practice also, to combine with the diaphoretics, the mostcordial stimulants; and of this class of remedies, he spoke highly of volatile alkali, in frequent and large doses. As malignant as this disease was. it appeared to pay some respect to persons. For the rich, or rather those who lived generously, were seldom attacked with it; while the poor, and the intemperate, in those places where its ravages were most destructive, hardly ever escaped. OR INFLAMMATION OF THE BRAIN. Symptoms.—A deep seated headach, redness of the eyes and face, violent throbbing or pulsation in the arte- ries of the neck and temples, incapability of bearing light or noise, a constant watching or delirium, with picking the bed-clothes. The pulse, although sometimes languid, is generally hard, tense and strong. The mind chiefly runs upon such subjects as have before made a deep im- pression upon it, and sometimes from a sullen silence the patient becomes all of a sudden delirious and quite outrageous. An approaching phrensy is announced by intense con- tinual watchings; or if the patient sleeps, his sleep is in- terrupted and troubled: he starts, and is affected with ter- rible dreams, soon forgetting what is said. If at any time he returns an answer to a question, his fierceness and anger seem to be increased; a pain is constantly felt in the back part of the head, and, as the disorder in- creases, the eyes become more fixed and red, tears at the same time flowing from them. The tongue is dry, rough, and of a yellow or black colour, the face of a deep red, and the pulse small, quick and hard. Phrensy is distinguished from mania, by the sud- den attack, the violent fever, pain in the head, and an evident exciting cause; and from that species of delirium which occurs in low fevers, unaccompanied with inflammation, by the appearance of the countenance and eyes; for in true phrensy the face is red, the features are rather enlarged than shrunk, and the eyes protuberate and sparkle; whereas in the delirium supervening to low fever, the face is pallid, the features are shrunk, and the eyes pearly. Causes. Exposure of the head to the scorching rays of the sun; to deep and long-continued thinking; exces- sive drinking; suppression of usual evacuations; concus- sion of the brain, and whatever may increase the afflux of blood to the head. Phrensy. 279 Treatment. Blood letting is the "anchor of hope" in this disease, wliich should be employed copiously on its first attack, and repeated as the symptoms and strength of the patient will permit. Immediately after bleeding, a dose of calomel followed by a large dose of salts, or some cooling purge must be given. Ice pound- ed and put into a bladder, or folds of cloth wet with vin- egar or cold water, shouhl constantly be applied to the head and temples; and if the symptoms prove obstinate the head ought instantly to be shaved, and the whole of the scalp covered with a blister. When the pulse has been reduced by bloodletting from the arm, if the pain in the head continue severe, let cups or leeches be forth- with applied to the temples, forehead, and back ofthe head. Bathing the feet and legs in warm water, or wrapping them up in flannel wrung out of hot water, is also of great service, by producing a revulsion of blood from the head. With the same view sinapisms should be employ- ed. One of the antimonial or camphorated powders [See Dispensatory] given every two hours, or large portions of nitre dissolved into the patient's drink, will be useful. If the disease be occasioned by a sudden stoppage of evacuations, every means to restore them must be tried. In all inflammatory a flections ofthe head, a copious dis- charge from the intestines will be found highly beneficial, by diverting the humours from the head; and when we cannot employ purgatives, laxative clysters should be used. To assist also in diminishing the determination ofthe blood to the head, the patient should be kept as near the erect posture as can easily be borne. In symptomatic phrensy, particular attention should be paid to the primary disease which has given rise to it. and the treatment ought to be varied according to the nature and progress of the disorder which has occa- sioned it. In its early or inflammatory stage, copious bleeding will be necesssry; but if it has been of some continuance, drawing blood from the temples, by means of leeches, or cupping with scarifications will be pre- ferable. The application of a blister to the neck or he- 280 Phrensy. tvveen the shoulders is not to be omitted, as it is well adapted, by keeping up a steady discharge, to lessen the accumulation. When the accumulation is removed, its effect, unsteadiness of mind, often continues. This is sometimes supposed to be owing to remaining inflamma- tion, and the violent evacuations are with little discrimi- nation employed; a plan wliich increases instead of mi- tigating the disease; for it depends on the too great pre- vious excitement. We have found no mode of conduct particularly serviceable, except absolute rest of mind, with moderate exercise of body. The camphor, hark with valerian, and some other medicines of this tribe, with cold bathing, and gentle alvine evacuations, seem occasionally to have contributed to the relief; but from time alone a cure may be expected. Regimen.—The diet should be of the lightest kind, as ripe fruits, with diluent drinks, such as cold water, tamarinds and water, &c. freely used. The patient to be kept in a dark room, as cool and quiet as possible, avoiding all irritating causes, and breathing a current of fresh air.* *It was of this disease, generally termed a stroke of thesim, that the brave General GitKE:<.,/an officer second only to Washing-to-, died at Mulberry Grove, his country seat near Savannah. A true Republican, he delighted in exercise, particularly that of gardening, of which he was s6 fond as sometimes to continue it under the meridian blaie. it was in this garden that the last summons found him. His honourable friend, E. Telfair, Esq. had often cautioned him against in.prudent exposure to the Georgia suns: but believing that he possessed the same nerves that sustained him in the hot field of Monmouth, he still pursued his favourite exercise: but while busily adorning the soil which his own valour had so gloriously defended, a sun-beam pierced his brain, and in a short time translated to heaven as noble a spirit as ever fought under the Standard of Liberty: * In 1818, the medical community lost, by this inexorable disease, John Syng Dorsey, >!. D who, by liis acquirements and performances, had attained to very great distinction, as a physician and teacher. Having been adjunct professor of -Surgery, with his venerable uncle, Dr. Physic, in the medical school of Philadelphia, and filled with great brilliancy the chair of Materia Medica, he was unanimously elected to the chair of anatonry, as successor of professor Wistar; and, but a few days before his lamented death, had delivered, with great eclat, his introductory lecture to his intended course. The chair, to which he had been pro- moted, was long filled by Dr. Shippen and Dr. Wistar; with what sue- tywraffft OR INFLAMMATORY SORE THROAT. Symptoms—Is distinguished by a sense of heat, paiu and tightness in the fauces and throat, accompanied by a difficulty of swallowing, particularly fluids. In gene- ral, the inflammation begins in one tonsil, a gland on each side of the palate; then spreads across the palate, and then seizes the other tonsil. When toe inflammation pos- sesses both sides, the paiu becomes very severe, and swal- lowing is performed with extreme difficulty; but if it at- tack the upper part of the windpipe, it creates great danger of suffocation. Causes.—Cold; wet feet; throwing off the neckcloth, or drinking cold water when overheated. Treatmknt.—The same rules are to be observed, in this as in all cases of disease highly inflammatory, such as bleeding, purging, and other cooling means. The extent to which these are to be used, can only be ascertained by cess and popularity, need not here be particularise d Tiie generous and benevolent Shippen has always been accounted one of the fa- thers, and V\ istar not the least magnificent pillar of that Scientific Edifice, which has contributed a full share of glory to our nation.— The immediate predecessor of Dr. Dorsey, was admired, not only for his professional qualities, but for his charming social virtues, and uniformly dignified, and polished hospitality. His house was wide open as the benevolence of his heart; and his daily companies comprised the learned of our country, and the enlightened visitors from Europe. On his death, he left vacant the chair of anatomy in the University of Pennsylvania, and the presidency of the American Philosophical Socie- ty. To t'ie former, !)r. Horsey, one of his favourite pupils and hourly companions, was un inim msiy elected, and carried with him the confi- dent expectation of every one, that it would not only be reputably sus- tained, l>',t adorned by his various genius, attainments, and popular elo> quenre. I'o say nothing of the great wmwmw^s Symptoms.—An acute pain ofthe side, which reaches to the throat, in some to the back, and others to the shoulders, but in general, is seated near the fleshy part of the breast, with" a high fever, hard and quick pulse, difficulty of breathing, and a teazing cough, sometimes moist, but most frequently dry. The seat of the inflam- mation, and consequently of the pain, may vary in dif- ferent cases, but this is not of much importance, as the same mode of treatment is required in inflammations of the viscera contained in the cavity of the chest, as the membrane which invests them. Causes.—The pleurisy, like other inflammatory dis- eases, proceeds from whatever obstructs the perspiration, as exposing the body to the cold air when overheated. It may likewise be occasioned by whatever increases the circulation of the blood, as violent exercise, or an impru- dent use of ardent spirits. Treatment.—In the cure of pleurisy or inflamma- tion of the viscera, our success depends on subduing the violent action of the vessels, by bleeding, blistering, and employing such remedies as are calculated to keep the bowels open, and to determine the fluids trthe surface. Hence, at the onset of this disease, a hrge bleeding is always necessary, succeeded by a dose of salts, senna and manna, castor oil, or some cooling purge, and so long as the blood exhibits a sizy crust on its surface, when cool, and the violence of the symptoms continue, the lancet should be used once or twice a-day, with this exception, that after a free expectoration has commenced, it will be less necessary. A blister over the pained part, after the pulse has been reduced by bleeding, is by no means to be omitted; and if the pain be obstinate, when the blister on one side ceases to discharge freely, apply another on the other side. When blisters cannot be obtained, some substitute 2U4 Pleurisy. must be resorted to, as a cataplasm of mustard and vine* gar. Warm cabbage leaves, or a bladder nearly filled with warm water, applied to the affected side, and repeated as often as it becomes cold, will sometimes afford a little relief. During this treatment, the patient should take freely of warm diluent drinks, as flaxseed, balm, or ground ivy teas, barley or rice water, to which may be added a lit- tle ofthe juice of lemons. The decoction of pleurisy, or seneka or rattlesnake root, [See Materia .hedica] exhibited in doses of one or two table-spoonfuls every two or three hours, abates the febrile heat, and produces expectoration. The antimo- nial powders or mixture, or camphorated powders [See Dispensatory] also produce these beneficial effects. When these medicines are not at hand, portions of nitre dis- solved in the patient's common drink, and ipecacuanha exhibited in such doses as will keep up a nausea at the stomach, without vomiting, will answer every purpose. Inhaling the steam of hot water from the spout of a tea- pot, or applying a large sponge dipped in warm vinegar, to the mouth and nostrils, will be beneficial. Flaxseed sirup [See Materia Medica] is a valuable medicine in this complaint, in allaying the cough, a symptom exceedingly distressing. When this is not convenient make use of some ofthe pectoral mixtures, as advised under the head of cold. In the advanced stage of the disease, when the inflamma ■ tory symptoms are almost wholly abated, and the cough proves the chief cause of pain and loss of sleep, then opiates may be given with the greatest advantage. It should be observed in the exhibition of opiates, that if they be administered in the commencement of inflam- matory disease, before the necessary evacuations are made, they increase the inflammation, and consequently injure the patient: but if given near the close of such ma- ladies they are of t\ie greatest service, and complete the cure. When persp\ration is obstructed, they should be coupled with some emetic drug, as in the form ofthe an- odyne sudorific draught or bolus, [See Dispensatory] but when this is not the case, opium or laudanum alone should be administered, and that in small doses, when the patient is much debilitated from previous evacuations. A Pleurisy. 295 half grain of opium, or fifteen drops of laudanum, or thirty drops of paregoric, given about an hour before the evening exacerbation, alleviates the symptoms, and if re- peated for a few evenings, gradually increasing the dose, ensures the cure. If the pulse sinks and becomes languid, blister the ex- tremities, and give six or eight grains of volatile salts every three hours with mulled wine. The bowels, in the course of the disease, must be kept moderately open, by emollient injections or mild laxatives, as castor oil, or the cathartic mixture. The bastard pleurisy is often confounded with true pleurisy. It consists of a rheumatic inflammation ofthe intercostal muscles, often of the other muscles, of the breast or abdomen. The disease is distinguished by ex- ternal soreness, and is relieved by bleeding, blistering, and exhibiting the seneka-root in decoction. Regimen.—In no disease is a strict abstinence more necessary than in this, since in proportion to the nourish- ment taken, will be the increase of the blood, and conse- quently of fever. Nothing but diluent drinks, as toast and water, barley water, bran, or flaxseed tea, ought to be allowed, until the violence of the disease is subdued; and these liquids should be taken often, but in small quantities at a time, and never cold. When nourishment is required, the lighter kinds only should be used, as ar- row root, sago, panado, &c. After recovery, great care must be taken to prevent a relapse? the sparest diet should therefore be used; the inclemencies of the weather care- fully guarded against; moderate exercise employed, and the chest protected from the action of cold, by wearing flannel next to the skin. In this state of convalescency, a prudent use of wine with bark or columbo, will assist digestion, and give tone to the system generally. OR INFLAMMATION OF THE LUNGS. Symptoms.—Febrile affections, succeeded by difficul- ty of breathing, cough, and an obtuse pain under the breast bone, or betwixt the shoulders, increased on inspi- ration. A sense of fulness and tightness across the chest— great an Kitty about the heart, restlessness, loss of appe- tite and sleep—the pulse quick, sometimes hard, and sel- dom strong, or regularly full—the breath hot, the tongue covered with a yellowish mucus, and the urine turbid.— From the obstruction to the free passage of blood through the lungs, the veins ofthe neck are distended, the face swollen, with dark red colour about the eyes and cheeks. The pain in the chest is generally aggravated by the pa- tient lying on the side most affected, and very often he can lie only on his back. Causes.—Cold, obstructing perspiration and thus pro- ducing a morbid determination to the lungs, or violent efforts, by over-distension. Treatment.—Such is the delicate structure of the lungs, that they will not sustain inflammatory attacks many hours before their important functions are destroy- ed, or so much mischief produced, as to lay the founda- tion of consumption. The antiphlogistic plan, therefore, as advised in the pleurisy, for the resolution ofthe disease, should be put into immediate operation; and not by degrees, as is often the case, by which many lives are lost, but should be carried to the utmost extent, particularly the taking away of blood in considerable quantities from the arm. We would remark, however, although the evacuating plan is indispensably necessary in the early stage ofthe disease; yet it should not be continued too long, for the truly salutary discharge is by expectoration; and if the strength is too far reduced, this will be prevented. INFLAMMATION OF THE Is of two kinds, the acute and chr-nic, and consequent- ly requires variation in the mode of treatment. Symptoms —The acute is marked by a pungent pain ofthe right side, rising to the top of the shoulder, so rse- thing like that o!- the pleurisy; attended with considerable fever, difficulty of breathing, dry cough, and often biiious vomiting. The chronic inflammation of the liver, is usually ac- companied with a morbid complexion. The symptoms are sometimes very obscure, and confined rather to the common marks of stomach complaints, as flatulence and frequent eructations. The appetite in consequence fails, and occasional uneasiness or pain is felt in the region of the liver extending to the right shoulder, the characteris- tic of the disease. An obscure fever prevails, which is generally worse at night, inducing languor, want of sleep, and much cppression. The patient has generally clay- coloured stools, and high coloured urine, depositing a red sediment, and ropy mucus. In the progress of the mala- dy, the countenance seems livid and sunk, and the eyes of a dull white or yellowish hue. Under these symptoms the body becomes gradually emaciated, while in the re- gion ofthe liver is felt a sense of fulness, with a slight swelling and difficult breathing, attended with a hoarse, dry cough, particularly aggravated when the patient lies on the left side. As the disease advances, dropsical symptoms accom- panied with jaundice supervene, and under these compli- cated maladies the sufferer sinks. Sometimes an abscess opens externally, which, if it do not effect a cure, at least prolongs the life of the patient. Causes.—Violent and repeated shocks from vomits— sudden changes in the weather, but especially cold nights 38 SOS Inflammation of the Liver. after very hot days—sitting in a stream of air when overheated—drinking strong spirituous liquors, and using hot spicy aliment. Treatment.—In this, as in all other cases of visceral inflammation, the same means to take off inflammation, as advised in the pleurisy, should be carefully observed. And as it is an object ofthe first importance to prevent the formation of matter, we should adopt these means as early as possible to produce resolution, the only salutary termination. Scarcely any complaint requires such prompt and copious blood-letting, as acute inflammation of the liver. After the acute stage is over, we may consider the affection of a chronic nature, and the mode of treatment must be regulated accordingly. In the chronic species of this disease the cure depends principally upon mercury which may be employed in the early stages of the complaint. The mercury may be in- troduced in the system, either by taking one or two ofthe mercurial pills, night and morning, or by rubbing as fre- quently on the part affected, the ointment about the size of a nutmeg, continuing the one or the other, until a ptyalism is produced, or the disease is subdued. During this course, the use of the tonic powders, or pills [See Dispensatory] or bark and snakeroot, when fe- brile symptoms have abated, wiil greatly hasten the cure. The nitric acid, with patients who are scorbutic, or mu< h debilitated, is far preferable to the calomel, on at count of its antiscorbutic and tonic powers. It should be given to Hie extent of one or two drachms daily, diluted with water, in the proportion of one drachm ofthe acid to a quart of water. At first it ought to be given in small doses, and frequently repeated, and the dose gradually increased as circumstances require. This medicine, like calomel, must be continued until the mouth becomes af- fected, the salivary glands enlarged, and their secretion increased: and when this takes place, the disagreeable symptoms will be removed, and the patient, from being debilitated, becomes healthy, vigorous and cheerful. >:y own experience ofthe efficacy ofthe nitric acid in chronic affections ofthe liver, induces me to speak well of it; and I am happy to add, it was a favourite remedy of Inflammation of the Stomach. 299 that celebrated anatomist, and distinguished physician, professor Wistar, in this distressing disease, particular- ly when there was an enlargement of the liver. Obstructions and indurations of the spleen, bear some resemblance to a diseased liver, and are very prevalent in low, marshy and aguish situations. Their treatment con- sists in t'le use of the same means recommended for the cure of this disease. Regimen.—The food should be easy of digestion, such as veal, lamb, fowls, or fresh beef. Watercresses, gar- lic, and other pungent vegetables are useful. A change of climate, and moderate exercise in the open air ofthe country, is both agreeable to the patient, and very salu- tary. INFLAMMATION OF THE Symptoms.— Acute pain in the stomach, always in- creased upon swallowing even the mildest drinks. In- expressible anxiety, great internal heat, something like heart-burn, constant retching to vomit—and, as the dis- ease advances, the pulse becomes quick and intermitting— frequent hiccoughs, coldness of the extremities, and the patient is soon cut off. Causes.—Acrid or hard and indigestible substances, strong emetics, or corrosive poisons taken into the sto- mach, or drinking extreme cold liquors while the body is in a heated state.—It may also be occasioned by exter- nal injury. Treatment.—Unless the inflammation can be resolv- ed in the very beginning, it rapidly terminates in a morti fication. Therefore, a violent pain in the region ofthe stomach, with sickness and fever, should always be very seriously 300 Inflammation of the Stomach. attended to. Copious and repeated bleedings, not regard- ing the smallnessof the pulse, are absolutely necessary, and is almost the only thing that can be depended on. In no inflammation is the immediate use ofthe warm bath so necessary as in this, wliich attacks at once the "throne" of life. If a better bathing vessel cannot be had, a bar- rel or half hogshead, filled with warm water, about blood heat, will do. Let the patient be instantly put in it, cov- ering the top with a blanket. Keep him in as long as he can bear it, and when taken out and wiped dry with warm cloths, he should immediately have a large blister or cataplasm over the stomach. The bowels' must be kept i open by the mildest glysters, as water gruel, or weak / bi-oth, with the addition of a little saltpetre, and sweet oil or sugar. These injections answer the purpose of internal fomentations, and also nourish the patient who is often unable to retain any food, or even drink, upon his sto- mach. The erythematic inflammation of the stomach often arises in putrid diseases and comes on insidiously. It is evident by the inflammation appearing on the internal surface of the month. When, therefore, an inflammation of this kind affects the mouth and fauces in the bilious, typhus, or puerperal fevers, with a frequent vomiting, and an unusual sensibility in the stomach, we may suspect that the same affection extends downward. In such cases, or when the state of inflammation is approaching to gan- grene, spirits of turpentine, in doses of a tea-spoonful given alone or in a little water, upon the high authority of Pro- fessor Chapman, will arrest the disease. This medicine is to be repeated, more or less frequently, according to the urgency of the symptoms. When the disease is a little alleviated, the infusion of bark with a few dr<>ps of any mineral acid is borne with ease and is highly bene- ficial. Regimen.—When the stomach will admit of nourish- ment, only that of the lightest kind should be allowed; barley water, and mucilage of gum arabic moderately warm, are the most suitable drinks. Every thing of a heating and irritating nature must be carefully avoided for some time after the attack. INFLAMMATION OF THE Symptoms—Tension of the belly—obstinate costive- ness—great internal pain—external soreness, especially about the navel, and so severe as scarcely to bear the slightest touch—great debility— hard, small, and quick pulse. Causes.—The same, generally, that induce the pre- ceding disease. It may also be the sequel of other dis- eases, as rupture, colic, dysentery, worms, &c. Treatment.—Whatever may be the cause, we must endeavour to bring about, as quick as possible, resolu- tion, lest mortification be the consequence. The treat- ment of inflammation of the stomach will also be proper here, as copious bleedings, emollient glysters, frequently repeated, the warm bath, and immediately afterwards a blister on the belly. Cuppin on the belly is also useful. Such is the nature of this complaint, that we cannot be too cautious in the administration of medicines or diluents by the mouth. But the frequent use of emollient injec- tions will in great measure supersede their necessity, and at the same time act as fomentations to the parts. Fresh olive-oil, in the dose of a table-spoonful, is perhaps the only medicine that can be admitted with safety. When the violence ofthe disease shall have considerably abated, we may venture to give some aperient medicine by the mouth, as castor oil, not rancid, calomel, or cathartic mix- ture. In this stage ofthe disease, laudanum may be employed with great advantage, particularly by way of injection. When the disease is combined with spasmodic colic, the application of cold to the abdomen, either by means of pounded ice, cloths wetted with very cold water, or cold water dashed from a pail immediately over the belly, has sometimes succeeded, when all other means have failed, in removing the obstruction; producing an increased ac- S03 Inflammation of the Kidneys. tion of the intestines, from sympathy with the external parts. Regimen.—Afterthe disease is subdued, the diet should be, for some time, ofthe lightest kind, and not flatulent.— The patient must be kept quiet, avoiding cold, severe ex- ercise, and all irritating causes. INFLAMMATION OF THE Acute pain and heat in the small of the back—great numbness along the thigh, and notunfrequently a retrac- tion of one of the testicles—retching to vom.t—voiding the urine in small quantities, sometimes very pale, and other times of high red colour, attended with febrile af- fections. The patient generally feels great uneasiness when he endeavours to walk or sit upright, and lies with most ease on the affected side. Causes.—Excessive exertions, external injuries, vio- lent strains, exposure to cold when heated, and calculous concretion in the kidneys. Treatment.—Bleed copiously, keep the bowels open with castor oil and emollient glysters, use the warm bath, or foment the part with a hot decoction of camo- mile or bitter herbs, or hot water alone; give mucilagin- ous and diluting liquors, as flaxseed tea, barley water, and thin gruel, with the camphorated powders [See Dis- pensatory] or small portions of nitre. A decoction of peach leaves [See Materia Medica] is also beneficial in this complaint. Flannel wetted with spirits, and harts- horn, or tincture of Spanish flies, may be applied to the small of the bark, for the purpose of exciting some degree of inflammation of the external parts. After the inflammation has somewhat abated, the exhibition of Inflammation of the Bladder. 303 laudanum in its usual quantities, either by mouth or glys- ters, will add considerably to the cure. This disease is often removed by a moderate ptyalism. If the disease have been treated improperly, or ne- glected at the onset, and a suppuration take place, known by a discharge of matter with the mine, use uva ursi, [See Materia Medica] or balsam capiva. twice or thrice a-day, for a week or two, and afterwards take bark or steel. Regimen.—The diet should consist ofthe most muci- laginous substances, as arrow root, sago, milk, butter- milk, custards, flaxseed tea, barley or rice water, &c — In the convalescent state, moderate exercise in the open air is of great service. INFLAMMATION OF THE Symptoms.—Acute pain at the bottom of the belly, which is much increased by pressure—a frequent desire and difficulty in making water, and frequent efforts to go to stool, attended with febrile affections. Causes.—Calculous concretions, suppression of urine from obstruction in the urethra, Spanish flies taken in- ternally or applied to the skin, wounds, bruises, &c. Treatment.—It must be treated as the preceding disease, excepting that where there is an entire reten- tion of urine, the patient should drink no more than ab- solutely necessary. Gum arabic kept in the mouth will sheath the inflamed parts without adding to the quantity of urine. If necessary, the catheter must be introduced; though much care is required in the attempt, which often fails. After using the warm batii a cataplasm of mustard and vinegar, applied to the perinoeum or some rubfacient, 304 Headach. to excite external inflammation will be attended with good effects. The lovers of wine and cider should remember that those beverages, however pleasant and exhilarating, have a tendency to aggravate all diseases of the kidneys and bladder, especially when they originate from an acrid state of the fluids. JEEEADAOE. If a foul stomach be the cause, give an emetic, after which take columbo three times a-day. If from a ple- thoric, habit, which is known by a heaviness of the head, and flushed face, bleed and give opening medicines. If from rheumatism, apply a blister to the back part ofthe neck, or between the shoulders, and at bed time bathe the feet in warm water, and take the anodyne sudorific draught. [See Dispensatory.] If from a weak habit, and where the pain returns at stated periods, as in cases of intermittents, and confined on one side of the head, as over an eye, the cure wilj generally depend upon the free use of bark and snakeroot, or the solution of arsen- ic twice or thrice a-day, which seldom fails, especially if preceded by a brisk purge. In this as well as other periodical pains, laudanum exhibited in a pretty large dose an hour or too before the expected fit, will often prevent its coining on. iEther externally applied over the pain on a piece of linen, with a warm band to confine it, will afford immediate relief in headachs attended with cold skin. Cayenne pepper mixed with snuff, by irritat- ing the membranes ofthe nostrils, has also given much relief in cold or nervous headachs. It is not unfrequent that the partial or nervous head- ach, as it is termed, is produced from a decayed tooth, which, on discovery, should instantly be extracted. Symptomatic headach is a disease of so many organs, that it is difficult to ascertain the organ primarily affect- ed. But when the real nature of «he complaint is asccp- Headach. 305 tained, the practice to be pursued will, of course, be ob= vious. Where the causes are beyond our reach, the dis- ease may be mitigated at least by some of the remedies we have pointed out, such as paying attention to the state of the bowels, blistering, and keeping up a determina- tion to the surface. The sympathy between the head and the stomach has been already noticed. It is the subject of such constant ex- perience, that to enlarge on it would be superfluous. Headach attends fever of almost every kind. Every ob- struction in the bowels; every accumulation of sordes, or indigestible matter in the stomach produces the same disease; every obstruction to the regular evacuation of any gland, particularly those of the surface; every ner- vous affection, either from excessive excitability or ex- haustion, has a similar consequence. Repelled fluids from the surface produce very constant- ly a symptomatic headach. A cause of this kind is the re- pulsion of acrid matter from the surface, by the applica- tion of astringent washes to cutaneous affections; by sa- turine or mercurial applications as cosmetics; from which the head generally suffers, though the mischief is often more extensive, and apoplexy or epileptic fits the fre- quent consequences. Repelled gout is a still more seri- ous cause. We have not mentioned the mental causes, anxiety, fear, suspense and grief; for these seldom produce the complaint until the body, or, in general, the stomach is affected. The headach of students is often a nervous af- fection merely. Whatever be the action of the nervous fibres in intellectual operations, its excess is often a cause of pain; though in many instances, the headach of stu- dents is connected with obstructions of the bowels, and very often with increased determination to the head. The Hysteric headach partakes of this nervous cause, partic- ularly, when the pain feels as if a nail was fixed in the brain. Are we then to be surprised at its frequent oc- currence? Is it not wonderful that the head is ever free from pain? In the nervous headach which occurs more frequent than is generally suspected, I have found no remedy so effec- tual as genuine wine. It may be given during the pa- 39 306 Earach. roxysm, to persons unaccustomed to it, from a half pint to a quart without producing any other than the pleasing effect of mitigating the pain. It is also the best preven- tive of all nervous diseases, when used regularly and in moderation. [See Vnie. Materia Medica.] When headach is accompanied with a coldness of the extremities, bathing the feet in warm water, rubbing them with flour of mustard or tincture of Cayenne pepper, and keeping up a general circulation to the surface by flan- nel next the skin, will often afford immediate relief. And in cases of great determination to the head as indicated by a flushed face and preternatural heat, the application of cloths wrung out of cold vinegar and water to the forehead and temples will be attended with good ef- fects. Those subject to this complaint, should bathe their head every morning in cold water; avoid full meals, lie with their head high in bed; and always keep their feet warm, and the bowels in a regular state. MMLMm Is frequently produced by living insects getting in- to the ear. The most effectual way to destroy them is to blow in the smoke of tobacco, or pour in warm sweet oil. If occasioned by cold, inject warm milk and water in the ear, or drop in a little laudanum or volatile liniment. If this produce not the desired effect, foment the ear with steam of warm water, and apply a bag of camomile flow- ers, infused in boiling water, and laid on often, as warm as can be borne. When the inflammation cannot be discussed, a poultice of bread and milk or roasted onions may be applied to the ear, and frequently renewed till the abscess breaks; after which, it must be syringed twice or thrice a-day, with Castile soap and water. In this complaint, a blister behind the ear is highly useful. StiBAVTOBSSb ts occasioned by any thing injurious to the ear, as loud noise from the firing of cannon, violent colds, in- flammation or ulceration of the membrane, bard wax, or by a debility or paralysis of the auditory nerves. It al- so frequently ensues in consequence of long protracted fever. Treatment.—It is difficult to remove deafness, but when it is owing to a debility of some part of the organ, or arises in consequence of any nervous affection, stimu- lants dropped into the ear, often prove salutary. jEther dropped into the ear, seems to possess a two-fold effect; one, of dissolving the indurated wax; and the other, of stimulating the torpid organ; but it is liable to excite some degree of pain, unless it be freed from the sul- phuric acid. No prescription for deafness from indurated wax ever acted more surprisingly—none, I am sure, more agreeably, to my feelings at least, than the follow- ing. In consequence of a violent attack of bilious fever, which degenerated into the nervous, my honourable friend, Col. George M. Troup, of Georgia, was afflicted with a deafness for a year or two, so entire, that, in congress, when the members were on the floor, he was obliged to place himself close to the orator, and even then frequent- ly failed of the pleasure and profit of hearing his reason- ings. Suspecting indurated wax to be the cause of his deafness, I directed the cavities of both ears to be well syringed with warm and strong suds of Castile soap. This was done twice a-day, the ears constantly filled in the interim with pellets of wool dipt in strong camphor- ated liniment, and sometimes plugs of camphor. In a few weeks, the nerves of hearing recovered their sensibil- ity, and as the colonel himself thought, more acutely, if possible, than before. Salt water is a better menstruum for the wax and may be employed, or some of the table salt finely powdered may be dropt in the ear. ■ Thete is reason, however, 308 Toothach. for apprehending one bad effect from this remedy, viz. giving such a susceptibility to the organ, that it is more li- able in future to be affected by cold, and therefore this remedy must be employed with caution. Deafness in old people is sometimes attended with noise in the ears, and is then generally owing to debility. Every evacuation increases it, and warm tonics, with a generous diet, are the best remedies. Is best removed by extracting the tooth; but if this can not be effected, fill the cavity with a little cotton dipped in the tooth-ach drops, Turlington's balsam, or any of the essential oils, or with pills of camphor and opium. The nerve may sometimes be destroyed by a hot iron or knitting needle. A carious tooth is sometimes pained by accidental colds, and in such cases it would not be prudent to have it extracted. If the external aperture is smaller than the carious cavity, after clearing away the carious matter, the access of air may be impeded by stuf- fing of gold or silver leaf. When the nerve is accustom- ed to the external air it will continue carious for many years without pain, and be truly useful. When toothach is connected with rheumatism or gout which sometimes happens, the remedies of either should be employed. This unpitied, though often excruciating pain is, in most cases, no more than the just punishment of our ne- glect ofthe teeth. Surely then we ought to take some care of them, though it were but for the pleasure of having them sound. But this care would be redoubled were we but daily to consider the advantage of good and clean teeth and sweet breath. Some women indeed are blessed with faces so nearly angelic, that not the blackest teeth can entirely defeat their charms, nor the vilest breath drive away their lovers.. But how different would be the Rheumatism. 309 effect of both, if, through their ruby lips, opened with a smile, we were to see teeth of ivory, white as snow, pure as the fair owner's frame, and accompanied with breath as sweet as that of infancy. Prevention.—To prevent the toothach, and to pre' 3erve the teeth and breath perfectly sound and sweet, the tooth-brush dipped in warm water, and then in charcoal tooth-powder, [See Dispensatory] should be used constant- ly every morning. The charcoal powder, an invention of the celebrated Darwin, is good for whitening the teeth, and admirable in correcting bad breath. The tooth-pick and tumbler of pure water should never be forgotten after every meal. If the calcareous crust or tartar upon the teeth adheres firmly, a fine powder of pumice stone may be used occa- sionally. When the gums are spongy, they should be fre- quently pricked with a lancet, and gently rubbed with a powder composed of equal parts of Peruvian bark and charcoal. Young persons who wish to carry fine teeth with them through life, must take care never to sip their tea scald- ing hot, nor to drink water freezing cold. Such extremes not only injure the tender coats of the stomach, but often ruin the teeth, and have caused many imprudent persons to pass a sleepless night, distracted with pains ofthe teeth and jaws. EMWffiATOOT* Symptoms.—Wandering pains in the larger joints, and in the course of the muscles connected with them, in- creased on motion, and generally worse towards night. When with fever, it is called acute or inflammatory rheu- matism, and chronic without. Causes.—Sudden changes of weather—application of cold to the body when overheated, wearing of wet clothes. S10 Rheumatism. Treatment.—In the inflammatory rheumatism, large and repeated bleedings are necessary, as indicated by the fulness of the pulse, especially on the first days, and when there is much pain. With this should be combined a free use of diluent drinks, as flaxseed or balm tea, barley or rice water, with a little nitre dissolved in each draught, or the antimonial powders or mixture in small doses, to excite slight perspiration, which should be kept up with great care, as in this relaxed state ofthe skin, the disease is liable to recur upon the least application of cold. In this disease, a very essential discharge is the per- spiration; and if this be not produced, every medicine ap- pears injurious. Of the diaphoretics, Dover's powder seems best adapted to this complaint; and it should be observed, when sweating is once begun, should not be in- termitted, and when it has relieved, should be suffered very gradually to decline. The foxglove, exhibited in doses from ten to twenty drops every four hours, will be found a remedy of con- siderable efficacy, particularly when an objection is made to the free use of the lancet. The blood-root [See Mate- ria Medica] is also a useful auxiliary in this disease. Bleeding and blistering over the part affected, when the pain and inflammation continue violent, have likewise their good effects. After the inflammatory symptoms have in a great mea- sure subsided, the anodyne sudorific draught or bolus, [See Dispensatory] or laudanum alone, may be adminis- tered at bed-time, with great advantage. During this general treatment, attention must be paid to the state of the bowels, which should be kept open by emollient glysters or cooling medicines, as the cathartic mixture, or castor oil, exhibited in small and repeated doses. When the disease has fully attained its chronic state, it then forms a local affection, distinguished merely by stiff- ness, distension, and considerable immobility in the joint. In this species of the disease, a different plan of cure must be followed. Large evacuations are to be avoided, and external stimulants ofthe warmest kind should be ap- plied, as the oil of sassafras, spirits of turpentine, opodel- doc, or the tincture of red pepper and mustard, and along Rheumatism. 311 with this, friction with a flesh brush or flannel over the afflicted joint is not to be omitted. If these means prove ineffectual to rouse the energy of the part, add to an ounce or two of either of the above articles, one or two drachms ofthe tincture of Spanish flies. In addition to these remedies, the internal use ofthe rheumatic tincture, [See Dispensatory] in doses of a table-spoonful twice or thrice a-day in a cup of tea, is much to be depended upon. When these remedies prove ineffectual, we may sus- pect that some peculiar fault exists in the habit, wliich must be corrected before a cure can be expected. If the patient be much debilitated, of a scorbutic habit, give him the nitric acid diluted, or bark freely. And if the dis- ease be in consequence of a venereal taint, or taking cold from the use of mercury, let him take calomel in small doses, or one of the mercurial pills night and morning un- til a ptyalism be produced. A strong decoction of sarsa- parilla [See Materia Medica] is also a useful auxiliary, and sometimes a remedy of itself. In some cases of obstinate rhuematism, I have witnessed the happiest effects from taking, for some time, a tea- spoonful of flour of sulphur night and morning in milk or spirit and water. In others again, I found nothing equal to the pokeberry bounce [See Materia Medica] in doses of a wine-glassful, morning, noon, and night. The cuckow pint, or wake robin [See Materia Medica] in the form of a conserve with an equal part of sugar is often highly useful. The seneka root and mezereron in the form of decoction, has also been exhibited with most happy effects. Another valuable medicine in chronic rheu- matism is the spirits of turpentine, in doses from twenty to sixty drops three times a-day, which may either be given on sugar, in a little water, or incorporated with double the quantity of honey, by melting them together over a gentle heat, But it should be observed these ac- tive stimulants are never to be employed when there is the least febrile action prevailing in the system. The solution of arsenic has in some instances been ex- hibited with success in the chronic form of this complaint. Compressing the large arteries by means of a tourni- quet or bandage, as mentioned under the head of intermit- tents, is another remedy which has been employed with advantage in severe rheumatic pains. 312 Rheumatism. In recent cases when the pain wanders from one part to the other, or whenever the joints are stiffened and rigid, and the pain upon motion severe, or where the muscles have become contracted, by the length and violence ofthe disorder, immersing the whole body in a warm bath, strongly impregnated with salt, or applying it topically, by pouring warm water upon the limb from a kettle, or fomenting tiie part with a decoction of mullein two or three times a-day, will often soothe the pain, and prove a use- ful auxiliary to the other means we employ. Warm bathing, and warm pumping are remedies of great utility in this disease; but as it requires painful mus- cular exertion to use the warm bath, it is not often resorted to. The vapour bath from its superior temperature, is better adapted to its chronic form. Two other forms of rheumatism ought here to be men- tioned, namely, the lumbago, and the sciatic. The first, attacks the loins or lumbar region, with a most acute pain shooting to the joints ofthe thigh. This affection is near- ly related to the inflammatory rheumatism, and must be treated in the same manner, only instead of applying blis- ters over the affected part, they should be applied on the inside ofthe thighs, and kept running for some time. The second, or sciatic, is a violent or fixed pain, attack- ing the hip joint, and, partaking of the nature of the chronic rheumatism, is most successfully to be treated like that disease. Regimen.—In acute rheumatism, the patient must be kept on a cool spare diet; but no change whatever will be necessary in the patient's ordinary mode of living, in chronic rheumatism. In this species, mustard and horse- radish [See Materia Medica] used freely in their natural state, or united with food, will be found very beneficial. Exercise, either of the whole body or of particular limbs, will be highly important. The want of exercise is apt to- produce stiffness in the limbs. Prevention.—Cold bathing, and the use of flannel next the skin, are the most effectual means of preventing the recurrence of both acute and chronic rheumatism. OR COW-POX. The vaccine discovery may be justly considered as one ofthe most extraordinary blessings bestowed on man, since it is inconstestibly a certain security against the small-pox, a disease distressing in its symptoms, formida- ble in its appearance, doubtful in event, and to which man- kind are generally exposed. The comparative advantages which the kine-pox has over the small-pox are very great and striking. First, it is neither contagious nor communicable by effluvia; se- condly, it excites no disposition to other complaints; third- ly, it can be communicated with safety to children at the earliest age, and almost in every situation; and fourth- ly, it is never fatal. What more can be required to pro- duce a general conviction of its superior utility? The method of performing the inoculation is, to hold the lancet nearly at a right angle with the skin, in order that the infectious fluid may gravitate to the point of the instrument, which should be made to scratch the skin repeatedly, until it becomes slightly tinged with blood. The operator must be cautious not to make the wound deeper than necessary, as the inoculated part will be more liable to inflammation, which may destroy the spe- cific action of the virus. The most certain method of securing the infection is, to inoculate with fresh fluid from the pustule; but as this is often impracticable, if is advisable to hold the infected lancet over the steam of boiling water to soften the hard- ened matter. Where the virus has been procured upon thread, make a small longitudinal incision in the arm, and insert in it the affected thread, and detain it there by court-plaster, until the disease be communicated. Mat- ter may also be procured from the scab. The mode of inoculating from it is the same as from the fluid, taking care, however, previously to moisten it with tepid water, -514 Vaccine Disease, or Cow-Pox. and to use the matter of the inner side of the scab. The scab will frequently retain its virus for months, provid- ed it be kept in a close box. The first indication of the success of the operation is a small inflamed spot where the puncture is made, which is very distinguishable about the third, fourth or fifth day. This continues to increase in size, becomes hard, and a small circular tumour is formed, rising a little above the level of the skin. About the sixth or seventh day the centre of the tumour shows a discoloured speck, ow- ing to the formation of a small quantity of fluid, which continues to increase, and the pustule to fill, until about the tenth day. At this time it shows in perfection the characteristic features which distinguish it from the variolus pustule. Its shape is circular, or somewhat a little oval, but the margin is always well defined, and never rough and jagged. The edges rise above the level ofthe skin, but the centre is depressed, and has not that plumpness which marks the small-pox pustule. As soon as the pustule contains any fluid, it may he opened for future inoculation. About two days before, and two after the eighth day, making a period of four days, is the sea- son when the matter is found in its greatest activity. At the eighth day, when the pustule is fully formed, the effects on the constitution begin to appear. The gen- eral indisposition is commonly preceded by pain at the pustule and in the arm-pit, followed by headach, some shivering, loss of appetite, pain in the limbs, and a fever- ish increase of pulse. These continue with more or less violence for one or two days, and always subside spon- taneously without leaving any unpleasant consequences. During the general indisposition, the pustule in the arm, which had been advancing to maturation in a regular uniform manner, becomes surrounded with a circular inflamed margin, about an inch or an inch and a half broad, and this blush is an indication that the whole sys- tem is affected; for the general indisposition, if it occur at all, always appears on or before the time when the efflorescence becomes visible. After this period, the flu- id in the pustule gradually dries up, the surrounding blush becomes fainter, and in a day or two dies away Vaccine Disease, or 6aw -Pox. 315 imperceptibly, so that it is seldom to be distinguished af- ter the thirteenth day from inoculation. The pustule now no longer increases in extent, but on its surface a hard thick scab, of a brown or mahogany colour is form- ed, which if not removed remains for nearly a fortnight, until it spontaneously falls, leaving the skin beneath per- fectly sound and uninjured. The above is the progress of the vaccine inoculation in the greater number of cases, from the time of insertion to that of drying up ofthe pustule, with only the variation of a day or two in the periods of the different changes. The successive alterations, that take place in the local affection, appear to be more constant and more necessa- ry to the success of the inoculation than the general in* disposition. With respect to the latter the degree is very various—infants often pass through the disease without any perceptible illness—with children it is extremely moderate—and even with adults, its severity is but for a few hours, and then never dangerous. Very little medical care is necessary to conduct the patient through this disease with perfect safety, especial- ly when children are the patients. Adults may take a dose of salts on the eighth day, which will be particularly useful in plethoric habits. In general, no application to the inoculated part will be required, unless the inflamma- tion increase, and the pustule become painful; then the part should be kept moist with cold vinegar and water, or lead water, till the pustule be dried up. To conclude, much attention and discrimination are ne- cessary in the vaccine inoculation, to ascertain whether the infection have fully taken, and whether or not, the disorder be complete and genuine. The regularity, with which the local disease at the place of inoculation runs through its several stages, seems to be the principal point to be attended to; for the presence of fever is certainly not necessary to constitute the disease, since the greater number of infants have no apparent indisposition. Therefore, when the vaccine inoculation is followed by no local disorder, or only a slight redness at the punctured part, for a day or two, we can have no doubt that the operation has failed. When the pustule advan- ces in very hasty and irregular progress, when t|he uioq- 316 Small-Pox. ulated puncture on the second or third day after insertion, swells considerably, and is surrounded with an extensive redness, the premature inflammation very clearly indi- cates a failure in the operation, even when the inoculation has advanced for the first few days in a regular manner, but, w hen about the sixth day, instead of exhibiting a well formed pustule and vesicle of fluid, the part runs in- to an irregular festering sore, the purpose of inoculation is equally defeated, and these varieties require it to be watched with an attentive and experienced eye, since they might readily lead to a false and perhaps fatal idea of security against any subsequent exposure to the small- pox. The circumstance, however, which most striking- ly distinguishes the genuine from the spurious disease, is the appearance of the pustule. In the genuine, the pus- tule has a well-defined elevated margin, with an indenta- tion in its centre, resembling a button mould. The spu- rious is either pointed like a small common abscess, or is rugged and irregularly formed, like an ordinary sore. Every other symptom, almost occurs in each disease, CTiiJLJMMD: It would seem unnecessary to take any notice of the small-pox, after having treated so largely of its mild and merciful substitute, the cow-pox; but as that dread- ful disease does sometimes find its way on board of ships and into country neighborhoods, sweeping whole fami- lies in its progress, it may be very proper to subjoin the following history of its symptoms and treatment. Symptoms.—A few days prior to the attack, the pa- tient complains of languor and weariness, succeeded by cold shiverings and transcient glows of heat, immediate- ly before the fever, which is accompanied by violent pain of the head and loins, and frequently with a severe, op- pressive pain at the pit of the stomach. The patient is Small Pox. 317 very drowsy, and sometimes delirious. About the third day, the eruption appears like flea bites, first on the face and limbs, and afterwards on the body. From this pe- riod the pustules gradually increase, and on the fifth or sixth day, will begin to turn white on the tops. The throat at this period often becomes painful and inflamed; and sometimes on the seventh day the face is considera- bly swelled. In the confluent, the spots assume a crimson colour, and instead of rising, like the distinct kind, they remain flat and run into clusters, and during the first days of the eruption, much resembling the measles, but of a purple colour. The flow of saliva is constant in this form of the disease, and becomes so viscid as to be discharged with the greatest difficulty. Treatment.—The cure of small-pox depends on the general principle of the antiphlogistic plan, especially in a free admission of cold air, which may be carried much further in this than in any other disease. Bleeding in the first stage of the disease, or when the pulse is full, may be allowed, but the use of cooling purgatives, with acid and diluent drinks, are indispensable. When the eruption makes its appearance in clusters of a dark red colour, the disease is more of a putrid nature, and consequently, instead of bleeding, requires a liberal use of bark and wine to invigorate the constitution, as directed in the nervous fever. [.See Oak, Materia Medica.] But besides this general treatment, there are some symptoms which require particular attention. Thus, when convulsions or great restlessness prevail, exposure to cold air, and a dose of laudanum are enjoined. Where perspiration is much impeded, or deglutition difficult, blis- ters may be applied to the breast and neck, and gargles, 3uch as are recommended for sore throats, frequently employed. If the perspiration be obstructed, the anti- monial mixture may be used. When this disease finds its way aboard of a vessel, or into a family, all those who have not had it, should im- mediately be inoculated with the variolus matter, if the vaccine fluid cannot be procured. 348 Measles. The benefits which result from inoculation are great, as we have an opportunity to prepare the system by ab- stinence from animal food, and by taking one or two purges of calomel and jalap before the eruption takes place. But if the subject be of a weak delicate habit, a restorative diet alone will be more proper. In every stage of the small-pox, the bowels should be kept open, either by mild purgatives or clysters. Regimen.—The diet is to consist of vegetable sub- stances, as arrow root, panado, milk, rice. &c. and when the eruption is completed, a more nourishing diet may be allowed. If the disease be of the putrid kind, wine, cider, perry, porter or milk toddy, may be given freely. In this as in all diseases connected with putrescency, the advantages arising from cleanliness as well as from frequent ventilation of the chambers, are so obvious, that to insist on them is unnecessary. [See Nervous Fever.] This disease is the effect of a specific contagion, and attacks persons only once in life. Symptoms.—Alternate heat and chills, with the usual symptoms of cold. On the fourth day from the attack, eruptions like flea bites arise on the face and body, and in about four days more, those eruptions disappear with die fever. Treatment.—When the disease is very slight, little mare is necessary than to keep the patient's body open with the cathartic mixture. But should the febrile symp- toms ruri high, with difficulty of breathing, bleed, blister the breast, and give Dover's or antimonial powders, the febrifuge mixture, or diaphoretic drops. [See Dispensa- tory.] The cough being usually troublesome, it will be Measles. 319 proper to take freely of flaxseed sirup, or some of the pectoral mixtures. Breathing the steams of warm wa- ter will also be useful, in relieving the cough as well as the eyes. The water should be put in a bason, and the head covered with a flannel large enough to hang over its edges. After the eruption is completed, the anodyne sudorific draught, paregoric or laudanum, will be ser- viceable at bed-time, to allay the cough. If the spots suddenly disappear, immerse in warm water, or bathe the legs and feet, and give freely of warm wine whey, until the eruptions return. The consequences attendant on the measles, are often more to be dreaded than the immediate disease, for al- though a person may get through it, and appear for a time recovered, still pulmonary consumption frequently arises and destroys him. Another bad consequence of the measles is, that the bowels are often left by them in a very weak state, a diarrhoea remaining, which has some- times proved fatal. An obstinate ophthalmia, or affec- tion of the eyes, will also ensue, if proper attention be not paid in managing the disease. Most of these disa- greeable symptoms may be prevented by blood-letting, and administering emetics, cathartics, and diaphoretics, in the first stage of the disease. Should the symptoms manifest a malignant kind ofthe disease, and a putrid tendency prevail, we must then adopt a very different mode of treatment from what has been advised for the inflammatory. The cure must be conducted on the plan recommended for the nervous fe- ver, and putrid sore throat. Regimen.—The diet should be low and proportioned to the degree of fever. Barley or rice water, flaxseed tea, or other cooling mucilaginous drinks, with jellies, as ar- row root, gruel, sago, &c. will, in general, be all that is necessary until the feverish symptoms are evidently on the decline. Much caution is necessary that the patient be not suddenly exposed to cold air, which might repel the eruption, and produce fatal effects. In this disease, an eruption much resembling that of iv Very favourable small-pox, appears after a very slight fe- ver. This eruption soon proceeds to suppuration, in which state it remains but a little time, before the dis- ease terminates by the drying up of the pustules, which seldom leaves scars behind. As to the treatment, medicine is very seldom necessa- ry, it being generally sufficient that the patient be kept moderately cool, and supplied with the diluent drinks and light food. Should there be fever, a cooling purge, and afterwards the antimonial powders or mixtures may be employed. linin wmw: Is now considered to be symptomatic only, because it never appears contagious or epidemic. It sometimes at- tends febrile affections, as well as those of an inflamma- tory as of a putrid nature, but it seldom occurs in any, unless a hot regimen and sweat precede. The symptoms which attend, are restlessness, frequent sighing, feted sweat, pricking of the skin and an eruption of red small distinct spots, at first confined to the neck, breast, and arms, but soon spreads over the whole skin, except the face. When these eruptions make their appearance, they must be treated according to the rules laid down under the proper heads. &CA2HL9KF W?ll< Symptoms.—Chilliness, followed by a burning dry heat—the pulse frequent, respiration irregular, a dejec- tion of spirits, great prostration of strength, and often a stiffness ofthe neck. The face and neck is at first cover- ed with red spots, which soon extend over the whole body. A sore throat generally comes on about the second or third day, but sometimes is wholly absent; however, a redness of the fauces in every case is conspicuous. This fever is distinguished from the measles by the eruption be- ing less distinct and more like a red coloured effusion, and by not being accompanied with catarrhal symptoms. It is distinguished from Saint Anthony's Fire by the fever being more considerable at night than the former, and the swelling being scarcely observable. It attacks more frequently young children; whereas Saint Anthony's Fire is mostly confined to adults, and is not attended with a scarlet hue on the throat. This fever is evidently infec- tious, generally epidemic, and appears most frequently at the end of summer. Treatment.—Give an emetic on its attack, and on the following day administer some gentle cathartic medi- cine. The bowels should be kept in a soluble state, and nitre given in the patient's drink. The heat must be re- pelled rather than encouraged. And this is to be effect- ed by cold affusions, which should be steadily applied.— It is not enough to sponge the body once or again, but the Gold water must be dashed against the patient repeatedly till the heat is subdued, and the process must be repeated as fast as it returns. In this disease cold water is peculi- arly applicable; the heat being considerable, the determina- tion to the head violent, and the debility alarming. We know no disorder which represses so powerfully the con- stitutional energy. Bark and cordials would appear peculiarly useful in this complaint from its tendency to putrefaction; but if these are early employed they will be found to increase both fever and delirium, to check the perspiration, and to impede sleep, 41 $2£ St. Anthony's Fire. Where this disease is attended with malignant symp* toms, its tendency is to the putrid kind of fever, and must be treated accordingly. [See Nervous Fever, and Putrid Sore Throat.] Regimen.—The diet should be light, the liquors cold and acidulated with vegetable and mineral acids. The stools should be frequently removed, the linen frequently changed, and the room kept airy. The nurses should carefully wash themselves, and frequently change their linen. With these precautions, there is little danger of infection.- Symptoms.—An inflammation on some part of the skin, attended with pain and heat; and when extensive, there is considerable fever, accompanied with drowsi- ness. Causes.—Imprudent exposure to cold when the body is heated—hard drinking—-and sudden stoppage of any natural evacuation. Treatment.—When slight, it requires only that the bowels be kept gently open, by an infusion of peach leaves, [See Materia Medica] small doses of cream of tar- tar and sulphur, or the cathartic mixture, with small por- tions of nitre in the patient's common drink; but when the attack is violent, and the head affected, then, in ad- dition to the above, bleed, bathe the feet in warm water, apply a large blister between the shoulders, and sina- pisms to the extremities, and give the saline or antimo- nial mixture [See Dispensatory] with diluent drinks. The best external applications are flour or starch, gent- ly sprinkled by a puff on the part, or in case of dryness and much heat, fresh leaves of the thorn apple, or cab- Bleeding at the Nose. 32g hage leaves, stripped of their stems and softened in boil- ing water, and renewed every two or three hours. Cold applications, as cloths wetted with vinegar and water, with the addition of a small quantity of camphorated spirits, has also been employed with great benefit and relief to the feelings of the patient. If, in spite of these means, ulcerations should take place, apply bark poultices, frequently renewed, or cloths dipped in the camphorated spirits, with the usual means of preventing mortification. Should the inflammation assume a purple colour, or the swelling suddenly sub- side, attended with internal oppression, anxiety and weak pulse, apply blisters or sinapisms to the extremities, and give wine or warm toddy freely, to throw out the erup- tions to the skin; and then it is to be treated as the ner- vous fever. Regimen.—The diet should be low, and the drink chiefly of rice or bailey water, acidulated with tama- rinds or the juice of lemons. Prevention.—Avoid the extremes of heat or cold, abstain from spirituous liquors, and keep the bowels re- gularly open. In febrile diseases accompanied with pain in the head, flushed countenance, and redness of the eyes, bleeding from the nose in general is salutary, and ought not to be checked, unless the patient is likely to be too much ex- hausted by it. However, when this discharge is too pro- fuse, the patient should have his head raised and exposed to cool air. Beside which, cold acidulated drinks should be used, and the patient should rather immerse his head in very cold water, or have cloths dipped in cold vinegar and water frequently applied to the nostrils, face and back of the neck. A piece of metal, as a key for exam- B#* Spitting of Blood. pie, applied cold to the naked back, is a familiar remedy, and often succeeds. If these should not prove sufficient, a pledget of lint dipt in strong alum water, or a powder Composed of flour and alum of equal quantity, should be introduced into the nostrils, with sufficient force to coin- press the orifice ofthe ruptured vessels. In addition to these means, give a dose of epsom or glauber salts, to eva- cuate the bowels, and from ten to twenty grains of nitre every hour or two, in a glass of cold water. Immersing the feet in warm water while the cold applications are continued to the head, will also be found beneficial. One of the most powerful styptics which we can use, says Dr. Thomas, is powder of charcoal. It may be ap- plied by means of tents, first moistened with water, and then dipped in this powder; but in slight cases, it will answer by being taken like snuff. After the bleeding has ceased, the patient must be care- ful not to remove the tents of clotted blood, but should allow them to come away of themselves. When there is a discharge from the mouth of blood of a florid colour, brought up w ith more or less coughing, preceded by a sense of tightness, weight, and anxiety in the chest, and attended with a saltish taste of the spittle, it is in consequence of a ruptured vessel ofthe lungs. Causes.—Plethora—violent exercise of the lungs— and frequently a faulty conformation ofthe chest. Treatment.—-The most important remedy in this alarming complaint is blood-letting, which should be ac- tively employed, paying at the same time attention to the state of the bowels. Spitting of blood, however, is sometimes owing to the contraction ofthe chest with de- bility; and in this case the lancet must not be so freely used. Spitting of Blood. 325 Sedatives, particularly those which repress the activi- ty of the circulation, are highly useful. Of these the chief are nitre and foxglove. Nitre in doses of ten grains giv- en every hour, in the coldest water, and swallowed while dissolving, is much to be depended on in the early stage of this disorder. > The tincture of foxglove exhibited in small doses every hour or two, by retarding the action of the pulse, will also prove a most useful auxiliary in sup- pressing pulmonic hemorrhages, particularly in those cases where an inflammatory diathesis prevails. When- ever there is fixed pain of the chest, a blister applied to the breast or back will do much service. According to Dr. Rush two tea-spoonfuls of common salt, dissolved in a small quantity of water and exhibited every two hours or oftener, will check this disease, as well as hemorrhages from the stomach and uterus. Astringents are frequently resorted to, as alum, kino and sugar of lead, but they are of little utility, except in the passive hamoptyses, and even in these nitre is often found preferable. If the cough be troublesome it will be necessary to have recourse to demulcents and pectorals as advised under the head of cold. Sometimes a spitting of blood is pro- duced in consequence of suppressed evacuation; in this case it is not dangerous, and only requires remedies to restore the customary discharge. Regimen.—A low diet must be strictly observed and the body kept as quiet as possible. Nothing should be taken warm: flaxseed tea, barley or rice water, acidulat- ed with the juice of lemons or elixir vitriol, ought to be used as common drinks, and taken as cold as possible. Prevention.—Carefully avoid all exertions which de- tain or which hurry the blood in its passage through the lungs, as singing, loud speaking, running or lifting great weights. Obviate costiveness by the occasional use of mild aperients, and use a spare diet. On experiencing any pain in the chest, blister, bleed, and constantly wear flannel next to the skin. mmmwwmmm* Symptoms.—Those which mark its first stage, are a slight fever increased by the least exercise—a burning and dryness in the palms of the hands, more especially towards evening—rheumy eyes upon waking from sleep —increase of urine—dryness ofthe skin, as also ofthe feet in the morning—occasional flushing in one, and some- times both cheeks—hoarseness—slight or acute pain in the breast—fixed pain in one side, or shooting pains in both sides—headach—occasional sick and fainty fits—a deficiency of appetite—and a general indisposition to ex- ercise, or motion of every kind. The first appearance of this disease will vary in differ- ent cases; but the most constant symptoms which char- acterise it, are a cough and spitting of phlegm resembling matter, of which at length it becomes entirely composed. This disease often attacks insidiously, and is chiefly confined to the young, the fair with light skins and blue eyes, florid complexions, contracted chest, and high shoulders. In constitutions disposed to hectic, the fin- gers are often long, and the nails bent; they grow rapid- ly, but seldom expand in breadth and bulk. From the age of twelve or fourteen to that of about thirty-five is the hectic period; more generally from sixteen to twenty- four; and the tendency seems to return about forty-five or fifty, especially in women at the period ofthe cessation of the catamenia. At the age of fourteen or sixteen in each sex, while the genital organs are evolving, there is often a considerable debility and irritability. The debil- ity in females is often formidable, and a slight cough is no uncommon attendant. The cough is either quite dry, or accompanied with an expectoration of a small quanti- ty of a thin frothy matter, which differs from that of true catarrh, in being easily diffusible in other fluids. Soon- er or later, the general health becomes impaired, and at length the fatal hectic makes its appearance with little suspicion; all the symptoms being referred to the great change that then takes place. No diagnosis can arise Consumption. from the existence of fever, since in the chlorolic state, coldness, with occasional flushing, are not uofrequent. In general, however, the fever of phthisis attacks more pointedly in the evening; that of chlorosis in the morning, The appetite of hectic patients is best in the forenoon; of chlorotic at night; and the latter can eat meat suppers fre- quently with impunity. It sometimes occurs that persons who have been im- properly treated in the venereal disease, have symptoms which assume the form of consumption; but, in general, the chest is free, while pains are more violent at night, and more frequently in the middle of the bones of either extremity, or deep seated in the head, than in the trunk. It has also seldom proceeded so far as to mislead, without shewing its nature by eruptions, or by an affection of the throat. From the state of mind we may draw some distinction; for cheerful hope illumines every hour of the hectic; despair darkens each moment of the syphilitic pa- tient. Strange as it may appear, amidst all the horrors of this disease, the patient's hopes are seldom abandoned, and even increase, as the fatal termination advances. Causes.—Obstructions and inflammation of the lungs, depending most frequently on the existence of small tub- ercles in the substance, which, coming to suppuration, burst and discharge a purulent matter. Sometimes it is induced by a general affection ofthe system, and some- times it is a consequence of other diseases, as cold mea- sles, small pox, pleurisy, &c. &c. Treatment.—This must be varied and adapted to each stage and case of the disease. In the first or inflam- matory stage, moderate bleedings, twice or thrice a week, according to the force ofthe pulse and habit of the patient, are essential, aided by blisters to the breast and back, and employing at the same time a cooling regimen. In almost every species of the disease, blisters or is- sues are often a means of relieving the cough; for even when they have no tendency to remove the stimulating cause producing cough, as when it arises from a tuber- cle, yet they diminish the effect of the stimulus. They MS Consumption. are particularly useful in that period ofthe disease, when a catarrhal has a disposition to degenerate into a phthi- sical affection; for in that modification ofthe disease, de- rivation from the lungs is of the utmost consequence.—■ By this means, a change may often be affected in that state of suppuration which takes place from the internal membranes of the lungs and the purulent discharge may thus be converted into the natural mucus. Among other remedies in consumption, the use of emet- ics is strongly recommended. By the action of vomiting, the blood is propelled to the extreme vessels in every part of the body, particularly to the extreme vessels ofthe sur- face. Thus, there is produced a derivation from the lungs, and a consequent change in the state of separation .at that part ofthe system; hut they are chiefly useful in consumption, as obviating symptoms, particularly cough and difficulty of breathing, and by promoting expectora- tion. A considerable variety of medicines ofthe refrigerating kinds have been strongly recommended for combatting consumption in its incipient state. They tend to dimin- ish the impetus of circulation, and although they do not immediately remove a plethoric state, yet they perhaps tend to diminish the inflammatory diathesis even more effectually than the repeated blood-lettings. The cooling neutrals through the whole course ofthe disease, are use- ful, particularly nitre, which may be advantageously taken in any period of the complaint. Demulcents are always indicated and usually employed in the manner we have recommended under the head of cold, to sheath the fauces and lessen (he violence of cough. Gum arabic held con- stantly in the mouth will also be found extremely useful in relieving this distressing symptom. Of all the remedies wliich have of late been fashionable in consumption is the fox-glove, [See Materia Medica;] but it does not seem to merit all the praises wiiich has been given it. Under proper management the fox-glove produces a slowness of the pulse, not perhaps to be ob- tained from any other medicine yet discovered. And it has been the opinion of some, that, by reducing it to the natural standard, from the employment of digitolis, con- sumption may be overcome. But it should be observed Consumption 339 that the quickness of pulse in this disease is merely symp- tomatic, and that the reduction of it even below the na- tural standard, can have no effect either in removing a tubercle, or in healing an ulcer in the lungs. Hence on this ground it is in vain to expect a radical cure from its use. However as a diminution ofthe celerity of the pulse will somewhat alleviate the hectic fever, it may in certain cases be employed with advantage. The most eligible mode of using the fox-glove is in a tincture, beginning with the dose often drops and gradually increasing it to sixty to an adult, morning, noon and night. In exhibiting this medicine, it should not, however, be given in such doses as to induce much sickness. Among other active medicines, recourse is frequently had to mercury, but unless consumption was excited by a venereal taint we have never witnessed benefit from this medicine. On the contrary, when mercurial salivation is produced in the genuine consumption, it has uniformly hastened the death of the patient. Iceland liverwort, or moss, has been of late, highly ex- tolled as a remedy in this complaint that readily allays cough, fecilitates expectoration, abates hectic fever, and quiets the system without constipating the bowels. It is likewise said to strengthen the organs of digestion, with- out increasing the action ofthe heart and arteries. In- deed the physicians of Europe have spoken so loudly in its praise, that every patient ought certainly to give it a trial. The most approved method of using it is in the form of decoction; one ounce ofthe herb to a quart of wa- ter boiled for fifteen minutes over a slow fire, to which two drachms of sliced liquorice root may be added about five minutes before it is taken off. A tea-cupful of this decoction should be taken four times a-day. Another form is by boiling two drachms ofthe herb in a pint of milk for ten minutes, and taking it for breakfast and sup- per. If chocolate be preferred, it may be blended with it, by making the chocolate with a decoction of the moss, without the liquorice, as above directed. Of all our indigenous plants, the Indian turnip [See Materia Medica] has the highest reputation, as a remedy in consumption. It is evidently an active expectorant, and may be useful in the latter stage of the disease. 42 33o Consumption. In the treatment of this disease, balsamic medicines are frequently resorted to. They are totally unsuited to the inflammatory state of any one ofthe complaints ofthe lungs, whether acute or chronic. Action having been sufficiently subdued by depletory measures, they may be safely and advantageously administered in catarrhal con- sumptions and protracted coughs; and will be found particularly useful when expectoration is checked from debility, and a want of irritability of the glands. So op- posite are the states ofthe lungs in catarrhal affections, that it requires essentially different substances to produce expectoration. It may be repressed, or imperfectly per- formed, by a constriction ofthe lungs, and by the removal of which an infinite degree of relief is often afforded. It is also apparent that the lungs occasionally, from extreme debility, pour out an excessive discharge, and that by di- rect stimulation ofthe exhaleiits, the effusion is abated and oppression removed. The advantages of the vegetable balsams, as they have been called, were supposed to consist in their power of promoting the healing of wounds and ulcers. At one time, many of them were highly extolled in pulmonary consumptions; but each have had their day of fashion, and have each fallen into deserved neglect. According to the testimony of Drs. Duncan, Simmons, and other eminent physicians, gum-myrrh exhibited in doses of twen- ty or thirty grains thrice a day, united with an equal quantity of nitre, has in many instances been employed with the best effects in this intractable disease. While for resolving tubercles or healing ulcerations in the lungs, many medicines have been taken internally, some modes of cure have been recommended with the view of acting topically on the diseased parts. In this way, different articles have been directed to be inhaled into the lungs, under the form of vapour. In an inflam- matory state of the bronchial glands, warm watery va- pour may be useful, and vinegar has occasionally been ad- ded; but it seems often to irritate the cough, and the more stimulant vapours are evidently injurious, except where expectoration is difficult and deficient. In cases where the accumulations ofthe chest are owing to debiltyof the Consumption. 331 lungs, or are retained by the vicidity and tenacity of the matter, sulphuric aether is strongly recommended; and we are told upon the high authority of Dr. Pearson, that its powers are improved by several substances which are soluble in it. Hemlock is particularly praised, half a drachm of which is to be digested in an ounce of aether, for several days, so as to form a saturated tincture. Of this, two or three tea-spoonfuls are to be put in a wine glass, to be held up to the mouth, and inspired till the whole is evaporated, and repeated several times in the day. Similar in its effect to these inhalations, is the practice of smoking tobacco, the stramonium and other substan- ces. With the same views tar fumigations, according to a dis- tinguished Russian physician, Dr. Crichton of Petersburg, have been employed, and, is said, with triumphant suc- cess. The mode he recommends for doing this is, to put the tar in an earthen vessel over a lamp, or heated iron, so as to cause a volatilization till the air of the room is sufficiently impregnated, and this process is to be repeat- ed three or four times a-day. Having stated the remedies which have been most high- ly recommended in consumption, and from which, when properly adapted to the circumstances of the case, there is the best chance of recovery, we will conclude with few remarks on the means of obviating urgent symptoms. It is a fortunate circumstance, that even in those dis- eases where the prospect of recovery is the most faint, and where there is next to certainty of an approaching dissolution in no long time, we still have it in our power to protract the period of life, and to alleviate the distress ofthe patient. In many cases of this terrible disease, it is all that we can reasonably expect to accomplish. Although colliquative sweats are not productive of pain, yet they tend very much to debilitate the patient, and by the loss of strength the chance of recovery is ve- ry much diminished. Hence the necessity in such cases of giving some tonic, as the elixir vitriol or infusion of bark. In every instance of consumption it is of importance to prevent costiveness, and it is always a desirable circum- 333 Consumption. stance to keep the bowels in a soluble state, which should be obtained rather by diet than medicines. But when diarrhoea occurs spontaneously, this should in like man- ner be restrained by shunning the use of those articles which are observed to increase it, and by employing what are found to moderate it. Of all the symptoms which require to be mitigated, there is none which more frequently demands attention, than the cough. For this purpose an almost infinite va- riety of articles, either of the demulcent or sedative kind, [See Cold] may be employed with advantage. But of these substantives, after the inflammatory symptoms have been subdued, none is so useful or so powerful as opium. This article, however valuable as it is, cannot be consid- ered free from inconvenience. There are some individu- als with whom, from peculiarity of constitution, it always disagrees, producing confusion of the head, vertigo, sick- ness at the stomach, and various other distressing symp- toms. Hence recourse has been had to a variety of other sedatives, both with the view of allaying inordinate ac- tion, and of procuring sleep. Of all the substitutes for opium, none according to the testimony of one of the most celebrated and distinguished physicians in Eng- land, Dr. Duncan, equals the preparations formed from the common garden lettuce. [See Materia Medica.] It has been supposed, that by the continued use of opi- ates, they might allay irritation, and contribute to the great object, the healing ofthe ulcer. They have, how- ever, failed in this view, though we cannot refuse their employment to lessen pain, and keep up the calm sereni- ty, the pleasing delirium, in the midst of distress, and a state hopeless of relief. From what has been said of the principal remedies recommended in consumption, the reader will find but lit- tle encouragement to indulge a hope of relief. He will probably exclaim, is consumption then never cur- ed? Whence can arise the confident promises which eve- ry newspaper offers, and which the most respectable au- thorities confirm? The deception arises from two sources. Catarrhal complaints are, in many instances, confounded with consumptive, and the most experienced eye is occa- sionally deceived, in somccases also vomicae are complete Consumption. 333 ly evacuated by expectoration, and the wound heals. So insidious is the attack of consumption that it has often been taken for catarrh; and on the contrary, so violent is often a catarrh, that it has been pronounced to be truly phthisical by practitioners of judgment and experience; nor has the delusion been destroyed but by the expectora- tion. From such errors it is not to be wondered; that so many medicines should have gained credit in the cure of consumption. To say, however, that this disease is never cured would certainly appear rash; for instances have occurred in which a recovery has been perfected by nature; but they are so few, that they can scarcely in- spire hope. Regimen.—Perhaps a greater number of cures in consumption have been effected by regimen than by me- dicine, especially if under this head be included, not merely diet, but air, exercise, and similar circumstances. It has been but too common to prescribe the same diet in every stage ofthe disease which has been attended with the most pernicious effects, and has often hastened the death ofthe patient. While the Brunonian fed his pa- tients to avoid debility, the other practitioner carried, apparently, their antiphlogestic system too far. In judg- ing of that diet which is best suited to phthisical patients, due attention must always be paid to its effects upon the system. While a considerable discharge by blood-let- ting is requisite, it is certainly proper to avoid those ar- ticles wliich can furnish a large supply of rich chyle, even although they should be, like milk, of the very mildest na- ture. But after suppuration takes place, and there is a free discharge of purulent matter, the antiphlogistic plan should be pursued no further; on the contrary, a more nu- tricious diet is essentially necessary. The healing of tu- berculous ulcers in the lungs, as well as of scrofulous sores at other parts, is only to be expected from recruit- ing and giving vigour to the system. In this state ofthe disease, therefore, a nutritious diet is naturally indicated; and indeed the evident marks of exhaustion point out the propriety of a due supply. Besides these particulars, a liberal and nutritious diet is often manifested in this stage of the disease by the feelings of the patient, for it is by 334 Consumption. no means uncommon to observe even a craving for ani- mal food; and it may be remarked that in very rare in- stances only are such calls of nature entirely to be ne- glected. The diet in the inflammatory state of consumption should be light, and composed of articles that tend to correct acrimony, and diminish inflammation, as milk, butter-milk, rice-milk, arrow root, sago, fruits of every kind, and vegetables. In the advanced stage of the dis- ease, and when the pulse is weak, a more cordial and sti- mulating diet, and strengthening remedies are necessary. To prevent weakness, and other ill effects of an empty stomach, patients should take frequently of meat, with wine, porter or toddy: raw oysters are thought to be pe- culiarly proper. With this cordial diet, tar pills, bark, and elixir vitriol, or an infusion of the inner bark of the wild-cherry-tree, or hoarhound and bitters of all kinds, have been exceedingly useful, in this state of consump- tion. Mr and situation are apparently objects of considera- ble importance, in a disease where medicine must con- fess the inutility of her resources. Change of air is among the remedies constantly recommended; and to change is often professedly the only object. Exercise when not carried to fatigue, in a dry coun- try air, often does more good than medicine, and conse- quently should always be taken. Long journies on horseback, are the most effectual modes of exercise, carefully avoiding night air, and the extreme heat of the day in summer. That exercise be not carried to fatigue, patients should travel only a few miles in a day at first, and gradually increase the dis- tance as they increase their strength. When exercise on horseback cannot be supported, sailing and swing- ing should be substituted, and no effort to cheer the spirits, or innocently to amuse the mind should be neg- lected. Great care should be taken to regulate the dress ac- cording to the changes of the weather. The chest in particular should be defended from the cold, and the feet from the damp. In the various stages of this disor Incontinence of Urine. 335 der, the bowels ought to be kept moderately open by emollient glysters, or the mildest laxatives, if the diet should not have the desired effects. utTOSTOMitOT w wmiitm Symptoms.—An involuntary evacuation of urine. Causes.—A relaxation of the sphincter of the blad- der—injuries received about the neck of the bladder—■• pressure of the womb in a state of pregnancy, &c. Treatment.—When the disease proceeds from a re- laxation of the sphincter of the bladder, a large blister to the os sacrum or lowermost part of the back-bone will be found highly beneficial, and often effects a cure in one or two days. The cold bath, or dashing cold water upon the genitals, and tonic medicines, as the nitric acid, lime water, bark, steel, and columbo, are peculiarly proper in obstinate cases of this kind. The tincture of cantha- rides in doses of ten or twelve drops every three or four hours is said by Dr. Morton to be a specific in this com- plaint. Others recommend alum whey, made as strong as the stomach will bear it, and direct a half pint to be taken night and morning. With others the blue vitriol in doses of half a grain given twice a-day in any agree- able liquor is most to be depended on. The occasional use of rhubarb in small doses to keep the bowels easy, tends greatly to alleviate the affection. When it is pro- duced by an impregnated womb, little more can be done than observing a horizontal position as much as possi- ble. BIW2OTILW Off wmot. When there are frequent uneasy urgings to void urine, and it is discharged with difficulty anil pain, the disease is called a strangury; and when it is totally re- tained, is called a suppression of urine. Causes.—It arises from a variety of causes, as calcu- lous concretions—obstructions in the urethra—blisters— or the tincture of cantharides, taken internally too free- ly—wounds, bruises, &c. Treatment.—The cure must greatly depend on the cause. If the pulse be full and feverish, bleed and pro- cure stools by emollient glysters and cooling laxatives, such as castor oil or the cathartic mixture. [See Dispen- satory.] Much dependence is to be placed in the free use of demulcent drinks, as bailey water, flaxseed tea, mu- i cilage of gum arabic, decoction of marsh-mallows, of [ parsley roots, or of water-melon seeds, especially if the affection he owing to the cantharides, or any injury of , the blcdder. One of the camphorated powders [See Dis- ' pensatory] given every three or four hours in the patient's common drink, often effects a cure. Great relief will be obtained from the warm bath, used oftener or seldomer as the case may require, or sitting in a tub of warm water, or from the frequent applu ations to the belly of cloths rung out of hot water, or bladders half filled with it. Opiates are very serviceable, but should never be used in the height of fever. A starch glyster, with laudanum, has very frequently given immediate relief. Cooling laxatives and diuretics, which operate without any stimulus, particularly the Epsom or glauber salts, as in the form of the cathartic mixture, often relieve. As a diuretic the following mixture is considered most salutary. Take of sweet < spirits of nitre one ounce, laudanum and antimonial wine, each, two drachms, a table-spoonful of which may be given in some diluent drink, and half this quantity re- peated every hour, if necessary. Difficulty of Urine. 33/ In the chronic strangury, after other means have fail- ed, the use of calomel in small doses, or mercurial oint- ment rubbed into the thighs every night till a slight ptyalism ensues, has frequently effected a permanent cure. In such cases an affection of the prostrate gland may be suspected to have been the cause. Walking on a cold wet floor, perhaps dashing water against the legs and thighs, would, in obstinate cases, succeed in procuring a discharge of urine, as it has done the discharge of the fseces. When a suppression of urine arises from partial palsy, as frequently occurs in the old and debilitated constitutions, our best chance of success, in giving tem- porary relief, is to give the spirits of turpentine in pretty ^ large doses, make use of general stimulants, and apply a large blister to the loins. When this complaint is in consequence of calculous concretions or gravel obstructing the urinary passages, which may be known by pain in the loins, sicknesss at the stomach, and sometimes a discharge of bloody urine, an infusion of wild carrot-seed sweetened with honey, as also the infusion of peach leaves, [See Materia Medica] have been found exceedingly beneficial. The infusion -^ of hops* which is considered a solvent of the stone, ad- ministered in doses of a wine-glassful, and taken to the quantity of a pint, daily, is said to be an excellent remedy in calculous affections. The uva ursi, is likewise cele- """ brated as a remedy in cases of gravel, in doses of five grains with half a grain of opium, thrice a-day. A more powerful medicine, however, for gravel complaints, is the caustic alkali or soap-lees, [See Dispensatory] but being of an acrid nature, it ought always to be given in mucilagi- nous drinks, and commenced with small doses, which should be gradually increased as far as the stomach can bear, and continued for a long time, particularly if there should be an abatement of the symptoms. When great pain attends a suppression of urine and the bladder is full, which can be ascertained by feeling it above the os pubis, and on pressure creating pain in the neck ofthe bladder, or at the end of the penis, it will be necessary to have recourse to the catheter, or a hollow bougie for drawing off the water. The larger sizes of each are more easily introduced than the smaiier, 43 y38 Difficulty of Urine. as they are not so liable to stop in the corrugations and foldings of the urethra, which occurs in elderly men. It is easy to introduce the catheter into the female bladder, since the direction ofthe urethra is nearly straight; but in males there is greater difficulty. The celebrated Heis- ter directs the man to lie on his back, and the operator to take the penis in his left hand as he stands on the pa- tient's left side, reclining the penis towards the navel, then he is to introduce the catheter thoroughly oiled, with its concave part to the belly, into the urethra, so far as the os pubis, and so thrusting it under the symphysis of those bones, and moving the hands gently outwards, forces it into the bladder. In the following cases this instrument cannot be used. W'.ien the neck ofthe bladder is greatly inflamed—when a scirrhosity or preternatural tumour of the prostrate gland or stone obstructs the passage—when the uterus is remarkably prominent and pendulous over the pubes—or when the uterus is retroverted, in which state it drags the bladder upwards and backwards. When the application of blisters causes a difficulty of urine, wash the blistered part frequently with warm milk and water, or apply sweet oil. In children, a suppression of urine is often relieved by a poultice of raw onions or radishes applied to the bottom of the belly. Regimen.—During the violence of this complaint the lightest diet only should be used, and mucilaginous drinks taken freely. Those who are often afflicted with it, ought carefully to avoid aliment hard of digestion, flatu- lent, or of a heating nature. nmm^msiaMK tW the Hypochondriac for the church-yard. They 45 354 Hypochondriac Disease. ed. From this supposed bodily affection, the mind should be diverted by employments suitable to the circumstance es and situation in life, and unattended with much emo~ tion, anxiety, or fatigue. Company which engages at- had not gone far before they were met by one ofthe towns-people, who having been properly drilled by the facetious Stevenson, cried out, ••Alt Doctor! what poor soul have you got there?" "Poor Mr. B——," sighed the Doctor—"left us last night." "Great pity he had not left us twenty years ago," replied the other, •'for he was a bad man." Presently another of the town* men met them with the same question. "And what poor soul have you got there, Doctor?" "Poor Mr. B----." answered the Doctor again, "is dead." " \h! indeed!" ssad tile other. «$nd so the devil has got his own at last." „ * T "Oh villain!" exclaimed the man in the coffin, "if I was not dead, how I would pay y^>u for that" Soon after this, while the pall-bearers were resting themselves near the church-yard, another one stepped up with the old question again, "what poor soul have you got there, Doctor?" "Poor Mr. b----," he replied, "is*gone." "Yes, and to h----11," said the other," for if he is not gone there, I see not what use there is for such a place." Here the dead man burst- ing off the lid of the coffin, which had been purposely left loose, leapt out exclaiming, "Oh, you villain! I am gone to h----11, am 1! Well, I have come back again to pay such ungrateful rascals as you are." A race was immediately commenced between the dead man and the living, to the petrifying consternation of n>any of the spectators, at sight of a corpse, bursting from the coffin, and in all the horrors of the winding sheet, racing through the streets. After having exercised himself into a copious perspiration by this fantastic chase, the Hypochondriac was brought home by Dr. Stevenson, freed of all his complaints. And by Strengthening food, generous wine, cheerful company, and moderate exercise, was soon restored to perfect health. To demonstrate further, the happy effects of possessing quick wit, "to shoot folly as it flies," I will cite another case of Hypochondriasm, which came under the care of that philanthropic and learned physician, the late Doctor Crawford, of Baltimore, who, in every thing amiable ahd good, was not unlike his intimate friepd, Doctor Stevenson. A certain Hypochondriac, who for a long time fancied himself dying of a liver complaint, was advised by Dr. Crawford, to make a journey to the state of Ohio. After an excursion of three months he returned home, apparently in good health: but upon receiving information ofthe death of a twin brother who had actually died of a schirrus liver, he immedi- ately took the staggers, and falling- down roared out that he was dead, and had, as he always expected, died of a liver complaint. Dr. Crawford being sent for immediately attended, and asked the Hypochondriac how he could be dead, seeing he could talk. Rut still he would have it that he was actually dead. Whereupon the sagacious Doctor exclaimed, "O yes; the gentleman is certainly dead, and it is more than probable, his liver was the death of him. However, to ascertain the fact, I will hasten to cut him open before putrefaction takes place."—And thereupon getting Hypochondriac Disease. 855 Mention, and is at the same time of a cheerful kind, will always be found of great service. The occasional read- ing of entertaining books, or playing at any game, in which some skill is required, and where the Stake is not an object of much anxiety, if not too long protracted, will further assist in diverting the mind from itself. The symptoms of indigestion, and hysteric complaints, that so frequently attend this state of mind, although the effect, rather than the cause, are objects of practice; in. asmuch as they tend to aggravate and realize the false apprehensions ofthe patient. These secondary affections require the same mode of treatment recommended for indigestion and the hysteric disease. The warm bath is peculiarly beneficial in this complaint, and when the sys- tem becomes somewhat invigorated, the cold bath may be employed with advantage, provided there exists no ob- structions in the bowels.—From an acid acrfmony gene- rally prevailing in the stomach, the rust of steel, or filings , of iron, in doses of ten grains thrice a-day, is the most salutary medicine of all the tonics. Magnesia and lime 1 water are useful on the same account. Regimen.—A proper diet constitutes an essential part in the treatment of this malady. In general, light ani- mal food is what alone agrees with such patients; for there are few, if any vegetables, which do not prove fla- tulent in their bowels. Acids are particularly injurious. AH malt liquors, except porter, are apt to excite too high a fermentation in the stomach; and wines, for the most part, are liable to the same objections. If an exception can be made in favour of any, it is good old Madeira, when it can be obtained, which not only promotes digestion, and invigorates the concoctive powers, but acts, imtnedi- » carving knife and whetting it as a butcher would to open a dead calf, he stepped up to him and began to open his waistcoat, when the Hypo- chondriac, horribly frightened, leaped up with the agility of a rabbit, and crying out, "Murder! Murder! Murder!" ran off with a speed that would have defied a score of Doctors to catch him. After running a considerable distance, until he was almost exhausted, he halted; and, not finding the Doctor at his heels, soon became composed. Prom that period this gentleman was never known to complain of his liver; nor had he for better than twenty years afterwards any symptom of this di* ease. 356 Cramp. ately, as a generous and wholesome cordial. The use of spirituous liquors is not to be recommended as a habitual resource, though they may be taken occasionally, in a moderate quantity, diluted with water. Tea and coffee, though hurtful to people with bad digestion, are often useful, however, to the hypochondriac. Moderate exer- cise, we have already observed, is indispensable in the cure of this complaint; and it cannot be taken any way with so much advantage as longjeurnies, when conveni" ent, accompanied with such circumstances, as may eon- vert them into an agreeable amusement. A painpui. spasm of the calf of the leg or muscles of the toes, and sometimes of the stomach. Causes.—Sudden stretching of the limbs—advanced pregnancy—acidity—indigestion, irritation, and debility/ Treatment.—A cramp ofthe calf of the leg is best relieved by standing up, which simple act, by throwing the weight of the body on the toes, forcibly extends the muscles, and thus takes off the spasm. If the cramp aris- es from acidity or indigestion, give every night a pill c -osed of half a grain of opium, with six grains each, of r rb and prepared chalk, and administer ten grains of £ nst of steel, morning and noon. .> cramji of the stomach is best treated by an infusion of red pepper, [See Materia Medica] or a large dose of aether or laudanum, accompanied with friction on the part, either by a flesh brush, or flannel. When these fail, a very copious bleeding will sometimes remove the spasm, after which the patient must be purged. The chief remedies of spasm are those wliich remove the irritating cause. If this cannot he ascertained we must endeavour to lessen irritability by anodynes. A Tetany, or Locked Jaw, 357 sudden terror, the apprehension of a Severe operation, on the return of the fit and unexpected surprise, have succeeded. Dashing water in the face, touching a per- son with something cold, or throwing up a cold glyster, have from the same principles, been effectual. Persons subject to the cramp in the leg may prevent it by wearing stockings in bed, and occasionally rubbing ! the part with camphorated oil. According to vulgar au- thority, sulphur grasped in the hand, is good to cure and carried in the pocket to prevent cramp. Symptoms.—A rigid and painful contraction of all or several of the muscles. Its first symjitoms is a stiffness in the back ofthe neck, increasing to pain, extending next to the root ofthe tongue, then shooting into the breast, and lastly seizing the back. Cacses.—Wounds of the head or extremities—and punctures of the slightest kind, as running a splinter un- der the nail, or into the toe or finger. It is equally induced from cold or moisture, particular- ly when sudden vicissitudes prevail, or sleeping on damp ground. Treatment.—On the first appearance of this disease give one or two table-spoonfuls of laudanum or six or eight grains of opium every two hours until the symptoms abate, and then the dose should be gradually lessened. Between the doses wine or spirits should be given very freely. The use of the warm bath will also assist the efficacy of the opium. These remedies should be in- creased and carried to the utmost extent as the symp- toms may indicate. If the opium cannot be swallowed, six times the quantity may be injected in glysters until the patient can swallow. 358 Tetany, or Locked Jaw. This disease has oftentimes yielded to a salivation, And when there is time for the operation of mercury it should be used both internally and externally. At the same time it is advisable to give opium, in more mode* rate doses. Dr. Brown, who is now one of the principal profes- sors in the Transylvania University, communicated sometime since, through the medium ofthe New-York Medical Repository, his success in the cure of tetanus with the tincture of cantharides. When recourse is had to this remedy, give from twenty to thirty drops of the tincture every hour until it produces strangury or a dif- ficulty of urine. As soon as this occurs, it must be dis- continued, and flaxseed or marshmallow tea or barley water, or some mucilagenous liquid drank freely, and some of it injected by way of glysters, to which may be occasionally added two tea-spoonfuls of laudanum. According to Dr. Nathaniel Miller, the solution of arsenic in doses of ten drops with an equal quantity of laudanum, and a large spoonful of spirits every half hour, has in several cases of tetanus succeeded admirably in performing a cure. When the symjitoms abate the dose must be diminished and the medicine gradually discon- tinued. Among the various remedies which have been recom- mended for the cure of tetanus, none has been employed with greater success than the cold bath. This is to be done by plunging the patient in the coldest water, or by pouring suddenly over his head and shoulders several tubs of cold water. The cold bath must be repeated ev- ery three or four hours until a perfect cure is effect- ed. On the decline ofthe spasm, bark with wine and opi- ates at bed time should be given until the patient's health is reinstated. Spirits of turpentine and infusion of tobacco [See Ma- teria Medica] have each been administered by way of in- jection with very happy effects in this alarming disease. In every stage of the disease it is of importance to keep the bowels open, by the usual stimulating purga- tives or glysters. When local injuries have been the cause of this dis* Palpitation of the Heart. 359 »ase, the wound should be dilated and filled with com- mon salt, Spanish flies, or turjientine, and afterwards dressed with warm po»!tices until the wound be brought to a state of good digestion. If a wounded finger or toe be the cause of this horrible malady, it ought instantly to be cut off. fAatlfAfiW <« TWM MSA W» Symptoms.—In this disease, the motion of the heart is performed with more rapidity, and generally with greater force than usual, which may not only be felt by the hand, but often be perceived by the eye, and even heard; there is frequently a difficulty of breathing, a pur- plish hue ofthe cheeks and lips, and a variety of anx- ious and painful sensations. It sometimes terminates in sudden death. Causes.—A morbid enlargement of the heart itself, and ofthe large vessels—organic affections—an heredi- tary disposition—plethora—debility or a morbid condi- tion of the system—mal-confirmation of the chest, and many of the causes inducing fainting. Treatment.—This complaint is best relieved by keeping the mind and body at rest, avoiding every cause of irritation, and keeping up a proper equilibrium of the circulation. When the disease arises from plethora, and the action of the heart is violent, bleeding is indispensable, which should be followed by a cooling cathartic, and afterwards the exhibition of nitre every two or three hours, or the tincture of digitalis, in doses from ten to twenty drops thrice a-day, by lessening the action of the arterial sys- tem will effect a cure. When there is reason to believe this affection is in con- sequence of debility, the solution of arsenic in its usual 360 Hiccup. doses, taken for some time, is a certain remedy. When the nervous system is affected, small doses of «ther, lau- danum, or some cordial will be found very serviceable. The feet should be kept dry and warm, frequently rubbed, and if not otherwise warm, with powdered mus- tard seed or tincture of Cayenne pepper. Those who are subject to a palpitation of the heart should carefully avoid violent exercise, irregular passions, costiveness, and all circumstances that may tend to in- crease the action of the sanguiferous system. HH&BTOh A spasmodic affection of the diaphragm, and some- times of the stomach, is a troublesome but not often a dangerous complaint. Causes.—Debility, acidity, flatulence, cold drinks when the person is warm, repletion, worms, repelled gout, &c. Treatment.—When it arises, as is most frequently the case, from spasm induced by debilitating causes, the warm antispasmodics,as sether,laudanum, the camphorat- ed mixture, hartshorn, tincture of assafoetida, or some of the essential oils will be useful. A tea-spoonful of vine- gar slowly swallowed has frequently afforded relief. Preserved damsons have likewise been found of excellent use in this complaint. When acidity is discovered to be the cause, give the absorbent mixture or twenty drops of hartshorn with a tea-spoonful of magnesia in a cup of mint tea, or a spoon- ful or two of milk and lime water; and to prevent its re- currence, take ten grains of the rust of steel thrice a-day. When occasioned by poisons or improper food, an emet- ic will be proper. In weak stomachs oppressed with indigestible food,- Night Mare. 361 a glass of good wine or spirit and water often relieves. JEther applied externally to the stomach on a soft linen rag with a warm hand to confine it, is a good remedy; so is the application of an acrid cataplasm or blister in obstinate cases. Like other spasms, it is often stopped by strongly ar- resting the attention, whether by hope, fear, or terror. A sudden alarm has often succeeded in curing this affec- tion after every other means had failed. On the same principle a deep continued inspiration will often remove slighter degrees of this troublesome complaint. i»m uAmm Symptoms.—An alarming oppression of weight about the breast, with dread of suffocation. Causes.—Late and excessive suppers—great fatigue —drunkenness, or sleeping on the back. Treatment.—If the patient be of a plethoric habit, bleed, purge, and use a spare diet. And when tk* dis- ease is the consequence of debility and weak nerves, the tonic medicines, as steel bark or columbo in their usual doses, are proper. A glass of brandy at bed time will generally prevent the attack. Prevention.—The patient should sleep on a hard bed, which invites to frequent changes of sides, eat light suppers, which with due exercise, and cheerfulness dur- ing the day, form the best preventive remedies. 46 ASTCEHOAa Is often hereditary. When attended with an expecto- ration of phlegm, it is termed moist or humeral; and when with little or none, dry or nervous asthma. Symptoms.—It generally attacks at night with a sense of tightness across the breast, and impeded respiration. The person thus taken, if in a horizontal situation, is obliged immediately to get into an erect posture, and solicits a free and cold air. Ih violent paroxysms, speaking is difficult and uneasy. Treatment.—On theirs* attack of asthma, bleeding is serviceable, if the pain in the chest and difiiculty of breathing be considerable; but less so afterwards, since the disease has a natural tendency to take off the pletho- ric state of the system. Vomits frequently repeated have been found of consid- erable utility in this disease. When there is reason to ap- prehend a paroxysm in the course ofthe night, an emetic exhibited in the evening will generally prevent it; and when the fit comes on in consequence of a loaded stomach, it will often afford immediate relief. As in other spasmodic affections, the most powerful antispasmodics, as laudanum and {ether, should be re- sorted to. These maybe given conjointly or separately, but in large doses, to allay the violence of the fit, or to prevent its accession. Thus half a tea-spoonful of lauda- num, or one of aether, to be repeated in an hour, if ne- cessary, in a glass of cold water, has frequently relieved the symptoms, or when taken at the approach of the fit, have suppressed it altogether. A cup of strong coffee has sometimes afforded great relief; and when the disease proceeds from the irritation of mucus, a table-spoonful or two of vinegar in a glass of cold water is a good re- medy. The skunk cabbage and stramonium or thorn apple, are considered most valuable antispasmodics, and ex- Asthma. 363 ^eedingly beneficial in this complaint. According to Dr. Cutler, the emetic weed or indian tobacco [-See Materia Medica] is a certain remedy. And Dr. Thomas speaks highly of the efficacy of the tincture of foxglove in doses of fifteen drops twice a-day, conjoined with a few drops of laudanum. In every stage of this disease the bowels must be at- tended to. The connection of asthmetic paroxysm with flatulence and costiveness plainly points out the import- ance of aperient medicines and those of the warmer class, as aloes and rhubarb. Expectorants are frequently required in this disease. The powder, or sirup of squills, or gum ammoniac exhib- ited in rather larger doses than usual, will often bring on expectoration, in cases apparently desperate. Blisters near the back are singularly useful, and should be often repeated. Cataplasms of garlic or onions to the feet are also valuable assistants. Regimen.—A light diet, easily digestible and not fla- tulent, is always proper for asthmatic persons; and dur- ing the fit, cool drinks and fresh air are proper. It will always be found serviceable to wear a flannel shirt and to keep the feet warm. Prevention.—During the absence of the paroxysm, tonic medicines and the cold bath, together with mode- rate exercise, will be most efficacious in obviating its re currence. Symptoms.—A burning sensation about the pit of the stomach, with acid eructations, flatulence, and sometimes retching to vomit. Causbs.-*-A relaxed state ofthe stomach, generating 364 Heart Burn. acidities and acrimonies from food too long detained.— As it is often a symptom of indigestion, the cause may be found under the head of the following chapter. Treatment.—The first indication is to remove the unpleasant sensations existing, which may be done by taking either a small tea-spoonful of salt of tartar, or a table-spoonful of magnesia in a glass of mint-water or tea; or a tumbler of mucilage of gum arabic or flaxseed tea taken cold, with a small piece of liquorice ball dis- solved in it. But to cure the disease effectually, after an emetic, give the lime water or ten grains of the rust of steel thrice a-day for some time, and keep the bowels moderately open with magnesia or the root of rhubarb chewed occasionally, or the tincture of it, taken in small doses; or the aloctic pill. If it should arise from bile, lemonade, or some ofthe vegetable acids, or a sea-spoonful of the spirits of nitre in a glass of the infusion of columbo, will often afford im- mediate relief. When not arising from the contents of the stomach, general warmth, particularly ofthe feet, is essentially useful; and even rubbing them with flour of mustard or tincture of cayenne pepper has produced good effects.— Great benefit has also been experienced and sometimes a complete, cure effected, by the application of a blister to the pit of the stomach. To render it the more effica- cious, the blister should be kept running for at least a week. Rfgimen.—The diet of those who are subject to this complaint, should consist chiefly of animal food; and all fermented or acid liquors and greasy aliment must be strictly avoided. A glass of brandy, or gin and water af- ter dinner, is the best beverage. Moderate exercise is particularly beneficial. Symptoms.—Want of appetite—nausea—sometimes vomiting—heart-burn—costiveness—distensions of the stomach, particularly upon taking a small quantity of food—frequent risings into the throat of a sharp acid li- quor, and eructations of imperfectly digested matter. Causes.—Errors and irregularities in the mode of living—cold and moisture-—intense study—depressing passions—and abuse of tobacco, opium, or spirits. Treatment.—To succeed in the cure of this disease, we must avoid the occasional causes, remove such symp- toms as tend to aggravate or continue the disease, and in- vigorate the tone of the stomach. Crudities, acidity and costiveness, must be obviated at least in their excess, as they tend both to aggravate and continue indigestion.— The management of diet is also of considerable impor- tance. The stomach should never be suffered to remain any time empty in dyspepsia, as all the symjitoms are aggravated by it. Persons afflicted with this complaint, should frequently eat a cracker or a piece of ship biscuit, as bread not subject to fermentation, is one of the best substances to be frequently taken. In some weak stom- achs a singular aggravation of the symptoms comes on in about an hour or two after a full meal, attended with a sense of sinking or weakness. This seems to be ow- ing to a digestion unusually rapid, and consequently im- perfect. In such cases aliment of more difficult digestion, as eggs boiled hard, or the addition of condiments which retard digestion may be allowed; but in general, a bit of biscuit and a glass of wine will remove the sense of weak- ness which is owing to the sudden emptying of the stom- ach before too much distended. In order to the cure recourse must be had to emetics, whenever the stomach is offended with mucous, bilious, or other humours. It is not unusual that a large quan- tity of very viscid mucus is thrown up on the exhibition of an emetic. And this must occasionally be discharged, and its accumulation prevented by aromatics and tonics. 366 Dyspepsia, or Indigestion. The columbo root is a medicine of great utility, when the stomach is languid, and the appetite defective. It may be given thrice a-day in substance or infusion with mint-water, or ginger tea, or infused in Madeira wine, or French brandy, now and then interposing small doses of the tincture of rhubarb. Taking a tea-spoonful of mustard seed with half the quantity of columbo thrice a- day will be found particularly useful where acidity and flatulence prevail. A great variety of stomachics and tonics of the vegetable class, as camomile, gentian, quas- sia, Peruvian, and black oak bark, have been employed in the cure of this disease, but scarcely any merits a pre- ference to the columbo, unless the sampson snakeroot, [See Materia Medica.] However it is not proper to con- tinue the use of any tonic longer than two weeks at a time. When acidity predominates, a wine-glass of lime water, with an equal quantity of new milk, or ten grains of rust of steel or filings of iron, will be found exceedingly ben- eficial. In some cases the digestion is injured by putrid matter, from decayed teeth, constantly mixed with the saliva, af- fecting the organs of taste, and destroying the appetite.— In such cases, the charcoal tooth powder, [See Dispensato- ry] or washing the mouth night and morning with the solu- tion of alum, will correct this tendency. Even when the teeth could not be the cause of indigestion, I have seen the most happy effects result from the exhibition of charcoal powder, in doses of a table-spoonful twice or thrice a-day, particularly when conjoined with a few grains of rhubarb, and double the quantity of powdered ginger, or by taking after dinner, as much of the tincture of rhubarb as would keep the bowels in a regular state. Another medicine, ap- parently simple, though of considerable efficacy in this complaint, is the cob-web ofthe black spider, which, gene- rally inhabits the cellars, barns, and stables. Of this from five to ten grains is to be given morning, noon and night, in the form of pills. If the disease, as is too often the case, has been brought on by hard drinking, its only radical cure is to be found in temperance, cordial nourishment, exercise, and the use of elixir vitriol with bark, the nitric acid or the tonic powders or pills. [See Dispensatory.] Dyspepsia, or Indigestion.. 367 When the patient complains of a pain in the stomach, resort to the remedies for heart burn, and use friction with a flesh brush or flannel over the part. Should this fail, give a dose of sether or laudanum; and, in case of costiveness, administer an injection. This treatment will generally palliate the pain, after wliich endeavour to restore the tone of the stomach by tonic medicines, as the nitrtc acid, bark, columbo, steel, &c. The costiveness peculiar to persons in this complaint, must be removed by medicines which gently solicit the intestines to a more regular discharge of their contents; and this effect is best obtained by flour of sulphur, mag- nesia, or rhubarb chewed every day, and only the saliva swallowed. Strong purgatives are unfit to correct habits of costiveness, as they weaken the action ofthe intestines, and thereby increase the complaint when the evacuation is over. But nothing can so effectually obviate this affection, as constant custom most sacredly observed, of going every mortiing to the privy, although you have not a natural inclination. Regimen.—The diet should consist chiefly of animal food well chewed, and taken in small quantities, follow- ed with a glass of brandy and water, or good wine.— Frequent friction with a flesh brush or flannel over the region of the stomach and belly will be found exceeding- ly beneficial. After taking a puke, we have known a milk diet, per- severed in for several weeks, effectually cure indigestion. This article, almost always offends the stomach at first; but, by continuance, becomes agreeable to it, and effects a cure. The milk should be new, and free from acidity. Early rising and moderate exercise in the morning air can hardly be enough recommended, inasmuch as they contribute so happily to restore the tone of the stomach, as also of the whole system. It is impossible to furnish a plan of regimen adapted to every constitution and habit, but if the patient will but pay due attention to what benefits, and what injures him, wisely regulating his mode of living by the information thus obtained, his present maladies will soon disappear, and their future recurrence be forever inhibited. mwsB* Symptoms.—A violent pain in the bowels originating from constriction, attended with costiveness and some- times vomiting. The pain is commonly seated about the navel, and resembles various sensations, as of burning, twisting, boring, or a ligature drawn very tight across the intestines. It comes on without fever, which soon follows, es- pecially if inflammation take place in the intestine affected, and then all the symptoms become greatly aggravated. Causes.—Flatulence—indigestible aliment taken into the stomach—acrid bile—hardened fgeces—costiveness— worms—drinking too freely of acids—intermittents im- properly cured—sudden check of perspiration—and the application of poisons, such as lead, &c. &c. Treatment.—When the disease evidently arises from wind which may be known by a rumbling in the bowels, by pressure on the belly, or by the ease experienced from a discharge of it, or by the patient's lying on the belly, a glass of brandy, gin, strong mint-water, or tea made of ginger or calamus, will generally give relief: but it is only in colic from wind that these hot spirituous and carminative substances are to be used, for in all other cases they do great harm, and often destroy life. The flatulent colic is frequently caused by wetting the feet or otherwise checking the perspiration. When this is the case, rubbing the legs and arms with warm cloths, and afterwards keeping the feet for some thne in warm water, will be the most effectual remedy. As a spasm is the immediate cause, its resolution is the chief indication of cure; for this purpose, relaxing and antispasmodic medicines, with purges, wliich, while they solicit the internal discharge, will not greatly in- crease the morbid irritation, are the most proper means. Where the pain is fixed and acute, bleeding is advisa- ble, particularly in full habits, to prevent inflammation. Colic. 369 Next the action of the intestines must be excited by brisk purgatives, such as castor oil, calomel and jalap, or salts, senna and manna, aided by stimulating glysters. if these means prove inefficacious, immediate recourse must be had to the warm bath, in which the patient should re- main as long as he can bear it. Where a bathing vessel cannot be procured, flannels wrung out of hot water should be frequently apjilied over the belly as warm as can he endured. Besides wliich, tobacco glysters, [See Materia Medica] ought to be administered; and when the pain continues obstinate, apjily a large blister over the belly. If the above remedies prove ineffectual, opium and calomel in large doses should be employed. To their exceeding utility in obstinate colic, I can subscribe, from numberless successful experiments, made by myself.* Eminent modern physicians advise, that when all other means are despaired of, the jiatient shoidd be placed erect on the floor, and a pail of cold water thrown on his feet and legs; this, though apparently a droll remedy, yet cer- tainly deserves to be tried in desperate cases, especially * How I came in possession of this admirable secret, both justice and gratitude require that I should explain. In the year 1801,1 spent several weeks in Georgetown, Columbia dis- trict. While there, I was requested to. visit a Mr. James Turner, who had long been indisposed with the ague and fever; but then suffering un- der a severe attack of the colic, accompanied with most obstinate cos- tiveness. For two or three days the best, aperients, as calomel, castor oil, salts, senna and manna, and injections, with the Warm bath, and blis- ters, were used, but without effect.' Being much alarmed about his sit- uation, I stated the case to my very excellent friend, the ingenious and learned Doctor John IVeems, who advised the immediate use of six grains of opium, with twenty of calomel, in a bolus, and one.ihird of that dose every two hours afterwards, if the first failed to operate. I expressed my fears that so large a. lose of opium might do harm. "No sir," replied he, " 'tis small doses that do harm; give large doses, large enough to take off the spasms, and you save the patient." I stilt retained my repugnance; however, re collecting his great medi- cat attainments, and the desperate case of my patient, I acceded to his advice and scarcely was the second dose swallowed, before it began to operate like a charm The spasm was taken off the intestines copious foetid evacuations succeeded.and our patient was presently restored. This is but one of many extraordinary cures performed by Doctor John Weems. The citizens of Georgetown and Washington, will long lament the early fate of this gentleman, of whom for ardent friendship, and medical sagacity, I can truly say—his equal I have seldom seen, his superior never. , 47 670 Colic. as we are assured from the best authority, that it has of- ten succeeded: it acts, as is said, by occasioning an im- mediate evacuation of the bowels. For the vomiting which often occurs in this disease, common garden mint, peppermint, [See Materia Medica] or any other spices boiled in spirits, and flannels wrung out of it, and laid hot on the pit of the stomach, are excellent, especially if a little laudanum be added.— If acrid bile be thrown up, the saline mixture, or in- fusion of columbo should be given; and when vomiting is attended with cold extremities, warm applications to the feet, and a blister to the back often relieves this symptom. It is also frequently removed by a blister on the pit ofthe stomach. In violent colics attended with vomiting it is always advisable to administer an anodyne injection, and if it be speedily discharged, the glyster should be repeated till the vomiting ceases. A dose of calomel andjalap, castor oil, or infusion of salts, senna and manna is then to be adminis- tered every two or three hours until evacuations jare pro- cured. Regimen.—Evacuations being once produced, muci- laginous drinks and light diet should be strictly adhered to, and the bowels kept moderately open by mild purga- tives, giving opiates at bed time if necessary, until the soreness and distension of the belly go off, and no harden- ed faeces appear in the stool. Prevention.—Those who are at times afflicted with pains in the belly, should keep the feet dry and warm; abstain from flatulent food, and attend carefully to the bowels, to prevent constipation. Those whose occupation subject them to the fumes of lead, should breakfast on fat broth before they begin their work, and frequently in- terpose oily purgatives. OR VOMITING AND PURGING. Causes.—It is generally occasioned by a redundancy and acrimony of the bile—indigestible food or such as becomes rancid or acid on the stomach—poisons—strong acrid purges or vomits—passions of the mind, or a sud- den check of perspiration. Treatment.—Endeavour as early as possible to ex- pel the acrimonious matter wliich affects the alimenta- ry canal, by large and repeated draughts of chicken wa- ter, beef tea, barley or rice water, or thin gruel, &c. which should also be given freely in glysters.—It is said upon high authority, that frequent small doses of cold water, not exceeding a gill at a time, will check the purging, cool the ardent heat ofthe stomach, and abate the thirst. Cold water is the more efficacious as the climate, season, and constitution of the patient are warm; for it cools, blunts acrimony, and restores the tone of the parts. It should be repeated as often as the patient throws up what he drinks, and if fainting, with other symptoms of weakness come on, a little wine should be added to each draught of water. After having cleansed the stomach and intestines, give a tea-spoonful of tether, or thirty or forty drops of laudanum, in mint water or tea, and repeat the dose every hour or oftener, as the frequency of the evacuations or the urgency of the pain may require. If the laudanum be rejected from the stomach, give a tea-spoonful of paragoric, or opium in pills of half a grain, repeated every half hour at farthest, until the dis- ease be checked; and at the sametime apply mint leaves stewed in spirits to the pit of the stomach. In general this mode of treatment is sufficient; but if the patient be of a plethoric habit, he ought to lose blood immediately: and in case the pain continues violent, be placed in the warm bath; should the bathing vessel not be at hand, peppermint stewed in spirits, or cloths 372 Diarrhoea, or Looseness. wrung out of hot spirits or decoctions of camomile, hops or lavender, ought to be applied to the stomach and bel- ly, and often renewed. If acrid bile be the cause of this complaint, the colum- bo must be given every hour or oftener, in large doses; and in case of great heat, a small quantity of nitre in the patients drink will be proper. In warm climates this remedy is considered almost a specific; it soon abates the violent evacuations; and by continuing it a few days a cure is effected. A tea spoonful of the columbo finely powdered, in a glass of mint water, or a gill of the in- fusion may be repeated every hour or two, according to the urgency of the symptoms. In preparing the infusion it is better to add one fourth ginger or some grateful aromatic, in cases unattended with fever. When the disease originates from food, either very acid or-putrid, besides plentiful dilution with the above drinks, give castor oil, salts or rhubarb; and if from poisons swallowed, the patient should drink largely of pure sweet oil, melted butter, or mucilaginous drinks, with small portions of salt of tartar. Regimen. As no disease more suddenly weakens the patient, he should take freely of a light but cordial and nourishing diet, occasionally assisting his appetite, if de- ficient, with elixir vitriol, tincture of bark, or infusion of columbo. If he cannot sleep well, an opiate at bed-time may be taken, until his strength and spirits return. Symptoms.—A purging without sickness or pain, suc- ceeded by loss of appetite. Causes.—Acid or putrid aliments; obstructed perspi- ration; acrid bile; drinking bad water; worms; violent passions, or a translation of morbid matter of other dis- eases to the bowels. Diarrhoea, or Looseness. 373 Treatment.—If offending matter be lodged in the stomach, give an emetic, and an opiate at bed time; and on the succeeding day, if the disease is not removed, a dose of rhubarb or castor oil, followed by forty or fifty drops of laudanum at night. In every case where the diarrhsea continues obstinate, an emetic should be premised. It relieves the stomach from acrimony, checks the increased peristaltic motion downward, and determines to the skin. After the emet- ic, it is necessary to procure some resjiite, and with this viewornates may be employed with perfect safety. By lessening or stopping the peristaltic motion, we relax any spasm ?dic stricture which may prevent the discharge of offending matter, and the gentle laxatives afterwards re- quired, will h;:ver and consequently wider incisions; thus a large quantity of water will often drain from the legs or thighs, without risque of inflammation, or deterring the patient from a repetition, if necessary. The punctures must be made in the most dejiending part of the leg; and their number and repetition depend on the circumstances of each individual case. The application of glasses, either before or after scarifying, is unnecessary; but the instru- ment must be gently pressed upon the skin, until a sur- face is formed sufficiently flat to admit the lancets in the scarificator to act equally. In aliases where the skin is so stretched as to threaten inflammation, rujiture, or a gangrene, and when the breath is greatly impeded, these openings should be made without delay. Blisters are of- ten employed in the same circumstances instead of scarifi- cations, and are equally useful. An oblong blister may be applied just ahove the inner ancle, and continued until a thick, white, or purulent discharge is produced. After this period but little water appears, and the sore should be healed. If necessary to be longer continued, blisters may be employed on the outside; and when these have acted sufficiently, we may return to the former surface, which will be now healed. Should a dark or black spot ajqiear, bathe the leg in a strong decoction of oak bark, and sprin- kle the spot with some ofthe bark, or myrrh powdered, or apply poultices of charcoal and bark, which will soon separate it, and arrest the mortification. Dropsy. 379 When the difficulty of breathing is considerable, relief will very generally be obtained by expectoration; and for this purpose, pretty large doses of gum ammoniac with the squill, or seneka infusion may be repeated as the occa- sion requires. The infusion of garlic is often useful, and assafoetida, in the form of pills or tincture, relieves the difficulty of breathing when it is connected, as is often the case, with wind in the stomach occasioning hysteric affections. Spasms often arise in particular parts, especially about the chest, frequently awaking the patient out of a sound refreshing sleep. In such cases, a grain of opium with five of camphor is the most effectual remedy. When the duplication of the peritonceum is the seat of dropsy, tapping is alone the remedy. Regimen.—During the inflammatory disposition, or when there is a preternatural heat on the skin, or much action in the pulse, the diet should be light and easy of di- gestion. In the other state, when the patient is weak and feeble, it should be ofthe most nourishing kind, with a liberal use of wine. The patient may, in general, drink in proportion to his inclination. Acid liquors, as lemon- ade, cider, the imperial drink, or wine, or gin and water may be allowed; and thirst is often prevented by holding nitre in the mouth. Exercise is of the greatest importance when not carried to fatigue. In the lowest stage ofthe disease, swinging or riding in a carriage are most proper; but as soon as the patient's strength will admit of it, riding on horseback will be found most beneficial. ©OTTlft Is often hereditary, but generally indolence and luxu- ry the hated parents of this disease, which righteous hea- ven has marked with such severity, that, like the leprosy of Naaman, it is hardly ever curable.* But though art has not often succeeded to cure the gout, yet it has discovered a variety of means to shorten the fits, and render them much more tolerable. Symptoms.—The gout mostly affects the joints, but the viscera are not exempt from its ravages. It some- times comes on suddenly, passing from one part ofthe body to the other, in the twinkling of an eye; but gene- rally is preceded by indigestion, flatulency, loss of appetite, unusual coldness of the feet and legs, with frequent numbness, sense of pricking, and cramp.— These symptoms take jilace several days before the paroxysm comes on, but commonly the day preceding it, the appetite becomes greater than usual. The next morning, the patient is roused from his sleep, by an excruciating pain in the great toe, or ball of the foot, resembling the gnawing of a little dog. Treatment.—No matter what part of the body this disease first seizes, the lancet will be required in every case where there is an increased action of the pulse, to take off the inflammatory disposition. The extent to * An English nobleman, after twenty years riotous living, awoke one morning in the torments of the gout. As he lay writhing with pain, his servant ran up stairs to him with great joy in his countenance: " O ! sir, good news! good news! there is a famous gout doctor below, who says he will venture his ears, he can cure your honour in less than a week." ' Ah ! that is good news indeed, Tom; well run my good boy, and put up his carriage and horses, and treat the doctor like a prince." " O sir, the gentleman has no carriage and horses; I believe he walked afoot!" -'Walka foot! what! cure the gout and walk afoot! go down Tom, go down, and instantly drive the rascal out of the house; set the dogs upon him, do you hear ? the lying varlet! why if he could cure the gout he might ride in a richer carriage than his majesty." Gout. 381 which the blood letting must be carried, can only be ascertained by the violence of the disease, and the sex and constitution ofthe patient. In this, as in all inflam- matory fevers, the bowels ought to be kept open freely by laxative medicines, as castor oil, sulphur, cream of tartar, rhubarb, senna, jalap, or calomel. Indeed a fit of the gout may be oftentimes entirely, and almost in- stantaneously removed by active purging. Even drastic purges need not be dreaded in this disease. Nitre, with diluting liquors, given in such quantities as to excite a gentle perspiration, are of great utility in the inflammatory stage of the disease. After the action of the pulse is somewhat reduced by evacuations, blisters over the pained parts are greatly to be relied on. As soon as the inflammatory state of the gout has subsided, stimulants and tonic medicines, as bark and steel, are the best remedies Laudanum, asther, good French brandy and aromatics, as calamus, ginger, Vir- ginia snake-root, and red pepper, [See Materia Medica] in the form of teas, are all exceedingly useful in this feeble state of the disease, especially when it affects the stomach or bowels. Besides these internal remedies, friction on the stomach and bowels, or the application of cloths wrung out of hot spirits or water, over the pained parts, and sinapisms to the feet, should be em- ployed whenever the gout attacks the head, lungs, bow- els, or stomach. Gentlemen long in the habits of intimacy with this disease, should remember that it is of immense rudeness, and ready on the slightest provocation to quit the toes and knuckles, and seize on the very stomach and bowels of its best friends. They should therefore be constantly on their guard, and keep always by them a vial of sether or laudanum, or a case of good old French brandy;* the latter of wliich is admirable for chasing the gout from the stomach. * For lack of this ammunition, the gallant Wayne was cut off long before "his eye was dim, or his natural heat abated." Late in Decem- ber, 1796, he embarked at Detroit for Presque Isle, but not without his usual supply of brandy, which, however, was all lost, through his ser. vant's carelessness in upsetting his case. On the passage he caught cold, which brought on a violent attack ofthe gout in the stomach; and, 882 Gout. The white hellebore [See Materia Medica] is highly extolled as a remedy in this distressing disease. Regimen.—The diet should be regulated according to the state of the patient. If feverish, and of a pletho- ric habit, the lighest diet ought to be used. If debilita- ted and of a relaxed habit, generous diet should be al- lowed. Exercise, although painful at first, must be freely taken. Prevention.—If the person be plethoric, and has been accustomed to drink freely of wine, and eat hear- tily, he should gradually diminish the quantity of the aliment; particularly every spring and fall, as the dis- ease is more liable to recur at those seasons than at any other time. But in debilitating habits predisposed to the gout, a stimulating diet is most proper, assisted with the use of the rust of steel, bitters or bark. In every case, costiveness should be avoided ; and flannel worn next to the skin is peculiarly proper. Nothing, howe- ver, prevents the disease, more than temperance and ex- ercise.* for want of his usual remedy, he suffered the most excruciating torture until he .reached Presque Isle, where he died early in January, 1797. His body was deposited in the centre ofthe fort, to show the children of future days the grave of him who so bravely defended their liber. ties. Filial piety has since removed it to his native state, where it now sleeps with the dust of his fathers. *• I am happy to acknowledge, that for this anecdote, I am indebted to the politeness of my worthy friend Captain Hugh M'Call, of Savan- nah. * The story of the wealthy Mr. Palmer in the reign of George I. though well known to many, is yet so apropos to our subject, that I cannot deny myself a wish to relate it. Young Mr. Palmer received from his father, what the London merchants call a plum, (i. e.) a round 100,000/- of which he contrived to make such "good use," that by the lime he was forty years of age, he was torn to pieces by the gout.— His physicians advised him to try the virtues of a sea voyage with the soft balmy air of Montpelier. He set out, but on his passage up the Mediterranean, was captured by an Algerine corsair, who took him to Morocco, and sold him for a slave.—He was bought by a farmer, who carried him into the country, and set him to hard labor, allowing him nothing better than brown bread and dates, and even of that hardly enough to support him. His only drink was water, and his only bed a plank. In a few weeks every gouty symptom disappeared, and he recovered his health, with an uncommon portion of activity. These first of blessings continued with him all the time he was in TrasmmAi* usiia The veneral disease is of two species : the one, a local affection of the genital organs, termed Oonorrltaia, or Clap; and the other, a general or constitutional com- plaint, termed Syphilis, or Pox. The Gonorrhoea, Of which we shall first treat, is an inflammation of the mucous membrane, lining the urethra, in men, and the vagina in women; seated in the male about the frsenum ofthe penis, and in the female a small distance up the vagina; but in its progress communicating to all the surrounding parts, and producing a variety of pain- ful sensations. Symptoms.—A discharge of mucus, at first white., but soon turning of a yellow or greenish ajipearance— an acute or scalding pain in making water, with most indecent erections of the penis termed chordee, very painful, and sometimes followed by a discharge of blood.—At times the, inflammation spreads to the conti- guous parts, occasioning strangury, swelled testicle,. swelling in the groins similar to buboes, or a contrac- tion and thickening ofthe fore-skin, which when drawn over the head or nut of the yard, is termed ])hymosis, and paraphymosis when retracted behind it. When these symptoms dance their attendance to the catastrophe, the clap may be said to flourish in its full bloom, and the patient finds himself fairly seated on the stool of repentance. The appearance of a clap in the female is pretty much captivity, (two years,) at the expiration of which, he was ransorrcd by his friends.—On his return to England, he was hardly known by his ac- quaintances, so great was the change which temperance and exercise has wrought upon him. —I!ut alas ! for the lack of fortitude, he soon re- lapsed into his old passion for the rich dishes, flowing glasses, and soft couches of epicurism. His system soon became bloated and relaxed ; and his ancient foe, the gout, returned, and killed him in a short time. 384 Venereal Disease. the same as in the male, allowing for the difference of the parts. The disease in them is always milder, inso- much, that at times there is no other symptom but the discharge, which is often mistaken for the flour albus. They are, however, more subject to excoriations of the parts than the men, and, indeed, when the inflammation is considerable, it often extends to the urethra, and occa- sions great pain. Treatment.—In the general treatment of gonorrhsea.. rest, together with abstinence from strong fo id, and eve- ry thing of a heating nature is of the greatt st conse- quence; and this alone, with little assistance from medi- cine, will complete the cure, in a short period. As the disease is local, topical apjdications jn the form of injections become necessary. The patient should therefore without delay employ one of the injections, See Dispensatory] which in irritable habits, must be a ittle weakened, and the strength gradually increased as the inflammation abates. Indeed, when the inflamma- tion is very considerable, it is better, at first, to inject with sweet oil or mucilage of sassafras, [See Materia Medica] and in such cases, the testicles ought to be sus- pended by a bandage, and the antiphlogistic regimen strictly adhered t», particularly in taking freely of mu- cilaginous drinks, as flaxseed tea, barley water, or the mucilage of gum arabic, and obviating costiveness, by small and repeated doses of cream of tartar. Which- soever of the injections is used, it must be thrown up the urethra six or eight times a day, immediately after mak- ing water, and with a syringe that works easily, that it may not hurt or inflame the parts. It should berob- served, if astringent injections of full strength be used in the early period, they often prolong the disease, and occasion swelled testicles, strictures, and enlarge- ment of the prostate glands; but after the inflammatory state is removed they may be employed with safety, and will be found to facilitate the cure. Frequent bathing the part, and the greatest cleanliness are too important to be neglected; particularly washingunderthegla d , to prevent the accumulation ofthe fluids from the odorife- rous glands; which produces irritation, inflammation, ind often ulcers. Venereal Disease. 385 For the chordee which is more severe during the con- tinuance of inflammation, and occurs mostly in the night, While the patient is warm in bed; take on going to rest a dose of laudanum, or souse the guilty member fre- quently in a vessel of cold water. Should a hemorrhage, sujierveile, it may be removed by rest, and immersing the part often with cold vinegar and water, or lead wa- ter, of the ordinary strength, of which the patient may throw a little up. According to Professor Chapman no remedy suc- ceeds better in the cure of gonorrhea than balsam capivi. He commences with this medicine on the very accession of the disease, regardless of all the ap- pearances of inflammation, such as scalding, chordee, &c. The proper dose is about forty drops, more or less accord- ing to circumstances, to be repeated morning, noon, and night. He directs it to be taken in a little wine, or milk, or if it should act on the bowels or be offensive to the stomach in this way, he advises it to be exhibited, agreeably to the following prescription. Take of bal- sam capivi and sweet spirits of nitre, of each half an ounce, the white of one egg, or powdered arabic and white sugar, each two drachms, mix, and then add laudanum, one drachm, and water three ounces; of this mixture, the dose is a table-spoonful three times a-day. One caution, he suggests, should always be en- joined on patients who are desirous of a speedy cure— An entire abstinence from every heating article of food or drink, and a state of complete repose. He says, contrasted with the ordinary mode of treat- ing it by injection, his plan has several advantages. It is more convenient to the patient—it produces no swelled testicles—it occasions no strictures—it leaves no gleet—it is more prompt and certain in the cure. Of the efficacy of this remedy, coming from such unques- tionable authority, there can be no doubt; but candor compels me to acknowledge 1 have never resorted to it, having uniformly succeeded in the cure of gonorrhsea by injections, as above advised. When the inflammatory symptoms of gonorrhoea in- crease to a violent degree, a swelling or inflammation of one or both testicles sometimes supervenes. The same 49 886 Venereal Disease. consequence is often produced by astringent injections imprudently exhibited. In such cases the general re- medies for allaying inflammation, as blood-letting, cool- ing cathartics, diluent drinks with small jiortions of nitre dissolved in them, become necessary. Besides which, the testicles must be suspended by a bandage, and kept constantly moistened with cloths wrung out of lead water, or cold vinegar and water, often renewed. The swelling of the glands in the groins, and of the spermatic chord itself, require a similar treatment In these affections, a horinzontal posture, ai.d spare diet, are particularly enjoined. In case of much pain with little or no fever, an opiate may be given at bed-time. And if hardness remain after the pain, the patient should have mercurial ointment rubbed on the part, night and morning, and take freely of a strong decoction of sarsa- parilla. But if a swelling without hardness follow, one or two vomits, succeeded by tonic medicines, with the use of the cold bath, will generally cure. In case of phymosis, cold applications to the penis, as lead water or cold vinegar and water, and topical bleed- ing with leeches, constitute the projier remedies. Be- sides which soap-suds should be often injected with a syringe between the skin and the gland, to prevent the stagnation of matter, whose extreme acrimony might otherwise produce a mortification of the parts. When these means assisted by opiates fail, an operation becomes necessary; it is simple, and by no means dangerous. A sharp pointed knife, concealed, and defended by a groov- ed directory, which must be previously introduced be- tween the prepuce and glans, are the only instruments required. The point of the knife should pass through the prepuce at the bottom, and the section be made by drawing it towards the ojierator. Common dressings are sufficient; but linen or lint should be interposed be- tween the glans and the prepuce, to prevent adhesions. Paraphimosis is the opposite disease, where the prepuce cannot be drawn over the head of the penis; and in this case bathing the part frequently in milk and water or soap-suds, and taking some cooling Iaxitive medicine will generally effect a cure. When the inflammation is considerable and long continued, a mixture of syphilitic Venereal Disease. 387 infection may be suspected, requiring a mercurial course. Indeed, these affections frequently originate from chan- cres. Such are the principal symptoms which attend go- norrhoea. Its consequences, which induce a new state of disease, after the original affection is removed, are no less important. Gleet. This is known by a constant discharge of mucus matter, after the inflammatory symptoms have subsided, occasioned by the relaxation of the mucous glands, or stricture in the urethra. A discharge of this kind may also be occasioned by hard drinking, violent exercise, or straining. A discharge of mucus, if not connected with a venereal taint, even when accompanied with inflammation, which have been excited by high living, or violent exercise, is not infectious. Treatment.—Although this disease often yields with great facility to the common remedies, yet, it is some- times peculiarly distressing and obstinate. The remedies generally employed are astringent in- jections; the use of balsam capivi, in doses of thirty or forty drops thrice a day, and tonics of every kind, par- ticularly cold bathing, both partial and general. In obstinate cases the uva ursi[See Materia Medica,]as well as the tincture of cantharides have often succeeded.— None of the remedies should be continued longer than eight or ten days, if they produce no salutary effects.— They often in this time remove the complaint which re- curs on their being discontinued, so that they should be employed long after the discharge has ceased. The tinc- ture of cantharides may be given conjointly with balsam capivi, or alone in common drink. This remedy must be cautiously employed, beginning with very small doses, about fifteen drops of the tincture, which may be gradu- ally increased daily, as in the irritable state of these organs even a common dose may excite dangerous in- flammation. The application of a blister to the sacrum or blistering the urethra, in its course, has sometimes 388 Venereal Disease. succeeded. Upon high authority an obstinate gleet was cured by the injection of punch, a remedy suggested in a convivial moment; at another time by green tea; and again by a decoction of red oak bark. An astringent injection of considerable efficacy in obstinate gleets, is prepared by dissolving twenty or thirty grains of alum in a half pint of water, which should be injected up the urethra, twice or thrice a day. When an ulcer in the urethra, is the cause, which may be suspected, if on pressing the penis slightly erected, between the finger and thumb, one part is found more sensible to the touch than another, the best remedy which has come under my notice in practice, is an injection composed of one or two grains of corrosive sublimate in a half pint of water, or made of sufficient strength to ex- cite some degree of inflammation in the part affected.— If a stricture be the cause, the introduction of a bougie is the only remedy. While the use of a bougie is con- tinued, the discharge usually proceeds, but after three weeks or a month it should be omitted. If the running stops, the cure is usually effectual; if it continues, the remedy should not be repeated. In women, gleets are equally obstinate, but they gen- erally jiass under the appellation offlour albus, or whites- Seminal Weakness, Is another consequence of clap, when there has been frequent returns of it, and is known by an involuntary discharge of the semen. At the beginning of the disease there is a great inclination to erections, and the emis sion of the semen is attended with pleasure; but gradu- ally the penis becomes lame, the testicles hang lower than usual, and unless they are otherwise suspended, become almost a burden to the possessor. Although veterans in the wars of Venus, are most liable to be complimented with this kind of gleet, yet it may originate from other causes, as self-pollution, a sudden lift or strain, hot glysters, straining to stool, or the im- prudent use of strong diuretics. Let the cause, however, be what it will, there is no drain which steals away the quintessence of life and strength more rapidly. Venereal Disease. 389 Treatment.—If the emission takes place on the slightest irritation, as heat, wine, &c. and is attended with some degree of spasm, it is a sign the patient is in a very rampant state, and can hardly get him a wife too soon. But if it oozes away insensibly, cold bathing, and tonic medicines, as bark, steel, or balsam capivi in the usual doses, with a generous diet, are the best reme- dies. Costiveness should be carefully avoided. Obstruction of Urine, Is another formidable symptom, which sometimes suc- ceeds gonorrhoea. It is produced by certain changes of the passage, from tumors seated high up in the urethra or contraction of the urinary canal. Treatment.—When this affection arises from tu- mours, a cure may be attempted, by the use ofthe mur- curial pills, [See Dispensatory] night and morning, and a decoction of sarsaparilla, or mezereon; but it is often incurable. When spasmodic constriction of the passage is the cause, it will be removed by the warm bath or fomen- tations. The penis may also be rubbed with campho- rated oil, [-See Dispensatory] or equal parts of aether and laudanum. If this fail to take off the spasm, bleed, and give laudanum in large doses. 3TOS£» Is the veneral disease in its confirmed state, manifest- ed by chancres, buboes, or warts about the genitals.—■ To these succeed ulcers in the throat, nose and tongue, blotches on various parts of the body, with nocturnal pains, especially in the shin-bones and shoulders. The system is now filled with the horrid poison, which, unless mercifully arrested, will soon ulcerate the eyes, consume the nose, contract the body, and convert the loveliest form into such a mass of corruption, such a dunghill of stench, such a picture of ghastliness, as is sufficient to strike the guilty person with terror. 390 Venereal Disease. A pallid youth, beneath a shade, A melancholy scene displayed; His mangled face, and loathsome stains, Proclaimed the poison in his veins; He raised his eyes, he smote bis breast, He wept aloud, and thus addressed, "Forbear the harlot's false embrace, Though lewdness wear an angel's face; Be wise by my experience taught; I die, alas! for want of thought." Cotton ELEGY. *wmwm» Is an eruption that attacks various jiarts of the skin, in a circle, with an inflamed basis, which gradually .spreads, forming an extensive excoriation, sometimes moist, at other times dry; and is attended with smarting and itching, succeeded by scurfy scales. Treatment.—If the habit of body be not faulty, exter- nal applications alone, are often sufficient to remove this affection. The saturated solution of borax, with vinegar or lemon J juice, one drachm to an ounce ofthe acid, is an excellent re- ' medy, without producing the least pain on its application. ' The itch lotion, when prepared with double its strength, is also equally good. Covering the eruption daily with ink, or the juice of black walnut, [.See Materia Medical nas often effected a cure. Where the disease is inveterate, internal medicines must be exhibited and continued for some time, such as lime-water, flour of sulphur, the mercurial pills, or which is preferable to all of them in obstinate cases, the solution of arsenic. [See Dispensatory.] 399 Hsstiiife « mjmm wmM>w< Symptoms.—This disease consists of little ulcers at the roots of the hair, wliich discharge a humour that dries in- to a white scab, or thick scales, and has an offensive smell. It is not only a very troublesome complaint, but contagious, and when united with a scrofulous, constitu- tion, found extremely difficult to be cured. Treatment.—When it is merely a complaint of the 3kin, it may be successfully treated with topical applica- tions. In the beginning ofthe affection, washing the sores well night and morning with strong soap-suds, or a de- coction of tobacco, or by applying an ointment, made with jimson-weed, or pride of China, [See Materia Medi- ca] will frequently effect a cure. But if the disorder prove obstinate, the head ought to be shaved, and after being well washed with soap-suds, covered with tar and suet, spread on a bladder. My very ingenious friend Doctor Chapman, has assured me, when every other ap- plication failed in removing this disease, he always suc- ceeded, by having the affected parts washed with the fol- lowing lotion twice a-day:—Take liver of sulphur, three drachms—Spanish soap, one drachm—lime water, eight ounces—rectified spirits of wine, two drachms—mix. But in cases where topical applications are resisted, medicine should be given internally, as lime-water, flour of sulphur, or calomel, according to circumstances; and to hasten the cure, the course ofthe fluids may in the mean time be in part diverted from the head, by blisters or sinapisms. 400 This disease is most frequent among the children of the poor, and negroes, who are ill fed, ill lodged and ill clothed; it is also hereditary, but never contagious. It most commonly occurs in children from the third to the seventh year; frequently, however, it discovers itself at a later period in habits peculiarly disposed to it. Symptoms.—It is known by indolent hard tumours ofthe lymphatic gland particularly those of the neck, be- hind the ears, or under the chin. The upper lip, and division ofthe nostrils are swelled, with a smooth skin, and hard belly. In the progress of the disease, these tumours degenerate into ulcers of bad digestion; the discharge of wliich consists of a white curdled matter, resembling somewhat the coagulum of milk; and previous to their breaking, they acquire a sort of purple redness, ind a softness to the touch. Treatment.—As soon as these tumours are first dis- covered, endeavor to disperse them by sea bathing, or bathing in salt and water, one pound to three gallons of water, or cold water alone, or by frequent application of lead water. Warm fomentations and poultices of ev- ery kind do harm, as they seem only to hurry on a sup- puration, which, if possible, should be prevented.—A draught of sea water every morning is a useful drink. Peruvian bark and steel used alternately every two weeks, or the nitric acid will be of infinite service by giving tone to the system. The remedy, however, most to be depended upon in this disease, is the muriate of lime, given in doses of ten to eighty drops, gradually in- creased, three or four times a-day, diluted with water or tea. When a suppuration takes place, the solution of arsenic should be given twice or thrice a-day. The best application to scrofulous ulcers, is a powder composed of one pound of finely powdered bark, and one ounce of white lead in fine powder, mixed well together; or a fine Jaundice. 40 i powder of calamine-stone alone, and the ulcers covered with it daily, keeping it on by brown paper and a bandage. Where these are not to be obtained, the constant applU cation of linen rags moistened with a solution of one ounce of sugar of lead, in a pint of water, may answer every purpose. With respect to the diet, it should be nourishing and easily digestible, avoiding all viscid food. Moderate ex* ercise in a dry warm air is exceedingly beneficial. $Awmwmm» Symptoms.—Yellowness of the skin, but chiefly of the eyes, the urine also yellow—inactivity—anxiety and uneasiness at the pit of the stomach—itchiness of the skin. Causes.—Whatever obstructs the passage ofthe bile, through its natural channel. Treatment.—The indications of cure are, to re« move the obstructions, which, as it originates from dif- ferent causes, will require different modes of treatmeut. As viscid bile is the most common cause of this com* plaint, in full habits, and where there are any feverish symjitoins, begin the cure with bleeding, afterwards give an emetic, and then a day after a dose of calomel and jalap, which should be often repeated if necessary. Com- mon soap in large quantities has been exhibited with much success in this case, but as this is disagreeable to take, the salt of tartar, which has the same advantage, or soda, may be taken in doses of twenty or thirty grains, three or four times a-day, dissolved in the infusion of columbo. If there be any acute pain in the region ofthe liver, with a quickness of the pulse, bleed more freely, give one ofthe mercurial pills, [See Dispensatory] night and morning; 51 402 White Swelling. until aptyalism is produced, use the warm bath, and ap- ply a blister over the pained part. In cases of much pain, three or four table-spoonfuls of olive oil should be swallowed, and if it do not succeed in quieting the jiain, one or two tea-spoonfuls of tether, or thirty drops of laudanum must be given. The warm bath, or bags of hot salt applied to the right side, are likewise beneficial. After the obstruction is removed, the columbo or nitric acid, tonic powders or pills, or dogwood, or cherry-tree bark, [-See Materia Medica,] with porter and wine are ne- cessary to restore the tone of the system. Regimen.—The diet ought to be regulated according to the constitution of the patient. In jilethoric or fe- verish habits, the diet should be low, and in cases of excessive debility it should be ofthe most nourishing kind. Vegetables, by creating flatulency and acidity, are to be avoided. Mucilaginous drinks are peculiarly proper; and in many instances, sucking a new laid egg every morning, on an empty stomach, has succeeded in curing this disease, when all other means failed. ¥IIfl EWmMMB® Is distinguished by an acute pain, without any exter- nal inflammation, of a joint, attended with a gradual in- crease of its size. Though all the joints are occasion- ally subject to it, yet its most usual seat is in the knee. White swellings are generally of a scrofulous nature, but sometimes they are produced by rheumatic affec- tions, and sometimes follow strains that have been neg- lectedi or badly treated. Treatment.—As soon as an affection of this kind is discovered, the patient should remain in bed, and the limb kept perfectly at rest, without which, remedies can- not produce any good effect. The great object is to prevent the formation of matter, Sea Sickness. 403 by the immediate application of leeches, or scarifications to the part affected, and by which, eight or ten ounces of blood may be taken away, every other day, or oftener, ac- cording to circumstances. The whole joint should then be kept continually wet and cold with the solution of crude sal ammoniac, [See Dispensatory] by means of four or five folds of linen. After the local affection is somewhat abated, frictions with the volatile liniment, or a mixture of soft soap and spirits of camphor, to which may be add- ed some tincture of cantharides, will have a good effect. With one or other of these liniments, the joint is to be rubbed well twice a-day, and afterwards covered with a piece of flannel that has been soaked in the same. If this should not produce good effects, the part must be rubbed night and morning with mercurial ointment, in the quantity of two drachms at a time, and continued until the mouth is gently affected. The cure may then be completed by small blisters on each side of the joint, which should be kept running for a length of time. If the disease in spite of these remedies continue to advance, emollient poultices must be applied often, un- til various abscesses appear, and these should be opened as soon as they seem to point, and afterwards to be treat-' ed as ulcers. In cases where the white swelling is evidently scrofu- lous, tonic medicines, as bark, steel, &c. and a nourishing diet, to correct the constitutional affection, with stimu- lating applications to the joint, form the best remedies. Symptoms.—A most unpleasant giddiness, with great nausea and vomiting, occasioned by the motion of the vessel. The duration of this complaint is very uncertain. Generally it lasts but a day or two, but in some cases it will continue a whole voyage. 404 Intoxication. Treatment.—Though time, perhaps, is the only cure, yet it will be greatly alleviated by keeping the bowels open. A tea-spoonful of sether in a glass of wa- ter, relieves the convulsive affection ofthe stomach.— High-seasoned food and acidulated drinks are peculiarly proper. But nothing will be found more serviceable than exercise, cheerfulness, and fresh air. Persons should, therefore, never go below, but romp on the decks, cut capers in the shrouds, and divert their minds, and move their bodies as much as possible. Symptoms.—Like every other kind of frenzy, it comes on with a burning redness ofthe cheeks—a swell- ing of the jugular veins, and a fiery wildness ofthe eyes. The tongue is considerably affected, but very differently in different stages of the disease. At first, only glib and voluble—then loudf and louder still—at length noisy and excessively disagreeable. The patient now is quite on his top-ropes, and nothing goes down with him, but the most ranting songs, roaring laughs, ripping oaths, and bluntest contradictions, accompanied with loud thumping of the fist on the table, especially if politics be the topic of conversation. There is no complaint that effects pa- tients so differently—some it makes so ridiculously lov- ing, as to hug and kiss one another—others It kindles into such rage and fury, that they will frequently throw the bottles and glasses at the heads of their best friends. And indeed, so wonderful is its influence, that it is no uncommon thing with it, to inspire cowards, with cour- age—to teach truth to liars, and to make persons natu- rally reserved, loquacious, and even boisterous. The memory now partakes of the general infirmity, being hardly able to connect the parts of a story begun. The tongue at length, as if about to lose its powers, be- gins to trip—then to stammer—and at last the utterance To Recover Persons apparently Drowned. 405 dies away generally in some idle half finished threat or oath. Hiccups now ensue, with a silly grin of the mouth, which continues half open, from the falling of the lower jaw. The face puts on an air of great stupidity—the eyes turn heavy and sleepy, and the patient begins to nod, with his head bending forward, until, becoming too heavy, he sinks under the table, and not unfrequently after a filthy vomiting, falls asleep among the dogs and cats. Treatment.—In a fit of drunkenness, the patient should instantly be jdaced in an airy situation, the head and shoulders kept erect, and the neck-cloth and collar of the shirt unbound, and copiously bled, if his situation seems alarming. The next step is to provoke vomiting, by the most expeditious means, such as tickling the throat with a feather or the finger. Cold applications to the head, as cloths rung out of cold water, or vinegar and water, often renewed, will have the happiest effect; so will plung- ing the body into cold water, for many instances have occurred of persons having fallen overboard in a drunken fit, and having been picked up sober. Therefore, it will be found an admirable mode of so- bering those vagabonds, who, as a nuisance, infest the streets of every city, to take them to the nearest pump, and there deluge them with cold water. This will not only bring them to their senses, but send them off, under that sense of shame, which ever follows the commission of a crime so truly ignominious. TO recover persons As soon as the body is taken out of the water, it should instantly be rubbed dry, and wrapped in warm blankets, unless the cooling process should be first ne- cessary, in consequence of the patient being in a half frozen state. For, in that case, the body ought to be rubbed with snow, or flannels wrung out of cold water 106 To Recover Persons apparently Dead. or vinegar, before any degree of artificial warmth ia applied. After which the patient is to be placed on a bed or mattress, with the head elevated, and air is then instantly to be blown into the lungs, by inserting the pipe of a pair of bellows into one nostril, or for want of that article, a tobacco pipe, a quill, or even a card folded in the form of a tube, while the mouth and oppo- site nostril are closed by an assistant, or covered with some wet paper. By thus forcing air into the lungs, and alternately expelling it by pressingthe chest, respira- tion may happily be restored. Volatile salts, or vinegar, should also frequently be applied to the nostrils. Next the intestines are to be stimulated by injections of warm spirits and water, or mulled wine. It will be more effectual still, if some warm spirits and water be introduced immediately into the stomach, by means of a syringe and a long flexible tube. While using the inter- nal stimulants, a bladder of warm water should be ap- plied to the region of the stomach, and the legs and arms briskly rubbed with a warm hand, or with flannel, ex- tending the friction gradually to the thighs, belly, and chest. At that critical period, when sneezing, slight twitch- ings, or gasping, mark the first dawn of returning life, it will be prudent to moderate the stimulating powers. When respiration and the power of swallowing are re- stored, the patient should be kept moderately warm, and gentle perspiration encouraged by warm drinks. Should feverish symptoms ensue, moderate bleeding, together with mild laxatives and cooling regimen, will complete the cure. Apparently Killed by Lightning, or Noxious Vapours. Treatment.—Instantly throw cold water with some force, in large quantities, on the face and head, which should be often repeated for some time, and if conveni- ent the whole body may be plunged into cold water, and Poison. 407 afterwards wiped dry, and warmth gradually apjdied. If the body and the extremities feel cold, instead of the application of cold water, the warm bath about the tem- perature of the blood, should be prepared as soon as possible, and the patient immersed in it for twenty or thirty minutes, using frictions at the same time with the hand. As soon as the patient is taken out of the bath, his skin must be wiped dry, and wrapped up in warm flannel, and gentle stimulants employed to produce a re- action. When by these means the circulation of the blood ie increased, and the extremities become warm, bleeding will be proper, and must be often repeated, if the patient have fever, or complain of pain. Besides which, evacu- ations must be procured by purgative medicines and glysters, and the antiphlogistic plan in every respect strictly pursued, until the febrile symptoms abate. Af- ter w hich tonic medicines, with wine, in case of debility, are of infinite service. wmmm Treatment.—The cure of poisons swallowed, whe- ther vegetable or mineral, requires either an immediate evacuation, or a counteraction of their effects. There- fore, as soon as possible, throw in an emetic, quick in its operation, as blue or white vitriol in a dose, from five to twenty grains, repeated in fifteen minutes, if necessary, and assisted by copious draughts of warm water. To remove the stupefaction, which generally ensues after an imprudent dose of opium, acids ofthe vegetable class, as lime juice, or vinegar diluted with water, ought to be exhibited freely. But if the patient lay in a deadly stupor, with cold extremities, the warm stimulating plan must be first adojited. Sinapisms or blisters ought in- stantly to be applied to the extremities; or as a more effectual remedy to produce reaction in the system, the legs and arms should be whipped well with rods, and the soals of the feet seared with a red hot iron. 408 Bites of Musquitoes and Venomous Animals. It appears from incontestible exjieriments that the white of an egg beat up with cold water is the best anti- dote against corrosive sublimate and the other mercurial preparations. The whites of twelve or fifteen eggs, are directed to be beat up and mixed with two pints of cold water, and a glass full taken every two or three miiutes, so as to favour vomiting. In defect of eggs, milk and muciligenous drinks may be used with great success.— The same method may be pursued in case of arsenic or any metallic salt has- been taken. A drink composed of equal parts of lime water, and sugar and water should also be given when arsenic has been swallowed. Unless these remedies are quickly resorted to death with inevit- ably take jdace. Should fever supervene, the antiphlo- gistic treatment must be jiursued. The application o tobacco will assist the operation of an emetic [See Materia Medica.] For the piosonous effects of lead. -See Vine. Muso.uito bites often degenerate into painful acrid ul- cers, particularly on the legs, in consequence of scratch- ing them. It is therefore proper, where these insects are troublesome, to wear loose linen buskins to guard the legs in the evening; and when this has been neglected, apply oil, vinegar, lime juice, or camphorated spirits, to the part, to allay the itching and tingling occasioned by their bites. &:m Treatment.—The bites of all venomous animals are cured by the same means, which are very simple, if the remedies were always at hand. The caustic volatile al- kali, or eau de luce, is a certain antidote against the bites or stings ofthe most venomous serpents or spiders. Sites of Venomous Animals. 409 Lint wetted with either of these should instantly be ap< plied to the injured part, and renewed as it becomes dry. A tea-spoonful of the same medicine must also be given to the patient in a little water* every hour or oftener, as may be indicated by the symptoms. Lunar caustic possesses the same admirable virtue, and should always be employed, when the other medicines are not at hand. The best mode of using it, is to dis- solve five or six grains of the caustic in two or three ounces of water, and keep the affected parts moistened with it, as above directed. Some of the same ought al- so to be given internally, only in a more diluted state. When these remedies cannot be procured, a cataplasm made of quick-lime and soap, should be applied to the bitten part, and as much Cayenne, or red pepper, mixed in spirits, swallowed every hour or two, as the stomach can possibly bear. The juice of plantain and hoar-hound, in doses of a table-spoonful every hour or two, is considered a good remedy against the bites of venomous serpents, as is also squirrel ear. [See Materia Medica.] As soon as a person is bitten by a poisonous animal, a tight ligature should be made above the injured part, until suitable remedies can be employed. When the toe or finger is bitten, cutting it off immediately will jirevent mischief from the poison. It is also a fact that sucking the wound, immediately af- ter being bitten, will arrest the progress of the poison. This was lately verified in the neighborhood of Augusta, in the case of a youth who was bitten by a rattlesnake, and the wound being instantly sucked by a man jiresent pre- vented its mischievous effects; nor did any injury result to the operator. When this remedy is resorted to, it may be prudent forthe operator to guard his mouth with sweet oil or milk, and not swallow the saliva. It should never be attempted by a person with a sore mouth or very bad teeth. 52 410 OR THE BITE OF A MAD DOG. This disease is so dreadfully alarming at all times,. that we ought, as the best means of security, to endeav- our to prevent it. Therefore, as the infection of a rabid animal is con- veyed by his teeth into the wound, the sooner it is re- moved, the less chance is there for absortion. Conse- quently, the bitten part should immediately be washed, and where it can be cut out, or burnt with a hot iron, deeper and m«re extensive, than the wound itself. After which, the wound should be filled with mercurial ointment. and kept open for some time. In addition to this treatment we should diligently em ploy mercury, both internally and externally, to excite a salivation. Opium, in such doses as are given in teta- ny, has been said to produce beneficial effects. It is probable, the caustic volatile alkali, might prove an antidote against the poison of a rabid animal, as that of the most venomous serpents. The scull-cap, chick-weed, and emetic weed, [See Materia Medica] are considered valuable remedies in this dreadful disease. The most certain remedy, however. is to cut out the part; and this is certain at any period previous to the inflammation. If the wound is inflicted so deep that the bitten part cannot be separated, a cans tic must be applied to what remains. This disease is frequent among the new negroes, and is pretty uniform in its appearance. The patient is at first sensible of an itching, and on examining the part, a small blister is generally to be perceived. Frequently two or three of these blisters manifest themselves; and at times the part has the ap- Swallowing of Pins. 411 pearance of being stung with nettles. Beneath these blisters, or other affections, on raising the skin, there appears a small piece of mucus, on removing which, the head of a worm is to be seen. It is generally firm- ly fixed, and requires force to detach it from the parts beneath. When once separated with the forceps, it can be twisted round a ligature, or a piece of lint, and by this means a portion of it, a foot or two in length, may be extracted in the course of one day. In its appearance, it resembles what is called bobbin, or small tape, and is of the same size. It is transparent and moist, and appears to contain something like a white liquid. As much of it as will come away without pulling is daily to be extracted. It is always dangerous to use force, on account of the risk of breaking the worm.— When this accident happens, it occasions the most acute pain, accompanied with swelling and inflammation ofthe neighbouring parts; and these symptoms will often con- tinue for two or three weeks. In this case the worm also takes a different course, and soon throws itself into another part. IWfflllWSW board, rolled gently with a linen roller: and in fractures of the fore arm, the limb preserves its natural length or form; it requires merely to be laid upon a long splint of paste-board, with a small splint laid above, the two splints being secured with light ribbons or tapes, and the arm from the elbow to the fingers' end's supported by a sling or handkerchief round the neck, raising the palm of the hand to the breast, with the fingers moderately bent. When the arm is fractured between the elbow and shoulder, the fore arm may be placed in the same posi- tion, as already described; but the sling, instead of sup- porting the whole length of the arm, should only support the hand, which should be raised higher than in the for- mer case, the elbow being allowed to sink; its motion, however, being prevented, by a handkerchief passed mode- rately tight round the trunk, including the fractured arm. When the small bones happen to be fractured, they must be replaced and retained in their situation, by splints and bandages fitted to the part. In using splints of paste- board or untanned leather, it is always necessary they should be applied in the first instance wet, so as to assume the form of the fractured part. After the first fortnight, the dressings should be occasionally removed to allow some motion of the joints; and then replaced, and daily removed for the same purpose. When there is an external wound, communicating with fhe cavity ofthe fracture, it is termed a compound frac- 440 Fractures of the Ribs. ture. This sometimes occurs by the protrusion of the bone; at other times by the same force which caused the fracture. In such cases, the bone is to be reduced by carefully attending to the posture of the limb, and by dilat- ing the wound, when the boiie becomes girded in it. The wound is then to be dressed with dry lint, in order to al- low the blood to coagulate, which will form a kind of scab, and every effort should be made to unite the wound by the first intention, thereby converting the accident to the state of a simple fracture. Almost all fractures are attended with contusion and consequently swelling; the abating of which is the first step that should be taken towards the cure, and is to be effected by bleeding, if the patient is of a plethoric habit, by mild purges, a cooling regimen, and by the exhibition of the anodyne sudorific drops, as already described: the application to the parts affected should be vinegar or lead- water, with crumbs of bread, or poultices made of stale beer or vinegar and oatmeal, with a little oil to prevent their growing dry or stiff. The swelling ofthe limb being subsided, and the callus formed, cold water may be poured through the spout of a tea kettle oyer the fractured limb every morning to re store the tone ofthe injured parts. The ribs are broken, for the most part, near to the mid die. The accident usually jiroceeds from blows or falls; and is known by an acute pain in breathing, and a crepitus or grating being perceived, on pressing the rib in differ- ent places. By carefully passing the hand over the rib, the inequality produced by the fracture may be sometimes distinctly felt. Coughing jiroduces a crepitation, which is frequently perceptible to the patient himself as well as to the by-standers. The only treatment necessary, in simple fractures of the ribs, whether one or several be broken, is to keep the part, during the reunion, as much as possible in a state of Blood-letting. 44i i'est. This is done by counteracting, to a considerable extent, their motion in-respiration. To effect this, a ban- dage, six inches wide, is to he passed repeatedly round the chest, as tightly as the patient can suffer it to be drawn* Its slipping down may be prevented by means of a shoul- der strap. Or instead of a roller, a jacket, of strong linen, capable of being drawn very tight, by means of tapes, may be used. Until the reunion be completed, the patient should be kept as quiet as possible. If the lungs be wounded by a splinter of the rib, blood will be spit up, and high fever and inflammation will be likely to ensue. In this case, blood must be drawn copiously from the arm; and the patient be treated, in all respects, as if he were labouring under pleurisy. The art of opening a vein, and the necessary cautions respecting the operation, should be learned by every one; since cases of emergency may happen, when the necessi- ty of its being performed is evident, and where life may be lost before medical assistance can be obtained. Ano- ther qualification necessary to be possessed, is that of be- ing able to stop the flow of blood from a vein thus opened. To bleed, you are to apply a ribbon or ligature with a degree of tightness, an inch or two above the elbow joint; and as soon as a vein is conspicuous, place the thumb of your left hand about an inch below the place of your punc- ture, and then with your right hand, holding the lancet firm betwixt your thumb and fore finger, make an incision obliquely into the vein, without changing its direction, or raising the handle, lest the point, being lowered in proportion, should cut the under part of the vein, or per- haps even wound an artery.* •To "discriminate between an artery and vein, is a matter of the ut- most importance. This is readily done if proper attention be paid;— 56 442 Blood letting. When the quantity of blood you wish is drawn, untie the ligature, and close the orifice. To accomplish this, let the thumb be |daced on the orifice, so as to bring its sides together, and to press it with a moderate force.— The flow of blood will now be stopped, and the ojierator, with the hand, must apjily a compress, made by twice doubling a piece of linen about two inches square, between the orifice and his thumb; over this place another coin- press, three or four inches square, of a thickness suffici- ent to fill uj) the hollow of the bend ofthe arm, confining the whole with a ribbon or tape, passing over the com- press, and above and below the elbow, in the form of a figure eight, finishing with a knot over the compress. If the bleeding continue obstinate, the sleeve of the gown or coat above the orifice, ought to be ripped or loosened; and if this do not succeed, the lips ofthe inci- sion should be brought nicely together; and while they are compressed firmly by the thumb of the operator, the coldest water should be poured on the arm, or the orifice washed with sharp vinegar. The placing of a piece of adhesive plaster over the orifice in the vein generally succeeds in checking the flow of blood. To bleed in the foot, a ligature must be applied above the ankle joint, and after opening the most conspicuous vein, if the flow of blood is not copious it may be increas- ed by immersion of the part in warm water. On remov- ing the ligature, the blood will readily cease to discharge, and a piece of court-plaster is the best bandage. Topical blood-letting is executed by the apjdication of leeches, as near as possible to the part affected, or by a scarificator, or an instrument with a number of lancets acted upon by a spring. When leeches are employed they must he previously prepared by drying them, or allowing them to creep over a dry cloth: and the part to attract them should be moistened with cream, sugar, or blood, and they confined on it by applying a wine-glass over them. The chief mark of distinction is, that the artery has a pulsation, which the vein has not. But frequently it happens, that an artery lies so immediately under a vein, that its pulsation may be felt through the vein. In such cases it will be prudent not to open the vein unless the operator is skilful; for it must be attended with danger. Blood-letting. 443 When the scarificator is used, so soon as a wound is made, a cup exhausted of its atmospheric air, by burning over it for a few seconds, a bit of soft paper dipt in the spirit of wine, and on the flame of which being nearly ex- hausted, must instantly be applied over the scarified part; when full, it is easily removed by raising one side of it, to admit the air. When you have taken away in this man- ner a sufficient quantity of blood, the wounds are to be co- vered with some cream or mild ointment. In the operation of blood-letting, certain morbid con- sequences at times arise, which demand a special treat- ment. . The most common of these are a swelling of the part termed eccymosis, and when it occurs, shifting the position of the arm, so as to induce a free discharge, will lessen the tumour, if not entirely remove it. Should this fail, com- presses dipt in the solution of sal ammoniac or brandy are to be applied. These also failing, and the swelling still continuing without any diminution, the tumour must be opened, and after removing the coagulated blood, the sore is to be treated as a common wound. This result, however, very rarely occurs. Another consequence which sometimes follows blood- letting is an acute pain, immediately felt on the introduc- tion of the lancet, and communicated from the part to the extremity of the member. The treatment of this com- plaint consists in the early use of cloths, wrung out of lead-water, applied to the part, and adopting in every respect the antiphlogistic plan, as blood-letting, cooling cathartics, and a low diet, to obviate inflammation. This treatment notsucceeding, laudanum must be given in large doses, which also failing a free division of the nerve or tendon, which was pricked with the lancet, is the only remedy left. The last accident required to be noticed, is the wound- ing of an artery, which is known immediately after the operation, by strong compression of the vein, above and below the orifice, by the tremulous motion in which the blood flows, and by not being able to stop the discharge as usual. The cure of this affection may be attempted in the early stage by compression, and observing the an- tiphlogistic regimen. On their failing, the tumour must 444 Issues. be extirpated, and then the ends of the vessel secured by means of a ligature until a reunion ofthe parts is affected, when the circulation is made to pursue a different chan- nel. These are a kind of artificial ulcers, formed in differ- ent parts of the body, for the purpose of procuring a discharge of purulent matter, which is frequently of ad- vantage in various disorders. Practitioners were form- erly of opinion that issues served as drains, to carry off noxious humours from the blood; and therefore they placed them as near the affected part as possible. But as it is known that they prove useful partly by the quan- tity of matter which they produce, and partly by sympa- thy, they are generally placed where they will occasion the least inconvenience. The most proper parts for them are, the nape of the neck; the middle, outer, and fore- parts of the shoulder; the hollow above the inner side of the knee; or either side of the backbone; or between two of the ribs; or wherever there is a sufficiency of cel- lular substance for the protection of the parts beneath. They ought never to be placed over the belly of a mus- cle; nor over a tendon or thinly covered bone; nor near any large blood-vessel. The issues commonly used, are the blister-issue, the pea-issue, and the seton or cord. When a blister-issue is to be used, after the blister is removed, a discharge of matter may be kejitup by dress- ing the part daily, with an ointment mixed with a little of the powder of cantharides, or Spanish flies. If the discharge be too little, more of the powder may he used; if too great, or if the part be much inflamed, the issue- ointment may be laid aside, and the part dressed with bascilicon, or with common cerate, till the discharge be diminished, and the inflammation abated. It is sometimes most proper to use the issue-ointment, and a mild one, alternately. A pea-issue is formed either by making an incision Issues. 449 With a lancet, or by caustic, large enough to admit one or more peas; though sometimes, instead of peas, kid- ney-beans, gentian-root, or orange-peal, are used.— When the opening is made by an incision, the skin should be pinched up and cut through, of a size sufficient to re- ceive the substance to be put into it. But when it is to be done by caustic, the common caustic, or lapis infernal- is of the shops, answers best. It ought to be reduced to a paste with a little water or soft soap, to prevent it from spreading; and an adhesive plaster, with a small hole cut in the centre of it, should be previously placed, and the caustic paste spread upon the hole. Over the hole an adhesive plaster should be placed, to prevent any caustic from es- caping. In ten or twelve hours the whole may be remov- ed, and in three or four days the eschar will separate, when the opening may be filled with peas, or any of the other substances above mentioned. The seton is used when a large quantity of matter is wanted, and especially from deep seated parts. It is fre- quently used in the back of the neck for diseases of the head or eyes, or between two of the ribs in affections of the breast. When the cord, which ought to be made of threads of cotton or silk, is to be introduced, the parts at which it is to enter and pass out should be previously, marked with ink, and a small part of the cord being besmeared with some mild ointment, and passed through the eye of the seton-needle, the part is to be supported by an assist- ant, and the needle passed fairly through, leaving a few inches of the cord hanging out. The needle is then to be removed, and the part dressed. By this method matter is produced in quantity proportioned to the degree of ir- ritation applied; and this can be increased or diminished by covering the cord daily, before it is drawn, with an irritating or mild ointment. i 44? ADMONITORY mras »© i^tos Light were my task if every gentle breast Owned the just laws of native truth imprest; For not by hopes of vain applause misled. In reason's injured cause alone I plead. 'Tis you to judge; nor I that judgment fear If truth be sacred, and if virtue dear. Roscos. If we consider but for a moment the wonderful power which superior beauty in woman exerts over the human breast; how instantly on the approach of its possessor, the hearts of the young are thrown into the most delight- ful palpitations, and the looks ofthe aged brightened with admiration and pleasure; we can no longer wonder that it should be so highly prized by the sex.' But it is to be lamented, that the most preposterous means should be em- ployed to gain a property so desirable, and that real beauty should be so often abused. Thus, some girls fancy that beauty can only exist in forms slender and delicate. At the very thought of being corpulent, they are alarmed, and to obviate grossness, as they call it, they drink such quantities of vinegar that not only destroys the tone of the stomach, but introduces a withered ghastly paleness. For the same purpose they continue the absurd practice of wearing jackets or cor- sets so oppressive as by compressing the ribs prevent the expansion of the lungs. Another imprudence, and still more detrimental, is that of appearing at assemblies, in winter, in light dresses, exposed to the baneful effects of cold, with the aggravat- ing addition of extraordinary warmth, by the fatigue of 448 Admonitory Hints to Ladies. dancing; hence consumptions, and a train of maladies tot long to be here particularly described are produced. Motives of delicacy, as well as regard for health, have been repeatedly urged in vain to enforce the necessity of relinquishing these destructive habits; the arguments of the moralist and ofthe physician having alike failed to convey conviction, and hundreds, who would now have shone forth among the loveliest of their sex, have been dressed in shrouds, because "in an evil hour" they laid aside those articles of their apparel which health, as well as decency, forbade them to relinquish. There are others who, reading of the fair skinned belles of Europe, foolishly conclude that the rose and the lily are the only colours of beauty. Catching at this female passion for fair and unfreckled faces, the quacks have prepared a number of nostrums, called cosmetics or beautifiers, which, they vauntingly profess are to heal the chops on the lips—to remove pim- ples and freckles—and to give the countenance such a fair, smooth and charming appearance, as to render it impossible for any one to contemplate it without being enamoured. But unfortunately, these boasted cosmetics, instead of heightening the polish and charm of beauty, too often contribute to tarnish and destroy it.* The truth is, beauty is not the creature of a quack, but the gift of na^ ture; anil to bring it to perfection, nothing more is neces- sary than exercise, cleanliness, temperance and cheerful* ness. These are the handmaids of health; and health, to persons of certain symmetries and expression, is beauty. ----------------------The rural wilds Invite; the mountains call you, and the vales, The woods, the streams, and each ambrosial breeze That fans the ever undulating sky; A kindly sky! whose fostering power regales Man, bea9t, and all the vegetable reign. Armstrong. * To such ot my readers as are partial to the use of cosmetics, an in- fusion of horse-radish in milk is recommended as one of the best and saftest. Another innocent preparation for clearing the skin of pimples, and recent eruptions, is the expressed juice of house-leak, mixed rith an equal quantity of sweet milk or cream. When these fail, blistering the face all over the eruptions will often succeed in removing them. Admonitory Hints to Ladies 449 How much then is it to be deplored, that so many of our young females should think so meanly of exercise, which alone brings the female frame to perfection—paints it in the loveliest colours—and by giving richness to the blood, and vigour to the nerves, disposes to habitual cheer- fulness, and alike qualifies the mind for thought, and the heart for love. On the contrary how different is the female who leads an inactive and sedentary life, too generally looked on as proofs of a fine modern lady, which seldom fail to relax the system—retard the circulation—vitiate the blood, and obstruct the secretions. Hence, that chalky j;aleness ol the face—that faintness of the eyes—indigestion—flatu- lence—weak nerves—low spirits—irregularities of nature and constant complainings. The grand discharge, th' effusion of the skin Slowiy impaired, the languid maladies Creep on, and through the sinking functions steal. Armstrong. Yes, many a girl by constant muffling and housing her- self; by dreading that the sun should ever kiss her cheeks, or the wind ruffle her tuckers; by much indulgence in bed, and other imprudencies, renders herself so exceed- ingly pale, delicate, and puny, that her ajipearance is better fitted to damp love than to excite it. "The vigour sinks, the habit melts away; The cheerful, pure, and animated bloom Dies from the face, with squalid atrophy Devoured." 5T 450 MANAGEMENT OF MENSTRUATION. One of the principal constitutional characteristics of the female, is menstruation, or the monthly evacuations peculiar to the sex. This important operation generally takes place about the age of twelve or thirteen, but varies through the world, either in degree or frequency, both from constitu- tion and climate. Women in the higher ranks of life, and those of a de- licate nervous constitution, are subject to sickness, head- ach, and pains in theback and loins, during the period- ical evacuation. Those of the lower rank, inured to ex- ercise and labour, and strangers to those refinements which debilitate the system, and interrupt the functions essential to the preservation of health, are seldom ob- served to suffer at these times, unless from general indis- position, or a diseased state ofthe womb. After the discharge has become established, it recurs periodically while in health; and its recurrence is so re- gular that it can be calculated with great exactness— The usual period of its visitations is from twenty-seven to thirty days. As to the time of its continuance, this is various in different women; but it seldom continues longer than six days, or less than three, and does not cease suddenly, hut in a gradual manner. Its approach is generally jireceded by certain feelings of oppression or deviation from the ordinary state of health which warn the individual of what is to happen. There is, in particular, a sensation of fulness about the lower part of the belly, and of relaxation about the uter- ine system, which can scarcely be overlooked by the most Menstruation. 45 i heedless. It must at the same time be admitted, that in some few constitutions those feelings are so inconsidera- ble as to be little attended to, so that the woman mixes in society as usual, without any apparent inconvenience. It is of importance for women to know that occasional irregularities are not always the consequence of disease. Constitutions vary asmuchin resjiect to the regular returns of this discharge, as they do with regard to its first appear- ance or its final cessation. Those in whom the change oc- curs very early from vigour of constitution, require little to be done for them; but in weak and delicate habits, the nonappearance of this evacuation is too often considered as the cause, whereas it ought to be viewed as the effect, of the state of the habit unpropitious to its taking place. And according to family practice, under this false im- pression, warm teas and forcing medicines are emjdoyed at the approach of this disease, which have often done much harm. Nature is not so defective in her own judgment as to re- quire such auxiliaries. Care should be taken to improve the general state of their health, by attention to diet, mo- derate exercise, change of air, and cheerfulness, which will be found to have the happiest influence on the body and mind, and gives a salutary impulse to the circu- lation of the blood. With respect to the flow of the menses, women should remember, that what is to one woman a due proportion, would be to another from the difference of constitution, and temperament, an immode- rate flow; and before they attempt to restrain it, let them carefully consider, what may have been the exciting or occasional cause. They are too frequently told that 9uch a situation arises from mere debility; and under that belief will take cordials, and stimulating medicines. In general this is not the case, and by such improper treat- ment, the flow is increased, and the habit rendered fe- verish. The quantity generally discharged in a healthy and regular woman is from four to six ounces at each visita- tion. Those of a delicate constitution have, however, a more copious and longer continued discharge than per- sons of a robust habit, thus the full blooming country girl does not discharge half the quantity that the pale 452 Menstruation. faced lady of quality does. In some instances the men- strual discharge does not make its appearance before the age of seventeen or eighteen, and nevertheless, health is not in the least affected. The mere want of evacua- tion at the ordinary time, therefore, is not to be considered as morbid, unless the system is evidently deranged thereby. In many cases, however, symptoms of disease appear which are evidently connected with the defect of the menses, and go off upon its discharge. The treatment in such cases must be regulated by the jiarticular cir- cumstances and constitution of the individual. There is no remedy adapted to every case of this kind, but an open state of the bowels, and a due regulation of the diet, together with moderate exercise, are useful in every instance of this complaint. Warm clothing too, particu- larly about the lower extremities, is of most essential benefit. The occasional use of the warm bath is [dea- sant and beneficial, especially if the skin be dry and warm. As the health imjiroves the cold-bath will prove an auxiliary, if after using it the patient feels a glow of heat, and a greater degree of liveliness. When the means ordinarily employed have failed, marriage or a change of climate has produced the wished for effect. In some instances the evacuation is impeded by a me- chanical cause, that is, an obstruction of the passage to the womb. This occasionally is met w ith, and the chief obstacle to its speedy removal is the difficulty of ascer- taining its existence. The operation by which it is com- pletely remedied, is not more painful nor formidable than blood-letting. Fortunately, in most cases, the evacuation takes place in due time, and the constitution sustains no material or permanent injury. It is, howcver,in every instance, prop- er to pay particular attention to the system during the continuance of the evacuation. The stomach and bowels, are at this period, very eas- ily disordered, and therefore every thing which is hea- vy or indigestible, ought to be avoided. Some are hurt by eating fruit, or vegetables; others by taking ferment- ed liquor. In this respect experience must enable each individual to judge for herself. Ex|iosure to cold, par- ticularly getting the feet wet, is hurtful as it tends sud denly to obstruct the discharge. The same effect is like Menstruation. 453 wise produced by violent passions ofthe mind, which are also at this time, peculiarly apt to excite spasmodic af- fections, or hysterical fits. It is in general, and a very proper rule, not to admin- ister any very active medicines, at this time, unless some violent symptom absolutely requires them. Opiates, for instance, are in many cases, necessary to allay spasmod- ic affections, or abate pain; and they are in such circum- stances uniformly safe. They give speedy relief, to hys- terical feeling or suffocation, or to spasm of the stomach and bowels. Blood-letting is also in some instances, ne- cessary, from particular circumstances, at this period, and in such cases it is safe, and does not obstruct the evacuation. Dancing, exposure to much heat, or making any great or fatiguing exertion are improper. These causes may increase, to an improper degree, the quantity of the evac- uation, and in certain circumstances may give a disposi- tion to a falling down ofthe womb. To conclude!'the period or time of life, when the month- ly evacuation should disappear altogether, is considered as critical. It is really so in two cases. The first is, when the woman has suffered considerably at each period, from sickness, pain, and disorder of the bowels. Such women, not unfrequently, when the constitution is freed from the monthly change, enjoy better health than form- erly. The second is, when there is a tendency to disease, in some particular organ, especially in the womb itself, in some of the abdominal viscera, or in any one of the breasts. In such cases, the time of life may prove the period, at which the disease begins to make its progress. The time, at which this evacuation ceases, varies from the forty-fotirth9to the fiftieth year. It is usual, for some time before it disappears, that it should become irregu- lar. It not only is sometimes greatly less, and again much more in quantity than usual, but it also is occa- sionally obstructed for some months, and then perhaps, comes oftener than it ought to do. The occasional ob- struction, before the final cessation of the discharge, is frequently accompanied with sickness, and swellings of the belly, from the wind in the bowels. These circum- stances, sometimes incline married women, for some weeks, to consider themselves with child. 454 Painful Menstruation. Others again, averse to be thought old, flatter them- selves that the irregularity is occasioned by cold, or some accidental circumstances, and therefore very im- properly employ their utmost endeavours to recall it. The complaints which, in many women, occur at this period of life, are to be ascribed rather to a general change in the habit, than merely to the absence or total cessation of the sexual evacuation. Women who have never had children, or good regular health, or those who have been weakened by frequent miscarriages, are most apt to suffer at the decline of life. It frequently happens, that women who were former- ly much pained when out of order, or who were troubled with nervous, and hysteric complaints, begin at the cessation of the periodical discharge to enjoy a good state of health, to which they had formerly been stran- gers. When no particular complaint occurs in consequence of the decline of life, it would be exceedingly absurd to reduce the strength by an abstemious diet, and low liv- ing. If, on the contrary headach, flushings of the face, or an increased degree of heat, restlessness in the night, and violent pains in the belly and loins, swellings of the feet, or eruptions on different parts of the body take place at this period, there is reason to believe that a gen- eral fulness exists, in consequence of the stoppage of the accustomed discharge. Under such circumstances, spare living, with increased exercise, occasional blood-letting, and frequent gentle purgatives are enjoined. If ulcers break out in the legs, or in any other part of the body, on a total cessation of the menses, they ought to be regarded as critical discharges, and should by no means be healed up without substituting some other drains by an issue. PAINFUL MENSTRUATION. In some instances, menstruation is attended with great pain in the back, thighs, and lower part of the belly.— This state is sometimes accompanied, with suppresion of PainfuI Menstruation. 450 urine, or violent colic pain and spasms ofthe stomach. The discharge generally takes place slowly, and is deficient in quantity, and not unfrequently attended with the expul- sion of a skinny looking substance. Causes.—This disease is supposed to be owing to a weak action of the vessels of the uterus, or spasm of the extreme vessels. Pain sometimes attends copious men- struation; but whenever it does, there is much reason to apprehend some local disorder of the womb. Treatment.—So soon as the symptoms that denote its approach are apparent, recourse should be had to the warm bath; when this is not convenient, the patient should sit fifteen or twenty minutes in a tub of warm water, or cloths wrung out of warm water, or a bladder two thirds filled with it, should be applied to the lower part of the belly. After this the back and abdomen should be well rubbed with the camphorated, or volatile anodyne liniment, and if the pain continue, the anodyne glyster should be administered. If notwithstanding these means the pain becomes violent it will be'proper to give a tea-spoonful of the diaphoretic drops, or four or five grains of Dover's powders, or one of the camphorat- ed powders [See Dispensatorij] every hour or two until a gentle but general perspiration be induced. This is also to be encouraged by drinking warm penny-royal or gin- ger tea. When this complaint arises from general ful- ness and irritation, it may require repeated bleeding and purging. If there be pain in the stomach without fever give a tea-spoonful of laudanum with twenty drops of essence of peppermint; or should costiveness prevail, give a dose of castor oil in conjunction with the ano- dyne. For the cure of this distressing complaint, Dr. Foth- ergill reccommends a pill of opium, of one grain, to be taken the moment the pain comes on, and to be repeated every hour until it be supjiressed; to keep the patient in bed, and to let her dilute freely with herb teas, until the discharge be fully established, after which the pain sel- dom returns; and when the period has passed cbalibeate bitters until within a few days of the next period. Dr 456 Obstructed Menses Denman proposes small doses of calomel every night at bed time, for several weeks together, and twice in the course of the day a dose of the volatile tincture of the peruvian bark. Dr. Dewees, of Philadelphia, recommends the volatiletincture of gum guaiacum, to be continued for a considerable length of time, and says it acts almost as a specific. And Dr. Robertson of Edinburgh is as san- guine in praise, of the tincture of cantharides given in pretty large doses, thrice a-day, until it excites some degree of pain in voiding the urine. Prevention.—In order to prevent this painful state, in those who are subject to it, the warm-bath should be used, three or four nights preceding the menstrual period, and on going to bed, two tea-spoonfuls of the diaphoret- ics drops, or ten grains of Dover's powder should be giv- en in some warm tea. The bowels are to be kept uni- formly regular; and exposure to cold, especially near the time of the appearance of the discharge, is to be careful- ly avoided. The constitution is to be improved, and strengthened by such means, as its particular condition requires, and in general, by the use of tonic medicines, and the shower- bath, provided these do not disagree with the patient. OBSTRUCTED MENSES. Many women have the menstrual evacuation postponed for a week or two, beyond the usual time, or miss one or two periods without any very evident cause, and without inconvenience. But when it is suddenly suppressed very troublesome symptoms occur; and when it is retained for any considerable length of time, it is usu- ally attended by bad health. Symptoms.—When suddenly checked, it is usually attended with considerable pain in the back, bowels, or stomach, and sometimes in the chest. In persons of a full habit the face is generally flushed, the pulse hard and frequent, flying pains in the chest, perhaps spitting of Obstructed Menses. 457 blood, cough, palpitation, difficulty of breathing, and a complication of nervous affection. Persons of a delicate frame and a melancholic temper- ament, and especially those who have suffered from some debilitating cause, have different symptoms, constituting what has been called chlorosis, or Green Sickness, a dis- ease always connected with and depending on some de- rangement of the sensual organs. In chlorosis every symptom of feebleness prevails, a pale skin, and even a greenish complexion, succeeds to the rosy hue of health; the skin under the eyes puffy and of a leaden colour; the whole body lax, cedematous and doughy; the judgment, memory, and natural cheerful- ness impaired; the pulse is generally slow and feeble, but easily excited; and it is then accompanied with short- ness of breath; a palpitation of the heart, and an almost unconquerable disinclination to motion; the apjietite is destroyed, and the stomach so deranged, that the food, instead of being digested, undergoes the fermentation pe- culiar to its nature. Hence the patient finds gratifica- tion in chalk, lime, pieces of old wall, and other improper substances; and the bowels are commonly costive. It not unfrequently happens that the blood which should have passed off by the uterus, being determined more copiously and forcibly to other parts, gives rise to he- morrhages; hence it is frequently poured from the nose, stomach, lungs, and other parts, in such cases. Causes.—A constriction ofthe extremities ofthe ves- sels ofthe womb arising from accidental c ire urn stances, such as exposure to cold, anxiety ofthe mind, fear^JK- cessive evacuations, inactivity of the body, poor blood, the frequent use of acids, and other sedatives, &c. In some constitutions, particularly in those where pain at- tends the discharge, very slight occurrences suddenly in- terrupt the flow, and prevent its usual return, such as passions ofthe mind, fright, fatigue, irregularities of diet, putting on damp clothes, &c. _ This fact shews the ne- cessity for certain cautions and attention during the dis- charge. Obstruction too is sometimes the effect of dis- ease of the general habit. 58 458 Obstructed .Menses. Treatment.—When the evacuation has been sud- denly checked, it is proper to have immediate recourse i to the warm bath, or sitting up to the hips in warm wa- ter, or fomentations to the lower part ofthe abdomen, and bathing the feet in warm water. It is also advisable to jiut the patient to bed and give a tea-sjioonful of the diaphoretic drops, or five or six grains of Dover's powder, in a cup of warm herb tea, such as sage, hysop, penny- royal, every two hours until a gentle perspiration is pro- duced. Should there be fever, or pain in the head, or discharge of blood from other organs, bleed, give the ca- thartic mixture, or an infusion of salts, senna and man- na, and afterwards endeavour to determine to the surface by the exhibition of diaphoretic medicines. In even case where there are febrile symptoms, an amendment cannot take place until the antiphlogistic plan, such as bleeding, nitrous medicines, cooling cathartics, and a low diet, with rest, are adopted. After the febrile symptoms are removed, strengthening medicines, if necessary, may be employed, and in no instance suffer the bowels to re- main in a constipated state. It is necessary to observe in endeavouring to restore the monthly evacuation we shall more likely succeed; if the usual remedies for removing the constriction which affects the extremities of the vessels in the womb are di- »^ rccted at the time of its expected return, or when some natural efforts for that purpose are observable, which may be known by a sense of fulness in the organs of generation, a weight in the back and loins, and slight spasmodic pains in the uterus. At this jieriod, bladders tWwlfibirds filled with warm water, applied to the lower parffof the abdomen, or sitting over a vessel filled with hot water, will have a most happy effect. And to in- crease the relaxing powers of these topical applications. we may at the same time give an opiate, particularly in the form of glyster, when there is pain. Sometimes an emetic administered about the time when the evacuation should appear, and the patient dur- ing the operation to sit in a warm bath has been of infi- nite service. In some instances an obstruction may con- tinue in young and healthy women, for many months without any inconvenience. This is chiefly the case in Obstructed Menses. 459 those who are very corpulent, or who have been in the pernicious practice of employing vinegar and strong purg- es to reduce their size. By the regular use of exercise, rising early in the morning, avoiding supper, keeping the bowels correct, and living upon the whole rather ab- stemiously, the health will be preserved, and in course of time, the desired alteration will take place. Obstruction of the menses may also occur in young women with florid complexions, but, at the same time, of very delicate constitutions, and subject to a slight cough, with pain in the breast, and a predisposition to con- sumption. Such cases require the utmost caution; and in them small bleedings, an antiphlogistic diet, mild laxa- tives, a temperate climate, warm dress, and moderate exercise, are essential; and when it can be procured a sea voyage, or change of air will probably prove the most useful remedy. In the chlorotic species of obstruction, the treatment is much the same, as advised under the head of menstruation; fir the management of those who are long having this evacuation. It will he found almost in every instance the complaint is occasioned by general debility, consequently the cure must be regulated on the plan of increasing the tone of the system and exciting the action of the uterine vessels in particular. This is to be effected by a nour- ishing diet, moderate use of wine, change of air, gentle exercise, particularly riding on horseback with strength- ening medicines, as bark and elixir vitriol, the rust or tincture of steel, or the tonic powders or pills in their usual doses, together with the occasional use of calomel or the stimulating purgative pills, [See Dispensatory] to keep the bowels in a regular state. The nitric acid, diluted in doses of a wine glassful three or four times a-day will be found a valuable medicine to improve the habit of body. And if the obstruction be attended with cough, it should be given in the form of the nitric lac ammoniac. [See Dispensatory.] Previous to the use of tonic medicines, it is advisable to give an emetic, and afterwards a dose of calomel and rhubarb, or the ajierient and diaphoretic pills, for the purpose of cleansing the stomach and freeing it from acidities and inactive fluids. Costiveness being a con- 460 Obstructed Menses. stant attendant on this disease, it is of the greatest im- portance, that purgatives be repeated, until all the sordes which have been collecting most probably for a consid- erable length of time shall be removed. After this, and not before, the happiest effects may be expected from the use of tonic medicines. Besides the above remedies many others may be em- ployed with the same view, as an infusion of camomile, wild cherry, or dogwood bark, tansy, penny-royal, hysop, rue, &c. A table-spoonful of mustard seed, morning j and evening, or a tea-cupful of a weak infusion of horse raddish on some occasions have produced very good ef- fects. Two ounces of the rust of steel, or filings of iron steeped in a bottle of wine or cider for a week, and given in doses of a small wine-glassful morning, noon and night, has also been found beneficial. WTith the view of exciting into action the uterine ves- sels, the surface of the body should be kept warm by means of a flannel shift and drawers, by frequent fric- tion of the lower part of the abdomen and limbs with a flesh brush or flannel, and by the exercise of walking, dancing, and jumping. By marriage or a change in the mode of life, the disorder has frequently been removed after having resisted all the ordinary remedies. In those instances, when the evacuation has become suppressed, in consequence of previous bad health, it is evident, that^no attempt to restore it, can either be effec- tual or useful till the cause be removed. Some have ob- struction caused by very slight weakness, or very early in chronic diseases, others continue regular, till even the last stage of consumption. From the great variety of causes of sexual obstruction, it is certain that many me- dicines, which possess very opposite powers, may, in dif- ferent cases, produce the same effects. Forthe same rea- son, a remedy which, in one case, may prove mild, inof- fensive, and sucessful, will, in another ajiparently simi- lar, occasion the most violent disorder. No remedy applicable to every case can possibly be discovered, therefore, medicines with a view to restore the periodical evacuation ought to be employed with the greatest cau- tion. 461 IMMODERATE FLOW OF THE MENSES. This alarming complaint may occur under two differ- ent states of the constitution. In the one, the woman is of a full habit, and often of a ruddy countenance. In the other, she is pale, delicate, and easily fatigued. Symptoms.—In plethoric habits it is often preceded by headach, giddiness, or difficult breathing, and is after- wards attended with pain in the back and loins, univer- sal heat, and a frequent, strong, and hard pulse. But when it arises from general debility, or in consequence of a laxity of the organ, paleness of the face, chilliness, las- situde of the whole body, oppressed breathing on the slightest effort, pains in the back on remaining any length of time in an erect posture, and coldness ofthe extremi- ties, together with a long train of nervous complaints. Causes.—A variety of causes may produce this trou- blesome disease. Some of these are general, such as a state of great weakness, or of too much blood; others are local, such as debility of the uterus occasioned by te- dious labour or frequent miscarriages. It may also be produced by accidental circumstances determining the blood more copiously and forcibly into the uterine vessels, as violent exercise in dancing, much straining at stool from great costiveness, contusion on the belly, excess in venery, or strong passions ofthe mind particularly at the menstrual period. Treatment.—In the management of this disease we have two objects; first to moderate the discharge and procure present security, and second to prevent a re- turn. The first thing to be done when the hemorrhage is sudden or profuse, is instantly to remove the clothing which may occasion the least interruption to the free cir- culation of the blood, and to put the patient to bed, light- ly covered with clothes. So long as the discharge con- tinues it is of imjiortance to keep her in a recumbent posture, as cool as possible, and perfectly at rest, both 462 Immoderate Flow ofthe Menses. in body and mind. Cloths dipped in cold vinegar and water, should immediately be applied to the loins and vagina, and renewed as often as they become warm.— These cold apjdications, have a powerful effect in re- straining uterine, hemorrhage, and ought never to be omit- ted where the discharge of blood is profuse. If the patient be of a full habit attended with severe pain in the head or back and febrile symptoms, it will be proper to bleed and to give the antimonial, or febrifuge powders or mixture. [See Dispensatory.] The state of the belly must also be attended to. It can be kept gently open by the cathartic mixture, sulphur, or any mild laxative medicine. Stimulating purgatives, or glysters, under such circumstances are improper, from their tendency to increase the discharge. When no symptom indicating an increased action in the vessels ofthe womb are present, astringent medicines should be employed. And in cases where the discharges have not continued long and the strength not much im- paired, it is often sufficient to arrest the disease by giv- ing fifteen or twenty drops of elixir vitriol, or six or eight grains of alum dissolved in a glass of cold water every hour: or what is jireferable alum whey sweetened to the taste in doses of a small cupful as often as the sto- mach will receive it. But if the discharge be obstinate, we should have recourse to pills of sugar of lead and opi- um. [See Dispensatory.] In no instance which has come under my knowledge, where the hemorrhage was in consequence of a laxity ofthe uterine vessels, have these pills failed in producing the de- sired effect. According to Dr. Thatcher, a mixture composed of three grains of sulphate of copjier (blue vitriol,) and twen- ty drops of sulphuric acid, (oil vitriol,) with two ounces of water and given in doses from twenty to forty drops in common drink every hour, seldom fails of success. In those cases where the hemorrhage is profuse or of long continuance, and resists the means already pointed out, it will be proper to inject into the uterus, from a gill to a half pint of a strong decoction of oak bark in wliich one or two drachms of alum has been dissolved, or as much of the saturated solution of alum in water, in order Immoderate Flow ofthe Menses. 44)3 to constringe and strengthen the vessels of the womb.— This may be repeated twice or thrice a-day according to circumstances. When symjitoms of an increased action in the vessels of the womb are observable, the tincture of foxglove, in doses of twenty drops every four hours, constitute the best remedy. When there is reason to sujvpose the hemorrhage proceeds from a scirrhous or ulcerated state of the womb, all that can be done is to afford temporary relief by giving opium in large doses. Indeed opiates may he given with advantage in every case where there is con- siderable pain or anxiety, and the patient much exhaust- ed. Under these circumstances from one to two tea- spoonfuls of laudanum, or from two to four grains of opi- um according to the urgency of the case, will be useful not only in giving a check to the discharge, but also in preserving the strength, and abating nervous irritation. In most cases it is jireferablc to give opium in the form of injections to allay the spasmodic pains of the womb, and when administered inthis way, glysters of thin starch or gruel in each of which two tea-spoonfuls of laudanum is added should be given every two hours until relief is obtained. [See abortion and flooding.] Regimen.—The diet at the time of excessive discbarge must be light and cool. The drink must always be cold, as ice water, lemonade or tamarind beverage. Port wine in such cases is too frequently resorted to, which uniformly does harm by increasing the circulation. Prevention.—To prevent a recurrence of the at- tack in those who are subject to it, the patient must ne- cessarily avoid the causes by wliich it has been produ- ced. When it is evident that the discharge is in consequence of a full habit it will be proper to reduce the system, by liv- ing sparingly, by keeping the bowels rather in a laxative state, and by rising early and taking through the day reg- ular but frequent exercise; and after the jilethora is re- moved, by strengthening the vessels which have been over distended, by the use of the cold-bath. In a greater number of cases, however, we meet with 464 Sexual Weakness. a delicate constitution and spare habit, with pale counter nance, this state requires the use of sea bathing or the shower bath, and the vessels of the womb are particular. ly strengthened by pouring cold water daily on the back and loins. It will be advisable to use a generous nutritive diet, with wine, and to have recourse to some of the tonic medicines, as advised under the head of obstructed men- ses to strengthen the system generally. At the same time the bowels must be attended to, and invigorat- ing exercise taken daily; whilst on the other band, fa- tigue, and especially exposure to relaxing heat, must carefully be avoided. SEXUAL WEAKNESS. This comjilaint, commonly called^wor albus, or whites, to women are peculiarly subject, must form an impor* tant object of attention, since it is always attended with disagreeable symptoms, and when aggravated, soon spoils the beauty of a fine face, weakens the digestive powers, produces a general bad habit, and occasions sterility. Symptoms.—An irregular discharge from the passage leading to the womb, of a fluid, which in different women varies much in colour, being of a white, green, yellow, or brown hue. In the. beginning it is, however, most usually white and pellucid, and in progress of the com- jilaint, acquires the various discolourations and different degrees of acrimony, whence proceed a slight smart- ing in making water. Besides the discharge the patient is frequently afflicted with severe and constant pains in the back and loins, indigestion, paleness of the face, chil- liness, and languor. In process of time, every symptom becomes highly aggravated, the feet and ancles swell, palpitations, and a difficulty of respiration are experi- enced, the menstrual discharge is rendered irregular, the urine is turbid, the mind is dejected, and either consump- tion or dropsy supervenes and terminates a miserable existence. Sexual Weakness. 465 In some languid habits the fluor albus returns periodi- cally, instead of the proper menstrual evacuation, until the patient's constitution is duly invigorated. Causes.—It may be produced by any cause, which either weakens or irritates the womb, and its appendages. It may arise from general debility of the constitution, but it is esjiecially caused by circumstances im|>airing the power of the womb itself, as for instance a severe labour, a miscarriage, or profuse menstruation. In some instances it appears to depend on a full and irritable habit of body; and, in other cases of local irrita- tion; such as disorders of the womb, or of the urinary organs, or a collection in the gut of the small thready worms called ascarides. Upon the high authority of Dr. Hamilton this disease is most, frequently, first brought on by some imprudence in respect to diet and clothing, or exposure to cold or fa- tigue, or neglect of the bowels about the time when men- struation begins. Treatment.—In the treatment of this complaint, regard must be had to the apparent cause, and to the state of the patient. The discharge is too often consid- ered by the sex as the effects of general weakness in their habit, and therefore are led to the indiscriminate use of heating medicines, as port wine, balsam capivi, &c. without paying attention to the habit of the body, or cause of the disease. A milk diet, change of air, and the partial cold bath, as sponging the loins and thighs with cold water every morning, with attention to cleanliness and projier exer- cise, are often sufficient to arrest the disease if early adopted. In addition to this plan of treatment, if the patient be of a full habit, a disposition to fever from slight causes, attended with a sense of heat about the passage to the womb, it will be necessary to have recourse to the lancet, cooling cathartics, and febrifuge medicines; also to inject several times a-day flaxseed tea or milk and water, into the passage ofthe womb. In the great majority of cases, the complaint arises from general debility or laxity of the 59 466 Sexual Weakness. vessels of the jiarts, and in such cases the indications of cure are to increase the vital heat, jiromote the digestion and restrain the preternatural discharge. In order to which, recourse, must be had to such of the tonic medi- cines as will be found to agree best with the patient. Of these, the bark and elixir vitriol, the tonic powders or pills, the rust or tincture of steel, and lime water have usually been employed, and often with good effects. In some instances however, I have known these medicines to fail, when the nitric acid diluted, [See Dispensatory] in doses of a wine-glassful three or four times a-day wonderfully succeeded. Previous to the exhibition of tonic medicines it is ad- visable to give a dose of epicacuanha or antimonial wine. Gentle emetics are supposed to he of singular utility in this complaint not only by cleansing the stomach and bowels, and making a revulsion ofthe humours from the inferior part ofthe body, but likewise by their exciting all the powers of the constitution to a more vigorous action. The bowels must be kept in a regular state by con- joining a few grains of rhubarb with some of the tonic medicines, or by taking occasionally at bed time one of the alectic or aperient or diaphoretic pills, or in the morning a tea-sjioonful of Epsom salts dissolved in a tum- bler of water. If there be a fulness of the stomach after eating, the tincture of rhubarb in small doses will excite digestion. In obstinate cases, it is often expedient to produce a change in the system by giving a grain or two of calomel, or one ofthe. mercurial pills at bed time until the gums become slightly affected, and then the cure may be com- pleted by strengthening medicines, together with the shower bath. Besides tonics, stimulating medicines, such as common- ly determine to the urinary passages, have very frequently been employed with great benefit. Of these, rosin in doses of ten grains in the yolk of an egg, or spoonful of molasses, or balsam cajiivi in doses of a tea-spoonful, or tincture of catharides in doses of twenty or thirty drops in some mucilaginous drink, and taken three or four times a-day, will be found most salutary. These means strike at the cause of the comjilaint, but if it do not remove the effect very soon, wc are not to Sexual Weakness. 467 trust to them alone. For once a morbid secretion being ex- cited, it is very apt to continue, although the exciting cause cease to operate. On this account we ought without delay to have re- course to astringent injections, such an a strong decoc- tion of red oak bark with the addition of a little alum or a solution of alum in water. Half an ounce ofthe former to be dissolved in a bottle of water wliich should be thrown into the vagina by means of a female syringe, two or three times a-day. The celebrated Dr. Burns says, after many trials, he satisfied himself, that although as- sistance may be derived from internal medicines and the cold bath, yet the chief dejiendence is to be placed on astringent apjilications to the seat of the discharge; and these, where there is no fulness ofthe general system, nor any affection of the womb itself, are jierfectly safe, and seldom fail in producing a cure. It will be prudent when this disease occurs as an early symptom of pregnancy not to check the discharge sud- denly, lest miscarriage be the consequence; but it may be moderated by injections of water with the addition of a little vinegar, or an infusion of green tea. Neither should the discharge be suddenly suppressed when it has been of long standing, and acquired a considerable degree of acrimony with an offensive smell. For if it be unseason- ably checked, the belly swells, and a train ofthe most dis- agreeable symptoms occur. In such cases, soap suds, or an infusion of camomile flowers or hops, should be frequent- ly thrown up the vagina; and so soon as the blood is freed of its impurities by suitable medicines, and recov- ered in some measure its soft and balmy quality of wliich it hath been deprived, the, astringent injections may be employed with perfect safety. The application of a blister to the sacrum, has in some obstinate cases been attended with advantage. When the fluor albus proceeds from worms, purgatives and bitter glysters are the proper remedies. Pain in the back and loins is often mitigated by the application of a large adhesive or strengthening jilastcr, and by avoiding a standing posture of long continuance, much walking, dancing, or any other violent exertion. Women should carefully avoid all the remote causes of 468 Pregnancy. the disease; they should pay diligent attention to clean- liness, by washing the parts frequently with cold waterj and when there are excoriations, milk and water, or lead water, may be employed as a wash. Regimex.—The diet should be light, cordial, and nourishing, consisting of isinglass dissolved in milk by boiling it, jellies, custards, rice, milk, soft boiled eggs, gelatinous broths, and light meats, together with a pru- dent use of genuine wine, particularly claret or port.— Women, afflicted with this disease, should by no means indulge in the use of tea and other warm slops of a relax- ing nature; but should lie on a mattress in preference to a feather-bed; and they should rise early, and take such daily exercise as their strength will admit, particularly on horseback. When there is much langour with chilli- ness, friction with the flesh brush, and wearing flannel next the skin must not be omitted. PREGNANCY. The great varieties of the female constitution occasion pregnancy to be, to some of the sex, of no trouble or dis- tress, through the whole period of child-bearing; but it is to others often a continual disease, being, perhaps, from the very first week to the last of their pregnancy, more or less disturbed in their frame from the peculiar irri- tability of their habits. Some feel very soon after conception, such an altera- tion in the state of the stomach, or in their sensations in general, as ajiprises them of their situation. The woman is troubled with heart-burn, acidity, want of appetite, or disgust at her usual food, and some times has a craving for things she formerly did not desire. She is usually sick in the morning, and generally vomits after she gets up, though some bave no sickness till the afternoon.— Sudden qualms and feeling of faintness, with or without an inclination to reach, occur at different times in the day. The bowels also generally become bound. Some instead of being sick, or in addition to the fits ofsickness, are Pregnancy. 469 troubled with a constant desire to spit, with tooth-ach, water-brash, cough, nettlerash or other affections. But the time to which these extend, varies, as well as the pe- riod at which they take place. In the young and healthy constitution, one of the most early symptoms ofthe incipient stage of pregnancy, is an uneasiness in the breasts, somewhat differing from what she may have been accustomed toon the eve of menstrua- tion, and soon attended with some sensible addition to the natural fulness and weight, as well as with a particular change in the appearance of the areola, or dark circle ' round each nipple. The nipjdes also soon become more prominent, the bulbous or glandular eminences around them enlarge, and a milky fluid will stain the linen, which had not been observed before. These occurrences may justly excite in the mind the first apprehension of pregnancy, after wliich, the inter- rupted course of menstruation generally establishes the certainty ofthe situation. Obstruction, however, it must be recollected, may take place from other causes; hence, though we conclude, that she who is regular is not preg- nant, we cannot infer, to a certainty, that she who is ob- structed is conceived. A woman in good health may ac- cidently be obstructed for one or two periods, but in this case the other signs of conceptions are usually absent, and at all events, prudence will dictate the necessity of patience till the fourth month. In bad health the courses are often stopped, but in such circumstances the appear- ances of pregnancy are absent, whilst the symptoms of the accompanying disease point out the nature ofthe case. There is a situation in wliich there may, for a time, be some ambiguity, and that is where the woman has actually conceived, but the embryo has almost immediately perish- ed, yet has not come away, but, together with some blood in the womb, is converted into a pretty firm, but shape- less mass, called a mole or false conception. About the end of the fourth month, or a little sooner or later, in difficult cases the motion of the child is perceiv- ed, and this is the most satisfactory of all the signs; but those who are anxious to think themselves jiregnant, when they really are not, are apt to mistake wind, passing along tb^e bowels, for the motion of the child. 470 Pregnancy. The motion is at first gentle, it is felt pretty low, and resembles a gentle fluttering. The sensation is peculiar, and not unfrequently is at first accompanied writh sickness, faintishness, or hysterical affections. It may be felt by night or day, and may either be repeated pretty regular- ly, or may not be again observed for two or three days. It is called quickening, not because the child at this time begins to live, for it is alive from the first, but because it can now move, or its motion is not till this time percepti- ble. Nature would seem, by these early notices to put the mother immediately upon her guard, that she might not disturb the tender embryo, by avoiding the occasions of either sudden alarm, fatigue, fever, or whatever might derange the equitable state of her health, and by attending to those means for its preservation, wliich are best suited to her particular constitution. At the end of five months, the infant's size is nearly double what it was at the completion of four months, and the size is again nearly doubled by the commencement of the eighth month. At the full time, or nine calendar months after conception, the ordinary size of the child is twenty inches in length, and seven pounds avoirdupois weight. But there are deviations from this standard. Some do not exceed sixteen or seventeen inches in length, and five pounds in weight; while others weigh nearly four- teen pounds, and measure above twenty-four inches.— This difference in size and weight renders it extremely dif- ficult, and it may be said impossible, to determine in many cases, whether the infant have attained to its maturity or not. The ordinary marks of hair on the head, nails on the fingers and toes, usually depended upon by those un- accustomed to consider this subject, are quite fallacious; and although there be certainly marks by which it can be unequivocally determined when the infant has not ex- ceeded the sixth month and a half, it would be an imposi- tion on the credulity of mankind to allege, after the. seventh month the exact age of the infant could be ascertained by its general appearance, or its size and weight. To protect the child, while in the womb, from the num- erous accidents to which it might be exposed from the ex- prtions or imprudences of the mother, a most simple and Pregnancy. 471 effectual apparatus is provided. Not only is it enclosed in a bag, and surrounded by a quantity of water, but also is it nourished by means of a substance similar to a sponge, by which the blood ofthe mother does not run directly in- to its system. The infant lies generally with its head down-most, that is, towards the mouth of the womb, and with its limbs so bent and folded together, as to occupy wonderfully little room, like the chick in the egg just before it breaks the shell. When there are twins in the womb, each infant is included in a separate bag, and attached to its own after- birth. The head ofthe one infant lies towards the breach of the other. By means of the apparatus thus imperfectly described, it may be understood that the infant, while in the womb, is admirably defended from external injuries, but it may not be very obvious how it is nourished, and by what con- trivance its increase of bulk is accomplished. There is every reason to believe, that the after-birth serves the pur- pose; and accordingly, the quantity of blood sent to it al- ways keep pace with the size ofthe child. Thus in the early weeks the vessels which run from the womb to the after-birth are not larger than the hairs ofthe head; while, in the latter months, many of them are as large as an or- dinary writing quill, and the number of vessels always corresjionds with the extent of its surface; for at every period of pregnancy, it is found, that a separation ofthe slightest portion of the after-birth is productive of the bursting of numerous blood-vessels. That the derangement of the general system during pregnancy is produced by the new actions which take place, for the purpose of supplying the infant with the principles of life, is rendered probable, by the fact, that the breeding symptoms cease from the moment the in- fant dies, and by the additional fact, that they most com- monly are less and less severe the more children a woman has. Accordingly, the ordinary complaints during preg- nancy seem to be the immediate effects either of a dis- turbed action ofthe stomach and bowels, or ofthe forma- tion of too much blood. The most important circumstances to be attended to in the incipient months of pregnancy, is the costive hab- it of the bowels^ Its prevention will subdue, if not who!- *7& Pregnancy. ly keep off, some of the troublesome complaints of the stomach, and will often guard, most securely against some of the exciting causes of early abortion. Blood-letting, cautiously used, either to reduce a too plethoric state of the general habit, or to alleviate some morbid affection, is a salutary agent; but it is in gene- ral more frequently had recourse to in pregnancy, than it should be, upon very erroneous principles. Because a pregnant woman, though by oneoftheestablishedlawsof nature, is now obstructed, they conceive, it proper to draw blood, that the constitution may be freed of an imaginary redundancy, not recollecting the process of pregnancy is going on, to employ the interrupted men- strual fluid, to the now essential purpose of affording growth and support to the increasing womb itself, as well as to its contents. All the temporary benefits to be de- rived from blood-letting may be most safely and perma- nently attained by a due attention to the diet, and to the state of the bowels. Nothing can be of greater importance to a pregnated woman, than cheerfulness. They should therefore not be depressed by the relation of any unpleasant in- telligence. Some women are often greatly disturbed by the account of misfortunes which have happened to others in the same situation. The impression made on a timid mind may remain during the whole state of pregnancy. The general health may be thus impaired, and the ajiproach of labour too much dreaded, so that both body and mind are in a less favourable state than they should otherwise have been. It should be consider- ed, that though difficult, and dangerous cases now and then occur", they most commonly terminate well, if properly treated, and their number exceedingly small, when compared with the multitude of women who are delivered; and it is probable it would be still smaller, if the cautions above laid down were properly observed. We would further caution women against having re- course to cordials; to raise their spirits when low. Their good effects are, at best, but temporary, w bile they are ultimately baneful to their constitution; and the use of a small quantity too frequently jiroduces the neces- sity for a larger, until the mother and the unborn infant are injured by this pernicious practice. The best cordi- Pregnancy. 473 als for lowness ofthe spirits in pregnancy, are pure air, moderate exercise, and a light and cautious diet. There is another affection of the mind of a different character, from which lowness and hysterical indisposi- tions often arise, namely the force of ajiregnant woman's imagination. This is often supposed to reach the infant in the womb and to occasion marks and other deformities. But every mother may feel confident, that Providence has better guarded the unborn innocent, than to have exposed it to injury, from every variation in the feelings of a parent. Even admitting the possibility of such an influence, it could only take jdace at a very early jieriod after conception, while the embryo is in its most tender state; and even then it seems in a manner secured by nature against the above accidents, by the peculiar pro- vision made for its defence in the womb: but it soon at- tains a sufficient degree of firmness to overcome any sudden or irregular impulse of the blood, from which alone such deformities, or other blemishes could hap- pen. * The mother should, as much as possible, avoid every Occasion of terror, on her own account, when any thing alarming occurs; but let her not fear that her child will be marked from thence, or, still less, from some hidden operation of a disappointed longing, which most general- ly does not take place, until the above mentioned period is past. Numberless examples could be produced to convince women, that the notion which most of them have, that figures of animals, or other extraordinary marks, are stamped on the face or the body of the foetus in the womb, by the mere force of the woman's imagination is a gross error. In every instance it will be found, where a child is marked, the supposed cause of it, has never been men- tioned by the mother until after its birth; and when a woman has really been alarmed during her pregnancy, and ventured to foretel her child would be marked, she has as uniformly been delivered of her fears and her child to- gether, for her prediction has never been verified.* • Dr. Moore, in his "Medical Sketches," relates a case so strongly in point, attended with such singular circumstances, that it is worth men- tioning here. "A lady who had a great aversion to monkies, happened 60 474 DISEASES OF PREGNANCY. When we reflect on the several changes in the system which are produced by pregnancy, we cannot be surpris- ed that it should be the source of disagreeable sensations, and ofthe cause of many diseases. No part ofthe hu- man body is possessed of greater irritability than the womb; nor any part the increased irritability of which is more readily communicated to the system in general. The breasts are so connected with the uterus by their of- fice, that every affection of the womb is immediately ac- companied by some change in the breasts. Next to the breasts, the stomach most readily sympathises with the womb; and through the stomach, the head and the heart are very soon brought to particulate in its changes and complaints. Breeding Sickness—When it does not materially impair the general health, is to be regarded as a favoura- ble symptom, because it certainly tends to prevent the for- mation of too much blood in the early months, which is one ofthe chief causes of abortion. It is generally suffi- unfortunately, during the course of her pregnancy, to visit in a family where one of those animals was the chief favorite. On being showed into a room, she seated herself on a chair which stood before a table, upon which this favorite was already placed. Not naturally of a reserved disposition, and rendered more petulant and wanton by long indulgence, he suddenly jumped on the lady's shoulders. She was terrified and scream. edj but on perceiving who had treated her with such indecent familiar- ity, she actually fainted; and through the remaining course of her preg- nancy, she had the most painful conviction that her child would be de- formed by some shocking feature, or perhaps the whole countenance of this odious monkey. "The pangs of labour did not overcome this impression, for in the midst of her pains, she often lamented the fate of her unfortunate child, who was doomed through life, to carry about a human soul in the body of an ape. When the child was born, she called to the midwife with'a lamentable voice, for a sight of her unfortunate offspring, and was equal- ly pleased and surprised when she received a fine boy in her arms.— After having- enjoyed for a few minutes, all the rapture from tbi^ change from pain and misery, to ease and happiness, her pains returned, and the midwife informed her that there was still another child. "Another," exclaimed she, "then it is as I have dreaded, and this musi. be the mon- key after all!" Sb« was, however, once more happily undeceived, the second was as fine a boy as the first. Diseases of Pregnancy. 475 cient to keep the bowels open. But when it becomes trou- bles ome, it is necessary to interfere in time, otherwise alarming nervous complaints may be induced. The most effectual means of affording relief in those cases are blood-letting, and gentle laxatives regularly ad- ministered. The application of mint [See Materia Medi- ca] or laudanum rubbed on the pit of the stomach, or ad- ministered in the form of an injection, has sometimes been of service. When sickness arises immediately upon first getting out of bed, a cup of tea or coffee, often affords re- lief. Costiveness—Is a common attendant on pregnancy and if neglected may produce serious consequences.— Women in this situation should never allow more than one day to pass without having a motion. [See Dyspep- sia.] Heartburn—Is commonly confined to the early months, but sometimes accompanies every stage of preg- nancy. A table-spoonful of a fluid prepared by mixing the white of an egg with a little sugar and water, so as to make it ofthe consistence of thin sirup taken occasion- ally, has in many cases afforded relief. When the heart- burn is attended with a constant desire to hawk up phlegm, the stomach should be emptied by a gentle emetic. [See this Disease.] Longings.—Pregnant women have often unnatural cravings, or what are termed longings, which, however absurd they may appear on some occasions, are frequently involuntary. They should be gratified, if possible, as women are apt to miscarry from the anxiety these occa- sion, when they are not indulged. It will be found when the appetite is feeble, and the powers of digestion impair- ed, the stomach often rejects particular substances, and retains others, which though seemingly whimsical, are found to agree with it. Fainting Fits.—Hysterical and fainting fits are apt to occur about the jieriod of quickening, and though some times attended with alarming appearances, are in gene- 476 Diseases of Preg n a n cy. ral slight and of short duration. A re|ietition is to be prevented, if the patient be of a full habit, by keeping the Dowels open, taking some blood occasionally, and putting her on a spare diet. But if she be thin, and there is ap- pearance of nervous delicacy, strengthening means as the cold-bath, nourishing diet, cheerful society, regular exercise in the open air, with attention to the state of the bowels are the best preventives. [See this Disease.] Palpitations—Is another distressing affection wliich some women are liable to during the whole of pregnan- cy. The treatment of those nervous comjilaints must be va- ried according to the constitution and situation of the in- dividual, but, in general, invigorating diet, moderate exercise in the ojien air, keeping the bowels regular, avoiding every thing that disagrees with the stomach and whatever can agitate the mind, will render the attack less frequent. [See Palpitation of the Heart.] Looseness.—This may occur during pregnancy and is to be treated just as at any other time. [See Diar- rhoea. However it may be necessary to observe women of full habit, especially in the early stage of pregnancy, should be very cautious in checking it suddenly, as an immediate overflow of blood to the womb may be the con- sequence. And because such discharges are sometimes the effects of an effort of the constitution to throw off some oppressive load. Difficulty of Urine.—In some cases during preg- nancy, there is great pain or heat in making water.— This is often accompanied with a most troublesome itch- ing at the neck of the bladder, and neighboring parts, with fever. In this case it will be proper to bleed, to keep the bowels open with some cooling laxative, to drink freely of some diluent liquors, and to wash the parts three or four times a-day with lead water, or apply a sponge wet with cold water, to be frequently renewed. Another more serious affection is a suppression of urine, at the same time that the stools are also obstructed. It chiefly takes place between the third and fourth month, Diseases of Pregnancy. 477 and is attended with much pain in the lower part of the belly, owing to the distension of the bl adder; and a feeling of bearing down, like the latter end of labour, with a desire to go to stool. This complaint consists in a change of the position of the womb, which is turned nearly upside down, and is sometimes brought on suddenly by a fall, sudden exer- tion, or straining at stool, but much oftener by retaining the water too long. Pregnant women therefore should on no account place themselves in situations which may lay them under res- traint in this respect, and carefully attending to every call is essentialto their safety. When the womb has descended very low, the os tinea? will be found to pro- trude the external orifice. In this case the complaint may generally be removed by pushing the womb up into the jielvis, and supporting it there while the woman dis- charges her water. The reduction may be affected by the patient placing herself on her hands and knees, and then passing two fingers of one hand into the vagina, and a finger of the'other into the rectum, by which means it is possible sometimes to succeed. But even this assist- ance may be rendered unnecessary, by trying the effect of different postures, by lying on her back with her hips raised, or kneeling on the floor with her elbows resting on a pillow, or by lying on either side, either of which attitudes may relieve the pressure on the urethra. In all cases of strangury, especially if the woman be of a full and plethoric habit, flushed and heated, she should lose blood according to the urgency of the symjitoms,— The bowels should be fully opened by copious injections or mild laxatives. She should take mucilagenous drinks and apply warm fomentations externally, or sit over warm water. These remedies, when the suppression is only partial, will gfenerally afford relief; but whenever a total sujipression takes place, the patient should keep gum ara- ble in her mouth, and avoid drink of any kind as much as possible, until she has been relieved; and if she does not succeed soon in her endeavours, recourse must be had to the catheter without delay. When the womb in- creases in size so large as to rise out of the pelvis, these distressing symptoms are relieved. • Too much caution cannot be given to pregnant women, 478 Diseases of Pregnancy. on the subject of the retention of their urine. Every moment's delay increases the difficulty, and an hour's ne- glect may lay the foundation of the most painful and dis- tressing comjilaint. Incontinence of Urine.—In the end of pregnancy there is sometimes an incontinence of urine, or the woman is obliged to void it frequently but has no pain. This often proceeds from the pressure of the child's head on the bladder, and is considered as a favourable sign of a natural labour. It can only be moderated by frequent horizontal jiosture, and its bad effects prevented by atten- tion to cleanliness, and the use of a thick compress of lin- en or sponge. Swelling of the Feet.—It is usual during preg- nancy, especially in the latter end of it, for the feet to swell. It is the effect ofthe large womb preventing the ready return of the fluids from the lower extremities.— But when the swelling extends over the knees, and more especially when it appears on the upper parts of the body, and where it does not entirely subside after having been a few hours in bed, it is to be regarded as a very serious complaint. In the slight degrees, which happen chiefly during a first pregnancy, or when the womb seems much distended, or when the woman is rather relaxed, the occasional hori- zontal posture, when the swelling is troublesome, with spare diet and an open state of the bowels, are all that seems necessary. But in the serious degrees of the com- plaint, it is generally found that blood-letting to a pretty considerable extent, and repeated purgatives, can only prevent the dangers which might ensue either during la- bour or after delivery. A different kind of swelling of the legs, proceeds from an enlargement of Hie veins. The feet are not necessarily swelled, but along the inside ofthe legs, towards the knees, is a chain of knots of a blue co- lour, disappearing by using friction after lying down.— This is relieved by applying a roller, with a moderate de- gree of firmness, but not so tight as to give uneasiness, or affect the circulation. Diseases of Pregnancy. 470 Inability of Sleeping.—Inquietude and inability to sleep prove troublesome complaints towards the latter pe- riod of pregnancy; the patient being obliged to rise fre- quently through the course of the night, in order to ex- pose herself to the influence of cool air. Nothing affords so great relief in cases of this nature, as bleeding in small quantities, with the occasional use of some cooling laxa- tive medicine. Opiates are never attended with advantage in such conditions. Pains—Often owcur about the back and top ofthe thighs in the early jiart of pregnancy, and frequently is brought on by walking rather more than is jiroper. This requires a state of strict rest for some days, and the part to be rubbed with the anodyne liniment [.See Dispensatory] or if the pulse be full and the patient strong, some blood should be taken away. Another kind of pain effects the back alone, and is of an aching nature, with a feeling of weakness. This is of- ten relieved by the shower-bath, and the ajiplication of a strengthening plaster. Towards the latter end of pregnancy, colic pains are often so severe as to resemble the throes of labour. If they be not preceded by, nor attended with costiveness, they may be easily remedied by opiates, and a proper regulation of diet. In consequence ofthe stretching of the muscles, some of the fibres may separate, so as to allow part ofthe intes- tines to be pushed out beneath the skin; or this may take jilace at the time of delivery, and a pretty large swelling arise on some part of the belly. If the opening be large, the bowel is easily pressed back, but starts out and re- news the swelling whenever the woman walks or even at- tempts to rise. This is called a rupture, and it may also take place at the navel, &e. The bowel is to be reduced and kept in by a well adapted but easy bandage, and cos- tiveness is to be prevented. When the woman is in labour, and has forcing pains, it is often necessary to apply the hand to the part to keep the bowels from being strongly- forced out, and after delivery pressure must be immedf- ately made, otherwise faintishness maybe produced. When the integuments ofthe belly become cracked and 480 Diseases of Pregnancy. sore, from over-distension. Nothing is so effectual as a frequent use of warm sweet oil by friction. Cramps.—Women near the end of pregnancy are sub- ject to cramps in the legs, the thighs, &c. which occur most frequently when, lying in bed. They are occasioned by the pressure of the womb; and therefore, like the other complaints depending on the same cause, they do not entirely cease till after delivery. In slight cases, change of posture affords almost immediate relief; when this fails, rubbing with a flesh brush or flannel„.or the application of cold vinegar, opodeldoc, or anodyne liniment to the affected parts, are the best modes of procuring relief.— When the stomach is affected, the same remedies as advis- ed in cramps of that organ are to be em|>loyed. False PAiNs.-r-Many women are afflicted, long before their confinement, with jiains so nearly resembling those of labour, that they often are mistaken for them. They are known by the name offalse pains. They may affect the back, and come on with regular intermissions, and are peculiarly apt to occur during the night.- They may be distinguished by being rather more irregular and shift- ing than those of labour or being more early attended with a pressing down. They are also usually accompanied with griping or wind in the bowels, or some difficulty in mak- ing water. In such cases, confinement in a horizontal position, bleeding, if plethoric, laxative medicines, if cos- tive, and administering small and frequent doses of some opiate, until the patient finds ease will be necessary.— They are sometimes produced by worms, which are re- moved by giving an injection of strong decoction of camo- mile flowers, with salt, and using laxatives. Occasionally they affect the side chiefly, and are accomjianied with a great motion ofthe child. Rubbing the part with ano- dyne liniment some times does good. Shivering not unfrequently occurs in the end of preg- nancy, especially in the night time; and as labour some- times, begins with this, it creates an unfounded belief that delivery is approaching. It is either unattended with pain, or the pain is irregular, affecting chiefly the bowels or sides. It goes off by taking twenty to forty drops of laudanum, in a glass of warm tea or thin gruel. Diseases of Pregnancy. 481 Convulsions—Are usually preceded by some symp- toms which indicate their approach, such as a sense of fulness or heaviness in the head, severe or even excru- ciating headach, dimness of sight, or appearance of sub- stances floating before the eyes, sometimes dark, some- times of a fiery brightness. They may also be preceded by cramp in the stomach, attended with dreadful sickness. They are likewise to be apprehended if the face and arms be swelled in the same way as feet are in ordinary preg- nancy. At whatever period of pregnancy convulsions take place we uniformly find, that if they are repeated, and do not prove fatal, they bring on labour, or at least open the mouth ofthe womb. But there are many instances where, by proper measures, tbe repetition of the fits have been prevented, and the patient has safely gone to the full time. A knowledge ofthe causes of convulsions cannot be too widely diffused, as their occurrence may, in more than the majority of cases, be prevented. The formation of too large a quantity of blood, and an increased susceptibility of impression of the nervous system, occasion the tenden- cy of this disease. When these exist in any considerable degree, circumstances suddenly brings on the fits, wliich in any other condition of the body have little influence, such as over fatigue, fright, distress of mind, irritations of the stomach or bowels, over-distension of the urinary bladder, or obstruction to the passage of the blood through the belly and lower extremities, in consequence of the pressure of the enlarged womb. The immediate cause of the fits is an overflow or too great determination of blood to the vessels within the head. These facts explain the necessity for so regulating tbe diet and exercise during the latter month of pregnancy, as shall prevent both too great fulness of the habit, and also impaired energy of the nervous system. Under proper and active management, convulsions are found to be in general more alarming than really dan- gerous. The frightful appearances which attend such cases having paralysed the exertions of practitioners, may perhaps account for the unfortunate event in many cases. 61 482 Diseases of Pregnancy. The practice consists chiefly in evacuation. The pa- tient must be instantly bled, and the bleeding must be re- peated once and again, if it do not jirove at first effica- cious. A prodigious quantity of blood has been taken away with advantage, and has been the means of saving < life. Two quarts of blood have been drawn off in the course of twenty-four hours under these circumstances, and with a happy effect. The bowels are also to be opened immediately by an in- jection of soft soap dissolved in warm water, and then giving a strong solution of Epsom salts, or an infusion of salts, senna and manna, every hour or two, until copious evacuations are produced. After the first bleeding the head should be immediately shaved, and a blister of con- siderable size should be applied to it. When convulsions are dependant on an irritable or ex- citable state of the nervous system, it is not necessary to use the lancet so freely. It will be best after moderate bleeding to apply leeches to the temples, at the same time not to neglect the bowels, which should be kept perfectly open. If by these means the disease be checked, the cam- phorated mixture in its usual doses may he given to allay the nervous irritation. For this purpose, opium in the form of a glyster has also been recommended. Doctor Denman proposed that a glyster, containing six grains of opium, should be administered under the supjiosition that, by putting a stop to the contractions of the uterus, the convulsive contractions in the other parts of the body may also cease. The warm bath is strongly recommended by Dr. Den- man among the means of preventing convulsions in wo- men previous to, or during their confinement. He also recommends the warm bath in labours rendered complex by convulsions, and this upon a long and extensive ex- perience. He says that when convulsions have continued or increased, notwithstanding copious bleeding and the use of all other rational means, the patient may be put in- to the warm bath, in which she may remain a considera- ble time if the convulsions are suspended while she is in it. In instances where a warm bath could not be procur- Diseases of Pregnancy. 483 ed, or while it was preparing, he has directed flannels wrung out of warm water, to be applied over the whole ofthe abdomen. Dr. D. also observes, that he has seen the patient re- lieved from that state of irritation immediately preceding the convulsion, by dijiping feathers in cold water and dash- ing it with force on the woman's face, as this roused her, and interrupted the progress of the fit. Where the fur- ther application of cold water is deemed necessary, and ap- pears advisable, we may throw water over the patient's head, bringing this over the side of the bed, and holding an empty pail underneath to receive it. It should be done on the ajiproach of the fit, which may be ascertained by attending to the vibrations of the intercostal muscles. Discharge of Water—May take jilace at different times during pregnancy, especially in the two last months. The quantity is variable, and sometimes the discharge is accompanied or succeeded by irregular pains. When this is the case, give a dose of laudanum, and afterwards some gentle laxative to prevent costiveness. At the same time the woman should remain quiet in bed. By these means she may go to the full time. If the water continue several days but trifling in quantity, a solution of alum or decoction of oak bark, should be injected up the va- gina two or three times a-day. Discharge of Blood—May proceed either from the passage to the womb, or from that organ itself. In the former case, no bad effects can be dreaded; but in the lat- ter one. the most serious consequences may ensue. The immediate cause of a discharge of blood from the womb, during pregnancy, is the rupture of blood vessels, by the partial or total separation of those parts wliich connect the child with the mother. This circumstance explains the difference of danger in the early and latter months; for in the former, the blood vessels of the womb being small, are incapable of pouring out much blood; but in the latter they are very large, and may discharge, in a short time, a great quantity. The management of these cases must be varied accord- ing to a number of circumstances. Tranquillity of mind, 484 Abortion. and confinement to bed in an airy room, lightly covered with clothes, are of great importance. A bladder two- thirds filled with cold water, or cloths wrung out of cold vinegar and water, should be immediately applied to the lower part ofthe belly. If the discharge continue in small quantities, accompanied with irregular pains, a dose of laudanum, or the anodyne glyster, should be administer- ed. W4ten it has suddenly been brought on by a fall, blow, or any great exertion, it is necessary to draw blood from the arm; but when the symptoms which threaten miscarriage have come on, it is improper either to bleed, or to give laudanum. The languor of faintness, usually induced by loss of blood, frequently lead officious attendants to exhibit spir- its or wine, as necessary cordials. As these generally increase the action of the blood vessels, they serve to promote and increase the discharge, and should therefore be strictly prohibited. In the latter stage of pregnancy, if the attacks be severe or repeated, nothing can save the mother and child but delivery, which must not be too long delayed in expectation of pains Coming on, or of their becoming brisk, if they have already taken place. ABORTION. By abortion or miscarriage is meant the expulsion of the child at a period of gestation so early that it cannot live. It is always accompanied with two circumstances, sep- aration of the membraneous bag, expulsive efforts, or contraction of the womb itself. The first is productive of discharge, the second of pains like those of labour. Sometimes the separation or detachment of part of the conception takes place before any pain is felt; on other occasions the pain or contraction of the womb takes place first, and produces a separation. In the first of those cases, the symptoms of abortion take place sudden- ly, and are usually occasioned by fatigue, sudden exertion or fright. In the second, the child is frequently dead for some little time before the pains come on, and there are particular feelings, and changes, which indicate that Abortion. 48d a miscarriage is likely to take place; as for instance, the cessation of the morning sickness, the subsidence of tbe breasts, absence of motion of the child, a feeling of weight, or heaviness in the lower part of the bel- ly, &c. Causes.—Violent exertions of strength, severe exer- cise, sudden frights, violent fits of passions, over-fulness of blood, profuse evacuations, excessive venery, former miscarriages, a diseased state of the uterus, general de- bility of the system, external injuries, and strong acrid and stimulating medicines, which are often taken for the express purpose of exciting abortion, and the death ofthe child. Such criminal intentions to destroy the foetus by arti- ficial means can never succeed, unless the most violent effects are produced on the organs contiguous to the womb, wliich seldom fail to produce inflammation of these delicate parts, and occasion the death of the mo- ther. Whenever, therefore, women commit such unjus- tifiable crimes to conceal the indulgence of irregular pas- sions, their life is exposed to the greatest danger. Treatment.—When a woman is threatened with a miscarriage, there are two objects to attend to: the first is to prevent it if we can; the second is to manage it so that as little blood as possible be lost; and these are ob- tained both by the same means With this view, the pa- tient should immediately, on the first alarm, undress and go to bed, lightly covered, with a firm determination not to rise till the process be either checked, or completely over. There should be little fire in the room though it be win- ter, and in summer the windows must be opened. Cloths wet with cold water should instantly be applied to the lower part of the belly and back; the drink must be cold, and every thing stimulating should carefully be avoided. In robust habits, or wben the symptoms have been brought on suddenly by some such cause as a fall or ex- ertion, it is proper to bleed, and in cases of sickness or great feebleness, to give a dose of laudanum, or what is better, to administer the anodyne glyster. [os- ed to a current of air. The mattress is to be put upper- most, as being more comfortable than a feather bed when it is not daily made uji. A folded blanket, or dressed sheep skin is put next this in order to prevent it from being wet and soiled. Over this the undermost bed sheet is thrown, and the bed made up as usual. Afterwards a sheet in five or six folds is laid across the bed, and these being re- moved when the child is delivered and the woman is laid up, she finds herself clean and dry without further trouble. Every thing ought to be in readiness before it*can pos- sibly be needed, particularly the baby-linen, and such ar- ticles of dress as the mother may require. The dress of the woman during labour ought to be as light and simple Progress of Labour. 491 as possible, and so prepared that it may not be necessary to disturb them soon after delivery by a change of apparel. When this is properly managed, they avoid an unreason- able fatigue, and the hazard arising from linen which may not have been cautiously aired. Little things are often of great importance, and are sometimes found so when it is too late. Premature labour is sometimes threatened by pains, which produce, for a while, some real change in the womb, sufficient even to give the practitioner just reason to ex- pect that they will terminate in delivery. But things again recover their pristine state, the alarm of nature subsides, and the woman proceeds in her pregnancy, for several days longer, and sometimes for weeks. As the change in the womb above mentioned does cer- tainly occur, even on a false alarm, it should put young and female practitioners on their guard, lest they promote labour too hastily, either by general treatment, or any manual operation; for these only would fruitlessly tease the patient, when the judicious exhibition of an anodyne would do every thing that can be wished for. When in consequence of irregular or premature pains, the membranes containing the water with which the child is surrounded have been broken before labour has really commenced, it must be expected soon to take place, though if the pains should have entirely ceased, on the discharge of the waters, it may be delayed for some days; but it most frequently happens within twenty-four hours. There is nothing in this circumstance alarming. It may occa- sion the first jiart of labour to be more slow, but not in any degree less safe in the end. It arises wholly from the fineness ofthe membranes, which contain the waters, and which must rupture in every labour, at some period or other; and hence the waters are unexpectedly dis- charged, in a sudden manner without the least preceding pain. In a slow labour, especially if it be the commencement, the time commonly spent in the lying in apartment might, with the more propriety, be passed in the usual do- mestic habits. It would serve to lessen the too anxious expectation of a speedy delivery, as well as to prevent the impatience of the attendants, both of which are often improperly indulged. 9 493 Progress of Labour. A sensible woman should always consider, that, in a slow labour, she may be afflicted with many distressing, or what have been called false or spurious pains, but there are very few by which nature does not mean some good in the end. She must therefore give her mind to patience, as all unnecessary interference would rather retard, than assist the labour, and will only be employed by the de- signing or unskilful. In the first stage of labour, the bowels should, if neces- sary, be emptied by means of a glyster, or a dose of some gentle aperient medicine. This is attended with several advantages; it renders delivery easier, and sometimes promotes it sooner. All beating drinks and stimulants are carefully to be avoided, as they increase the natural tendency to fever which women have at that time, and the temporary vigour they induce is soon followed by a great degree of langour, that retards the delivery. Violent agitations of the body must be carefully guard- ed against, that the waters may not be discharged prema- turely, which might be productive of the worst conse- quences. For these reasons the frequent interference ofthe practitioner in the beginning of labour, except where there is some unusual resistance to the opening of the womb, or the water has drained off too early, migbt do much harm, and could be attended with no good effects. At that pe- riod no medicine, or other expedient for increasing the force of the pains, should be prescribed, as the more slow- ly the passages are enlarged, the less injury will the pa- tient suffer. In every instance she should be kept quiet and cool, though she ought not to be confined to one po- sition. She may be allowed to stand, walk or sit, or re- main in bed as most agreeable to her feelings, but she ought by no means to stand so long, or walk so much, by way of forwarding the labour, as is productive of fatigue, and after the pains become very frequent and pressing, it Will be. in general, most prudent not to come out of bed. Second Stage.—When the first stage is nearly complet- ed, the woman should be placed on her left side in bed, with a folded pillow between her knees. The bearing down pains, by which the child is forced through the passage, should be the effort of nature alone, and ought not to be assisted by the exertions of the mo- Progress of Labour. 493 ther; for, in that event, either the delivery might be hurri- ed on before the passages are sufficiently prepared, or the woman would be so much worn out, that she could not undergo the necessary fatigue that attends the complete expulsion of the infant. This important caution cannot be too strongly inculca- ted; for inattention to such conduct, and the impatience which women in such Situations cannot perhaps avoid, often make a labour difficult and painful, that would oth- erwise have been natural and easy. Voluntary bearing down must be particularly guarded against at the time when the head of the child is only prevented from being born by the soft parts at the outlet ofthe bason; for, if the delivery then be hastened, these paits may be readily torn. The utmost attention of the practitioner is indisjiensably necessary to prevent so un- fortunate an accident, in every case where, from tbe acute feelings of the patient, violent bearing down at that pe- riod cannot be resisted. When the child's head presses against the perinaum, it should be supported by gently pressing with the hollow of the hand during the pain, to prevent its tearing. After the head of the child is excluded, the woman should be allowed to enjoy for a little time the temporary relief she feels, and therefore the body ought not to be immediately taken out with force, as is often done; for, besides the injuries wliich may be occasioned by not al- lowing the patient a little rest, the extraction of the. af- ter-birth will be thereby rendered difficult. Two or three minutes may therefore be allowed to elapse before the body be drawn forward. If the patient have a rajiid labour, and the midwife is at a distance, she ought to keep constantly in bed, and refrain as much as possible from bearing down. If the child should be born before assistance is procured, the most experienced woman present should take the nav-4- string between the finger and thumb, and so soon as she finds the pulsation in the cord stopped tie a string firmly near the navel, and apply another ligature about three inches from the first, and cut the cord between these; or if she be afraid to do this, the child must lie beside the mother till the midwife comes, taking care that the face be uncovered, to permit of breathing. 494 Progress of Labour. We will now suppose the woman is just safe delivered of her child, and that a complete cessation ofthe regular pains has followed. She must now endeavour to calm that disturbance of the whole frame, which added to her anxiety of mind before delivery, had excited a great de- gree of heat and perspiration, especially if it should have been her first labour, or one attended with some unusual difficulty. In this state she must not let herself chill or cool too fast. It may perhaps, have been necessary to throw off the bed-clothes, during tbe last hour or two; if so, they should immediately on the birth of the child, be lightly placed over her again. She may now moisten her mouth with a cup of tea, grit gruel, or barley water, for either of which she will feel desirous, if she has not been frequently taking of one or the other during the latter part of her labour, but they must be given her without wine or brandy. If she feels herself disposed to sleep, she should indulge it; at all events, she should keep herself quiet and not encourage conversation. For it may be ob- served, that in general the mind of a woman newly deliv- ered of her first child, is so occupied with the novelty, as well as the anxiety of her situation, that her attention is long kejit alive, and therefore she can scarcely sleep, though exhausted by the fatigue of her labour. In the third stage the midwife must carefully attend to the de- gree and force of contraction, which the womb is dispos- ed to take on, immediately, or soon after, the birth ofthe infant. The experienced practitioner will indeed have a presentiment, even while it is coming into the world, of what is likely to take place afterwards, from the manner in which the expulsion of the infant is completed: This should be effected slowly, as we have already observed, because such a practice favours that kind of action of the womb necessary to detach the placenta. Premature or active endeavours to loosen it, must, however, be avoid- ed, if its separation should not readily take place, by the seasonable contraction of the womb. Let the opera- tions of nature be watched, and she will prove the surest guide, though in this part of the delivery she ought never to be wholly depended on. We generally find, when there has not been any sudden or hurried delivery of the infant, the after-birth is soon expelled without any assistance. Progress of Labour. 493 The vessels which passed from the womb to the after- birth would, when this was separated, pour an increased quantity of blood, did not the womb contract so much as to diminish their size and compress their orifices. This contraction both expels the after-birth and prevents flood- ing. When, therefore, the after-birth is expelled, we have an evidence of the existence of that state of the womb which ensures the safety of the mother. A woman should, however, avoid expressing any im- patience about this, as it might induce some practitioners to use that despatch which many have done, that the pa- tient or her friends might not insinuate that they were a long while in bringing away tbe after burthen. This kind of censure is too frequently passed upon the just conduct ofthe midwife, from the improper prejudice too often in- dulged in favour of a speedy delivery ofthe placenta.__ Women are apt to deem that practitioner most skilful who is the shortest time in finishing that part of her labour. Fatal, therefore, have sometimes been the consequences of this ill judged management, particularly among the female practitioners. It is a mistaken idea, that in general some external me- chanical force is necessary in order to expel the placenta. We cannot, therefore, approve ofthe modes occasionally recommended, of coughing, sneezing, blowing on the back ofthe hand, or making general pressure over the belly, with a view of helping its descent, by any kind of tight bandage applied to the abdomen, immediately after the birth ofthe child. There is a general action of the hand on the abdomen, which the patient herself may perform, and by which the uterus is tenderly excited to contract, and the placenta of course detached in the most favourable manner, that will be found more useful than a bandage, or any extra- ordinary exertions ofthe patient, for this purpose. But as this may not be necessary in every case, it must be left to the judgment of the practitioner to direct, with the proper caution to be observed in the applications. We would further observe, that there can hardly ever be occasion for a woman to bear down during the deliv- ery of the placenta. Indeed on many occasions it must be carefully avoided, lest it should produce, or increase, 496 Progress of Labour. a disposition to the prolapsus uteri. The throes, which take, place naturally, are caused by the contractions of the womb; and with them alone the practitioner can, gen- erally, in due season safely bring it away. When the efforts of nature do not tend to disengage the secundines within an hour after the birth of the in- fant, the interference of art ought to be submitted to. For if it be not thrown off w ithin a short time after the in- fant is born, it becomes putrid, and induies an alarming feve:-, from which few women have recovered. In assist- ing the expulsion ofthe after-birth, unless the practition- er waU for the contraction of the womb, that part may be turned inside out. This circumstance should be pro- perly understood by all those who happen to be out of reach of regular assistance; for the patient's life, after an easy labour, may be destroyed by the rashness of an ignorant practitioner. By explaining, however, the cause of danger those who are prevented from being under the care of persons of skill, may thereby escape those hazards to which they might otherwise be exposed. The after-birth is generally fixed to the bottom ofthe womb, and as the greater portion of the womb, at the full period of pregnancy, is not attached to tbe adjoining parts, if the navel string be violently pulled before the after-birth be separated, the womb must be turned inside out. the ordinary consequence of which is fatal. When the grinding pains are felt by which the con- traction of the womb is distinguished, the practitioner should assist by pulling gently the navel string during a pain, and by endeavouring to bring down the after-birth through the bason, in such a manner that its progress may not be interrupted by any ofthe neighbouring jiarts. Until the after-birth is expelled, the patient and midwife should be attentive lest there be a great discharge, and if this occur no time is to be lost in checking it. This is done by exciting the contraction of the womb, by the ap- plication of cloths wet with cold water, to Ihe lower part of tbe belly and to the passage, or by pouring cold water out of a pitcher from a height on the abdomen: and also by the introduction of the hand of the midwife to stimu- late the womb. Some do this with the sole object of ex- tracting the placenta or after-birth, considering the reten- Laborious Labour. 497 aion of this as the cause of the flooding. But this opi- nion is wrong, and the mere extraction of the placenta can only do good, so far as the introduction of the hand and *.the means used to effect this, serve to excite the action of the womb itself. We do not approve of a free and indiscriminate use of greasy application, in the progress of labour. They are wholly unnecessary in the first stage of it, and in the latter part they interfere with the changes wliich then take place naturally, and produce that mucus secretion by which the jiarts are most favourably lubricated, for the easy ter- mination of the labour. But after the complete removal ofthe placenta, it will be proper to apply a small quan- tity of jiomatum or fresh lard, to defend the parts from the acrimony of the ensuing discharges. LABORIOUS LABOUR. When the delivery is not completed within twenty-four hours from its real commencement, though the head ofthe child be forced foremost, it is styled laborious labour. It may occur under three different circumstances—First, the pains may be, from the commencement, few and weak; and the labour may, if left to itself, be long of becoming brisk. Second: the pains during the first stage may be sharp and frequent, but not effective, in consequence of which the power of the womb is worn out before the child has advanced far, or come into a situation permitting it to be expelled. Third: the pains during the whole pro- cess may be strong and brisk, but for some obstacle the delivery may be either greatly protracted, or rendered altogether impossible, without assistance. Different causes may produce these states; such as gen- eral weakness of the constitution, particularly the action ofthe womb itself, premature, discharge ofthe water, fear, impatience, and strong passions of the mind. When the first stage of labour is protracted, and the pains do but little good, a glyster has often had the hap- piest effect in exciting more brisk and productive action. In like manner, a change of posture, or walking a little 63 498 Laborious Labour. in the room, lias sometimes rendered the pains brisker. But whenever sitting or walking produces fatigue, or felt to be disagreeable, they certainly do harm. The most powerful means we can employ for remedy- ing some of those conditions, which give rise to tedious and severe labour, are blood-letting and the use of lauda- num, either in the form of a draught or glyster. The states requiring or admitting of these it is impossible to explain here; but it may be of service to do away a pre- judice which may exist against their employment, when they are necessary. Opiates are serviceable sometimes, as cordials or general stimulants; at other times they are beneficial by suspending the useless, but painful action of the womb, and thus allowing time for the strength to recruit, and these effects they produce more safely and ef- fectually than any other means could do. They are also of efficacy in checking that irregular spasmodic action of the uterus, which gives much pain, and rather retards than forwards the expulsion of the infant. With regard to blood-letting, there is only one objec- tion of any weight, namely, that it will weaken the pa- tient; but, in reply to this, we observe, that if it have the effect of rendering the delivery more speedy and safe than it otherwise would be, it will rather save the strength by preventing unnecessary fatigue. It is also well known, that a much greater quantity of blood is often lost after delivery than would have been taken from the arm, and yet no bad effect whatever follows from it. When convul- sions occur during labour, or in the end of pregnancy, six times the quantity of blood that would be taken in any other situation, are often detracted with present relief and future advantage. Last of all, the experience of dif- ferent ages and various countries proves the safety of the practice. It is not a remedy newly introduced, the ef- fects of which we are ignorant of, for it has been even the habit of some to bleed women in natural labour in order to render it still more easy and expeditious. Blood-letting is also a powerful mean of preventing local inflammation, which may be excited by protracted labour. In difficult labour we must always pay due attention to the state of the bowels, and we should also be very atten- Laborious Labour. 499 five that the urine be voided regularly. There are some unfavourable positions of the head, which may be rectified by the finger without giving pain. If, notwithstanding all our care, the labour be protract- ed until the strength be impaired, and the pains are ceas- ing; or if the obstacle be so great as during the course of la- bour to make the head be fixed within the bones ofthe pel- vis, and produce suppression of urine, or a tender state of the soft parts, with a sense of tightness within the pelvis, restlessness, giddiness, or pain in the head, severe pain or feeling of pinching, even in the absence of the la- bour pain, about the share bone, or other symptoms in- dicating that the powers of nature cannot any longer be safely trusted to, it will be necessary to have recourse to the use of instruments. These are never to be resorted to except in cases of absolute necessity, but it cannot be too strongly enforced on the mind of a patient who requires them, that if she delay after they have been advised by a practitioner of judgment and integrity, her own life, as well as that of her child, may be lost. Preternatural Labour.—When any other part of the infant than the head is forced foremost during labour, the case is styled preternatural, or in common language, a cross-birth. Where neither the head nor lower parts are placed next the passage, nature cannot in general ac- complish the delivery; and therefore the life of the woman must depend on the position ofthe infant being changed. The operation by which this is jierformed is called, in the language of midwifery, turning, and consists in bringing the feet into the passage. When the case is discovered before the water is drain- ed off, the operation of turning may be had recourse to with perfect safety, provided the woman be in good health, and without occasioning much pain to the patient or trouble to the practitioner. But when, either from the restlessness of the patient, or from the improper inter- ference of the practitioner, the water has been evacuated at an early period of the labour, the life both of the wo- man and infant must be exposed to considerable hazard. In this case the turning is not to be attempted, till, by the 500 Laborious Labour. administration of sixty or eighty drops of laudanum, the pains are suspended. A neglect of this rule may be fol- lowed by very serious consequences. Dr. Denman relates three cases of the upper extremi- ties presenting; and the delivery being partly effected by the spontaneous evolutions of the child. In the first case the woman had been in labour during the whole night, and one ofthe child's arms was the presenting part; on attempting to turn the child, the pains were too violent to admit the introduction ofthe hand into the uterus. Im- agining that the child was small, so that it might pass, doubled, through the pelvis, farther endeavours to turn were omitted, and on waiting a "little the breech presented, and the head was the last part that was delivered. In the second case the presentation was the same as in the first, and it was agreed on to turn the child; but the pains were strong and frequent, so that the action of the uterus was such as to forbid all endeavours that way. It was then agreed on to wait for the effect which a continuance of the pains might produce, or till they were abated, when the child might be turned with less difficulty. The jiains continued and propelled the child lower in the pelvis, and in little more than an hour it was born; the breech being expelled as in the first case. In the third case, the arm presenting, and labour gone on for some time, after w hich attempts were made during several hours to turn the child, whose shoulder strongly pressed upon the pcerin- seum. At length, by the action of the uterus, the child was doubled and the breech expelled; after which the shoulders and head were extracted. In all these cases, the Doctor observes, that the women were at the full pe- riod of utero-gestation, and the children were of the usual size. More cases might be related, but these sufficiently prove the fact, that in cases in which children present with the arm, women will not necessarily die undeliver- ed, though they are not assisted by art. With respect to the benefit we can in practice derive from the knowl- edge of this fact, it may be observed, that the cus- tom of turning and delivering by the feet in presentations of the arm, will remain necessary and proper in all cases in which the operation can be performed witb safety to the mother, or give a chance of preserving the life of Laborious Labour. 501 the child. But when the child is dead, and when we have no other view but merely to extract the child, to remove the danger thence arising to the mother, it is of great importance to know that the child may be turned sponta- neously by the action ofthe uterus. If we avail ourselves of that knowledge, the pain and danger which sometimes attend the operation of turning a child, may be avoided. Some jiropose bleeding ad deliquum for abating the too strong contraction of the uterus; and at the moment of fainting, to attempt delivery. Twins —It has been supposed when women have con- ceived twins, there are certain symptoms before delive- ry, by which that circumstance can be ascertained: but there are no sure indications of the existence of a plurali- ty of children, till after the birth of one child, when this takes place it is very easy to determine whether any other remains. This may commonly be done without having re- course to the painful and indelicate means that have been proposed and practised; for by feeling the state ofthe belly alone, a judicious practitioner can be very seldom mistaken on such occasions. When only one child has been originally contained in the womb, that organ soon after delivery, diminishes very much in size, while the bowels, which are kept out of their natural situation, in the latter months of pregnancy, im- mediately get forward to the fore part of the belly, and render it soft and yielding. But when a second child re- mains, the womb does not apparently diminish in size.— The intestines, therefore, remain behind and at the sides, and the forepart of the belly has the same hardness as be- fore delivery. It sometimes hapjiens, that the pains ad- vance rapidly; and the second infant comes very soon after the birth of the first. In such cases, all that the practition- er has to do is to be assured that the second infant is in a proper position, and to take care so to conduct the extrac- tion ofthe after-births, that no alarming discharge may follow their expulsion. But when the labour-throes cease, or become trifling on the birth of the first infant, the object of the practitioner (should be neither to interfere before the woman have re- cruited sufficiently from her fatigue, nor to delay extract- 502 Laborious Labour. ing the second child so long that the passages should be- come contracted, or the after-birth of the first born be separated. Inattention to this important rule has been the cause of the loss of many lives. In more than the ma- jority of cases, not more than an hour should be allowed to intervene between the birth of both children. Navel String.—A portion of the umbilical cord may be forced down, either naturally or in consequence of mis- management. In the former case, it will be felt through the membranes at the beginning of labour; in the latter, it does not come down till after the waters are drained off. When the cord is felt originally through the membranes, the patient should be kept very quiet, and in one posture, till the circumstances preparatory to delivery are com- pletely accomplished, when the practitioner, by turning the infant, may probably be able to save its life. But when the early discharge of the water has occasioned the protusion of the cord, it is not alw ays in the power of a practitioner to obviate the threatening danger, without exposing the life of the patient to much hazard, which is a risk that ought never to be incurred for the precarious chance of saving the infant. Convulsions.—The precautions by which convulsions, during labour, may in many cases be prevented, have al- ready been mentioned, under the head of pregnancy, and the dangers to wliich pregnant women are exposed, when attacked with this frightful disease, have also been pointed out. But when it does happen in time of labour, the safe- ty of the woman commonly depends on expeditious delive- ry; and therefore the proper means for accomplishing so important an object, must be employed without delay. Flooding.—Arises in labour either from an accidental separation of the whole, or more commonly of a part of the after-birth, or from the unusual place of attachment of that substance. When the discharge is considerable, there cannot be a question that the patient must be deliv- ered, either by turning the child, or by the forceps, ac- cording to the stage of labour and situation of the child. Management of Child.Bed. 503 After the birth ofthe child, if the natural powers do not separate the secundines within an hour, the practitioner should also perform that duty.' When necessity obliges the practitioner to introduce a hand into the uterus, the back of the hand should be to- wards the uterus, and the hollow of the hand kept as qlose to the placenta or after-birth as possible in seperating it, that the womb may not be injured. In some rare cases, the adhesion is so strong that it is imjiracticable to separate the whole ofthe cake without tearing the womb. The portion that is left generally be- comes detached in three or four days, and its expulsion may be promoted by the use of a stimulating injection. Such cases require the most serious attention, lest any putrid portion may be absorbed. After these stages of labour are safely completed, flood- ing sometimes takes place. This is the effect of the womb not having become sufficiently contracted, and it requires different management in different cases. If the discharge be profuse, cloths soaked in cold water and vin- egar applied to the naked belly, or even cold water poured on that part from a height, should be had recourse to.— But sometimes the flooding is not observable by the at- tendants, as the blood congeals as soon as discharged, and is collected within the womb and passages. This cir- cumstance may be feared, if the woman becomes sick or faintish, or complain of ringing in her ears, or dimness of sight. In such cases the womb must be forced into contraction by manual assistance. In all cases of considerable loss of blood, large doses of opium, frequently rejieated, are found of the greatest service in supporting the living powers. [See Immoderate Flow ofthe Menses—Progress of Labour, and Abortion.] MANAGEMENT OF CHILD-BED. A child-bed woman, so soon as all the circumstances of her labour have been adjusted, may with propriety, con- sider herself as still in a state of health, and as requiring little more than the common cautions, and good manage- ment on all occasions necessary to preserve it. 504 Management of Child-Bed. The first hours after delivery, provided some light nourishment has been taken, should be dedicated to quiet and sleep, and no person should be allowed to enter the patient's chamber, except such as are absolutely necessa- ry. The chamber door, and even the windows, if the weather be warm, should be opened, and the room in eve- ry respect kept as clean and as free from any disagreeable smell, as any other part of the house. The patient should often be supplied with clean linen, well aired; for cleanliness and free pure air, are essential in this situation; and upon the strictest examination it appears that there never was miliary eruption produced without a sweat,nor puerperal fever without foul air. The heat of the room ought to be so tempered that the patient may neither be chilled with cold, nor yet suffer from sweat or burning. The strictest attention should be observed to have an evacuation daily by the use, if necessary, of mild laxatives, or by the exhibition of glysters composed of milk, oil and sugar, or of soap suds. It is a security against fever and inflammation, and even forms one principal mode of re- lief when they occur. An equal regard should also be paid to get out of the bed as soon as they can with pro- priety, and to set up as long as possible without fatiguing themselves. If the lochia do not flow so plentifully as may be ex- pected, or if they entirely stoji, no regard need be paid to this circumstance, if the patient be otherwise as well as can be wished. We not only find this evacuation differ- ent in different women, hut even in the same woman in different lyings-in, from which she recovers equally well. Much mischief is often done by binding the belly too tight. If there be any occasion for support, a thin nap- kin pinned very slightly round the waist, is all that is ab- solutely necessary, and the sooner this is disused the bet- ter. But little change takes place in the breasts, after the first months of pregnancy, until about the second day af- ter delivery. Then it is usual to feel a great sensation of fulness in them, accompanied with a febrile irritation, which varies in different women, according to constitu- tion and management; but in all is favoured by temper- ance, a cool regimen, and composure of mind. Management of Child-Bed. 505 The child should always be put to the breast early, be- fore the milk can have stagnated in them, or they can have, acquired any great degree of hardness. It will be beneficial both to mother and child, if this be done a few hours after delivery; and this is most consistent with the operations of nature. If the patient have not nursed any former child, the infant will probably meet with difficulties in fastening on the nipples. In this case some older infant should be ap- plied, or it will be proper to have them drawn by some other means without giving pain. Thick rings made of beeswax, and fitted very exactly to the nipples, are often preventives of sores, by keeping the nipjiles enlongated. They should be applied imme- diately after the child has finished its suction, and be put on so that the ends of the nipples may protrude themselves through them. These rings, however, ought not to be used when the milk runs out in too great quan- tities. If the woman do not suckle her child, no method should be used either to rejiel the milk, or invite it into the breasts. Nature will be certain to do her part. She is soon made sensible, that the blood determined to them is not want- ed, and there will therefore be little further effort made on her part to continue it, and it will in the course of a short time cease of itself. A cooling cathartic, with a suitable regimen, will entirely supersede the necessity of any local treatment, and is all that can be required, even when a mother has suckled before. No degree of fever in childbed should be passed over unattended to, or be thought lightly of. Even the m >st serious are often slight at their beginning. Neither should any local pain, or tenderness, or fulness of the bowels, be neglected, lest they should arise from the incipient stage of some inflammation, which, if not checked at first by proper medicines or suitable regimen, might, in a short time put on some alarming apjiearance. Let it be remembered, that it is much easier to prevent diseases, than to cure them. The diet of lying-in women should be particularly at- tended to. All gross meats which might overload the sto- mach, or by heating the woman, prove a cause of fever 506 Management of Child-Bed. should be strictly prohibited. But every patient, after child-bearing ought not to be half starved, as some re- commend. Proper regard in this respect should be paid to her habit, former manner of living, and present state. Too great indulgence, it must always be remem- bered, is more to be dreaded than too much abstinence, though both extremes should be equally avoided. The bad effects of confined or impure air are now most universally known; consequently, the propriety and ne- cessity of having the bed curtains always open, of pre- venting many visitors from crowding the room, of remov- ing as speedily as possible every thing which can contami- nate the air, and of admitting occasionally the fresh air, by ojiening the windows and doors, must be obvious. Women were formerly obliged to remain in bed for a certain number of days after delivery, by which they were much weakened and fatigued. In modern times the practice has passed from one extreme to another. This circumstance should surely be regulated accord- ing to the strength of the patient. When the woman feels that she can easily undergo the fatigue of rising, which, in ordinary cases, happens about the second, third or fourth day, she ought to be taken out of bed that it may be properly adjusted. If she be made to sit upright, she will suffer considerable uneasiness; and, at the same time, by the bulky womb, (for that organ does not resume its natural state till two or three weeks after delivery,) pressing forcibly on the soft parts at the bot- tom of the bason, the foundation for a very troublesome and disagreeable complaint, viz. the falling down ofthe womb, must unavoidably be laid. She ought, therefore, to be placed in a position half sitting and half lying, when out of bed, as long as the womb continues enlarged, by which means these inconveniences will be avoided. For the same reasons, walking, even from one room to another, at least as long as the lochial discharge con- tinues, and the womb is bulky, is highly improper. Ma- ny women boast that they have been able to go through the whole house within a few days after delivery; but they often find, at a subsequent period of life, by the complaints which they suffer, that they had little cause to be satisfied with their own prudence, or the attention of the practitioner who indulged them in such liberties. 507 DISEASES OF CHILD-BED. As there are certain natural causes of disease during lying-in, so there are certain disorders to which women of every description are liable for some time after deliv- ery. The most usual complaints which occur in child-bed are as follow, viz:— Faintings.—The languid state in wliich many women are, immediately after delivery, is sometimes succeeded by faintings. This is not dangerous whilst the pulse and breathing continue good, and there is no unusual dis- charge. In this case, the complaint may be attributed to the peculiar state of the body and mind of the patient at that time, and will be readily removed by the exhibition of a little wine, toddy, or any cordial. But when the faintings are attended with quick irregular pulse and cold extremities, the greatest danger is to be apprehend- ed; for it will generally be found that they are the con- sequences of some violent injury, or of great loss of blood. In this alarming case, if there be a considerable discharge from the womb, a soft cloth is to be pressed firmly on the external opening, and pressure to be made at the same time on the lower part of the belly with the hand, to prevent the womb from distending with blood, and to excite its action. A large dose of laudanum or opium is1 also to be administered without delay. And the heat is to be preserved by the application of warm flannels to the stomach, hands and feet. Shiverings—Occur from similar causes to faintings, and sometimes in-consequence of rash and sudden expos- ure to cold, after being heated with the exertion of labour. Nothing, in general, affords more speedy relief, than a tea-spoonful of spirits of hartshorn or laudanum in w ater. At the same time the ordinary means for restoring warmth, by the application of heated flannel, as recom- mended in case of fainting, ought to be had recourse to. If it should continue, the camphorated mixture [See Dis- pensatory] in doses of a table-spoonful every two hours, will be of service. This medicine, given as soon as the 508 Diseases of Child Bed. child is born, commonly prevents both shiverings and faintings in those who have been formerly liable to such symptoms. After Pains—For some time after delivery, the con- tractions of the womb frequently continue, and occasions pain, which in some cases are so violent as to resemble throes of labour. This complaint, termed after-pains, though productive of considerable uneasiness, is never to be considered dangerous. In general they are most effectually relieved by a full dose of laudanum. When the pains continue after the ex- hibition of this medicine, warm flannels or bladders two- thirds filled with hot water, should be applied to the low- er part of the belly. The camphorated julep in obstinate cases will be beneficial, as well as glysters to open the bowels, and afterwards an opiate pill, or an injection of camomile tea, with two tea-spoonfuls of laudanum, should be administered. Lochial Discharge.—An increased and sometimes a continual discharge, after delivery, is often the conse- quence of getting up too soon, or making some early ex- ertion. When this evacuation continues beyond the or- dinary time, it occasions weakness, and requires the early employment of means to prevent the train of nervous disorders, which commonly succeeds a profuse discharge of the menses. With this view, tonic medicines, as bark and elixir vitriol, &c. must be employed along with nour- ishing diet, a liberal use of claret wine, and such other means as may support the strength. The importance of cleanliness, as long as the lochial discharge continue, does not require being jiointed out: but when the evacuation has a bad smell, common atten- tion in that respect is not alone sufficient; for unless the most scrupulous regard be paid to prevent its stagnation in the passage ofthe womb, excoriations or inflammations, with all its formidable consequences, will ensue. The nurse should, therefore, on such occasions be directed to wash that organ by means of a syringe, twice or thrice a-day, with warm milk and water, or with an infusion of camomile flowers, or decoction of oak bark. The lochia! discharge is in some w omen very trifling, Diseases of Child-Bed. 509 and may even stop very soon without any bad effect.— But when it is suddenly checked by exposure to cold, or other causes, most painful consequences may follow, such as swelling of the belly, great pain, sickness and fever. In such cases the evacuation ought to be jiromoted by sitting in a tub of warm water, or by the application of warm fomentations to the parts and the exhibition of some gentle evacuating medicine, and afterwarls endeavour to determine to the surface by the use of Dover's powder, with warm diluent drinks. Milk-Fever.—The breasts are greatly distended for the first two or three days after delivery, and in some cases a considerable degree of pain and fever are occa- sioned. The best management in these cases consists in gently rubbing the breasts with a little sweet oil morning and evening, covering them with flannel, and keeping the bowels open with some gentle laxative medicine. When the mother's health will not admit of suckling the child, she should have her breasts occasionally drawn, and every circumstance which can contribute to the se- cretion of the milk, should be carefully avoided. Great abstinence should therefore be enjoined, her body should be kept jierfectly open with laxative medicine, and as lit- tle milk as jiossible taken. Ripe acid fruits ought to be used, which will assuage thirst, and by proving laxative, will assist to carry off the milk and prevent its secretion. Laceration of the Parts.—The excessive dilation sometimes required for the exit of the infant, and the contraction which follows delivery, occasion a degree of soreness and of uneasy feelings that not unfrequently lead the woman to suppose herself torn. These feelings are re- moved by bathing at first with warm milk and water, and afterwards with warm spirits. But w'here the swell- ing is considerable, attended with throbbing pain, emol- lient poultices ought to be applied, and renewed every four hours, until suppuration takes jilace, and then treat- ed in the ordinary way. [-See Abscess.] Women are sometimes really torn during the birth of the infant; which, in most instances, is the effect of mis- management. Where the laceration is inconsiderable, little more than the ordinary management is required, as 510 Diseases of Child-Bed. the process by which the passages are restored to their former state tends to reunite any slight separation of parts. Inversion of the Womb.—There are two degrees of the inversion Ofthe womb, viz:—the partial and complete. The former, which is the more ordinary one, appears in the shape'of a swelling as large as a child's head, pro- truded without the passages immediately after expulsion of the after-birth, accompanied with violent forcing and bearing-down pains, and followed by flooding, faintings, and urgent fruitless attempts to make water. This arises from a part, more or less, of that portion of tbe womb, which had extended, previous to delivery, above the bones of the bason, being turned inside out. The other degree is so complete an inversion of the womb, that it is torn away from its attachments to the sides of the bason, the immediate consequence of which is instant death. Such accidents can only arise from rash and ill direct- ed endeavours to extract the after-birth, by drawing down the navel-string before it can be completely sepa- rated. But whatever be the cause, the part must be im- mediately restored, or the consequence will soon be fatal; for its orifice will contract in this unnatural state, and so prevent the needful relief. Therefore, without delay, place the patient on her back with her hips raised, and gently return the uterus into the vagina with three fin- gers, and then with the whole hand place it in its natural position; after which, clench the fist, and retain it there, until the uterus contract upon it; lastly, apply the ban- dages as advised in the case of falling down of the womb, and direct the patient to remain in bed some days. Separation of the Share-Bones—Is the effect of severe labour or. of some former accident, or inflam- mation within the joint which connect these bones. This affection is distinguished from every other, by the pain being uniformly increased or excited upon the slightest motion of the lower part of the body, and by feeling the share-bones rasp against each other when either leg is moved. The treatment must depend upon the cause. Where Diseases of Child Bed. 511 these bones have been separated by a blow or fall, at a former jieriod of life, they only require being held toge- ther by means of a broad belt, till the patient have re- gained strength. The cold bath, whenever it can be used with propriety should be had recourse to, morning and evening, as it tends greatly to the accomplishment of that object. Swelled Leg.—This disease takes place at different periods after delivery, from the fourth or fifth day to the seventh week. It is ushered in with pain in the back, smart fever, and painful stiffness in one groin. Soon af- ter these symptoms the thigh begins to swell at the upper part, and gradually the swelling is extended to the whole limb, so'thit in a short time it is double the size of the sound one. It is rather pale coloured than red; and is called by some the white leg. It is hot, shining, very painful on being touched or moved, and at first it does not pit when pressed upon by the finger; and may be dis- tinguished by the above marks. By active treatment at the beginning of the complaint, Its jirogress may be certainly stopped. The bowels should be kept open by salts or cream of tar- tar, and a determination to the skin produced by Dover's powders or some ofthe diaphoretic medicines, [See Dis- pensatory.] Should these not have the desired effect in arresting the disease, a grain or two of calomel, given morning and night, until a slight affection of the salivary glands are excited, and afterwards the nitric acid will generally succeed. Topical applications are also to be employed, as flan- nels wrung out in hot vinegar, and renewed as often as they become cold. Good effects have also been derived from the application of a strong solution of crude sal am- moniac, and sugar of lead in vinegar. When these fail to produce any good effects, surrounding the limb with a portion of English bran and sweet oil, with the addi- tion of half an ounce of laudanum, or soft boiled turnips. and renewing it night and morning, will afford considera- ble relief. The best apjdication, however, in such cases, when they can be procured, are the leaves of the thorn apple, scalled in vinegar, with wliich the limb must be thickly covered, and then confined by a flannel bandage. 512 Diseases of Child Bed. Friction with the anodyne or camphorated liniment ha? produced some good effects, but the mercurial ointment, united with camphor, has been externally emjdoyed with more permanent advantage. When the acute symptoms are over, and the limb re- mains weak, friction with the flesh brush is jiroper, and a roller should be applied with moderate firmness from the toe to the groin. The cold bath is useful to re-establish the health. The diet, after the inflammatory symptoms have abated, ought to be nourishing; and sleep, when re- quired, should be procured by opiates. Inflammation of the Breasts.—This disease is easily known by the pain, hardness and swelling which accompany it. In some cases, the whole breast appears to be affected, in others, only one side, and in some the affection is small and superficial. When the breast inflames, it is evident that the reten- tion of the milk must, for a time at least increase the pain. The first object then should be to have the breast drawn, either by the child or some other means; but should the milk not come away readily, and the pain be increased thereby, further attemjits must not be made, otherwise both the disease and the sufferings of the woman may be aggravated. A cooling diet and an open state of the bowels are necessary while the swelling continues. And it is better for the patient to remain in bed as the weight of the breast, while in the erect pos- ture, often increases the inflammation. Tbe breast should be gently rubbed with a small quantity of sweet oil or unsalted butter, and poultices of crumb of bread and lead water applied. If the pain and hardness do not very soon go off byjthis apjilication. warm emollient poultices as milk and bread with a little oil, or united with the leaves ofthe thorn apple, must be had recourse to These poultices will not jiromote suppuration unless the inflammation has proceeded so far, that that process has already begun, and in this case the sooner it is produced, the better. If the abscess do not point and break soon no good can he gained by delay: an opening should therefore be made, so as to evacuate the matter freely. This not on- Diseases of Child-Bed. 5i3 |y gives immediate relief, but prevents a further exten- sion of the mischief. The milk and bread or flaxseed poultices must be continued for a few days, in order to remove the hardness, and then the part must be dressed, as in ordinary cases. [.See Abscess.] Indurations remaining after an abscess, may be fre- quently remedied by the application of a mercurial plaster or cloths, wet with the camphorated spirit, or rubbing night and morning the part with mercurial ointment united with a little camphor. Sometimes after the abscess heals and the breasts seems to be cured, it swells a little, especially towards night. This is from weakness, and is cured by strength- ening tbe constitution. Soreness of the Nipples.—The nipples, from the delicacy of their structure, are very liable to be injured by the action of the childs mouth in sucking, along with the irritation which the stagnant milk occasions, unless they be kept very dry. Women are subject to this com- plaint more frequently while nursing their first or second child than afterwards; for the nipples lose much of their sensibility by use. In the treatment of this disease the great object to be attended to is, to remove as much as possible every cir- cumstance which can tend to irritate these parts. It is im- portant to keep the nipple dry and cool, for which purpose rings of lead are generally worn. The nipple ought to be washed frequently with some gentle stimulating liquor, as brandy and water, or port wine, or a solution of alum or white vitriol, in proportion of fifteen or twen- ty grains to four ounces of water; these must be frequent- ly varied, for the same lotion soon loses its effects. A saturated solution of borax in vinegar or water, with the addition of a little honey has been very beneficial to sore nipples. In obstinate cases, the sores should be touched by means of a fine hair pencil, with a solution of blue vitri- ol, or the following liniment which is highly extolled by Dr. Hamilton. Take of litharge and vinegar each two drachms, olive oil six drachms, to be made into a liniment by rubbing the whole together in a mortar until it be- 65 514 Diseases of Child-Bed. comes of a flesh colour, and the consistence of cream.— Washing the sore nipples with a decoction of the roots of wild indigo [See Materia Medica] is also celebrated as a valuable remedy in these affections. As long as we are under the necessity of applying any medicines to the nipples of the mother, it will be prudent not to suffer the child to suck her. Where this cannot however be dispensed with, the partshould be well wash- ed with a little warm water each time previous to giving tbe child the breast. To prevent the sore from being aggravated by stick- ing to the woman's clothes, a little cup made of wax may be laid over the nipples which is the part most apt to suffer. If only one nipple is affeGted, the child may be confined to the other; but if both are affected, and the pain occasioned by its sucking is too great to be borne, the woman must then desist from the duties of a mother until the excori- ations are somewhat healed, taking care however to have the breasts drawn regularly twice or thrice a-day. In many cases where the woman has never nursed be- fore, the nipjdes at first are not sufficiently prominent to afford a proper hold for the child. In such cases the breasts should be fomented by flannels dipped in warm water, and then, by gentle pressure on the sides of the breasts with the hands, the milk is pushed forward. At the same time the pressure is made, the nipple should be drawn out by a breast pipe, and the instant the glass is removed, the child being put to the breast will keep it out by sucking until satisfied. After the operation has been rejieated two or three times, the child, except in extraordinary cases, will find no difficulty in sucking. Those who have been subject to sore nipples should endeavour to diminish the sensibility of these jiarts, by applying to toem, for several weeks previous to delivery, cloths dipjied in alum water, in strong spirits, or in the pickle of salted meat boiled, which latter has been re- commended as an infallible specific for that purpose. When little sores appear in the brown circle surround- ing the nipple, and correspond with similar appearances in the child's mouth, or other parts of the body, there i9 Diseases of Child-Bed. 515 just cause to suspect some latent poison lurks within the system which more than probable will require a mercuri- al course of medicine to subdue. Inflammation of the Womb—Commonly occurs about the second or third day after delivery, though in some instances later. The existence of it may be ascer- tained by pains in the lower part of the belly, which are greatly increased by pressure, a constant fever, with a quick hard pulse, and a great prostration of strength.— The lochial discharge is very early suppressed, and the secretion of milk very much diminished. It is commonly attended with sickness. It often hap- pens that the woman can only lie on her back, and on turning to either side she feels a painful heavy mass fall to that side and at the same time an excessive pain in the loin, kidney, and groin, of the opposite side. Many causes tend to induce inflammation of the womb; such as abortion, difficult or tedious labour, the exhibition of heating and stimulating drinks, exposure to cold after delivery, &c. As this disease is very rapid in its progress, it calls for the earliest attention. Blood-letting is of great im- portance in the incipient stage, and may be repeated in ten or twelve hours if the effect produced and the consti- tution of the patient would justify it. Although strong active purges would be highly improper in this disease, yet it is necessary to preserve the regular motion of the bowels by giving occasionally the cathartic mixture or Epsom salts in small doses. Emollient and aperient glys- ters should be frequently administered, as they not only un- load the intestines, but likewise act as fomentations. Medi- cines which determine to the surface, as Dover's powder, or diaphoretic drops, with the saline mixture, are also high- ly serviceable. To remove the tension, and alleviate the pain and sore- ness, flannel cloths wrung out in a warm decoction of camomile flowers, or any bitter herbs, with the addition of one fourth of spirits, to which a little laudanum may also be added, should be kept pretty constantly applied to the lower part ofthe belly, and at bed time it may be rub- bed with the camphorated or volatile anodyne liniment.— 516 Diseases of Child Bed. [See Dispensatory.] In using fomentation due care must however be taken that they are not apjilied so wet as to run about the bed, and thereby occasion inconvenience to the patient. Opiates are necessary to procure rest, but they should not be employed until the inflammation has been subdued by blood-letting, and aperient and diaphoretic medicines. Too much caution cannot be observed by women in guarding against any exposure to cold after delivery, as they are thereby apt to bring on diseases, which if they do not prove quickly fatal, not unfrequently leave effects behind them, of which they will be sensible the whole fu- ture period of their lives. Peritoneal Inflammation—Frequently occurs in women after delivery, and is produced by the same causes which give rise to an inflammation ofthe womb. In some cases the inflammation attacks only a small portion of the membrane at first, and is afterwards com- municated to the whole at once. The patient is usually seized with rigors and shiverings, thirst, fever and an acce- lerated pulse, and soon feels considerable pain with sore- ness, either in a particular jiart of the abdomen, or over the whole of it. The uneasiness and pain increasing ra- pidly, the abdomen becomes puffed up and swelled to a size nearly equal to what it was before delivery. From the inflamed state ofthe parts, and the exquisite pain wliich prevails, the very weight of the bed-clothes becomes irk- some and insufferable; and in order to support it, the pa- tient is obliged to lie on her back with her knees bent in towards her belly. She is, moreover, incapable of bear- ing the least motion. In the cure of this disease, nearly the same mode of treatment which had been advised for an inflammation of the womb must be adapted. Bleeding from the system to about sixteen or twenty ounces should therefore be had re- course to at a very early period, particularly where the patient is of a robust plethoric habit, and with such it may be necessary to repeat the operation within twelve hours. To empty the bowels freely, it will be necessary to em- ploy active purgatives from time to time. Fifteen or twenty grains of calomel with four of ipecacuanha, fo! Diseases of Child-Bed. 517 lowed by an infusion of senna and manna, castor oil, or Epsom salts, will not fail to afford relief by promoting several evacuations of foetid and dark stools. Should there prevail great irritation at the stomach, with frequent vomiting, the patient should take every two or three hours the saline draught in the act of effervescence with twelve or fifteen drops of laudanum, and drink freely of barley water, flaxseed tea, or some mucilaginous drink. In order to determine to the surface, the diaphoretic medi- cines should be employed; and to procure sleep, after the inflammatory symptoms have somewhat subsided, the anodyne sudorific bolus or draught may be given at bed- time. To alleviate the pain and soreness, fomentations as advised in inflammation of the womb, must be resorted to very early. Emollient glysters should be administered during the intervals of employing purgatives, as they will not only assist in keeping the bowels open, but will act likewise as internal fomentations. Throughout the whole period ofthe disorder the patient is to be supported by food of a light nutritive nature, ad- ministered in small quantities at a time, and repeated frequently, so as never to overload the stomach. Delirium, or wandering ofthe mind, seldom occurs sooner in lying-in women than eight or ten days after delivery, and sometimes not for a much longer time. It makes its appearance very suddenly, the patient not unfrequently awaking terrified from a dream, or all at once she breaks out in some absurd or furious conduct. There is often very little increase of heat of the skin,' or other appearance of fever; though in some instances there is considerable heat, and the pulse is very quick, and this is especially the case where there has just been some strong exertion, or much speaking. But, as in all other cases of nervous constitutions, the state of the pulse is subject to considerable and sudden variations. The patient is usually extremely talkative, and some- times speaks with wonderful volubility. In some cases one idea seems to jiossess the mind; and in others the ob- ject of apprehension or consideration is rapidly varied. She can, however, for a short time be commanded, and at times, at least, appears perfectly sensible of what is 618 Diseases of Child Bed. going on beside her. It is not easy to say what cause pro- duces this disease, for it does not appear to be connected with a tendency to mental derangement in other circum- stances. It is, however, a curious and an important fact, that sometimes suckling the infant produces melancholy, or other modifications of this complaint. When delirium, accompanies the milk fever, or the weed, it is only a temporary symptom, and ceases upon the original disease being removed. When it is the effect of phrensy, the treatment consists in those means as ad- vised under the head of Inflammation ofthe Brain. But when it appears to be dependant on nervous irritation, the most successful mode of jiractice is, shaving and blister- ing the head, keeping the bowels open by cooling laxatives, determining to the surface by the diaphoretic powders or mixture, and afterwards allaying irritation by the cam- phorated mixture in their usual doses. If these remedies prove of no avail, the most soothing mild conduct towards the patient ought to be invariably pursued, and the suitable means to promote general good health are to be adopted. The woman should be carefully watched, and never left alone. The recurrence of this disease, in cases where it has formerly taken place, may be prevented by pursuing steadily such measures as shall re- move the increased susceptibility of impression which fol- lows delivery, and by guarding against all exciting causes. Miliary Eruptions.—These certainly originate is a child-bed state from improper treatment; for whenever a woman in such situation is confined within a heated room, oppressed with a great quantity of bed-clothes, and forced to drink stimulating liquors, with a view of pro- moting a sweat, according to the absurd and pernicious customs, in the treatment of lying-in-patients, she is gene- rally seized with rash fever. [See Miliary Fever.] To conduct the patient with safety through the disease, we must have recourse to some opening medicines, and afterwards restore the strength by the use of Peruvian bark, elixer vitriol, and other tonics. Where the rash suddenly recedes, it will be necessary to have recourse to cordials and diaphoretics. Affections of this kind may in general be avoided by at- Diseases of Child-Bed. 519 tention to diet, by keeping the patient's bowels in a good state, and by admitting a proper ventilation through the chamber. Puerperal Fever.—A fever happening from any dis- ease in consequence of pregnancy, or delivery of a child, and happening during the time of lying-in, may be prop- erly called a child-bed or puerperal fever. The symptoms which characterise this disease are, pain and tension of the abdomen, short anxious breath- ing, uncommon quickness of the pulse, increased tempe- rature of the body, tensive pain over the forehead, pecu- liar wildness of the eyes, prostration of the vital powers, suppression or diminution of the milk and lochia, a flac- cid state of the breast, and upon drawing them, blood instead of milk, is frequently discharged. The progress of a puerperal fever is sometimes so ve- ry rapid, particularly in warm climates and hot seasons, as to destroy the patient in forty-eight hours. Even in cases seemingly the most favourable, we should look on the event as doubtful, as the complaint is apt to be ac- companied with delusive remissions, and indications arise in its progress, which are by no means equal to the danger. Tbe causes are various, and sometimes the disorder is inflammatory, but it soon tends to the putrid kind, and sometimes from the beginning a putrid fever. During the first stage of puerperal fever, if there be marked inflammatory symptoms, it is advisable*to draw some blood from the arm, proportioning the. quantity to the habit and constitution of the patient. The necessity of procuring stools by purgative medicines, as well as removing putrid feculent matter must be obvious, and an equal regard should be paid to the state of the skin by administering such medicines as determine to the surface of the body, and thereby abate febrile heat.— With the first intention the aperient and diaphoretic pills, given in broken doses, or ten or twenty grains of calomel with a few grains of ipecacuanha, followed in a few hours afterwards by a table-spoonful of Epsom salts, will be found very beneficial at the commencement of the disease. And in order to excite gentle perspirJt- 520 Diseases of Child- Bed. tion the spirit of Mindererus, Dover's powders, or diapho- retic drops [See Dispensatory] should be emjiloyed in their usual doses. After these means have produced some good effects, one or two grains of opium alone, or conjoined with a few grains of ipecacuanha, or the ano- dvne sudorific draught, may safely be given to relieve pain as well as to procure rest. It often happens that nausea and vomiting of bilious matter attend an attack of this fever. In such cases give a gentle emetic of ipecacuanha, and after its opera- tion, if the sickness continue, apply to the stomach poul- tices of mint stewed in spirits. It has been observed that this fever, after continuing a day or two, very often acquires a malignant and pu- trid tendency Under such circumstances it will be proper to have immediate recourse to the remedies ad- vised under the head of nervous fever. To alleviate the soreness and distension of the ab- domen, we should apply fomentations both inwardly and externally; inwardly, by injecting emollient glysters from time to time, and externally, by applying flannel cloths, wrung out in a warm decoction of camomile flow- ers, or some bitter herbs, with the addition of one fourth spirits and an ounce of laudanum, to one gallon of the decoction, over the whole region of the abdomen; and these ought to be renewed as often as they become cold, taking due care that they are not so wet as to run about the bed and incommode the patient. Where the abdominal cavity is highly painful to the touch, and is occupied by extensive inflammation, the ap- plication of cold to the parts by cloths dipped in a mixture composed of two parts of vinegar or cold water, and one of spirits of camphor, has frequently been attended with happy effects. If a gentle purging arises in the first stage or com- mencement of the comjilaint, it ought not to be too hasti- ly stopped, as the fever has in some instances been car- ried off by such a spontaneous evacuation. Protusion ofthe Vagina.—f ailing of theWomb. 624 PROTUSION OF THE VAGINA. The vagina, or passage to the womb, is sometimes protruded, or pushed out of its natural situation. The disease appears in the form of a soft compressible tumour or swelling, protruding without the external passage, in some cases extending backwards, and in other cases sit- uated on one side. It is not painful when pressed upon, and most commonly it subsides when the patient lies down, being only troublesome when she is in an erect posture. . . The disease is owing to local relaxation, and that is frequently the consequence of mismanagement after lying-in. . If the prolapsed part be not inflamed, and there is lit- tie or no swelling, the tumour will be very little trouble. The part may be restored with the fingers, which when done, the patient should rest in bed some days and inject into the vagina three or four times a-day, warm vinegar and water, or port wine and water, or lead water, or so- lution of alum in a decoction of red oak bark or water. If the patient be weak, strengthening remedies will be required, as the cold-bath, bark, rust or tincture of steel, or tonic powders or pills. At the same time it will be prudent to wear the T bandage. When these means fail it is recommended to make scarifications in the de- scending vagina. FALLING DOWN OF THE WOMB. This is a much more common complaint than the for- mer; and takes place in women of every age, and every rank. As its name implies, it consists of a change in the situation of the womb, by which that organ lies much lower than it ought to do. In some cases it absolutely protrudes entirely without the parts. The slighter de- grees are styled bearing-down; and the more violent ones descent or falling down of the womb. In general, the first symptoms of this complaint is an 66 522 Falling Down of the Womb. uneasy sensation in the lower part of the back while standing or walking, with now and then a kind of pres- sure and bearing-down. If these feelings be disregarded, the complaint in- creases and the patient becomes incapable of making wa- ter without first lying down, or pushing up a swelling which seems to stop the discharge of urine; and if the disease continue to increase, the womb is actually forced out of the parts, and takes on the form of a bulky sub- stance hanging down between the thighs. This extreme degree of the complaint can seldom hap|ien, excepting in women who have had a great many children, but the lesser degrees of it occur occasionally in very young unmarried women. The causes of descent of the womb ought to be known to every woman, as many of them may be avoid- ed. Every disease which induces weakness ofthe habit in general, or of the passage leading to the womb in particular, must lay the foundation for the complaint.— Frequent miscarriages, improper treatment during la- bour, too early or violent exercise after delivery, are, in married women, the most frequent circumstances by. which falling down of the womb is jiroduced. In the unmarried, it is apt to take place in consequence of vio- lent exercise, as in dancing, riding, &c. while out of or- der, a fact that ought to be impressed on the mind of every young woman. In the treatment of this complaint, the means must be adajvted to the degree of its violence. When the descent is inconsiderable, and the case is of recent date, the daily use of the cold-bath, invigorating diet, very moderate exercise, and the injection of any mild astrin- gent liquor into the passage, evening and morning, will probably prove successful. But should the disease be in a greater degree or of long standing, a Course of tonics, with the frequent use of astringent injections as a strong solution of alum in water or decoction of red oak bark must be added to the above means. Dr. Leak advises that after the parts are reduced, the intention of contracting the relaxed vagina so as to pre- vent its future descent, may be effected by the frequent use of the following astringent injection. Take of alum, Falling Down of the Womb. 528 and white vitriol, each, one drachm, boiling water one pound, mix and filter through paper. Inject it into the vagina, milk warm, with a womb syringe. At the same time endeavour to strengthen the whole bodily system by nourishing diet, and tonic medicines. When the complaint resists such remedies, or when, from its degree, it shall appear unnecessary to employ them, the only relief which can be afforded, unless the womb become pregnant, is to be obtained by wearing an instrument called a jiessany. It is made of wood or ivory, and if properly adapted to the passage, and of a proper construction, it can be worn without much inconvenience, and it never occasions pain. Certain attentions, are how- ever necessary, whenever such an instrument is used.— Thus, the pessany should never be allowed to remain in the passage above a few days at a time, otherwise it be- comes the source of great irritation. It should therefore be occasionally withdrawn on going to bed, well cleaned and re-introduced in the morning, before the patient rises. In some instances, after a pessany of a certain size has been worn for several months, one of a smaller size be- comes better adapted to the passages, and in other cases one of a larger size is required. Sponges of such a size as, when expanded, fill up the cavity of the vagina, are very good pessaries. They sup- port the uterus, and by putting a string through them, the end of wliich is to be left hanging out of the os exter- num, the woman can take them away and apply them her- self very conveniently. To answerthis purpose, a fine sponge wrungoutin alum- water may be dried in a compressed state, and cut into any convenient form, so as to be introduced as high as possible; this will act by its astringency, and by its pres- sure, in a gentle and uniform manner. During the use of this application, an astringent injection may be used twice a-day; and the sponge tent should be made grad- ually smaller as the vagina contracts. The apjilication of a bandage round the whole belly, with a moderate degree of firmness, often gives great re- lief to the uneasy feelings. The T bandage has also been worn in this case with considerable advantage. If a woman, liable to falling down of the womb, be- 524 Polypus in the Womb. come pregnant, there is no occasion for the pessany after the third month, and by proper treatment after delivery, the return of the complaint may be prevented. In the Edinburgh "Medical Commentaries" is the fol- lowing account. A woman of singular fortitude, about fifty years of age, was much afflicted with prolapsus uteri. After trying many remedies in vain, and being tired out with the continuance of complaint, she at length cut into the substance of the womb with a common kitchen knife, A considerable hemorrhage ensued; after which the uterus gradually contracted, and she had neither a return of the prolapsus, norwrasshe afflicted with any other symptoms. Having boasted of her success, many women in the neigh- bourhood afflicted with the same comjilaint, apjilied for her assistance, and by a similar operation were effectually cured. It is supposed that scarifications may succeed instead of incisions or the prolapsed womb, and the same method of cure is still more strongly recommended in theprotun- sion of the vagina. POLYPUS IN THE WOMB. The vagina and womb are subject to fleshy excrescences, called Polypous Tumours, in common with some other parts of the body. These in many cases, are soft as clot- ted blood; in others they resemble flesh; and sometimes they are found of a hard consistence. They are of differ- ent sizes and shapes. The mild polypus is connected to the womb generally by a narrow neck. As it grows the womb enlarges, and pres- ently its mouth dilates, so that the polypus can be felt with the finger. Then it gradually descends into the pas- sage, or in some instances, is forced down, with pains like those of labour. Excrescences of the womb differ from descent of that organ, in being attended with the frequent discharges of blood, and when felt, in being broad and bulky, and hav- ing no orifice like the protruded womb, and in being easily moved or twirled round, as it were by the finger. Polypus in the Womb. 525 The cause of this complaint has not been ascertained. It is evidently unconnected with the married state, as it occurs in unmarried women, and it does not appear to attack exclusively any particular constitution. No medicines have any power over this tumour, but it may be safely and successfully removed, by the appli- cation of a ligature round its neck. This operation gives no pain, and is practicable, whenever the mouth of the womb has dilated comjiletely. But, if the symjitoms be not ur- gent, it will be better to delay, until the polypus have wholly, or in part, descended into the passage, as the liga- ture can then be still more easily and successfully ap- plied. There is a tumour of a different kind, met with in the womb, which does not spring from the surface of its cavi- ty, but is imbedded in its substances. It forms a knob or projection, which gradually increases, and in some in- stances, several of these form in succession, and the womb becomes considerably enlarged. This tumour is called a tubercle. It produces very nearly the same symptoms with polypus. The distinc- tion between this disease and a polypus, can only be made by a skilful examination, wdiich determines the jioint. The growth may very frequently be checked, and in several cases its size may be even greatly diminished, by taking for a length of time two or three drachms of the vitriolated tartar, or cream of tartar, in a glass of water every morning before breakfast. Should this not be suf- ficient to keep the bowels in rather a laxative state, its operation may be assisted by taking at bed-time an aloctic pill. Much advantage is also derived by the use of the warm sea bath, which if not attainable, a little salt added to the water may be substituted. The patient must ob- serve a light diet, and carefully avoid heating and stimu- lating drinks. Perhaps a mercurial course might be attended with good effects in this affection of the womb; and afterwards the nitric acid. Thepossibility of removingthis complaint, or of keeping it in subjection by proper remedies, and the great proba- bility of curing completely a polypus, by a simple opera- tion, or of relieving by a mechanical contrivance, a bear- ing down of the womb, must be surely powerful induce- 526 Cancer of the Womb. ments for women labouring under symptoms of these complaints, to submit early to skilful examination, which can alone determine the precise nature of their disease. CANCER OF THE WOMB. This disease most frequently appears about the time when the menstrual evacuation ceases, but no age is ex- empted from it. Its approach is in general gradual. At first the patient feels an uneasy weight in the lower part of the belly, with the sensation of heat or disagreeable itching. By degrees irregular shooting pains, darting across from the share-bones, take place. The pain at last becomes fixed in the womb, and is described to occasion a constant gnawing, burning sensation. A discharge of ill-coloured foetid, acrid matter from the vagina, attends this pain; and, notwithstanding every attention to cleanliness, ex- coriates the neighbouring parts. The nature of cancer is not yet properly understood by practitioners; but it is well known, that the first change in the part which afterwards becomes cancerous, is a thickening and hardening of its substance. This may be suspected to have taken place in the womb, if there be pains in the thighs and back, bearing down when using exercise, and occasional violent discharge of clotted blood. By early attention to such symptoms, many in- dividuals have had the progress of the disease complete- ly arrested. In the early stages of cancer of the womb, a continued perseverance in milk and vegetable diet, a total absti- nence from animal food of all kinds, and every fermented liquor, and occasional blood-letting, and in some cases the establishment of one or two issues in the arms or above the knees, together with frequent doses of cooling laxative salts, tends most materially to relieve the symp- toms, and to retard the progress of the disease. Pain and irritation, which strongly tend to increase, are allayed by the use, every night, of the warm-bath, A Mole. 527 impregnated with salt. This sooths the part, and in- deed the whole system, and contributes materially to the relief of the patient. The injection or decoction of cam- omile flowers into the passage, morning and evening, is always proper. Discharges of blood are moderated by rest, keeping the patient cool, and pressing a cloth firm- ly on the passage. Should the size of the tumour render the passage of the stools or urine difficult, it will be ne- cessary to assist the evacuation ofthe former by laxatives, and to have the latter regularly drawn off. Care must be taken, however, to give no stronger laxative than is sufficient to produce the desired effect; for frequent stools, in such circumstances, give-great fatigue and produce much injury. Should there be, in the last stage, much pain or rest- lessness, these must be overcome by opiates. The foetid discharge is to be carefully washed away, and every at- tention must be paid to the mitigation of those evils and distresses connected with protracted disease. A variety of medicines have been proposed for the cure of cancer in every part of the body. These are generally useless, and sometimes hurtful. The pretensions of em- pyrics, and the no less injurious interference of friends and acquaintances, who have all their own mode of cure, too often deceive the patient, and prevent her from using those simjde but salutary means, which at first keep the disease in subjection; or from submitting to an operation when the complaint is seated in a part capable of being removed. The only time when benefit can be derived is thus lost, and nothing afterwards remains but to diminish. as much as possible, the misery of the patient. A MOLE, Is a fleshy or bloody substance, contained in the womb, and its size varies from that of a nut to an orange, or it may even become larger. The symptoms are very much the same at first with those of pregnancy, so that this has been called a false conception. However, in pregnan 528 A Mote. cy the belly often becomes flat and less, until the end of the second month; on the contrary, when there is a mole, the belly increases from the first, and so continues to the second or third month, at which time it generally comes away. If it continues longer, it often proves troublesome by the flooding it occasions. After the period of four months, the mole excites no motion in the womb like those of a living child, it distends the belly equally, and changes its situation according to the posture of the mo- ther, which is never known to hajipen whilst the foetus is alive. It is produced by the retention of a clot of blood in the womb after a miscarriage, a profuse menstruation, or it may follow a delivery at the full time, or may be occa- sioned by the retention of a blighted conception. When a mole occasions no ill symptoms in the mother, no violence should be used to bring it away, but it may continue many years without creating any remarkable inconvenience. If it comes away by the end of the third month, it rarely happens that any assistance is necessary. Let the finger be gradually introduced into the womb, and, if that suffice not, introduce another, and thus the mole will generally be excluded by the pain which attends on these occasions. The mole is expelled with the same symjitoms as in a miscarriage, and requires similar man- agement. A substance of a different nature is occasionally met with, namely, a mass consisting of small bladders, called hydatids. These bladders, which contain water, may be very numerous, and somewhat resemble a thick cluster of grapes. Some of them are not larger than the head of pins, others larger than a nut, or one or two may even acquire a greater size. Generally speaking, they are produced by the same causes which occasion a mole, but they usually proceed from the retention of a blighted con- ception, which comes to be converted into hydatids. In this last case, the time when the embryo or foetus perishes, is marked by the breast becoming flaccid, and the morn- ing sickness going off. The belly does not increase in size, or if it do, it is slowly. The patient does not become regular, as she would have done, had the womb been Dropsy of the Ovarium. 529 emptied; but she may be subject to irregular discharges of blood. At length, after an uncertain period, pains like those of labour come on, and the mass is exjielled, often with a very considerable flooding. The management is the same as in an abortion. After the expulsion milk sometimes appears in the breasts. DROPSY OF THE OVARIUM. The appendages of the womb called Ovaries, are fre- quently the seat of dropsy. This disease occurs at every period of life. It is a most extraordinary fact, that a small body, not larger than a nutmeg, and having naturally no cavity, should by disease become so enlarged as to contain, in many instances, above ten gallons of watery fluid. At first, dropsy of the ovarium is very inconsiderable, and attended with no disagreeable symptoms. It in- creases gradually in bulk, and is originally confined to one side only, more frequently the left one. The patient enjoys usual good health in most cases, till the tumour has acquired a considerable size; it then induces pain and numbness in the thigh corresponding with the side in which the swelling is situated, and by degrees the body becomes wasted, the appetite bad, and the strength im- paired. Nothing can be more uncertain than the progress or termination of this comjdaint. Experience has proved, that, under the most apparent desperate circumstances, the health has been in a manner restored, or life for a considerable time protracted; while, on the other hand, where no urgent symptoms have appeared, a sudden ag- gravation of complaints has occurred, and a rapid ad- vance to the fatal termination has taken place. With respect to the cause of this disease, nothing sat- isfactory can be offered. Womenvif every age and con- dition are found afflicted with it. Human prudence, there is no reason to fear, can neither foresee nor prevent its occurrence. 67 530 Barrenness. This disease can be very rarely cured. Our chief and most rational object is to keep it from increasing quick- ly. For this purpose diuretics have been tried, but they have no effect. The best practice seems to be, to make gentle jiressure externally with a bandage, so as to sup- port the parts, at the same time, that we may keep the bowels open, and use means for invigorating the consti- tution. Troublesome symptoms must be palliated by ap- propriate remedies. When the symptoms of heathlessness and very great debility become urgent, the water may be taken off by the operation of tapping. A temporary relief, however, will in general be obtained by these means, for the fluid is commonly soon again accumulated in increased quan- tity. In some rare cases, where the general health of the pa- tient remain unimpaired, by the use of strengthening remedies, the disease has been prevented from returning after tapping; and hence patients, under such circumstan- ces, should not altogether despair. Dr. Cutbush gives an instance of a dropsy of the fal- lopian tubes, being effectually cured by the application of tobacco. [See Materia Medica.] BARRENNESS. Sterility is a misfortune few women become altogether reconciled to. In various countries and in different ages ofthe world, charms and spells, and powerful elixirs, have been resorted to; rich offerings have been presented at the shrine of a favourite saint; pilgrimages have been undertaken to holy wells; and, in addition to all, the vir- tues of potent herbs and drugs have been made trial of, for the removal of this infirmity. When we consult the writings ofthe old physicians on this subject, we find numerous recipes, containing medicines sometimes of op- posite qualities, and sometimes of no quality at all. The practice of the moderns is, at least, more simple, if not more efficacious. Sterility proceeds from either a tem- porary or permanent incapability of conceiving or retain- Barrenness. 581 sng the embryo, till it acquires a form. The causes pro- ducing this incapability, may consist in some malforma- tion or deficiency of the womb, or its appendages, which cannot always be discovered during life, or in merely a weakness in the action of the womb. • This last is by far the most frequent cause, and it is occasioned by local weakness of the. womb or general affections of the whole system; and is marked usually by an obstruction, deficien- cy, or redundancy of the menstrual evacuation, or by the complaint termed female weakness. It is very rare in- deed, for a woman to be barren who is, in all respects, regular. We do not in the present age, pretend to the knowledge of any elixir or medicine, which has the s|iecific power of curing sterility. We proceed on the principle of rec- tifying the constitution, where it is injured or weak, and of restoring the menstrual evacuation, to its due and healthy state. The means for effecting these purposes, must depend on the situation of the individual, and may be learned from some of the preceding chapters of this work. There are chiefly two states of the constitution pro- ductive of those deviations in the action of the womb, which cause barrenness. The first is a state of fulness, and a disposition to obesity. The person gradually becomes fat and inactive, the menstrual evacuation continues regular for some time, but at last diminishes, and becomes obstructed, or goes to the opposite extreme, and becomes frequent or profuse. The patient is either barren, or subject to false concep- tions and abortion. This state is to be rectified by spare or vegetable diet, total abstinence from malt liquor, reg- ular and constant exercise, especially early in the morn- ings and on horseback, the prudent use of laxatives, and after some time the cold-bath. These means will, if persisted in prudently, effect the desired change, but if pushed to an undue degree, and especially if repeated purgatives, and much vinegar, or great abstinence re- sorted to, the health may be completely ruined. The second state is that of relaxation, the habit is spare, instead of corpulent; the mind is lively, and per §88 Barrenness. haps even irritable; the menstrual evacuation either pro- fuse, or it recurs too frequently; and at times clots and shreds are discharged. This requires a different treatment: the diet, if not unusually nutritive, is at least not to be sparing, the ex- ercise must not be carried the length of fatigue, the cold bath is useful, and strengthening medicines are required. Such remedies as have been pointed out for the remov- al of irregularities of the menstrual evacuations, or of fluor albus, must be employed when necessary. By persisting carefully in a proper plan, sterility may at length be frequently removed. There are many in- stances of women bearing children, after having been several years barren. MANAGEMENT and After tbe child is born, the first thing to be done, if it be lively, is to separate it from the mother. But if it do not cry or manifest signs of life, this is to be done with greater hesitation. Children do not breathe in the womb, but have that function compensated for, by the circula- tion of the blood, through the after-birth, by means ofthe navel string. Now, if after being born, the child do not breathe, gasp, or cry, then after ascertaining that the face and mouth are not covered with the membranes, and that the navel string is not incircled round the throat so as to prevent breathing, the next thing for consideration is, whether it is still deriving any assistance from the after- birth, for if so, removing the child would be a fatal step. This we know, by taking the navel string between the fingers and thumb; if a beating or pulsation be felt, the circulation is going on, and as long as that continues, the cord ought not to be tied. There may be exceptions to this general rule, but of these exceptions, nurses and at- tendants cannot judge, and therefore to them, the rule is absolute. The child is to be kept warm below the clothes, except the face, and is to be rubbed with the hand, par- ticularly over the breast. If it begin to breathe soon, and give one or two convulsive struggles, there is seldom any risk; it will speedily cry aloud, and may then be separat- ed. But if it do not breathe, and the pulsations in tbe cord stop, then, after this, no good can accrue from let- ting the child remain in that situation; the cord is to be tied and cut; or, if the pulsation stop immediately after the birth of the child, it is not to be continued connected to the mother. In either case, whether there never was 584 Management of Children. pulsation discernable, or whether there was at first pulsa- tion, but that have now ceased, tbe child is to be immedi- ately removed, and measures used for restoring anima- tion, unless there be evidence from the putrid appearance of the child or cord, that it has been long dead. Still-Born.—Children may be still-born, in conse- quence of various causes, such as pressure on the navel string, during labour, so as to obstruct the circulation; long continued labour after the waters are drained off; or from remaining long with the head pressed in the bones of the mother; besides other causes connected with the state of the child itself, inducing actual death before delivery, or unfitting it for breathing after birth. The occasional recovery of still-born children under circumstances where experience alone could have encour- aged such hopes, ought to teach practitioners of midwifery the importance of employing, withpatience and attention, the means conducive to this purpose. These means consists chiefly in preserving the heat, and endeavouring to produce respirations. The first is done by immersing the child up to the neck in luke-warm water, or covering it with warm flannel until that can be procured. The second is effected by such means as tend to rouse the system in general, such as friction with spirits over the body, the application of some stimulant to the face, such as touching the temples, nostrils and lips with a feather dipped in vitriolic sether or spirits of hartshorn, slapping the buttock and soles of the feet, with the palm ofthe hand, and giving an injection consisting of a tea- spoonful of spirits with two or three table-spoonfuls of warm water, or a little salt and water, but chiefly by endeavouring directly to excite the functions of respi- ration, by inflating the lungs with air. This is done by means of a bag of elastic gum, or a common syringe, the pipe of which is to be inserted into one nostril, while the other and the mouth are carefully closed, and are then, by gentle pressure on the breast to be emptied. In this way the lungs are to be alternately distended and compressed for some time. Should the process of breathing commence after these means have been used for a few minutes, no- thing else is to be done than keeping the infant warm, with its face freely exposed to the air. Management of Children. 535 Fortunately the above means for recovering still-born infants are seldom required, and the child in a few se- conds after birth cries and breathes freely. Navel Cord.—In general there is more impatience shown by the attendants than is prudent, in respect to tying the navel string. In order to tie the cord as it ought to be, two ligatures will be necessary, which should be formed of such a number of threads, knotted together at each end, that in tying firmly with them, there may be no danger of dividing tbe navel string. And as soon as the circulation in the umbilical cord isstopjied, oneof them is to be applied about three or four fingers' breath from the navel, and the other about two inches from the first, on that side next the placenta, and then divide the cord between them. On separating the child from the parent, the first thing to be done, is cautiously to wash off the white crust which covers the skin, by means of a little soap and lukewarm water. The child being cleaned, a small bit of soft rag is next wrapt round tiie navel string, and a band is wound lightly round the belly. After this the child is to be dress- ed, suitably to the season. The portion of cord which is left next the belly, drops off within five or six days after birth, and leaves a tender- ness that is generally entirely removed in two or three weeks by the ordinary means which nurses employ. A split raisin applied every morning underneath the singed rag, accelerates greatly this process. When a complete separation of the cord does not take place in a week, it is usually found to hang only by a very small filament or thread, which should be divided. Clothing.—The clothing of infants should be light and simple, and made to tie with tape as pins are danger- ous. Almost every child cries on being dressed, and there- fore, it is desirable to have the dress constructed in such a manner, that it may be easily and readily applied. Very improper methods are often taken to strengthen the apparent weakness of a young child, such as the prac- tice of tight rolling, by which means the circulation ofthe blood is impeded, and the action ofthe abdominal muscles hindered from properly performing their offices. 536 Management of Children. If it is wished to have them strong upon their limbs, and active, early in life, as by nature they are intended to be, they should have the perfect freedom of their limbs, and their bodies easy, from the first day of their birth.— Tlr it- clothes should therefore be reasonably loose upon them, and not too great in quantity, although properly proportioned to the nature and variableness ofthe wea- ther. The quantity of an infant's bed covering should also be appropriate to the season of the year. The night-clothes must not be equal in quantity to those wliich are worn during the day; otherwise a great tendency to be effected with colds, &c. may be induced. For the same reason, when the infant sleeps in his day clothes, he should be very slightly covered. Infants sleep much at first, and ought not to be dis- turbed; in this resjiect, they may be left to their own pro- pensity, and as they grow older, they sleep less. The only point to be attended to, when they become so old as to have the sleep regulated, is to prevent their sleeping so much through the day, as would make them restless at night. Purging.—The practice of giving infants, as soon as born, butter and sugar mixed, salt and water, or purging medicines, has often proved detrimental by promoting acidity in tbe bowels. If the infant, after being complete- ly dressed, is apparently quite easy, it should be laid down to sleep, without taking any thing; and after a few hours it may be applied to the mother's breast, whose milk at that period being laxative, answers the purpose of cleansing better than all the drugs in the apothecary's shop; and by putting the child early to the breast, especi- ally the first time of suckling, the nipple will be formed, and the milk gradually brought on. Hence much pain, and its consequences will be prevented. To teach the child how to suck, a little milk and water, sweetened with white sugar, may be given it at the end of a tea-spoon, which the innocent will clasp in its mouth; or a finger wetted with it may be frequently put between the gums. In cases where the infant appears to be loaded with phlegm, a little well made plain grit gruel should be given Management of Children. 537 immediately, and when this or its natural food, the milk is not found sufficient to ex|iel the meconium, or first black stools, a solution of manna, or a tea-spoonful of good cas- tor oil may with propriety be given. Nutrition.—It is too much the practice, to give chil- dren food or drink before putting them to the breast, on the principle of supporting them until the milk come.— Infants do not suffer so much from want of nourishment immediately after birth, as they do when deprived ofthe breast forthe same number of hours, after they have once sucked. The young of no other animal requires to be fed before sucking the mother; and if infants be applied early to the breast, they will not require it either. No food is so proper for the child, as the mother's milk, and where she has plenty, and the milk agrees with the infant, it ought to constitute the sole support for several weeks. "Doubt ye the laws by nature's God ordained? Or that the callow young should be sustained Upon the jiarent breast? Be those your schools Where nature triumphs and where instinct rules.'' After the second or third month, it may then be pro- per to give the child once or twice a-day, a little of some other food. This will ease the mother, will accustom the child by degrees to take food, and will render weaning both less difficult and less dangerous. Nature abhors all sudden transitions. For this purpose the food of children ought not only to be simple, but to resemble, as nearly as possible, the projierties of milk. Indeed milk should make a jirincipal part of their food, not only before they are weaned, but for a long time after. Infants generally suck greedily, and if allowed, would gorge themselves, and injure the stomach, The mother, therefore, ought not to become the slave ofthe child, and es- pecially, ought not to allow it to sleep at the breast.— Children may early be, taught to suck at regular intervals, and never should be indulged as often through the night as through the day; which breaks the mother's rest, is apt to hurt her health, and generally injures her as a nurse. One suck late at night, and another early in the morning, will be quite sufficient. 68 338 Management of Children. It has been improperly imagined, that all mothers ought to be nurses. By this opinion many children have been destroyed, and a greater number have only lived to regret their existence; the weakness of their frames having made them strangers to the comforts of good health. Whenever the parent is injured by giving suck, or the child is stinted in nourishment, or hurt by the quality of the milk, it becomes a positive duty to procure a healthy nurse. "Think not that I would bid your softness share Undue fatigue, and every grosser care; Another's toils may here supply your own, But be the task of nurture yours alone." When the infant cannot obtain the milk ofthe mother, or that of a healthy woman who laid in about the same time, the best food, for several weeks at least, is new milk alone, or mixed with an equal quantity of arrow root, or well boiled grit or barley gruel with the addition of a little sugar. As the child advances in age, and its strength in- creases, weak broths, with a little barley, rice, or hard biscuit boiled in them may be allowed. It is soon enough to allow children animal food, when they have got teeth to tear it. Bread may be given to a child as soon as it shews an inclination to chew. The very chewing of bread will pro- mote the cutting of the teeth, and the discharge of saliva. Children discover an early inclination to chew whatever is put into their hands. Parents observe the v clina'ion, but know not how to apply the remedy. Instead of giving to the child something which may at once exercise its gums and afford it nourishment, they commonly put into his hands a piece of hard metal, or impenetrable coral. A crust of bread, or a hard biscuit not only answers the pur- pose better than any thing else, but has tiie additional pro- perties of nourishing the child, and carrying the saliva down the stomach, which is a great promoter of diges- tion. In feeding children considerable judgment is necessary to proportion the quantity of food to its age and strength. Weakly children will always require less food than those Management of Children. 539 who are stronger, for they are less able to digest it. They are frequently attacked with alarming and even fatal con- vulsions, fromtheirbowelsbeingoverloaded. Underallcir- cumstances, if the foot! is too thick, or given in too great a quantity, the perfect digestion of it is prevented. It is not necessary to feed a child oftener than five or six times in twenty-four hours, and the less it is fed in the night the better. It is a most ridiculous errorto suppose that whenever a child cries it wants v irtuals, asd thus to be constantly feeding it both day and night. If the child's wants and motions he. judiciously attended to, it will be found that it seldom cries, but from pain; and if it be pro- perly nursed, and quite easy in irs dress, it will rarely cry at all. Nurses should be particularly cautioned not to lay a child on its back when fed. In the posture of sit- ting, it swallows its food more easily, and more readily feels when it has enough. Cleanliness.—The most scrupulous attention to cleanliness, during the whole period of childhood, cannot be too strongly inculcated. For the first week or two the infant should be bathed, morning and evening, in tepid water, and afterwards in cold water. The whole body ought to be washed in the morning, and the lower half at night. In washing with cold water it is proper to begin with the head, and to finish as expeditiously as possible. The infant should be afterwards well dried, particular- ly at the bendings of all the extremities, and the whole body and limbs should be gently rubbed with dry soft linen or flannel until a glow of warmth appears upon the skin. It is the manner of washing a child that secures it from suffering from the application of cold water. The more delicate and weakly an infant is born,the more will cold water strengthen it. if well applied; and, besides its bracing qualities, it will by cleanliness prevent excoria- tions, and keep off that troublesome complaint termed the scald head. When the application of cold water has been omitted for some days, it will be better to begin with the addition of a little salt or some brandy to the water, lessening the quantity of it gradually, so as to leave it off entirely in a few days. 540 Management of Children. When children are a few months old, cold bathing may be substituted in the room of washing with cold water; and it may be proper here to add some directions, respecting the mode of dipping a child in cold-water. Of these, the principal is, carefully to watch for that moment when it has taken in a full breath, and then to plunge it into the water, and take it out instantly, so that no part of the ac- tion of respiration may be necessary during the time of submersion. The child will then breathe freely on being taken out of the water, and suffer little or none of that agitation which often defeats the intention ofthe practice, and produces a terror when it is to be repeated. Children should have their linen and clothes frequent- ly shifted, flow often do we meet with little infants, merely from sloth or ignorance, wearing the same dress for days, and rendered disgusting both to sight and smell. Scarcely any other care or advantage can pre- vent the child from suffering, when cleanliness is neg- lected. Attention should be paid to keep the child dry, and the clothes ought to be immediately removed when soil- ed or wet; the child should also be wiped with a soft sponge, dipped in water. It is wonderful how early an infant may be taught to void the urine and stools at pro- per intervals into a pot. Air, Exercise, and Sleep.—If grown persons, who have been many years accustomed to impure air, often feel themselves sick in a crowded room, it must be very evident, that a much less degree of bad air will affect in- fants, whose lungs are weak and irritable. The temperature in which children are kept should be so regulated as never to be below that which is agreea- ble to an adult. By sudden exposure to cold air, the infant is apt to have cough, or stuffing of the nostrils produced; on the other hand, warm apartments, and es- pecially a neglect of a circulation of air, hurts the health, and makes him liable to fits. On the proper exercise of infants, more depends than superficial observers could imagine; for by inattention to this circumstance, a foundation is often laid for dis- eases, which, though their first approaches be slow and gradual, terminate suddenly in a fatal manner. Management of Children. 541 It is therefore of great importance, both to the popula- tion of the Country, as well as the health ofthe inhabit- ants, that parents should attentively consider, that the more children are e^ised to the open air, within pru- dent bounds, the less they are subject to take cold By exercise in the fresh air, weakly and delicate infants will Acquire a vigour and elastic spring To which they were not born.— Armstrong. For a week or two the mere washing and dressing of children, and the motion which they from time to time make with their arms and legs, is productive of sufficient exertion. By degrees, they may be tossed or dandled a lit- tle, and ought to be occasionally placed on a bed to allow them to kick, and move their arms freely. When they are able for it, they should be encouraged to creep on the carpet, and even when two or three months old, the feeble and unavailing attempts they make to move or to raise themselves are useful. The age at which infants may be taken out depends much on the season. In warm weather they may be carried out when a fortnight or three weeks old, but in winter they must be older. At first they ought only to be kept without doors for a ve- ry short time; and the person who has charge of them should walk slowly and gently, and avoid standing, especially in a current of air. By degrees they may be sent abroad twice a-day, when the weather is favourable, and may be kept out gradually for a longer space of time. Infants sleep much at first, and ought not to be disturb- ed. In this respect, they may be left to their own propen- sity, and as they grow older they sleep less. The only point to be attended to, when they become so old as to have the sleep regulated, is to prevent their sleeping so much through the day, as would make them restless at night. A crib is the proper bed for a child. Cradles are hurtful, as the rocking is often carried to a dangerous degree, and, besides, they are so confined, and generally so closely covered, that the child breathes an impure air. S42 Management of Children. Nature never intended that infants should have exer- cise d iring sleep after they have breathed: therefore the idea, that rocking in a cradle resembles the motion to which infants have been accustomed when in the womb is an erroneous one. The young of other animat- ed beings sleep quietly and profoundly for a great part of their time without any rocking, although they also were habituated to a gentle waving motion before birth. Every restriction to one particular position, in what- ever situation the infant may be, ought to be constantly guarded against; for as the softness of the bones renders them easily moulded into an improper shape, deformities which may destroy the health, or prove the source of much future distress, will, if this caution be not observed, be readily induced. An infant should not therefore be laid always on the same side, nor carried constantly on the same arm. Weaning—Forms an important sera in the life of 'an infant, as on the proper regulation of this great revolu- tion in his mode of living his future health often depends. The time at wliich a child should be weaned depends much on his health, and on circumstances connected with the nurse. A delicate child requires to be nursed longer than one who is stout; and where there is reason to suspect a tendency to particular complaints, connect- ed with weakness of constitution, or where children suf- fer from teething, or former children have suffered from weaning, it will be right to continue the nursing for near a twelve month. But when the child is vigorous, he may be weaned at nine months, or even earlier, if any particular circumstance require it. Since there's no help, come let us kiss and part, Nay, I have done, you get no more from me, And I am glad, yea, glad with all my heart, That thus so clearly I myself can free. Drayton. This is perhaps one of the severest trials a mother is called to endure, when compelled to relinquish the sweet office of nurse, to her babe. What sensation can equal the rapture of that moment! Management of Children. 543 When the fond mother, bending o'er his charms, Clasps her fair nursling in delighted arms; Throws the thin kerchief from her neck of snow, And half unveils the pearly orbs below; With sparkling eye the blameless plunderer owns Her soft endearments and endearing tones, Seeks the salubrious fount with opening lips, Spreads his inquiring hands, and smiles and sips. Darwin. Many errors are daily committed in the method of wean- ing. Some women deprive the infant of the breast at once; and others, by the application of mustard, or any nauseous substance, to the nipples, endeavor to make him desert the breast of his own accord. Both practices are equally cruel and improper. In all cases, the change ought to be made gradually, the child receiving more food, such as arrow root, bis- cuit, jellies, beef-tea &c. and less milk for some time pre- vious to weaning. It will also be of advantage to ac- custom him for a few weeks to have no suck early in the morning; nothing from bed-time till an early breakfast. Many give drink through the night, which is merely a bad practice. By giving food three, or even four times daily, and lessening the quantity of milk gradually, as the other diet is increased, children very seldom suffer from weaning. The great cause of injury is the change of diet, which produces disorders of the stomach and bowels, and this it is evident cannot be so effectually pre- vented by any method as making the change gradual- ly. The practice of giving a child toddy, or laudanum, &c. to make it sleep, when it is weaned, is very hurt- ful, as these injure the stomach and bowels. The infant should be accustomed, when weaned, to re- ceive food or drink at stated periods, and not according to the caprices of nurses. Although this task will at first be somewhat difficult, it can always be accomplished by perseverance.-, and the benefits which the infant it- self, and its attendants derive from this circumstance, will more than compensate for the trouble attending the attempt. As little drink or food ought to he given 544 Management of Children. during the night as possible; for a bad habit may be induced, which may lay the foundation for many future complaints. Nursing.—Much of the present comfort and future health of a child depends upon tbe nursery maid. "What careless dread a mother's breast alarms, Whilst her loved offspring fills another's arms! Fearf'il of ill, she starts at every noise, And hears, or thinks she hears, her children's cries.'" Among the qualifications required in a nurse, the fol- lowing may be enumerated.—Cleanliness in her person, with a cheerful obliging temper—patience, and a method in all her arrangements—attention to regulate the tempera- ture of the nursery, so as to avoid either cold or exces- sive heat, and to have the clothes always dry and clean— prudence in the diet of the child, and perfect obedience to rules and orders. As children can be early educated to evil and mischief, it will not be denied, that, with equal attention, they may be trained to good. And since they are, in some mea- sure, under the control of the nursery maid, it behoves parents to be watchful, and not to trust their offspring in the hands of one not endowed with good qualities. "Once exiled from your breast, and doomed to bring His daily nurture from a stranger spring; Ah! who can tell the dangers that await Your infant, thus abandoned to his fate?" Indeed there is no doubt, much ofthe misery, and many ofthe crimes of human life, have their foundation laid in the nursery; and could some of those who have suffered most for their misconduct know all the steps which led to it, they would regret that the seeds of ungovernable passion, of selfishness, and other vices, had been jdanted before they could discern their right hand from their left. It is greatly in the power of a nurse to regulate the disposition of a child, as well as promote its bealth, by carefully avoiding those causes which may have the least Management of Children. 545 tendency to render it fretful and peevish, and by remov- ing, as far as possible, every distress on its first appear- ance. A child does not cry unless uneasy from hunger, want of sleep, pain, or some inconvenience. Bodily uneasi- ness will, with any child, affect the mind, rendering it peevish and irritable, and presently causes, which may be called mental, will do the same. For a child is not merely an animal machine, it has also a mind capable, very early, of feeling various passions. So soon as children begin to notice, and to be attract- ed by sounds and objects, the nurse ought to sing in a cheerful and lively strain. And we should present, and take away, in a cheerful and amusing manner, objects which attracts the eye, by which the cbild is early taught to receive, and readily part with, what it desires. Now, when his little hands from bondage free, Restless expand in new-born liberty, You teach the child, with reprehension light, In preference to the left, to use the right. Roscoe. The practice of servants scolding children in jest, and teaching them to scold in return, encouraging them to scratch, and revenge real Or pretended injuries, and to take vengeance on chairs and stones, is productive of in- calculable mischief. And we not unfrequently find great pains are taken by the nurse to inspire the child with a terror at the doctor, and at medicine, the effects of which are best seen when the child becomes sick. We will further observe, it is through a most criminal inattention to children in the nursery, a foundation is sometimes laid in their tender minds for those supersti- tious terrors, from which not all their efforts in subse- quent life can entirely relieve them. I allude to those dismal stories about witches, spirits, hob-gobblins, raw head and bloody bones, wherewith silly nurses, especially poor blacks, are so fond of frightening infants. Consid- ering the importance of deep impressions made during those tender years, parents cannot, too strictly forbid ev- ery thing of this sort; neither can they ever exceed in 69 546 Management of Children. their generous labours to illuminate the minds of their children with lofty ideas of their Creator, and that mighty power which he will never fail to exert in their favour, if they will but be good. Caution to Parents.—Independent of the means we have pointed out to ensure the health of children, and preserve the human species, we must have an equal re- gard to the dispositions of children. We consider the health of the mind of even greater importance than the health of the body, and indeed they are very intimately connected; for what mother can vouch for the health of her babe a single day, if she has not command enough over herself and it to control its appetites, wants, and flesires; on the due regulation of which not only its hap- piness, but its health, must depend. It is to be recollected, that a child has a mind endowed with gradually unfolding powers and passions; that when it begins to notice and desire, it becomes an object of education or training; and this is the time to acquire that ascendency over your children's minds, which, if projierly employed, will ensure you a due degree of in- fluence over them through life. Every discreet mo- ther, deeply impressed with the importance of the trust committed to her. will begin by gentle admonition, soft- ened by maternal endearments, to check the first indica- tions of obstinacy and ill temper in her child; for like small weeds s|iringing up in a luxuriant soil, they may, with care, be easily eradicated; but if permitted by neglect to take root, they will soon overshadow the choicest virtues, or choak them while yet in embryo. And should life's olive branches rise To bless your fond parental eyes; She who, with all a mother's care, The nursling plants can fondly rear; Th' excrescent shoots with firmness prune, Each noxious weed with care consume, Till nurtur'd by her fostering hand, The-rising plants grow and expand, Bud, blossom, bear—While each survives The ripened fruits of virtuous lives. POLYANTHUS: Management of Children. 547 As soon as children can comprehend language, they may be taught obedience, and their inordinate desires be reg- ulated in such a manner as to prevent their becoming so totally unmanageable, as is too often the case. For in- stance, should an infant of eight months take a fancy to its mother's watch, as it would be a very improper play- thing, it should .receive a gentle but firm denial. It would probably grieve. Something else should be offered it; and if it takes it and is pleased, all will be well. Often as it reverts to the watch, the denial must be repeated, and it will soon relinquish the expectation, and be per- fectly happy with other toys, and so in every thing else. On the other hand, should it show resentment when the watch is denied, and refuse all other play- things that may be offered, instead of weakly yielding to the storm, and with mistaken tenderness giving up the watch, or with anxious care concealing it from its sight, still greater resolution must be observed, tempered with tenderness and moderation, as the object must he to cor- rect the disposition. On no account permit it to have the watch, and as often as it inclines to dispute the point, let it perceive you are determined. After a few lessons of this kind, your word will no longer be disput- ed, while your children, thus early taught submission, will never require any severity whatever. But then our government must be uniform to produce this happy effect. It will not do, because we should chance to feel out of humour, or it should militate against our own gratifica- tions, to deny an infant an indulgence to-day, wliich, in a paroxysm of maternal fondness, we may grant it to- morrow. Be assured, children will very soon learn to take advantage of such capricious conduct; and when once they discover that we are irresolute in our commands or may be overcome by resolution and importunity on their part, they will not fail to profit by the discovery, and that by such imperceptible degrees, that many a fond mother finds her authority gone, and her jurisdiction contemned, before she is aware that she has by her im- becility forfeited the one, or alienated the other. Nor is this evil confined to infancy. She will feel the melancholy effects of failing to substantiate her claim to obedience 548 Management of Children. from her children during the docile period of childhood, to the latest evening of her life. "How sharper than a serpent's tooth it is "To have a thankless child." It is absurd to pretend that a child is inferior to a pup- py, and yet a puppy may be early rendered docile and gentle, or sulky and ill-natured, according as he is edu- cated. Toteaze and contradict infants and children is not the way to improve the disposition, or to teach patience; but it is not impracticable to treat them in such a way as to prevent their crying, if they do not immediately obtain, or should be deprived of, what they desire, whether that be the breast or a shining toy. This is to be accomplish- ed, not by stubborn harshness, always hurtful to a child, and indicating a savage disposition in those who use it, but by prudence. Does any child, at least any one not under the guidance of an absolute fool, ever make a practice of crying, be- cause it is prevented from grasping the flame of a candle? No, surely; and why?—because the mother or nurse will never yield to this; and very soon the child beholds the candle without a wish to do more than look at it—yet, tbe very same cbild shall cry himself asleep, or almost into a fit, if prevented from scattering the sugar out of the su- gar bason. Some children, we know, are cheerful, good humoured, lively, and little disposed to be petted or fretful, when de- nied what they wish. Others equally healthy are per- petually crying, passionate and cross, if they do not in- stantly obtain what they desire. Peevishness and cry- ing cannot, when the child is sickly and uneasy, at all times be prevented; but when these propensities exist in health, there is no question that the fault lies with the pa- rents. It ought therefore to be remembered, that on the treat- ment the child receives from its parents during this stage, will perhaps depend much of its misery or happiness, not only in its passage through this, but through the other stages of existence. Diseases of Children. 549 If, on the one hand, every little sally of passion and impatience is immediately controlled; if that which is admissible is regularly permitted, and that wliich is im- proper as regularly withheld, the little creature will soon learn to distinguish that which is allowed from that which is prohibited. It will indeed urge its claim for that which it has been taught it has a right to, but will not harass itself and its attendants with ceaseless winnings, or raving to obtain that which uniform prohibition has placed beyond expectance. But a melancholy reverse appears, if, on the one hand, no consistency is observed in its management; if at one time the slightest indulgence is refused, and at another the most extravagant, and even injurious cravings are gratified; the child becomes more and more fretful, till at length it manifests such ill-nature, as to render it odious to all around, and sooner or later the poor little sufferer pays with its life the purchase of its early indulgencies. DISEASES OF CHILDREN REQUIRING EX- TERNAL TREATMENT. In considering the diseases of children, we shall begin with those to which the new born infant is liable from circumstances incidental to its birth, or mismanagement soon after it, which require principally external treatment; and then shall take notice of original imperfections. Sickness, the minister of death, doth lay So strong a siege against our brittle clay, As while it doth our weak forts singly win, It hopes at length to take all mankind in; First it begins upon the womb to wait, And doth the unborn child there uncreate, Then rocks the cradle where the iufant lies, Where ere it fully be alive it dies. Carew. 550 Diseases of Children. INJURIES IN CONSEQUENCE OF BIRTH. When the infant has been detained a long time in the passage, the several parts subjected to pressure are lia- ble to be injured. Swelling of the Head.—The most common of these injuries are swellings on the head, or alteration of the shape of that part. First born children are generally affected with some degree of swelling on the crown ofthe head. The edges of this swelling are hard, and the middle soft, so that an inexperienced person would sup- pose that the bones ofthe lead were deficient at that part. It will commonly subside in a short time. But when a tumour remains on any part of the head, a cloth dipped in equal parts of spirits and vinegar, and applied two or three times a day, will soon disperse it. The practice among nurses, therefore, of endeavouring to give the head a proper shape by squeezing and press- ing it with the hands, &c. is unnecessary, and ought nev- er to be allowed, on account of the dangers which may be the consequence. Scratches or Marks on the bead require no parti- cular attention as they soon disappear. Injuries of the Face.—In some cases, where the infant has come down in an unusual direction, the/ace is much affected: the eyes being inflamed, the nose flattened, the lips swelled, the features distorted, and the colour of the countenance livid. These frightful appearances usu- ally go off in a few days, when no violence has been done by improper interference during the delivery. Swelling of the Breasts.—The breasts of child- ren sometimes swell and inflame, especially if attempts be made to press out forcibly a milky fluid, which they often contain. If the pressure of the clothes is avoided by their being put on loosely, it will generally go off without any application. However, it is sometimes ne- cessary to rub the part gently with warm olive oil; and in case of much inflammation, equal parts of spirits and vinegar must be applied cold, by means of soft linen, or poultices of the crumbs of bread, and lead water or milk, Diseases of Children. 551 should be employed for its resolution. If from misman- agement they should suppurate, a warm milk and bread poultice, is to be frequently ajiplied, and when the tumor bursts, the part is to be dressed with simple ointment. Swelling of the Scrotum.—The scrotum will also be remarkably tumid, and even discoloured, particularly when a child has been born by the breech presentation. In this case, it will be proper to suspend it by a cloth, af- ter first covering it with a piece of linen, wetted with brandy, which should be frequently renewed. Injuries of the Limbs.—The limbs are in some cases fractured or dislocated, by the rashness and awkwardness of the practitioner. These accidents, on some rare oc- casions, unavoidably happen from the situation of the in- fant; but are most frequently to be attributed to ill direct- ed attempts to accomplish the delivery. From whatever cause these disagreeable occurrences originate, they should never be concealed from the at- tendants; but, on the contrary, the proper means to reme- dy them should be immediately adopted. Management of the Navel.—From neglect, or from a bad constitution of the child, the navel sometimes, after the cord drops off, becomes very tender and exco- riated, giving a good deal of trouble. Great attention is to be paid to cleanliness. It is to be bathed twice or thrice a-day with infusion of camomile flowers, and afterwards with a solution of ten grains of white vitriol in six ounces of rose water. A bit of singed rag is usually employed as the dressing, but when this sticks firmly, a little sim- ple ointment may be used. If there should be more than usual tenderness, it may be proper also to sprinkle it with a little prepared chalk or starch. In some instances there is a discharge, and the part continues raw; then it will be proper to apply three or four pieces of soft cabbage leaf, laid one over an- other, that they may be preserved moist and cool, and continued as long as the discharge may continue con- siderable. The bleeding which sometimes happens at the navel, is of such little consequence, that a light com- press, with some gentle styptic, and secured by a stick- ing plaster or bandage, soon removes it. The soreness, 552 Diseases of Children. when considerable, may require a milk and bread poul- tice, and the exhibition of some mild laxative medicine. Sore Eyes.—Children within a few days after birth, in consequence of exposure to much light, or a strong fire, or from other causes, some of them operating during de- livery, have sometimes inflammation of the eyes. The eyelids swell, and the inside as well as the white of the eye become red, and covered with a quantity of yellow purulent matter, which comes out at the corner ofthe eye, which hardening tends to glue the lids together. In some cases, the eyelids are little swelled; in others their insides are turned out, especially when the infant cries. If this be neglected, specks may form on the eye, or the disease may be communicated to the eyeball, and suppu- ration take place within, destroying vision forever. The cure consists in guarding against exposure, to large fires, much light, or cold; and in bathing the eyes, morning and evening, with a little warm milk and water, and twice or thrice through the day with a very weak so- lution of sugar of lead, or of white vitriol. When the inflammation is considerable, a blister to the nape of the neck, and the occasional use of a grain of ca- lomel at bed time, or the cathartic mixture [See Dispensa- tory] in doses of a tea-spoonful every hour or two, to keep the bowels in a laxative state, are proper. Should the eyelids stick together, the edges should oc- casionally be anointed with simple cerate or a little mer- curial ointment, and a drop of the vinous tincture of opi- um or equal parts of laudanum and water, applied with a camel's hair pencil into the eye four or five times a-day. Excoriations.—From the delicate texture of the skin of infants, excoriations readily take place whenever one part of it is in constant contact with another, unless the most careful attention be paid to keep every part dry. The inflammation termed galliig, wliich so frequently occurs in the groin, between the legs, and on the neck of an infant, evidently arises from inattention to cleanliness, and from the use of coarse or new pilches.* * If children were attentively held over a pan from the month, it would be found that they are more cleanh than people suppose, and would supersede altogether the use of cleths, either by night or day. Diseases of Children. doi> The cure will easily be effected by washing the parts often in cold water, and, after being wiped dry. dusting them with prejiared chalk or starch. But if they have been neglected, and become fretted, they require to be washed, frequently, with a solution of ten grains of white vitriol in five ounces of rose water. If the excoriations are situated about the genitals, it may also be proper to apply a thick mucilage of gum arabic, or to cover the part with a little fresh saturnine or simple cerate, to defend it from the action of the urine. Slight ulcerations behind the ears of infants are also ve- ry common, and only require to be washed daily with cold water, and covered with a single rag to keep the cap from sticking to them. They are sometimes beneficial, espe- cially during bowel complaint, or teething, and will get well and break out again into very foul sores several times, without any cause for alarm. However, when these sores become extensive and pain- ful, it will be projier to apply a blister to the nape ofthe neck, to draw off the heated serum, and to give now and then a few grains of magnesia and rhubarb, or the absor- bent and aperient mixture. [See Dispensatory], The sores should also be well washed with castile soap and wa- ter, and dressed with an ointment composed of one drachm of calomel and one ounce of the simple cerate mixed well together, and spread on each side of a double linen cloth, wliich must be applied twice a-day. ORIGINAL IMPERFECTIONS. Infants are not always born in a state of perfection with respect to the structure of their bodies; for, sometimes they have deficient, superfluous, or misplaced parts. Many of these imjierfections admit of no remedy, while others may be easily rectified. Flesh Mark.—The most frequent of these, imperfec- tions is the flesh mark, or redness on the skiu, resem- bling a stain with a bramble. This may occur on any part, the face, the body, or the fingers. It has been at- 70 554 Diseases of Children. tributed to the. effect of the mother's imagination, or to a fright, but without any sufficient cause. It is met with when no such circumstance has occurred, and on the other hand it is wanting in those cases, where, if this had the Sujiposed effect, we would chiefly ex|iect it. The mark may be more or less extensive, and of different shades of colour. It proceeds from the collection of a great many blood-vessels, by which the structure ofthe part is alter- ed. By pressure, the redness disappears, for the blood is forced out, but it immediately returns. When it becomes elevated and enlarged, then there is an evident pulsation in the part. It grows with more or less rajiidity, and at last bursts, and discharges soinetimes an alarming quantity of blood. Pressure applied early, when the mark is on such a part as to bear it, is frequently an effectual mean of re- moving it, or at least of preventing all tendency to en- large. The application of some stimulant or astringent to the part, if it be small, the cuticle being previously re- moved by a mild blister, and also, occasionally employing pressure, will be found useful. Hare-Lip—Is so w ell known as to need no description. The treatment ofthe hare-lip must be varied according to many circumstances, which can only be determined by an experienced surgeon. If the child can suck, the ope- ration by which alone the blemish can be removed, should be deferred till he be several months old at least, as the parts will then be better adajited for retaining the pins by which the cure is accomplished. But when sucking is prevented, the operation may be tried, though it affords only a forlorn hope. To.ngue-Tied.—Infants are born with a thin mem- brane under their tongue, called the froznum, which is sometimes so broad as to require dividing, in order to give freedom to the tip, and to allow the child to take pro- per hold of the nipple in sucking. If the tongue is not bound down, and if the child suck the finger when put into the mouth, there is no reason for saying he is tongue tied. The operation, where it is really necessary, is very trifling, but if incautiously per- Diseases of Children. 555 formed, the artery below the tongue may be opened, and much blood lost. . It iseasilv divided by a sharp pair of scissors, and the operation can never be attended with any inconvenience, or hemorrhage, if it be done with proper caution. Clur-Foot.—The gristly state of the bones of the foot renders a cure in most cases practicable, when the proper means are begun immediately after birth; but if the deformity be not attended to till the infant be some months old, it will be difficult and precarious. The method by which this disease can be removed is very siinjde. It is merely the application of prop- er means to reduce the foot, in the most gradual manner, to its natural situation. These should not be continued only till .this is effected, but ought to be kept ajijdied constantly for several weeks after, in order that the de- formity may be completely removed. In the most fa- vourable cases, the cure cannot be completed within less than several months, and it often requires even a much longer time. Natural Passages.—Sometimes the natural passa- ges, particularly the bowels, may be shut up, the nostrils or eye lids may be closed, or the fingers may adhere, or have" fleshy attachments, like additional fingers. These cases admit of cure only, by a surgical operation. The one generally of the most importance, is the imperfor- ation of the bowel, by which the stools are prevented from passing. This case can only be relieved by a sur- gical operation, by which the natural passage is opened, and afterwards secured from closing again by the intro- duction of a bougie. The vagina of the female is also sometimes imperfora- ted. Parents should therefore carefully examine the in- fant, that it may not grow up with a defect, which at a cer- tain period of life, must inevitably prove troublesome, and whirh, at last, will require an ojieration to relieve. Infants have sometimes a discharge from the vagina, a few days after birth, resembling matter; but it is of no consequence, as it goes off of itself in a short time. When a child docs not make water, the use of a sil- ;i56 Diseases of Children. verprobe will ascertain whether there be any obstruction, and if there be not, it promotes the discharge. Sometimes an infant will be very long, perhaps a day or two, before it voids the urine, where no defect or ob- struction is to be seen. It will then be proper to rub the belly with some warm brandy mixed with a little oil. Some have recommended it to be rubbed with an onion. Which ever he used, it is advisable immediately after- wards to apply to the belly a bladder half filled with scalded bran, or camomile flowers, or hot water; and lest by some accident it should burst, it would be proji- er to enclose it in a secon-I bladder. A glyster of thin gruel, with a little oil, should be given, and if necessary, a tea spoonful of castor oil may be swallowed. If the child is in considerable pain, a few drops of laudanum may with projiriety be added to the glyster. , Ruptures—Are very common complaints among in- fants; but are fortunately not attended with so much danger as similar disorders in grown people. The kind, which is in general most immediately dangerous, is that wliich takes jilace at tiie navel; where a great part of the bowels may be forced out. covered only with a very thin and almost transparent skin. If this be so large, that the intestines cannot be jiressed back, the child general- ly dies, in consequence of the tumour inflaming, or go- ing into moitiiication. But if the bowels can be pressed back, and, especially, if the skin of the tumour be not very delicate, there is no risk. The application of a compress, and a suitable bandage round the belly keejis the intestine in its jdace. and in the course of some time, the aperture closes so far as to prevent the protru- sion. A broad piece of flannel, in the form of a roller, to- gether with a piece of adhesive jdastcr applied over the part, by affording a safe and firm support, proves ex- tremely useful. When they hajipen in the groin, all that can be done, is to bathe the jiart occasionally with equal parts of brandy and vinegar, keep the body open, use the cold- bath, and prevent tin* child from crying as much as pos- sible. A bandage cannot easily be applied with effect. Diseases of Children. 557 to so young a patient, though it is still worth a careful trial. In proportion as tbe infant acquires strength, tins'' troublesome complaints disappear. And nothing is more conducive to this than the continued use of the cold-bath, and paying attention to the state of the belly, as costiveness always aggravates the disease. There will often appear in the scrotum of infants, at birth, a turgescence, which has been called the watery rupture. Of this it is jiroper that parents and nurses should be aware, that it may not be mistaken for the true rujiture. From this it will be readily distinguished by its being elastic, and it cannot be made to disajipear by pressure, and by its not becoming larger when the infant cries. If it be placed between the eye and a lighted can- dle at night, it will be seen to be transparent. It will generally be cured by compresses moistened with vine- gar and water, with the addition of as much brandy as the skin is able to bear, or by the repeated application of cloths dip|ied in a solution of two drachms of sal am- moniac in eight ounces of water. But the best method is to puncture the bottom of the tumour with the point of a lancet, which is attended with very little pain and soon effects a cure. Another little complaint like the watery rupture, is tumefaction of the prepuce, wliich also arises from ex- travasated water, and is a partial dropsy of the skin.— The complaint will be removed in a few days, by wash- ing the part frequently with lead water, or by applying a poultice made with it and the crumbs of bread, and by keeping the bowels open. DISEASES OF CHILDREN REQUIRING MEDI- CAL TREATMENT. Before we proceeed to the consideration of those dis- orders requiring medical treatment, it may be proper to give a hint in regard to the doses of medicine. In pre- scribing for children, the chief difficulty lies in fixing the appropriate dose; and hence medicines more frequent- ly fail with them, or are over-dosed, than with the adult. 558 Diseases of Children. As a direction, therefore, it is proper to examine in a general manner, the proportions fit for this early period of life. Thus seven years require half the dose of an adult. Three years........the fourth. One year.........the sixth. One month.........the tenth. With these proportions in view, where no peculiarity of constitution exists, the doses stated will generally succeed. SNUFFLES. This term is given to a disease, which generally af- fects children within the month, and most commonly in the first or second week, on account of the noise made in respiration. The discharge is much more abundant than that which attends common cold. It is, from the first, purulent and thick, and afterwards turns thin. Children afflicted with this malady are always of a weakly, unhealthy habit; and though having apparently no particular complaint, they seem incommoded from a stoppage of the head, which is particularly perceptible in sleep when their breathing is difficult. A purple streak is observable on the verge of tbe eye lids, as an attendant on this disorder, with a general fulness ex- ternally, about the throat and neck. Its duration ex- tends to several weeks; and when it departs, it is usual- ly succeeded by a disorder of the bowels and other com- plaints. This disease appears with various degrees of violence. The chief symptom that gives uneasiness here is the dif- ficulty of breathing through the nose, which arises from an inflammation of the membrane that lines the posteri- or nostrils and throat. By this inflammation extending, every part comes to be affected, even to the stomach and bowels; and hence the great and increasing debility it quickly occasions. The stools are thick and pasty, and of a peculiar green or blue colour. Diseases of Children. 559 From this account of the disorder, the state of the bowels is a circumstance which must be more attended to, than in almost any other disease. To this end, one or two tea-spoonfuls of castor oil should be given every day, so as to procure four or five evacuations daily.— The bark should be given in a decoction or glyster, joined with cordials, to support the strength ofthe child. The same remedies should be exhibited to the wet nurse. The acrimony of the discharge on the adjacent sur- faces of the nose and throat, should be prevented by washing the parts frequently with warm camomile, or elder-flower tea, and afterwards applying a little sweet oil. Where convulsions are threatened, or occur, lauda- num is very proper, after the operation of laxative medicines; and in many cases, the anodyne should be given two or three times a-day. In this disease, blis- ters are improper, as tending to produce gangrene of the part. CUTANEOUS AFFECTIONS. Infants are much subject to an eruption called the gum, which assumes a considerable variety in its appearance in different cases, and even in the same individual. Rkd Gum—Is the most common, and usually appears a short time after birth, and occasionally recurs till all the milk teeth are cut. The red gum of infancy, con- sists of a number of small, red, elevated spots. The top is clear, and the base is of a vivid red. This eruption is scattered over the trunk of the body, and sometimes on the cheek and forehead. On the feet the spots are still larger, more distinct, and sometimes a clear fluid is found at the top. When the redness round the base is considerable, the rash has at first sight an appearance of measles, but there is no fever, nor sneezing, nor wa- tery eye, nor cough; on the contrary, the infant is in perfect health. In general it is necessary only to keep the bowels open with the absorbent and aperient mix- ture, or magnesia, and to keep the child moderately 560 Diseases of Children. warm, otherwise the rash striking in, may fall upon the bowels and produce fever. Yellow Gum—Is merely a species of jaundice, but is in general of very short duration. It affects most children in a greater or less degree, and usually appears within a week, or much earlier after birth. It proceeds from the absorption of bile, and is known by a yellow col- our of the skin, or even of the eyes, and is preceded, and attended by sleepiness, and carelessness about sucking. It is readily removed by the exhibition of three or i four grains of ipecacuanha, or a few drojis of antimnnial wine, to excite vomiting, and by keeping the bowels open by the occasional use of calomel, the absorbent and aperient mixture [See Dispensatory] or a watery infusion of rhubarb. Should the symptoms continue, the emetic ought to be repeated after two or three days, and one or other of the above aperients given every other day. White Gum—Appears after the period at which in- fants are subject to the former variety; consisting of a number of white, hard, elevated spots, Vpears lodged in. the stomach, the cure should begin by giving an emetic, or a dose of calomel that will both vomit and purge, and afterwards small doses of rhnbarb, or the absorbent and aperient mixture. [See Dispensatory ] 'I he nature of this disease is to be often drawn from the appearance, of the stools; and the treatment ought in a great measure to be regulated from that circumstance. Thus when the stools are sour and curdled, after the ne- cessary evacuations have been premised, the. absorbent mixture, or prepared chalk or magnesia, in suitable do- ses, combined with grated nutmeg, or some aromatic, is strongly pointed out, in addition to opening medicines. When again the stools are slimy, and of a clayey colour, in addition to the former plan injections of soap-suds are not to be omitted, and Castile soap dissolved in milk will be found a useful drink. When the stools are wa- tery and bloody, or foetid, castor oil and calomel are the best jiurgatives, and if attended with much griping, glys- ters of milk and soap-suds should be often repeated. The extent and continuance of this jilan, must depend on the obstinacy of the complaint. To these medicines, opiates according to the age of the child, may be given with the greatest advantage at bed-time, provided there exists no febrile symptoms. When the child is cold and languid, the purgative med- icines ought to be joined with some aromatics, as grated ginger, and given less frequently: and during the inter- mediate days, as wejl as the evening after the physic has operated, a cordial diet, such as the addition of wine in gruel or arrow root, with jilenty of nutmeg, should be allowed. The occasional exhibition of injections of thin starch and laudanum, in the proportion of ten drops of Diseases of Children. 573 the latter to two table-spoonfuls of the former, must be had recourse to, in order to moderate the discharge when the strength is much reduced. Besides this internal treatment the warm-bath, or bath- ing the child night and morning in a strong decoction of oak bark, will be found exceedingly beneficial. Exter- nal applications are also oi the greatest service, as cloths moistened with the camphorated spirits, or wrung out of brandy stewed with spices, and applied warm to the bel- ly and extremities. Blisters to the legs and arms have al- so their good effects, and ought to be repeated in obsti- nate cases. Wearing flannel next the skin, or a bark jacket, will also prove an auxiliary. A soft flannel bandage, passed frequently and with some degree of tightness, round the body immediately over the stomach and bowels, is found to be a very use- ful remedy in this complaint. In the treatment of all abdominal complaints, much attention is necessary to the nature and kind of food or nourishment taken. The food of children, with this view, should be deprived of acid as much as possible; hence, instead of milk, animal food, in the form of beef tea, or mutton broth, is preferable. When there is an habitual disposition to purging, there is no diet superior to arrow root; and when this is not at hand, flour baked in an oven till it breaks into a powder, and afterwards made up with boiled milk, is a good substitute. Tapi- oca and sago are also very nutritious. Indeed it is pro- per to alternate the food occasionally, from one kind to another, and frequently to exhibit the animal food in a solid form, when the stomach rejects fluid nourishment. The change ofthe wet nurse sometimes makes a necessary part of the treatment; and when a child has been wean- ed, resuming the breast has often had the happiest ef- fect. Although powerful astringent medicines are common- ly inadmissible in cases of purging during infancy, great benefit has sometimes seemed to accrue from the use of a mixture composed of twenty grains of toasted rhubarb, two drachms of prepared chalk, a table-spoonful of bran- dy, jireviously set fire to and allowed to burn as long as any spirit remains, and three table-spoonfuls of water.— 574 Diseases of Children. The dose is from one to two tea-spoonfuls every hour or two while awake. The dewberry root boiled in milk [See Materia Medica] will also be found a valuable as- tringent medicine in this troublesome complaint. In sev- eral hopeless cases burnt cork [See Page 374] has won- derfully succeeded. In many instances, a change of air alone has prov- ed an effectual remedy, after every other means had failed. DISCHARGE FROM THE VAGINA. Infants have sometimes a discharge from the vagina, a few days after birth, resembling matter; but it is of no consequence, as it goes off itself in a short time. Children of five or six years old are subject to a mu- cous discharge resembling the genuine whites of adults, which will in some instances be in an excessive quantity so as to run through all their clothes. The disease rea- dily yields to a little cooling physic, as the cathartic or absorbent and aperient mixture, and keeping the parts perfectly clean with soap-suds or lead water. When it is obstinate, balsam copivi may be given thrice a-day, and if the child is puny, the tincture of steel is a suita- ble remedy. WORMS. The symptoms enumerated as most commonly distin- guishing worms are, pain and eructation of the stomach, variable appetite, foul tongue, foetid breath; the belly full, hard and tense, with occasional gripings or pains in dif- ferent parts of it, particularly about the navel; irregular state of the belly, heat and itchiness of the fundament, urine white and limpid, and often discharged with difficul- ty. With these symptoms are joined a dull appearance of the eyes, often dilation ofthe pupil, itchiness ofthe nos- trils, short dry cough, slow fever, with evening exacer- Diseases of Children. 575 bations and irregular pulse, grinding of the teeth in sleep, &c k However, many of the above symptoms occur in other diseases, and I believe, as was suggested to me by the learned Dr. Caldwell of Philadelphia, that worms are much oftener suspected to be the cause of children's com- plaints, than what they really are. For the cure of worms, two indications arise; first, to expel them, and secondly, to prevent their generation.— The first may be effected by giving a dose of calomel at bed-time, and rhubarb the next morning to work it off— The pink-root [See Muteria Medica] has long been held in high estimation as a vermifuge. It may be given in the form of tea, with milk, sweetened, for breakfast, observ- ing not to continue the use of it, if it is found to affect the child's eyes. The bark ofthe Pride of China [See .Valeria Midica] is much extolled of late as a remedy for worms. My friend Dr. Grimes, of Savannah, said, that he consid- ered it one ofthe best vermifuges we are acquainted with. He directs a tea to be made of the bark of this tree, and as much of it taken during the day, as the child can bear without producing vomiting, purging, or considerable weakness ofthe limbs. External applications have also been found useful for the removal of this complaint. These consist of a lini- ment made of equal parts of beef's gall, aloes and sweet oil or fresh butter, rubbed on the belly every night; or a plaster made of dry rue and aloes, or gall mixed up with a little turpentine and lard, and apjilied over the region of the belly, taking care to cover the navel with a piece of cotton. The future generation of worms will be prevented by avoiding greesy food, and by taking the rust or tincture of steel thrice a-day, joined with bitters, to give tone to the bowels. WATERY HEAD. This disease is distinguished by pain of the head ac- companied with nausea, sickness, and other disorders of the animal functions, without any evident cause, and sud- 576 Diseases of Children. den in their attack; variable state of pulse; constant slow fever; and in the advanced stage of the disease, dilation of the pupil of the eye, with a tendency to a comatose state. It most frequently takes place between tbe age of two and ten years, and with children of a scrofulous habit.— It may, however, arise from falls and blows on the head. The first stage of the disease is marked by loss of ap- petite, and a degree of melancholy and uneasiness, with- out the child being able to fix on any particular cause.— Pain in the head is next felt, especially above the eyes, and in a direction betwixt the temples. In very young sub- jects, pain in the head is indicated by the child putting his hand often to his head, and waving it about. This pain gradually extends, and is at last felt more particu- larly in the arm and leg of one side. The affections of the stomach next commence, and alternate with pain and uneasiness of the head. The febrile symptoms, though pretty constant, are milder in the morning, but suffer also an evening exacerbation. Vomiting occasionally occurs, but costiveness is a leading symjitom. The tongue is a lit- tle affected, except towards the end, when it assumes a scarlet colour, and sometimes becomes apthous. As the disease advances, all the symptoms of hectic are conspi- cuous, and during the whole disease, the child shows a strong propensity to the bed, or a desire to avoid being moved. This disease is truly inflammatory in its commence- ment, and can only be treated with success by the early employment of those means which are best calculated to subdue inflammation; such as copious and repeated bleed- ings, the application of leeches or cups, blisters to the head and temples, and an issue behind the neck. Besides these external remedies, active purges, as calo- mel and jalap, must be frequently administered, and if possible a jityalisin should be produced by the use of mer- cury, either in the form of calomel in small doses, or by rubbing in the unction. If acid prevails, the absorbent mixture [See Dispensa- tory] must occasionally be given, and during the contin- uance of fever, the tincture of digitalis or foxglove [See Dispensatory] will be found an auxiliary. Diseases of Children. 577 After subduing the inflammatory action of the system, opium or laudanum may be employed with advantage, to relieve the spasm, or pain ofthe head, when it is consider- able. In the last stago of the disease, cold bathing and the use of tonic medicines, may be required to invigorate the system. CROUP, OR HIVES. This disease, peculiar to children, is a species of asthma, with violent catarrhal symptoms. It is most common in low marshy countries, or on the sea coast, and in wet and cold seasons. Indeed it is readily occasioned by any thing wet or damp, or which obstructs the perspiration. There are two species of croup, the acute or inflamma- tory, and the chronical or lingering. The former is attended with a very quick pulse, cough, hoarseness, and difficulty of breathing, soon after and sometimes even before the occurrence ofthe croaking noise, which is the characteristic of this disorder. As the dis- ease increases, the pulse quickens, the heat augments, and an excessive restlessness takes place. The breathing be- comes more and more difficult, and laborious, and the pe- culiar wheezing sound which accompanies it, so increas- es, as to be heard at a considerable distance. The symptoms continue to increase in violence, until a spasm of the muscles of the parts taking place, the pa- tient is suffocated; the disease often completing its course in the space of three or four days and nights. The extreme degree of danger which always accom- panies this disease, and the rapidity with which its symp- toms proceed, show that immediate remedies are requi- site to arrest its progress. Therefore, on the first appear- ance, blood letting, both general and topical, should be employed, and rejieated two or three times a-day, accord- ing to the violence ofthe symptoms, and habit ofthe pa- tient. Immediately after bleeding, an emetic should be administered, and the sickness kept up for several hours or even days, by small doses of the antimonial solution. 'See Dispensatory.] 578- Diseases of Children. Inhaling the steams of hot vinegar and water, and em- brocating the throat with the volatile liniment have also their good effects. Besides which, the apjilication of a ca- taplasm of mustard or blister to the throat are not to be neglected, if the symptoms are the least .ilarming. The decoction of seneka or rattle-snake root, [eee Ma- teria Medica] is a valuable medicine in this dreadful com- plaint. It should be given at first in such doses as to ex- cite vomiting, and afterwards in smaller doses, to keep up a nausea at the stomach, and to produce perspiration. Onions [See Materia Medica] are also celebrated as a sove- reign remedy. The tincture of digitalis or foxglove is considered by some a good remedy, if emjdoyed in the early stage of the disease. Attention should always be paid to keep the bowels ojien by castor oil or some ajierient medicine. The most speedy and efficacious of all remedies, in this alarming disease, which has come under my notice, is calomel in very large doses. For this valuable remedy, I candidly acknowledge myself indebted to my excellent and very learned friend, professor Davidge of Baltimore. From him I have been emboldened to use it in des- perate cases, in doses from thirty to sixty grains, to chil- dren. On my own daughter, only four years old, and ap- parently in the. very act of suffocation, I used it in the dose of at least sixty grains. The cure was almost in- stantaneous. Among other instances of cure as surpris- ing, was one in the infant of my amiable friend, Mrs. Chalmers, lady ofthe Rev. Mr. Chalmers, of Washing- ton, with the dose of forty grains. The cure was so im- mediate, that the over-joyed parent insisted I would in- struct her in the remedy, for fear, on the next attack, I might not be. in the way lo prescribe. On learning I had given her infant, not more than between three and four years old, forty grains of calomel, she was excessively friglitened, and exclaimed, "you have killed my child!" and indeed she could hardly he jiersuaded for some time, though her eyes told her the contrary, that 1 had not kill- ed her child. So powerful is the effect of this medicine, that it sud- denly removes the disease without having recourse to other means. It acts on the stomach, bowels and skin. Diseases of Children. 57$ In cases not very alarming, I have given calomel in smaller doses, conjoined with ipecacuanha, with good effects. The flaxseed sirup is peculiarly beneficial in all dis- eases attended with cough, and therefore should not be omitted in this. To prevent a relapse, and to restore the strength of the patient, it will be proper, at the close of this complaint, to use the cold bath and to give bark in any form which is most agreeable and convenient. The latter, or ch onical croup, is produced by spasm, and unaccompanied with fever. A most important reme- dy in this species, if early used, is the warm bath, imme- diately followed by a glyster, to which some of the juice of raw onions may be added. A tea-spoonful or tvvo of the juice may also be given by the mouth, and some applied externally. [See Materia -Medica.] If the symp- toms do not yield to this treatment, an emetic should be administered, and after its ojieration, a dose of laudanum will be proper. Some children are troubled with this complaint for seve- ral years, and then seem to out-grow it. A flannel shirt, light diet, cold bath, change of air, gentle exercise, and whatever strengthens the body, are the best preventives. WHOOPING COUGH, Is a contagious disease, attacking in paroxysms of a convulsive suffocating cough, with a loud noise or whoop at each respiration, and generally terminating by vomit- ing. It is clearly the effect of a specific contagion, of a peculiar nature, aud highly active, affecting, like the small pox and measles, but once in life. The treatment of this disease must be regulated by the degree of fever and spasm. When the fever is consid- erable, bleeding becomes clearly indicated, as well as blisters over the breast, and the use of laxative medi- cines, together with such as may determine to the sur- face; of which class, the decoction of rattle-snake root, [See Materia Medica] or the antimonial solution are to be preferred. When the spasmodic state is most predominant, and the symptoms of fever mild, emetics will be highly use- 580 Diseases of Children. ful, followed by a dose of the anodyne sudorific drops [ ^'ee Dispensatory] at bed-time. If a free use of the flax- seed sirup is not sufficient to allay the cough, laudanum, or paregoric, when fever does not forbid, may be given with the greatest advantage. In this tiresome disease, I have found no remedy, when there is little or no fever, superior to the following mixture in doses from thirty to sixty drops or more, giv- en in sirup or tea, three or four times a-day, until a slight strangury is excited. Take of tincture of bark, on- ounce and a half; jiaregoric, half an ounce; tinc- ture of cantharides, one drachm;—mix. The strangu- ry usually comes on about the third day, and the whoop- ing-cough seldom continues longer than a few days af- terwards. A grain of asafoetida, administered four or five times a-day, proves oftentimes a very useful remedy in cases of whooping cough. When the disease is recurrent, and returns some time after its apparent departure, as it frequently does up- on taking cold, an emetic, a dose or two of castor oil, and the anodyne sudorific drops, laudanum, or paregor- ic at bed-time, as the symptoms may indicate, will quickly remove it. A milk and vegetable diet is pecu- liarly proper in this complaint; and when the patient is debilitated a change of air, and tonic medicines, as the bark or columbo, will be found necessary. RICKETS, Consist in an enlargement of the head, belly, and joints, flattened ribs, and general emaciation, with a bloated or florid countenance. This disorder generally takes place from six months to two years of age, and arises either from unhealthy parents, or from the child- ren being improperly nursed, kept wet, dirty, in a close damp air, without due exercise. Weakness and relaxation being the cause of this com- plaint, its remedy must of course be to promote diges- tion, and to brace and strengthen the solids. Hence a nutritious and cordial diet, with exercise in the country Diseases of Children. 581 air, is indispensable. Along with this, the cold bath and tonic medicines, as bark, columbo, and steel, to warm and invigorate the constitution, are peculiarly proper; but they should not be entered up«n without previous purging with calomel and jalap. The tincture of rhubarb [See Disnensatory] should also be occasionally employ- ed, to keep the bowels in a regular state. However, no- thing will be found more effectual in recovering the pa- tient, than a generous diet, and cold bathing, particular- ly in salt water. Sea-bathing constitutes, perhaps, the most promising remedy in this disease. ST. VITUS'S DANCE. The disease called chorea, or St. Vitus's dance, occurs most frequently from the age of eight years to the period of puberty. It approaches with languor, and indifference with regard to the usual amusements, a variable, and sometimes a keen appetite, continued costiveness, occa- sionally combined with a flabby, lank state of the belly, but much oftener with a hardness and swelling, particu- larly at the lower part. The stools are not of natural appearance. Presently convulsive affections of the face take place, and are succeeded with twitches and starting of the extremities. The patient often cannot walk easi- ly, in consequence of one leg twisting in before the other. He is perpetually changing his position, and fidgetting when sitting. This disease generally proceeds from, or is connected with, a costive state of the bowels; and nothing gives so essential relief, as regular and continued purging. When the patient is old enough to swallow aloetic pills, two, or sometimes more, of these, may be taken twice or three times a-day; or where these cannot be used, infusion of senna, epsom salts, or other purgatives, must be employ- ed; and it will be found, that usually, though not always, the stools are foetid, or unnatural in their appearance. This, so far from weakening the patient, has a contrary effect; for although he may, perhaps, have five or six stools in a day, the pulse becomes stronger, the counte- 58% Diseases of Children. nance brighter, the step firmer, and the gesticulations or twitches abate, and at last, after a period, varying from a fortnight to several weeks, or some months, the cure is completed. The cold bath and tonics may sometimes be useful; but the great remedy is tbe steady exhibition of purgatives, which have been introduced into general prac- tice, and with success, by Dr. Hamilton, senr. (£P* Scald Head, and other diseases peculiar to children, which have not been noticed here, will be found in the pre- ceding part of this work. 583 IHJtflWISAi EDQE2IM£B4t» Life's lowest, but far greatest sphere I sing, Of all thing's that adorn the gaudy spring; Such as in deserts live, whom, unconfined, None but the simple laws of Nature bind; And those who, growing tame by human care, The well bred citizens of gardens are; Those that aspire to Sol their sire's brii ht face, Or stoop into their mother Earth's embrace; Such as drink streams, or wells, or those dry fed, Who have Jove only for their Ganymede; And all that Solomon's lost work of old (Ah! fatal loss!) so wisely did unfold. Though I the o;ik's vivacious age should live, I ne'er to all their names in verse could give. Cowlbt. "How wonderful are thy works, O Lord! in wisdom hast thou made them all; the earth is full of thy riches." In all parts of these his Gi.oRiors Works, is their admirable fitness to one another, and their constant sub- serviency to the good of all, we behold the Wisdom and Goodness ofthe Great Creator. But in no department of his works do mingled wisdom and goodness shine with greater lustre than in the vege- table kingdom. There is scarcely a plant that greens the fields, a flower that gems the pasture, a shrub that tufts the garden, or a tree that shades the earth, which does not contain certain medicinal virtues, to remove our pains and to heal our diseases. The American continent, though the last found, is not the least favoured of God in this respect. Embracing almost every clime and soil of the globe, it richly abounds with drugs of every healing quality. 584 Materia Medica. The common saying, that every country contains the best cures for its own diseases, seems fully verified in America. Here, above all countries, is the ague, and here, exclusively, is the grand cure, the Peruvian bark tree or dogwood. And bere too, exclusively, is found the Spanish fly, the tobacco, the Jamestown weed, the pink and snake root, besides those other valuable plants, equal to the ipecacuanha, rhubarb, jalap, &c. &c. which have hitherto been imported at a great expense, though not always genuine; but which may now be obtained in our own fields and woods, both unadulterated and cheap. Worthy of the high character of Americans, many gentlemen ofthe finest genius among us, have explored the medical treasures of our own country, and have shown an eagerness to make known the precious means to preserve the health and lives of our citizens. First on the list of this noble band of philanthropists stood that bright literary and professional genius, the late pro- fessor Barton, from whose "Coio-ections towards a Materia Medica of the United States," much valuable matter has been selected. If by the laws of Rome, "a civic crown was adjudged to the. man who saved the life of a single citizen," what eulogy is suffi- ciently great to be attached to the memory of him who, besides illuminating several other walks of ornamental and useful knowledge, has, by investigating the virtues of our native vegetables, laid the foundation whereby millions of our worthy citizens may be rescued from an untimely death. Professor Chapman, succeeding the lamented Barton, as teacher of Materia Medica, gave additional interest to the studies connected with his department, and by the application of his powerful talents to the acquisition of appropriate learning and discovery, has made a hand- some accession to the stock of knowledge before extant. In the chair of Materia Medica, this accomplished teach- er displayed advantageously those happy qualities which have since secured to him the post he now enjoys, pro- fessor ofthe theory and practice of physic, &c. Much is due also to professors Dexter, Mitchill, Ho- sack, Cox, Baker, Caldwell, and to Doctors Mease, Cut- ler, Thatcher, &c. Materia Medica. 585 From the valuable discoveries and communications of these gentlemen I have, with great industry and care, compiled an American Materia Mfdtca, exhibiting, in alphabetical order, the names, characters, and quali- ties of our best medicinal plants hitherto discovered, to- gether with the diseases they suit, and their proper dos- es, and forms of administration; the whole strijiped of technical terms, and making, as I humbly hope, one of the most complete systems for family use now extant. AGARIC. See Touchwood. AGRIMONY, Agrimonia—Grows two or three feet high, in hedges and the margins of fields—blossoms in July on long spikes, yellow. It is known by the vulgar name of cuckold, from the seeds sticking to the clothes in the fall of the year. In whey or tea it forms a good drink in fevers. The * juice of this plant, or a strong infusion of the roots, two handfulsto a quart of boiling water, and sweetened with honey, is an excellent medicine in the jaundice, scurvy, and habitual diarrhoea or looseness. Dose of the infu- sion half a pint; ofthe juice a wine-glassful three times a day. The herb has been applied externally to fresh wounds. ALDER, BLACK, Alnus Nigra—Sometimes called Virginia winterberry, grows in moist places, generally sending up several slender stalks to the height of ten feet, and bears a red berry. The bark is tonic, and accordingly is used in sub- stance, or in strong decoction, like the Peruvian bark, in intermittents, and other cases of debility, as dropsy, gangrene, &c. The inner bark in the shape of poultice externally, with the decoction internally, a handful or two boiled slowly in three points of water to a quart, is celebrated both by professor Barton and Dr. Mease, as of admirable use in arresting the progress of mortifica- tion. A strong decoction of the berries formed into a sirup with molasses in dose of a wine-glassful, or two tea-spoonfuls of the powder of the inner bark, is said to be a good purge. 74 586 Materia Medica. ALEXANDER. See Parsley, Wild. ALUM ROOT, Heuchera Americana—Called also American Sanicle. The root is a very intense astrin- gent. It is the basis of a powder which has lately ac- quired some reputation in the cure of cancer. Professor Barton observes that he does not believe that the alum root has cured genuine cancer, but that it has proved ve- ry beneficial in obstinate ulcers, which have been mis- taken for cancers. He says it is one of the articles in the Materia Medica of our Indians, the powdered root of which they apply to wounds, ulcers, and cancers. ANGELICA, Angelica—Grows in marshy woods and hedges, flowering in June and July. It is frequently cul- tivated in our gardens, Every part of this useful vegetable partakes of its aro- matic virtues, but especially the root, which in the form of powder, tincture or tea, is useful in flatulent colics. Conjoined with dogwood bark, or any other tonic, it may, like the Peruvian bark, be employed with advan- tage in intermittents and low stages of fever. The dose, one tea-spoonful, in substance, of the former to two of the latter. It may also be emjdoyed in the form of strong decoction, in doses of a gill, or in cold phlegma- tic habits, in tincture, either alone, or with dogwood ber- ries, centaury, lemon peel, or any other articles of the bitter and tonic class. A strong decoction of the root, combined with red oak bark, a large handful of each to a pint of boiling water, makes an admirable gargle for relaxed and spongy gums, and ulcerated sore throats. APPLE, PERU. See Thorn Apple. ARBUTUS. See Bearberry. ARROW ROOT, Maranta Arundinacea—Is cultivat- ed in the southern states. A table-spoonful makes a pint of the finest jelly in nature, which affords the most nu- tricious food in acute diseases for children. To persons labouring under bowel complaints, as diarrhoea and dys- entery, it is of itself a remedy. Materia Medica. 58? The jelly is made in the following manner—To a ta- ble-spoonful of the powdered root, add as much cold wa- ter as will make it into a thin paste, and then pour on boiling water through the spout of a kettle, stirring it at the same time briskly, till it becomes a clear jelly; after which season it with sugar and nutmeg, and to render it still more palatable, a little wine or lemon juice may be added. But to children, blending it with new milk is best. ASARABACCA SWAMP, Asarnm—Grows in low lands. It has but two leaves, which rise immediately from the root, and divide from one stem. The flowers are purple and bell-shaped and proceed from between the leaves. The whole of this plant has a nauseous bitter taste.— The root, from a half to a table-spoonful in powder, op- erates both upwards and downwards. In the form of in- fusion, a half-handful to a quart of boiling water, is said to be serviceable in the whooping-cough, in doses of a table-spoonful to children every half hour, or oftener, until it vomits; and in doses of a tea-cupful three times a-day, it has been used with success to promote the men- ses, or courses. AVENS COMMON, Geum Urbanum—Grows a foot high by fences and borders of fields. The blossoms are white or yellowish in July. Its smell resembles that of cloves. A strong tincture of the root* two handfuls steeped in a quart of spirits, given to the quantity of half a wine- glassful, or the powder, in doses of a tea spoonful, sev- eral times a-day, has afforded an excellent remedy in in- termittents and other disorders where strengthening med- icines are requisite. It is said to be equal to the Peruvian bark. There is another variety of this plant, called water avens, throat root, cure-all, which is to be found in bog- gy meadows. The blossoms are purplish, and appear in May. Its properties are the same as the preceding. A decoction of it has been found beneficial as a gargle in | ulcerated sore throats, which probably gave rise to the ! name of throat root, or throat wort. 588 Materia Medica. BACK-ACH BRAKE. See Fern Female. BALM, Melissa Officinilas—Makes an excellent tea in fevers, and when sweetened, and acidulated with the juice of lemons or cream of tartar, forms a most grateful beverage. BARBERRY, Berberis Vulgaris—Grows along the sides of roads in hedges;—leaves oblong, tender, and subject to the rust; the flowers are in clusters; the fruit oblong and acid, the stem is defended by three thorns. A double handful of the berries boiled in three quarts of water to two, and given in doses of a tea-cupful four or five times a-day, sweetened with white sugar, is ex- tolled as a remedy in diarrhoea, dysentery and jaun- dice. BASTARD IPECACUANHA. See Ipecacuanha Ame- rican. BAYBERRY, Myrica Cerifera Humilis—Called also Dwarf-Candleberry Myrtle, grows in swamps to the height of two or three feet, and hears numerous green berries, of which tallow is made. The bark of the root has been considered a good rem- edy for the jaundice. The powder of it in doses of twen- ty or thirty grains, has been emjdoyed as a mild emetic. The inner bark, in poultice, applied morning and even- ing to scrophulous swellings, and drinking a tea-cupful of a strong infusion of the leaves, is said to have wrought surprising cures in a few weeks. BEARBERRY, Arbutas Uva Ursi—Bears whortle- berry—wild cranberry. Is alow evergreen shrub some- what resembling the myrtle. The leaves have a bitter astringent taste, and unques- tionably possess great medicinal virtues, especially in re- lieving the irritation of the stone, gravel, and old cases of gonorrhoea, menstrual discharges, also catarrhs and consumptions. Materia Medica. 589 The dose—half a pint twice or thrice a-day of a decoc- tion made of the leaves, a handful to a pint, or a tea- spoonful in substance, two or three times a-day. BEECH DROPS. See Broomrape Virginia. BENNE, Se Samum Orientale—Is now cultivated in South Carolina and Georgia. The leaves by infusion afford an excellent mucillaginous drink, which is used . witli manifest advantage in dysentery, diarrhoea and 1 cholera infantum. The seeds yield a pure and pleasant oil, which in do- ses from one to two wine-glassfuls, acts w been found useful, not only in venereal complaints, but also in cases of gravel. Thus ignorance sometimes leads to knowledge. The lobelia is generally administered in the form of a decoction, a handful of the root and leaves boiled slowly in three pints of water to a quart, of which a gill or more may be taken three times a-day. MADDER, WILD, Rubia Tinctorum—Is cultivat- ed in Pennsylvania and South Carolina for dying a fine red colour, but also possesses great medicinal pow- ers. It has been highly recommended in visceral obstruc- tions, particularly of the uterus, in coagulations of the blood induced either by falls or bruises, in dropsical com- plaints and especially in the rickets. It may be given in powder from five to fifteen grains to children, and from half to a whole drachm three or four times a-day to adults. When taken internally, it possesses the re- markable quality of tinging the urine of a red colour, and produces similar effects on the bones of animals, when eaten with their food. MAGNOLIA—Goes by several names, as beaver tree, swamp sassafras, elk bark, Indian bark. It is an agree- able aromatic tonic bitter medicine. 80 63* Materia Medica. An infusion or decoction of the bark has been used in the ague and fever, and much celebrated among the western Indians as a remedy in rheumatism. I am informed from a respectable source that John Dickinson, esq. author of the celebrated Pennsylvania Farmer's Let- ters, was completely cured of a violent attack of the chronic rheumatism by a strong decoction of the twigs of the magnolia. The species Magnolia Grandiflora, evergreen laurel, sometimes called tulip tree, grows to the height of eighty feet near Savannah. The bark of the root of this tree is also used as a substitute for the Peruvian bark in in- termittent fevers. The cones or seed-vessels of the magnolia, which is commonly called cucumber tree, has been advantageously used in Virginia in the form of tinc- ture, in rheumatic complaints. MAIDEN HAIR, Asplenium Trichomanes—Called al- so milk waste, spleenwort. Grows on old walls, rocks, and shady stony places, generally to the height of seven or eight inches; leaves very fine and soft, and spotted un- derneath; stalks of a dark purple colour; flowers from May to October. Its leaves have a mucilaginous sweet- ish taste, without any peculiar odour. An infusion, by pouring a quart of boiling water on a handful of the dry herb, sweetened with honey, and ta- ken in quantity of a tea-cupful every hour or two, or a spoonful in the form of sirup, is said to be good in tick- ling coughs, hoarseness, and disorders ofthe breast, pro- ceeding from acrid humours in irregularities of the men- ses, and obstructions of the viscera. MALE FERN. See Fern Male. MALLOW, COMMON, Malva Sylvestris— Grows in hedges, foot paths, and among rubbish; flowering from June to August. The leaves possess a mucilaginous sourish taste. A decoction of this plant is said to be useful in dysen- teries and gravel comjilaints, though it is chiefly em- ployed as an emollient poultice to produce suppura- tion, Materia Medica. 635 MANDRAKE, OR MAY-APPLE, Podophyllum Pel- tatum—Grows on low grounds, two or three feet high, leaves generally three, broad at the base, and terminat- ing in a sharp point; flowers yellow: the fruit resembling a lime, or small yellow apple, which is much admired by some, The root is an excellent purgative, and may be taken in doses from ten to thirty grains in substance, or dou- ble the quantity infused in a gill of water. Dr. Little, of Pennsylvania, esteems it preferable to jalap. The honourable Paul Hamilton, who often used it, directs equal parts of the juice and molasses to be mixed, and a table-spoonful taken every hour or two until it ope- The best time of gathering the mandrake, for medici- nal purposes, is in autumn, when the leaves have turned yellow, and are about falling off. The Indians dry it in the shade, and powder it for use. MARSH MALLOW, Allhcea Officinalis—Grows in marshes and wet jilaces. The leaves have a soft woolly surface, feeling like velvet. The flowers are of a white pale flesh colour, and apjiear in August. Every part of the marsh mallow,.and especially the root, when boiled, yields a copious mucilage, on account j of wliich it is employed in emollient cataplasms or poul- > tic.es, for softening and maturating hard tumours. It is likewise of eminent service in the form of infusion, in asthma, hoarseness, dysentery and gravel. MARSH ROSEMARY. See Lavender Thrift. MASTERWTORT, lmperatoria—Grows in meadows and rich soils, two feet high; leaves three together, saw- edged, and spear-shaped; flowers in June. The root of this plant is a warm and grateful medi- cine in flatulency, weakness of the stomach and bowels, and dropsical affections. It may be taken in the form of jiowder, decoction, or tincture. One drachm or a tea- spoonful of the powder in a glass of wine, or soints, ind taken an hour before the fit, has frequently prevent-d the ague. The decoction or infusion is made of one handful 636 Materia Medica. in a quart of boiling water, and the dose a tea-cupful three times a-day. MAY APPLE. Sec Mandrake. MAY WEED, OR WILD CAMOMILE, Cotula Fot- tida—Grows about two feet high, in jrastures near fences; the flowers yellow, resembling camomile flowers, and arc frequently used as a substitute for them. MEZEREON, Daphne Mezereum—Called also spurge laurel, dwarf bay. Grows plentifully in woods and shady places near the Ohio, and flowers in the month of Fe ruary or March. The fruit is a berry, in which is found a single seed. The leaves are spear- shaped, and the flowers grow of a beautiful red or rose colour. The bark ofthe root of this jilant is the part used in medicine, and has an extremely acrid burning taste in the mouth and fauces. Dr. Withering asserts that a patient who lived under extreme difiiculty of swallowing for three years, was ef- fectually cured in two months, by chewing the root as often as she could support its irritating effects. The fresh root scraped, and applied to the surface of the skin, affords an efficacious blister—when taken internally, it . determines to the surface, and has been found greatly * serviceable in rheumatism and obstinate cutaneous dis- eases. Its principal use, however, is in the venereal dis- ease, in the last stage, or when mercury has failed. It \ is particularly efficacious in relieving nocturnal pains, and removing venereal nodes. One gill to a half pint ofthe decoction, made of tvvo drachms, or a handful of the bark, with an equal quantity of liquorice root, boiled in three pints of water to a quart, may be taken three or four times a-day. MILK, OR SILK WEED, Vincetoxicum—Grows by the road sides, and on sandy ground, about three feet high; the stalk square; leaves oval and milky; flowers yellow, which terminate in a pod resembling a cucumber, filled with down, which when ripe, is blown away. . Materia Medica. 637 A handful ofthe root boiled slowly in a quart of wa- ter for half an hour, and given in doses of a gill or more three or four times a-day, is rejiuted to be an effectual remedy in the cure of dropsy, and serviceable in ca- tarrhs, scrophulous and rheumatic disorders, and gravel complaints. MILKWORT, COMMON, Poly gala Vulgaris— Thrives in dry pastures, and flowers in June and Ju- ly. Its roots possess an extremely bitter taste, togeth- er with all the virtues of the American rattle-snake root. A table-sjioonful of a strong decoction of the root, two handfuls boiled slowly in three pints of water, to a quart, and taken every hour or two, promotes perspiration, as | well as expectoration, and has therefore been used with advantage in colds, pleurisies, and other disorders of the breast. MILT WASTE. See Maiden Hair. MINT. See Peppermint. MISLETO OF THE OAK, Viscum—Is to be found on several kinds of trees. That which grows upon the oak is said to have cured epilepsy or fits. It is directed that the misleto be separated from the oak, about the last of November, gradually dried, and when pulverised, con- fined in a bottle well corked; to be given in doses of a tea-spoonful three or four times a-day, gradually in- creasing the dose according to its effects. MOORWORT, BROADLEAVED, Andromeda Ma- riana—Called wicke at the southward. A strong decoc- tion of this plant is extremely useful as a wash in that disagreeable ulceration of the feet, which is called toe- itch, and ground itch, a very common complaint among the negroes and lower class of people in South Carolina an d Georgia. MOTHERWORT, Leonurus Cardiaca—Grows in waste places, and flowers in July and August. The flow- 638 Materia Medica. ers are in thorny whorls, purplish within, and white on the outside; the leaves are opposite, two to each whorl; they have a strong disagreeable odour, and bitter taste. > An infusion of this jilant is a common domestic medi- cine in fainting, and disorders ofthe stomach. It is said to be peculiarly adapted to some constitutions affected with nervous and hysterical agitations; and that if taken at bed-time, procures refreshing sleep, when opium and laudanum had failed. MOUNTAIN TEA, OR DEERBERRY, Gaulthe- ria Procnmbens.—It sjireads very extensively over the more barren, mountainous parts of the United States. A strong infusion of this plant, a large handful to a quart of boiling water, in doses of a tea-cupful three or four times a-day, is esteemed useful in asthma, and for promoting the menstrual discharge. MOUTH ROOT, OR GOLDEN THREAD. Nige- Ha—Is found in swamps; the stems erect and naked; the leaves grow by threes at tbetermiuation of the stems; the white solitary blossoms appear in May; the roots are thread-shaped, and of a bright yellow colour, and possess considerable astringency and bitterness. By the country people the root is employed as a remedy for the thrush and cancerous sores in the mouths of chil- dren. MUGWORT, OR COMMON WORMWOOD, Arte- misia Absinthium—Grows two or three feet high, on road sides and among rubbish; leaves deeply divided, pointed; on the upper side of a deep green, and on the under soft or downy; flowers small and purplish. An infusion, a handful ofthe tops to a quart of boiling water, in doses of a tea-cupful, or a tea-spoonful of the powdered leaves three or four times a-day, is an admira- ble stomachic in weakness of the stomach, lowness of sjii- rits, and hysterical affections. It is also said to be a useful medicine in difficult menstruation, in intermittents, jaun- dice, and dropsical affections. Externally it is applied in the form of fomentation and poultice, to resist putrefac- tion and relieve the pains of bruises, as well as prevent the swelling and discoloration of the part. Materia Medica. 639 MULBERRY TREE, Moms, Nigra et Alba—Its fruit hath the common quality of all other sweetfruits, quench- ing thirst, abating heat, and proving laxative in its effects. A sirup made'of the juice of the fruit, serves as an ex- cellent gargle for mitigating inflammations ofthe throat, and ulcers of the mouth. . The bark ofthe root ofthe black mulberry tree, in doses of thirty grains, or half a tea-spoonful ofthe powder, or double the quantity infused in a gill or half a pint of boiling water, or equal parts of a strong decoction and molasses formed into a sirup in dose of a wine-glassful, is an excellent purgative, and has been used with success as a vermifuge, particularly for the tapeworm. The fruit of the common mulberry tree, when properly fermented, and prepared, yields a pleasant vinous liquor, known under the name of mulberry wine. Considerable quantities of these berries are likewise consumed in the cider countries, where they are mixed with the apjiles, in making a delicious beverage called mulberry cider. For this purpose, the ripest and blackest mulberries are se- lected, and the expressed juice is added to the cider, in such a proportion as to impart a perceptible flavour. The liquor thus acquires a very pleasant taste, as well as a deep red colour, similar to that ofthe finest port wine, both of which continue undiminished by age. MULLEIN, Verbascum—The leaves, a handful to a quart of milk, is a common remedy in bowel complaints. ! In the form of fomentation or poultice, it is employed to relieve the piles, and other painful swellings; and in a dry and pulverised state, to destroy fungous or proud flesh. MUSTARD, BLACK AND WHITE, Sinapis, Ni- gra et Alba— Mustard used with our food, provokes the ajipetite, assists digestion, and promotes the fluid secre- tions, and is especially adapted to persons of weak stom- achs, or where much acid prevails, as it acts upon the system generally without producing much heat. A table-spoonful of prepared mustard in a pint of warm , water, on an empty stomach, operates as an emetic in ' nervous disorders. A table-spoonful of the unbruised seed 640 Materiu Medica. taken tw ice or thrice a-day, proves a gentle laxative, in- crease the urinary discharges, and is useful in chronic rheumatism, asthma, palsy and drojisy. In obstinate in- termittents, or ague and fever, or with persons who find the Peruvian bark oppresive at the stomach, a tea-spoon- ful ofthe whole seeds, or the flour of mustard, united with the bark or any of its substitutes, will very frequent- ly succeed in the cure, when a pound of bark alone would not produce the desired effect. In languid consti- tutions, or low stages of fevers, a gill of the seeds mixed with a small handful of horse-radish, and infused in a quart of wine in doses of a wine-glassful occasionally, is a most cordial stimulant. Another excellent form in wliich mustard may be taken, is that of whey. It is prepared by boiling two or three table spoonfuls ofthe seeds bruised, in half a pint of milk, and as much water, till the curd be perfectly separated, to which a little sugar may be added, and of this drink a tea-cujiful may be taken three or four times a-day, in ner- vous fevers. The powder of the seeds, mixed with the crumbs of bread or flour, and formed into a poultice with sharp vinegar, is an excellent application to the parts affected with rheumatism, and to the soles ofthe feet, and palms of the hands, in fevers, where there is a languid circula- tion, or cold extremities, or in cases of delirium. NETTLE, STINGING, Urtica—The expressed juice a wine-glassful, or a decoction, one handful to a quart of boiling water, in doses of a tea-cupful three or four times a-day, is said to be useful in jaundice, asthma, consump- tion, and gravel complaints. It is also said that the flow- er and seeds, in doses of a drachm thrice a-day, may be substituted for the Peruvian bark in ague and fever. Externally it, has been employed in restoring excitements to paralytic limbs and other cases of torpor and lethar- gy. It may be applied by stinging the part with the nettles; or the fresh leaves maybe apjilied to the arms or legs. ' NIGHTSHADE, AMERICAN. See Pokeweed. Materia Medica. 641 NIGHTSHADE, DEADLY, Atropa Belladonna— Grows two or three feet high in hedges, among rubbish, and uncultivated places; flowers dusky brown on the out- side, and a dull purple within, ajipearing single among tbe leaves in June or July; the berries round, green, changing to red, and when ripe, of a shining black. The whole of this plant is poisonous, and children allured by its beautiful berries, have too often experienced their fa- tal effects. Like all other strong poisons in the hands of skill it performs wonderful cures in palsy, epilejisy, melancholy, jaundice, dropsy and cancer. I have, says the great pro- fessor Cullen, had a cancer of the lip entirely cured by it. A scirrhosity in a woman's breast, of such a kind as frequently proceed to cancer, I have found entirely dis- cussed by the use of it. In the employment of this dan- gerous medicine, it is necessary to begin with very small doses. Half a grain of the powdered leaves or root, or two table-spoonfuls ofthe infusion, prepared by infusing twenty grains in half a pint of boiling water, and strain- ed after cooling, is a sufficient dose for adults to com- mence with. The dose is to be gradually increased, and repeated daily; but as soon as any dangerous symptoms occur, its use ought to be suspended for some days, and afterwards resumed in smaller doses. Externally the powdered leaves are applied to mitigate the pain in can- cerous and other ill-conditioned ulcers, and the leaves in the form of poultice, to discuss scirrhous and cane erous tumours. The garden nightshade, growing also on dung-hills, with white flowers, odour of musk, and the berries, when ripe, of a shining black, possess similar virtues of those of the deadly nightshade. From one to three grains of dried leaves infused in boil- ing water, and taken at bed time, will generally induce a copious perspiration, increase the discharge of urine, and operate as a mild laxative on the following day. If after increasing the dose some visible effect is not produced, its further use will not avail much. The dose is to be re- peated every night, or every other night. In the form nf poultice it hath abated the inflammation of the eyes, 81 012 Materia Medica. * painful swellings, and inflammations of tho venereal kind, and scrophulous and cancerous tumours. The woody nightshade, called also bitter sweet, because it is first sweet, and then bitter, grows on the sides of ditches, and in moist hedges, climbing upon the bushes with winding, woody, but brittle stalks. The flowers are in clusters of a blue purple colour, appearing in June or July, and always turning against the sun. The berries are red. This species is not so deleterious as the above two, and it acts more uniformly. Its sensible operation as a me- dicine, is also by sweat, urine and stool, and in the form r of infusion, is said to be eminently serviceable in acute rheumatism. It has also been found efficacious in jaun- dice, scurvy, obstruction of the menses, and in obstinate cutaneous disorders. An infusion, jirepared by adding a pint of boiling water to an ounce or half a handful of the { twigs or stalks, either in a fresh or dried state, of which a tea-cupful or more may be taken morning and evening. i Another form is made by steeping four ounces of the twigs in a pint of wine. The dose a wine-glassful. In the form of jioultice or cataplasm, it is also said to be a powerful discutient of hard tumours. For this purpose boil tvvo or three handfuls ofthe leaves in wine orvinegar, to wliich v may be added a little flaxseed, and this to be applied warm to indurated or hard tumours. The application of the juice and leaves to cancerous sores, in some in- stances, has performed a cure. OAK, Quercus.—The bark of the oak possesses, in a considerable degree, astringent, tonic, and antiseptic pro- perties. Hence we can never be at a loss for a remedy in those diseases in which the Peruvian bark has been re- commended. In intermittents and low stages of fever, in the advanced stage of dysentery, diarrhoea, indigestion, and other diseases of weakness, or loss of tone in the sys- tem, I have myself employed internally the black and red oak bark with equal effects, though in rather larger doses than the Peruvian bark. Many cases have come under my knowledge in practice, of persons, especially child- ren, reduced to mere skeletons, by protracted disease, of bilious, nervous fever, and bowel complaints, whose sto- Materia Medica. 643 machs would not retain medicine, being most wonderfully restored to the blessing of health by bathing in a strong decoction of oak bark, not more than milk warm, twice a-day. In the year 1809, I was requested by my brother, Dr. Thomas Ewell, who had the superintendence of the Ma- rine Hospital in Washington, to visit some of his patients in the confluent small pox, which had proved fatal in sev- eral instances. The first case presented to my view was that of a poor sailor in the last stage of this dreadful disease, and so far gone that it was thought utterly useless to prescribe for him, his coffin being actually ordered. Reflecting, how- ever, on the virtues ofthe oak bark, I did not myself en- tirely despair of his case; and instead of passing him by, I ordered a bath of a strong decoction of oak bark to be prepared with all possible despatch, setting at the same time some of the soldiers to boil the water, while others hastened to the woods for the bark. When we came to immerse him in it, we found his whole body such a mass of corruption, from the top of his head to the soles of his feet, so filled with vermin, that there was no other way to bathe him but in a sheet. I directed him to be sup- plied liberally with milk toddy, and to repeat the bath ev- ery two or three hours. By persevering in this treatment for two or three weeks, gradually diminishing the toddy, and oak bath, as his strength increased, to the astonish- ment oT all the spectators he was miraculously snatched from the jaws of death. When his sight was restored, he was much surprised to see that the astringent waters of the bath had made him look, as he said, "as black as a negro." I am happy to add, that of several others in the hospital, who were treated in a similar mode, not one died. In further proof of the tonic and antiseptic virtue of the oak bark, 1 beg leave to cite the following case from professor Barton. In a case of gangrene of the foot, says this learned pro- fessor, from the puncture of a nail, which came under my notice in the course of last summer, I gave to the patient very large quantities of the decoction of oak bark, at the same time that the affected part was constantly kept 644 Materia Medica. wet with the same decoction, or with a poultice.inade of bread and milk and the bark. I cannot but ascribe the recovery of my patient to the use of these means, and I am emboldened to recommend the use of this cheap reme- dy, as one highly worth attention in similar cases. OAK POISON. See Poison Oak. ONIONS, Allium Cepa—Possess similar virtues with the garlic, only in a less degree. The disagreeable smell which they impart to the breath may be effectually obvi- ated by eating a few leaves of parsley immediately after the onions. Onions are justly reputed an efficacious remedy in sup- pression of urine, in dropsies, and in abscess of the liver. The following exemplification of the virtue of onions in liver complaints, deserves the attention of the reader. Captain B. Burch, of the District of Columbia, was af- flicted with an abscess of the liver, deemed incurable by his physicians, and seeing some onions in the room, ex- pressed a wish to eat one. Thinking his case desperate, and no longer a matter of any consequence what he ate, his wife immediately gratified his appetite. After eating one or two onions he found himself much better, which induced him further to indulge his appetite. He subsist- ed for several weeks entirely on onions, with only the addition of a little salt and bread; and from using this diet be was restored to perfect health, and is now a very hearty man in his 53d year. This, with innumerable in- stances of a similar sort, ought to convince the young practitioner, that in the cure of this disease nature ought always to be consulted, as she seldom or never errs. Upon the high authority of our virtuous and able states- man, the honourable William H. Crawford, onions ex- ternally applied is an invaluable remedy in violent sore throats. This worthy patriot informed me, that one of his children being violently attacked with the croup, at his mansion in Georgia, a ph ysician was sent for; but be- fore he arrived, the disease became so alarming as to threaten the child with immediate death, if something for its relief was not speedily done. Having heard that an ointment of garlic had been employed with beneficial ef- Materia Medica. 645 fects in sore throats, he instantly had some onions beat- en not having any garlic at hand, to which was added a small portion of hog's lard; and with this mixture, the neck, breast, and back of the child was well rubbed, which, in the short space of one hour, relieved all the distressing symptoms. Another case of croup, cured by this application, came under the notice of Mr. Crawford last fall, as he was travelling from Georgia to the seat of government. A little girl, daughter of the gentleman at whose house he tarried one night, was seized with this alarming malady; and on his recommending the above remedy, it was employed with the same happy effects. He also stated to me, that, while in Paris, he was af- flicted with a violent sore throat, which did not yield to the usual remedies; he directed some onions to be beaten, and had them applied to the soles of his feet and legs, over wliich his stockings were drawn. The happy result was, that he had a good night's rest, and in the morning found his throat entirely cured. He communicated the cure wrought on himself to a French lady who was great- ly distressed with a sore throat, which induced her to make the experiment, and the fortunate result was very / remarkable. ORANGE TREE, Citrus Aurantium—Is now culti- vated in the southern states, and deservedly esteemed for its grateful acid juice, which, by quenching thirst, and diminishing heat, is of considerable use in febrile disor- ders. From its virtues to resist putrescency, it has al- ways and most deservedly held the first place on the list of antiscorbutics. The following is a recipe for making orange wine:— Take the expressed juice of forty sour oranges, five gal- lons of water, and fifteen pounds of sugar; boil the water and sugar for twenty minutes, skim constantly, and when cooled to a proper heat for fermentation, add the juice and outer rinds ofthe fruit, rasped or sheered off, putting all in a proper keg; leave it open for two or three days, and then bung it close for six months. PAPAU. See Custard Apple. 646 Materia Medica. PAPOOSE ROOT. See Cohush. PARSLEY-LEAVED YELLOW ROOT, Zanthori- *a Apiifolia—Is a native of the southern states. The stems reach the height of three feet, and are somewhat thicker than the barrel of a goose quill. The root is from three to twelve inches long, and about the diameter of a man's little finger, sending off numerous scions, some- times two feet in length, by which means it spreads con- siderably. The flowers appear before the leaves, very early in the spring. Both the stem and the root are of a bright yellow co- lour, and possess a strong and bitter taste. In medicinal virtues, it is nearly allied to the celebrated columbo root. The powdered stem and root, in the dose of two scruples, is highly recommended in all cases requiring bitter and tonic medicines.* According to professor Barton, we have a very com- mon plant in various parts of the United States, particu- larly in the rich soil adjacent to the Ohio and its branch- es, in the western parts of Virginia, Pennsylvania, and Kentucky, which is commonly called Yellow Root. He describes the root of this plant as being a very powerful bitter, perhaps not less so than the preceding, and very popular as a tonic medicine. The usual forms of admin- istering it are powder, tincture, and infusion. This lat- ter has been employed as a wash in inflammation of the eyes. It is supposed this is the plant which some of the Indians make use of to cure cancers. PARSLEY, WILD, Petrosellinum—Grows in meadows, and among rocks near the sea; stems firm, near six feet • The above is the character of this plant, as given by my excellent friend, the late professor Woodhouse. Friendship is often partial; but eulogy, to be just, must employ bright colours to paint the character of such a man as Dr. Woodhouse. With that rare benevolence which im- parts its noblest ardour to friendship, he combined a genius which threw a solar radiance over the dark abyss of chemical science, besides illumi- nating other walks of useful knowledge. To darken the gloom of so awful a dispensation, it pleased the great FATHER of LIGHTS to take into his presence another star of equal lustre with Dr. Woodhouse. I mean that refulgent genius, Dr. Shaw, late professor of Chemistry in the University of Maryland. The friends of an art so important as Chemistry, will have cause to mourn the early extinction of those bright luminaries. Materia Medica. 647 high; long, thick root, strong smell, acrid taste; flowers in July, and kidney-shaped seed, which alone are used in medicine, as a powerful diuretic. A small handful of the seed, boiled in a quart of water, and sweetened with honey, in doses of a tea-cupful every hour or two, is celebrated as a remedy in suppression of urine, or gravel complaints. PEACH TREE, Amygdalus Persica—Both the flow- ers and leaves are excellent cathartics, and ought to be preserved by every family. A tea-spoonful of a strong infusion, sweetened, and taken every hour or two, will operate mildly on the bowels, without griping as senna does. Of the sirup, prepared by boiling slowly the juice of the leaves, with nearly an equal quantity of molasses, honey, or sugar, a table-spoonful to children, and a wine- glassful to adults, will also prove a mild laxative medi- cine. I have myself witnessed its good effects in St. An- * thony's Fire and measles, and have no doubt of its utility in other diseases requiring gentle laxatives. Two of my most intimate friends, on a visit to one of their cotton plantations just settled in the interior part of Georgia, and where there was neither medicine norphy- , sician, were taken dangerously ill of the bilious fever.— A good neighbour hearing they were ill, went to see them, and prescribed what he called "an excellent physic," which was simply a strong infusion of peach leaves, to be taken in doses from a gill to half a pint every two or three hours. It operated on the stomach, bowels and skin; and by persevering in the use of it for a few days, they were happily restored to health. A decoction, prepared by boiling a handful ofthe dried leaves in a quart of water to a pint and a half, and tak- en in doses of a tea-cupful every two or three hours, is reputed, upon respectable authority, to have proved an effectual remedy in many cases of affections of the kid- neys or gravel complaints, as also in cases of voiding blood by urine, which had resisted the usual remedies. PENNYROYAL, Mentha Pulegium—An infusion, a handful to a quart of boiling water, a tea-cupful the dose three times a-day, has long been esteemed in hysteric 648 Materia Medica. complaints and obstructions ofthe menses. Dr. Wither- ing says, that the expressed juice of pennyroyal, with a little sugar or honey, a tea-cupful every two or three hours, is a useful medicine in the whooping cough. PEPPERMINT, Mentha Piperita—la an excellent sto- machic in flatulent colics, languors, hysteric cases and vom- iting. The usual modes of administering it, are infusion, the distilled water, and the essential oil. This last, uni- ted with rectified spirits of wine, forms the essence of pep- permint, so highly esteemed. In nausea, cholera morbus, obstinate vomiting, and griping, peppermint, infused in spirits, and apjilied as hot as can be endured to the stomach and bowels, will be found a most valuable remedy. A lady of Alexandria was seized with a violent fit of the colic, bringing on a weakness and irritability of the stomach, with nausea and vomiting incessantly. Two eminent physicians sent for could prescribe nothing that did any service. Dr. Craik being called in, immediate- ly ordered a large cataplasm of stewed mint in spirits, to be applied as warm as it could be borne, to the pit of the stomach and abdomen. It operated like a charm. The distressing nausea and vomiting left her, the aperient medicines were then retained, and the obstinate consti- pated state of the bowels was speedily removed.* • To heighten my satisfaction in this cure, it was wrought by a man, of whom I can never think without feeling the most tender sentiments of gratitude; I mean my uncle, Dr. James Craik, with whom I was then a student in Alexandria. From the double motive of pleasure to myself and profit to others, I beg to sketch a short outline to Dr. Craik. Habits of temperance, early adopted and steadily adhered to, imparted to his constitution, though naturally delicate, a degree of vigor and viva- city that carried him through life very pleasurably, till his eightieth year. After he retired from practice, he continued daily to take considerable exercise; and such was his activity, that, but a short time before his death, he walked from his country seat to Alexandria, a distance of eight miles! The virtues which adorn the husband, the parent, the friend, and the master, have seldom been sent to shine with more durable lustre than in Dr. Craik. In reward of his virtues, Heaven was pleased to distinguish him with uncommon favours. For upwards of forty years, he was honoured in an extraordinary degree, with the friendship ofthe great Washington, be- ing all that time his companion and physician. This, however, was no- Materia Medica. 649 PEPPER, RED OR CAYENNE, Capsicum Annum —Is cultivated in our gardens; it is a powerful stimulant, and has been found beneficial in chronic rheumatism.— Those who are subject to flatulence will find benefit in using it with vegetables and soup. In cases of violent pain or cramp in the stomach, no medicine is superior to a strong infusion of red pepper, one or two pods to half a pint of spirits, in dose from a half to a wine-glassful.— It is also useful, both as a medicine and gargle, in putrid sore throat, when infused in water. Steeped in spirits and ajiplied warm to the extremities in chronic rheuma- tism, or low stages of nervous fever, when the circulation is languid, it has produced the most happy effects. PINKROOT, CAROLINA, Spigelia Marilandica— Grows abundantly in the southern states, and is deserved- ly esteemed a vermifuge, or destroyer of worms. An in- fusion, a handful to a quart of boiling water, and one or two tea-cupfuls night and morning, is the usual form and dose. With the addition of milk and sugar, children will take it almost as readily as their tea. It sometimes oc- casions disagreeable affections ofthe eyes; when this oc- curs, suspend the use ofthe medicine until these symp- toms disappear, and then select from another parcel, or make tea ofthe tops only, as it is supposed the deleteri- ous effects are in consequence of some other root being attached to it. Pinkroot is also considered a valuable medicine in fe- vers, as is verified daily, when given to children in a fe- thing compared to the happiness he enjoyed in marriage with a lady, who, for all the charms "of a mind, illumined face, and all the graces of truth, goodness, and harmony of love," never had her superior among the fairest daughters of Eve. "So like an angel did she spend her days, So like a blessed saint's, were all her ways; So bland, so gentle, all her actions were, One would have thought her an immortal here." After more than fifty years ofthe happiest life, Dr. Craik was removed to those scenes where bliss immortal reigns. But their separation was short. "He first deceased, she for a few months tried To live without him—-lik'd it not, and died," 82 650 Materia Medica. brile state for a vermifuge, when no other effect has been produced than a removal ofthe fever. PISS WORT. See Flea Bane. PLANTAIN, Flantago—Has long been employed as ? an antidote against the bites of snakes, sjiiders, and other venomous insects. The juice, extracted from the whole ofthe plant, is generally given in doses of two table-spoon- fuls every hour, or oftener, until the patient is relieved. It is sometimes given in conjunction with horehound or rue. The leaves bruised are considered by some a good application to fresh wounds. PLEURISY ROOT, Asclepias Decumbens—Has a va- riety of names, as butterfly weed, flux root, decumbent swallow wort. It is a beautiful plant, growing two or three feet high under fences and upland pastures. The flowers are of a bright orange colour, and appear in July and August. These are succeeded by long slender pods containing the seed, which have a delicate kind of silk at- tached to them. The root is spindle or carrot-shaped, of a light brownish colour on the outside, white within. This plant possesses great medicinal virtues, and ought therefore to be cultivated in our gardens. It has long i been employed as a remedy in the treatment of violent cold and pleurisies. No medicine is better calculated than this to produce general and plentiful perspiration without \ heating the body, and hence its well-merited fame in cur- ing the disease, which name it bears. Mr. Thomson Ma- son, of Virginia, was among the first who noticed the vir- tues of this plant, and from his long experience of its utili- ty in jdeurisy, recommended it as a specific. He states, that after the use of an emetic, and the loss of some blood, in the incipient stage, he administered, of the pleurisy root finely powdered, as much as would lie upon the point of a case-knife, in a cup of warm water, and repeated the dose every two hours until the patient recovered, which happened frequently in a very few days. By these sim- ple, means Mr. M. cured great numbers. WTe have also many of the most respectable physicians celebrating its virtues in pleurisy, and other recent affec- Materia Medica. 651 tions of the breast. A tea-cupful of a strong infusion, a handful to a quart of boiling water, is given every two or three hours. Professor Barton says the root of this plant in powder possesses a purgative quality, and that he has used it with advantage in dysentery. In Virginia also it has been used with great effect in this complaint. This root is frequently resorted to by country people for the re- lief of pains of the stomach from flatulence and indiges- tion, hence it is called by some wind-root. The late Paul Hamilton, esq. ascribed the same virtues of curing pleurisies and dysentery to a plant that grows in South Carolina, and which is also called Pleurisy Root, Asclepias Erectus. He thus describes it: It grows in rich high lands. The root lias the appear- ance and taste of a small, long, sweet potato; the stalk erect; the leaves resembling the persimmon leaf, is situa- ted transversely, and when broken, it throws out a viscid milk; blossoms in May and June. The blossoms are a cream colour, with purple centres. Twenty grains of this root in powder, he says, given in warm water or tea, is excellent in flatulent colic; and the same quantity re- peated every two hours, in pleurisy, will seldom fail to bring on a perspiration, while its pectoral effects are ad- mirable. POISON OAK, Rhus Toxicodendron—Embraces seve- ral species, the most dangerous of which is the swamp su- mach. The poison may be communicated, not only by the touch, but also by the smoke, smell, or steam produc- ing an eruption on the skin, with pain and itching, and sometimes attended with swollen head and fever. One % of the best remedies which has come under my notice, is a wash of crude sal ammoniac and corrosive sublimate, two drachms of the former to one of the latter, in a quart of water, used externally twice or thrice a-day, with a dose or two of salts, or an infusion of senna and salts.— I have lately been informed, from a source which can be relied on, that lime water excels any other application as awash in this distressing affection ofthe skin. The species called sometimes poison wood, has a low shrubby stalk, the leaves somewhat heart-shaped,theflowerssmall, the berries round, and of a yellowish grey colour when 652 Materia Medica. ripe. Dr. Anderson, of Hull, has employed the leaves of , this species in doses from half a grain to four grains, thave times a-day, with success in paralytic cases. Poison vine, called also poison creeper, has a slender stem, and frequently climbs to the top of our tallest trees. The flowers, which appear in June, are small, of a light yellow colour, and have a delightful odour. An extract of the leaves, two grains to a dose, and increased, has been successfully employed in paralytic affections, as well as an infusion in tetter-worm and scald head. Professor Barton says, that a decoction has been used , with seeming advantage in cases of consumption; and ' others say, that a decoction of the root is serviceable in asthma. POKE WEED, Phytolacca Decandra—Is known by a variety of names, as American night-shade, coacum, garget, skoke. The berries steeped in spirits, have long been emjdoyed in the chronic rheumatism. It has, how- ever, sometimes failed, which may have been owing to the peculiarity of constitution, or to the inertness ofthe bounce or tincture from age, an effect often observed by profes- sor Barton, as also by myself. From the authority of this learned professor, the juice of the ripe berries, in- spissated to the state of an extract, and spread upon a rag, or upon the leaf of the plant, is an excellent appli- S cation to scrofulous or indolent tumours.' The juice of the leaves has been applied in the same manner with equal advantage. An ointment of the leaves with lard is good in various kinds of ulcers. The roots, bruised, are some- ■ times applied to the hands and feet of the patients in ar- dent fevers. To make an extract, expose to moderate and continued heat, the juice of the berries or leaves, un- til, by evaporation, it thickens to the consistence of honey. > It may also be made from the root, which is equally effi- cacious. Boil the roots for some time, strain the decoc- tion, and then reboil it to a thick consistence. Other virtues have been recently ascribed to this plant by res- pectable physicians. An infusion of the leaves is recommended externally as an admirable remedy forthe piles. One ounce ofthe root Steeped in a pint of wine, and given to the quantity of two Materia Medica. 653 table-spoonfuls, is said to operate mildly as an emetic.— It is also said that this plant may be relied on as an effi- cacious remedy for the venereal disease, in its various stages, even without the aid of mercury. From my own experience of the virtues of poke weed, I can recommend it as a most valuable medicine in rheu- matic and gouty affections, as also in nocturnal pains, and obstinate ulcerations in the venereal disease, brought on by the excessive use of mercury. The usual form of ex- hibition is the bounce, a wine-glassful three times a-day. The bounce is prepared by filling a jug with the whole berries when ripe, and then pouring as much spirits to them as the vessel will contain. An ointment, prepared by simmering slowly the leaves or a handful of the root scraped in a pint of hog's lard, with a small portion of beeswax, has been used with great success in cancers, and various kinds of ulcers. POLYGONUM—An infusion of it, as a diet drink, is a powerful promoter of urine, and very useful in gravel complaints. POLYPODY, COMMON, Polypodium—Grows on old walls, shady places, and at the roots of trees, flowering from June to October. The root has a sweetish taste, but by long boiling becomes bitter. An infusion of half an ounce ofthe fresh root in half a pint of boiling water, in doses of a wine-glassful every hour or two, operates as a mild laxative. POMEGRANATE, Punica—Is cultivated in the southern gardens. The fruit is agreeable to the palate, and possesses the general properties of subacid fruits.— Its rind, boiled in milk, and drank freely, or in powder, a tea-spoonful for a dose, three times a-day, has been used with success, in diarrhoeas, dysenteries, and other diseases requiring astringent medicines. The flowers possess the virtues of the rind, only in a less degree. POPLAR TREE, OR WHITE WOOD, Lirioden- djrum Tulipifera.—The bark of this noble tree, as well as the root, is a very strong bitter, and considerably aro- matic. 654 Materia Medica. In intermittents, in the last stage of dysentery, and other disorders requiring tonic medicines, it is considered but little inferior to the Peruvian bark, and is generally em- ployed in similar doses and forms. There is another species of poplar, the aspen tree, po- pulus tremula, the bark of which, according to professor Barton, is also an excellent tonic and stomachic. POPPY, WHITE, Papaver Somniferum— Grows in our gardens, and yields a juice, which, when inspissated, to a proper consistence, is called opium. According to the experiments of Dr. S. Ricketson, of Duchess county, New-York, the opium obtained from our poppies, is equal, if not superior to the imported. With respect to the method of cultivating the plant, and preserv- ing the opium, we shall insert the directions given by Dr. Ricketson. "The poppy seeds should be jilanted about the middle of May, in rich moist ground, an inch deep and ten or twelve inches apart, and kept clean. When the plants are arrived to the state of flowering, on a sun-shining day, cut off the stalks, at about an inch distance from the flow- ers, and as soon as the juice appears, which it does at first equally well on the part of the stalks cut off with the flowers, as on the standing part, collect it with a small scoop, or penknife. After the juice ceases to appear on the standing stalk, it should be cut off about an inch low- er, when it will be found to yield almost as freely as be- fore, and repeated as long as any juice appears. The juice, when collected, should be put into an evaporating pan, placed in the sun's heat, and frequently stirred, till it becomes of a consistence to be formed into pills, or made into rolls for keeping and exportation. The quan- tity of opium that may be preserved, depends very much on the largeness of our plants, and the care used in col- lecting it. From one poppy plant, I have obtained seven grains of opium. If any would choose to have the opium freed from its impurities, it may be easily done, by press- ing the juice, before it is inspissated, through a linen strainer; but if pains be taken, according to the foregoing directions, I believe there will be little or no occasion for it." Materia Medica. 6;"i5 A strong decoction ofthe dried heads mixed with half the quantity of sugar, or honey, and formed into a simp, by simmering slowly by a gentle fire for an hour, is oc- casionally used in doses of a table-sjioonful in coughs and breast complaints, on account of its anodyne effects.— Poppy heads are also used externally in fomentations and poultices, either alone, or conjoined with the leaves of southernwood, camomile flowers, or other ingredients. POTATO, SWEET, Convolvulus Batata—From this ^ root Bowen's patent sago is prepared, which forms a very nutritious jelly, like arrow root, and is prepared in , the same manner; to which the reader is referred. The process generally used for procuring the powder of the sweet potato, is to grate the clean roots, wash the mass through brass sieves of different sizes, and collect the flour at the bottom of the vessel which receives the fluid; finally, dry it in pans either by the fire or in the sun. i The vine of the sweet potatoe, supports the famous in- sect, called the potato fly, which from repeated experi- ments, is found fully equal in all respects to the best Span- ish flies. The potato flies generally make their appear- ance about the last of July or first of August, and may be collected in great abundance morning and evening, by shaking them from the leaves in a vessel of hot water, and afterwards drying them in the sun. These insects will also feed upon the vine of the Irish potato. As they can be procured in immense quantities annually, with but little trouble, every family should carefully collect them. POTATO, WILD, Convolvulus Panduratus—Grows in low grounds and sandy soils, near running water.— It trails along the ground several feet, much like a grape vine, the root very large, hard, and white, running Very deep in the earth; the leaves triangular, the flowers are whitish with a purple tinge, and bell-shaped. It is called wild rhubarb, and from the article whose name it bears, is employed as a purgative in doses from a tea to a table- spoonful of the powdered root. Professor Barton says, the root in powder or decoction has been much recom- mended in Virginia, and other parts ofthe United States, in cases of gravel. The decoction is prepared by boiling : 656 Materia Medica. slowly a handful of the root sliced or bruised in three pints of water to a quart, of which, in gravel complaints, a tea-cupful may be taken four or five times a-day. PRICKLY ASH, & PRICKLY YELLOW WOOD, Zanthoxylum—Possess the same virtues. Both species are covered with numerous prickles, whence the name.— Both the bark and berry are of a hot acrid taste, and when chewed, powerfully promote spittle. It is used in this way to cure the tooth-ach, as well as by putting some within the hollow, also to cure the palsy of the tongue. A decoction, or infusion ofthe bark of the root, a small handful to a quart of boiling water, in doses of half a pint three or four times a-day, has long been employed with great success in chronic rheumatism, paralytic af- fections, and venereal disease. There is no medicine which I have found so effectual in relieving nocturnal pains, and disposing venereal ulcers to heal, as the prickly ash in the above form and doses. A tincture, prepared by steeping half a pint ofthe ber- ries, or a handful of the bark, in a bottle of spirits, is • much esteemed as a remedy in doses of a wine-glassful in flatulent colics. It is sometimes employed in this form, in cold phlegmatic habits, afflicted with the rheumatism. PRICKLY PEAR—Grows on sandy lands, and rocky places. A large handful of the pear cut in slices, boiled in a quart of milk, and taken in doses of a gill every morning, is reputed to be of great benefit in scurvy, dropsy, can- cers, and cutaneous eruptions; and that the inner soft mucilage of the pear, while green, on a rag, to ulcers morning and night, is very efficacious. It is also said that a fresh piece of the inner side of the pear, applied twice a-day to corns, after soaking the feet in warm wa- ter, and paring off the horny part, will in a few days per- form a cure. PRIDE OF INDIA, OR CHINA, Melia Azedarach —Is now completely naturalized to the southern states. The public walk and streets of Savannah and Augusta, are ornamented by rows of this tree, a mile long, which fur- Materia Medica. 657 nish a most delightful shade against the scorching sun, and adds not less to the healthiness than to the beauty of these cities. Independent of its luxuriant verdure, and cooling shade, it is highly valuable for its medicinal pro- perties, being now ascertained to be one of the best vermi- fuees in nature. , Many physicians in the southern states have witnessed its remarkable effects in destroying and dislodging worms. It has been even found a remedy against the tape-worm. I have not myself made use of this medicine, possibly because of having witnessed the deleterious effects of the berries on some pigs and a parrot. In the fall ofthe year 1795, at a country seat which I then owned, in Lancaster County, Virginia, a sow with eight or ten pigs came into the yard where I had several trees ofthe Pride of China, and observing the pigs to eat with avidity the berries, which were dropped on the ground, I had many of them thrown from the tree, and in a few hours all the pigs were seized with the common symptoms of inebriation, and died. The sow did not ap- pear to be the least affected, although she also ate of them. The death of the pigs would not have operated so strong- ly on my mind, had it not been for a parrot, which not long after fell a victim to those berries. This enchanting bird, which spoke many words as plainly as a human person, and which for several years had been a pet in the family of Dr. Andrew Robertson, the father of Mrs. £####, j,ad not long arrived at its new home, before it was tempted to eat of the fruit of this tree. A gentleman who was not apprised of the deleterious properties of this berry, presentd the much-admired Poll with one of them, which she soon ate, and relished it so well, as loudly to call out, "give me some more!" "give me some more!" Af- ter consuming several, she in a short time fell into a state of stupefaction, followed by a violent purging, which soon terminated her existence. The common modes of using this medicine, are the in- fusion or tea, and saturated decoction. Of the former a handful of the bark to a quart of boiling water, is given in doses of a small tea-cupful morning and night. The decoction is made by boiling a large handful of the fresh bark ofthe root in three pints of water to a quart, which 83 658 Materia Medica. is given to children in doses from a half to a whole wine- glassful. Dr. Kollock, of Savannah, observes, when ex- hibited in the latter form, every three hours, until it ope- rates, he has found it beneficial as a febrifuge in those af- fections usually denominated worm fevers, but where no worms are voided. The pulp which invests the stone of the fruit, pounded with tallow, has been successfully em- ployed in cases of scald head. Would not an ointment prepared by slowly simmering the. root in hog's lard, be found also an excellent application to that loathsome dis- ease; also to tetter worms and ulcers? PUCCOON. See Blood Root. QUEEN OF THE MEADOWS—Grows in hedges, and on the sides of meadows, about four feet high; the stalk reddish, leaves long, spear-shaped, and opposite each other; flowers purple. A large handful of the roots boiled in three pints of wa- ter to a quart, and given in doses of a tea-cupful every two hours, is said to be an excellent remedy in suppres- sion of urine, and carrying off the water in dropsy. QUINCE TREE, Pyrus Cydonia—The liquor ex- pressed from the ripe quince, also the sirup, has frequent- ly been given with great success in nausea, vomiting, and fluxes. The juice of the quince with sugar, a gallon of one to two pounds of the other, is said to make a most delight- ful wine. The ripe fruit sliced and steeped in French brandy or spirits, with a little sugar, or equal parts of the juice and spirits sweetened, forms an admirable cor- dial and stomachic. The quince makes also a nice pre- serve, and the seeds a fine mucilage, which, with sugar and nutmeg, is an excellent drink in dysentery. RADISH, Raphanus—Is esteemed as an antiscorbutic, particularly if eaten with the skin. When old, or after having been kept some time, they ought to be avoided, especially by persons of weak stomachs, as apt to create indigestion and colic, and to render the breath disagree- able. Materia Medica. 659 RASBERRY, Idceus—Like the rest ofthe rich subacid fruit, when ripe, are wholesome and nourishing. Ras- berries, as well as strawberries, held in the mouth, will dissolve tartarous concretions formed on the teeth. RATTLE, OR SENEKA SNAKE ROOT, Poly- gala Senega—Grows nearly a foot high, the leaves point- ed, and somewhat oval; the stalks upright and branched, the flowers white, the root variously bent and joined, whence it is supposed to resemble the tail of the animal whose name it bears. In violent colds, croup, pleurisy, acute rheumatism, and all inflammatory complaints, 1 can recommend it as an admirable medicine to promote perspiration. The best form of using it is in decoction, a handful to a quart of boiling water, a wine-glassful to adults, every tvvo or three hours, increasing or lessening the quantity to avoid vomiting and purging. Professor Chapman recommends it very highly in ob- structions of the menses; four ounces of the decoction to be taken in the course of the day, increasing tbe quantity when the menstrual effort is expected, as far as the stom- ach will allow. If this excite nausea, aromatics are to be added, as cinnamon, calimus and angelica. Dr. Archer, of Hartford county, Maryland, was among the first who noticed the efficacy of this medicine in cases of croup or hives. He directs a tea-spoonful of the strong decoction to be given to a child every half hour or hour, as the urgency of the symptoms may demand, and during the intervals a few drops occasionally, until it acts as an emetic or ca- thartic; then repeated in small quantities, to keep up a constant stimulus in the mouth and throat. Patients who use this medicine, should not be jiermitted to drink any thing whatever for some time after each dose. He has also employed it in the form of powder in doses of four to five grains, mixed with a little water. Professsor Barton, with his usual candour and liberali- ty, observes, "I am persuaded that the Seneka is a very important medicine in the treatment of this common, and too frequently unmanageable disease; and praise is, in my opinion, due to Dr. Archer for his important discovery, for such I cannot but deem it. That the Seneka is a spe- 660 Materia Medica. cific or certain remedy forthe cure of croup, I do not be- lieve; but from my own experience, I am led to repose more confidence in the use of this medicine than in any other. I have made use of a very strong decoction of the root. I have always given it in large quantities. It ap- pears to be chiefly beneficial when it occasions an expec- toration of mucus, and when it proves emetic. It is also very useful by virtue of its purgative quality. But I have known it occasion very plentiful stools, without benefit- ing the patient. Indeed, in the exhibition of Seneka, I would rather wish to guard against large purgings. I have sometimes treated my patients almost entirely with Seneka. Even in such cases I have perceived most une- quivocal good effects from it. But I have more generally given along with the Seneka, calomel, and sometimes ca- lomel combined with ipecacuanha. 1 have not omitted the emjiloyment of the lancet, though this in many cases of croup is not absolutely necessary, and the use of blisters or sinapisms applied near the seat ofthe disease. I am happy to close this short notice by observing, that seve- ral respectable physicians in Philadelphia inform me that they have used the Seneka with much advantage in the dis- ease in question. Along with its emetic, cathartic, expectorant and dia- phoretic qualities, the Seneka possesses a diuretic power, and hence has been found useful in cases of dropsies. It likewise acts upon the salivary glands. In the prevailing epidemic I have found a decoction of this vegetable, taken freely at the commencement of the disease, a medicine of great utility." RATTLE SNAKE VIOLET. See Violet. RHUBARB, WILD. See Potato, Wild. ROSE, Rosa—The hundred-leaved, or damask rose, is justly termed the queen of flowers. Otter, or essence of roses, is obtained from these by distillation, and is doubtless the most elegant perfume in vegetable nature. Independent of their use in this manner, a decoction of its leaves will be found a mild laxative, and, when formed in- to a sirup, maybe given with advantage to children. The conserve of roses is also prepared from them for medical purposes. Materia Medica. 661 ROSE WILLOW, Salix—Grows near brooks, along the banks of rivers, and on the borders of meadows. It is about the size of an apple tree, and covered with a greyish-coloured bark, and very red within, with a bunch in the top resembling a bunch of roses. Four ounces, or a large handful of the bark, boiled in three pints of water to a quart, and taken in doses of a tea-cupful three or four times a-day, is said to be an ex- cellent remedy in cases of gleet, the whites, immoderate flowing of the menses, and in cutaneous eruptions. RUE, Ruta—Has an ungrateful smell, and a pun- gent, bitter taste. The leaves are acrid, and when appli- ed to the skin are apt to produce blisters. Employed in the form of tea, they are reputed to be of great ser- vice to persons of cold phlegmatic habits. According to Boerhaave, an infusion of the leaves powerfully pro- motes perspiration, quickens the circulation, removes obstructions, and is particularly adapted to weak and hysterical constitutions, suffering from retarded, or ob- structed secretions. SAGE, Salvia—An infusion of the leaves, or tea, is considered serviceable to persons of cold phlegmatic ha- bits, labouring under nervous debility. Sweetened, with the addition of a little lemon juice, it forms an exceed- ingly grateful and useful drink, in febrile disorders. Sage was supposed by the ancients to possess the vir- tue of prolonging human life; hence the following verse: «Cur moriatur homo, cui salvia crescit in horto?' How can a man die, in whose garden there grows sage? in al- lusion to its many virtues. What a shameful abuse of this pretended property was made by the late sir John Hill, in his patent tincture of sage, for the prolonging of human life, and warding off old age, is known to every one. This conduct could not fail to draw upon him the pen of the wits of the age; and Garrick, with Thomson, conjointly published the following epigram: Thou essence of dock, valerian and sage, At once the disgrace and pest of the age, The worst that we wish thee for all thy bad crimes, Is to take thy own physic, and read thy own rhymes. 66g Materia Medica. Dr. Hill made the following reply: Ye desperate junto, ye great, or ye small, Who combat dukes, doctors, the deuce, and them all, Whether gentlemen, scribblers, or poets in jail, Your impertinent curses shall never prevail; I'll take neither sage, dock, nor balsam of honey; Do you take the physic, and I'll take the money. Such shameless imposition on common sense, deserves something worse than ridicule; for deceiving the sick and helpless, they merit the execrations of every man who has one spark of humanity. SAMSON SNAKE ROOT—Grows from six to twelve inches on dry land, and bears on the top two or three pale blue flowers; leaves opposite, sword-shaped; the root matted, variously bent, and has an agreeable bitter taste. Upon the respectable authority of the honourable Wil- liam Mayrant, of South Carolina, the root of this plant possesses in a very great degree tonic powers. He stated to me, that being himself reduced to a mere skeleton by dyspepsia, or indigestion, and having tried the usual re- medies employed in such cases without receiving any be- nefit, he was at length induced, as his last hope, to try the virtue of this plant, which had been recommended to him by a negro man. He was directed to steep a hand- ful of the root in a bottle of spirits, of which he was to take half a wine-glassful diluted with water three times a-day; and such was the astonishing effect wrought by this medicine, that in a few weeks his health was per- fectly reinstated. He discovered the plant to grow near Fredericksburgh, Virginia, and collected some of it to exhibit in Washington. Several persons in delicate health, and troubled with dyspepsia, were readily per- suaded, from the recommendations of col. Mayrant, to make use of his favorite remedy, and not without re- ceiving considerable benefit. It may be taken in the form of powder, tincture or decoction. SANICLE, AMERICAN. See Alum Root. Materia Medica. 663 SARSAPARILLA, Smilax Sarsaparilla—Grows in several parts ofthe United States. It is a small vine re- sembling a bramble. A decoction of sarsaparilla, prepared by boiling a large handful of the root in a quart of water, till the third part be evaporated, has long been employed as an auxiliary to mercury, in the treatment of venereal complaints. It v promotes perspiration, attenuates viscid humours, re- lieves venereal headach, nocturnal pains, and disposes venereal ulcers to heal. In rheumatic affections, cutane- ous disorders, and scrofula, it is a very useful medicine. It may also be exhibited in the form of powder in doses of two drachms, or extract in doses of one drachm, three or four times a-day. SASSAFRAS, Laurus Sassafras.—An infusion or tea of the flowers, or bark of the root, has often been suc- cessfully given as a sweetener or purifier of the blood, in scorbutic, venereal, and cutaneous disorders, or where an acrimony of the fluids prevails. Conjoined with the bark of dog-wood, cherry-tree, or oak, it is very useful in obstinate intermittants. The oil, externally applied, in the chronic rheumatism, and also in wens, has often- times proved salutary. The pith of the small twigs, in water, forms a mucilage of excellent use for sore eyes, and as an injection in the incipient stage of gonorrhoea. It also affords, when sweetened, with the addition of n utmeg, a palatable jelly, useful in dysentery and fe- brile diseases. SCULL CAP, BLUE. See Hooded Widow Herb. SCURVY GRASS, Cochleara Officinalis—Is a pungent stimulating plant, and in the simple state of a salad, or in the form of expressed juice, a wine-glassful three times a-day, has long been esteemed one of the best of all the antiscorbutic plants. SENNA, AMERICAN, Cassia Marilandica—Is easi- ly cultivated from the seeds, and ought to be more gene- rally introduced in our gardens. It has long been employed as a purgative. To in- 664 Materia Medica. crease its effects on the bowels, manna, salts, or tama- rinds are generally added. To correct its ill flavour, and prevent griping, it should be joined with some aro- matics, as coriander or fennel seed, ginger, &c. In the form of decoction, a handful to a pint of boiling water, the dose is a tea-cupful every hour or two, until it op- erates. It may also be exhibited in the form of tinc- ture, to relieve flatulent colics, four ounces of senna to a quart of spirits, with an ounce of coriander seed, or ginger, and a wine-glassful the dose. SKOKE. See Thorn Apple. SKUNK CABBAGE, Draconitu Foetidum—Abounds in swamps and meadows, and emits a disagreeable smell, nearly resembling that of a skunk or pole-cat, and from this, and its leaves resembling those of a cabbage, it has acquired its name. The roots dried and powdered, have proved of excel- lent use in asthmatic cases, and often afforded relief in this distressing disease, when other means were ineffec- tual. It should be exhibited during the paroxysm, and repeated as circumstances may require, in doses of thir- ty or forty grains. It will be proper to persevere in the use of it for sometime after the paroxysm has gone off, until the patient has perfectly recovered. Dr. Cutler has celebrated its efficacy in his own case of asthma, after other medicines had failed. In one ofthe most violent asthmatic cases, two tea-spoonfuls of the powdered root in spirits, procured immediate relief; and on repeating the trials with the same jiatient, it afford- ed more lasting benefit than any other medicine. In childbed it produces the desired effect, in doses of a tea- spoonful repeated occasionally. In numerous other in- stances of spasm, and also in chronic and acute rheuma- tism, and dropsy, in powder or decoction, it has per- formed important cures. The seeds possess the same virtues with the root. Dr. Cutler vehemently cautions, that, in collecting the roots, the white, hellebore, or poke root, which some people call skunk weed, be not mistaken for this jilant, as the consequence might be fatal. There is an obvious Materia Medica* 665 difference; the hellebore has a stalk, but the skunk cab- bage has none, and the roots ofthe latter are much larg- er than those of the former. SOAPWORT, Saponaria Officinalis—Grows in moist swamps and meadows, particularly on the Ohio river, where it is used as a substitute for soap. It rises about a foot high, the leaves are pointed, and furnished with three ribs, the flowers numerous, large, and of a pale pink colour. . A handful of this jdant boiled in three pints of water to a quart, in doses of half a pint, three or four times a-day, has been found useful in the jaundice, obstruc- tions of the liver, and the venereal disease. SORREL, Oxalis Acetosella—Called also sour tre- foil, or cuckow bread. Yields, on expression, a grate- ful acid juice, which has been beneficially used in the scurvy, and scorbutic eruptions. An infusion of the leaves makes a palatable diet drink in fevers, and on be- ing boiled in milk, forms an agreeable whey. A con- serve made of the leaves, with double their weight of loaf sugar, forms an excellent substitute for lemons, and may be given with advantage, in all putrid and other fe- vers, where antisceptics are indicated. The leaves bruis- ed, and externally applied to scrofulous ulcers, have pro- duced excellent effects, by promoting suppuration and granulation. SOUTHERN WOOD. See Mugwort. SOUTH SEA TEA, OR YAUPON, Alex Vomitoria— Grows abundantly in the southern states. It rises about twelve feet high, shooting into many upright slen- der stiff branches, covered with whitish smooth bark; the leaves small, evergreen, and saw-edged; the flowers small and white, and grow promiscuously among the leaves, succeeded by small berries, wliich become red in Octo- ber, and remain so all the winter. It is held in great esteem among the southern Indians. They toast the leaves, and make a decoction of them, which is called black drink. 84 666 Materia Medica. An infusion, or tea of the leaves, is considered as pala- table as Bohea tea, and when used freely, is a powerful r diuretic, and hence of service in the cure of dropsy and suppression of urine. SPIKENARD, Aralia Racemosa—Grows in low rich grounds and among rffcks, to the height of three or four feet; the leaves are many, on long branches, from a thick purjdish stalk, flowers very small, of a bluish colour, producing berries much resembling those of the elder, of a sweetish pleasant aromatic taste. The roots are ve- ry long, about the thickness of a finger. A pint of the berries steeped in a quart of spirits, in dose of a wine-glassful, is said to be a speedy cure for ? the gout in the stomach. The roots in the form of infu- sion, a handful to a quart of water, and given in doses of a tea-cupful three or four times a-day, have been found efficacious in gouty complaints. The fresh root applied . in the form of poultice, is said to be excellent for wounds 1 or ulcers. SPLEENWORT. See Maiden Hair. SPRUCE LAUREL. See Mezereon. SQUIRREL EAR, OR EDGE LEAF—According to the late Paul Hamilton, esq. is produced on barren pine land, in Carolina and Georgia. It is a species of I sage, and very efficacious as an antidote to the poison of the snake bite. It is known by the remarkable char- acteristic which forms its name; the leaf instead of the surface presents its edge to the sun, and is in colour and shape, very much like the ear of a squirrel, although larger. The stalk never rises beyond three feet, and its leaves are alternate and transverse. A wine-glassful of the juice of this plant has been known to rescue from death persons bitten by the rat- tle snake, who were so far gone, as to be incapable of speaking. The flower of this plant is white and fuzzy, and appears in every warm month in the year; the smell that of mellilot, with a slight tincture of the aro- matic. Materia Medica. 667 STINK WEED. See Thorn Apple. STRAWBERRY, Fragaria:—The fruit of this plant * is delicious, and being of a cooling and laxative nature, may be considered as medicinal. If freely eaten they impart their peculiar fragrance to the urine, and when retained in the mouth for some time, dissolve tarta- reous concretions on teeth. They are of great service in cases of scurvy, and according to Linseus, a copious use of them has proved a certain preventive of the stone in the kidnies. An infusion of strawberry leaves, while I young and tender, makes excellent tea; but for such pur- pose they ought to be dried in the shade, being slightly bitter and styptic. They have been used with advan- tage in laxity and debility of the intestines, as likewise in hemorrhages and other fluxes. Lastly, they are of considerable service as aperients, in suppression of urine, visceral obstructions, and jaundice. SUMACH, COMMON, Rhus Copallinum.—The ber- ries or seeds, when ripe, are red and very acid. An in- fusion of them, sweetened with honey, is a good gargle , for the sore throat, and for cleansing the mouth in pu- trid fevers. Mr. Jesse Torrey considers the bark of the root of sumach to be one of the best antiseptics produced by ve- getation. Corroding ulcers, defying every common ap- plication, immediately began to heal by washing them 1 with a strong decoction, and applying the boiled bark as a poultice. He says it is a very important material ' in decoctions for hectic and scrofulous diseases. Su- mach constitutes one of the ingredients of the following recipe, which was handed to me by a gentleman of the first respectability and veracity, as a remedy for the ve- nereal disease. Of the inner bark of pine and swamp elm, and the \ bark of the root of sumach, take each one pound, boil them in a gallon of water to three quarts, drink half a pint three times a-day; if costiveness be produced, a dose of salts may be used. If there be ulcers, they are to be washed with the decoction made warm. The detergent effects will appear in a very short time. Abstinence - 668 Materia Medica. from too much stimulants will accelerate the cure. This remedy is one of Heaven's best mercies to offending man, and instances can be produced of the effects of it, which would stagger credulity. Mercury, and nitric acid, have failed, but this has never been known to fail when properly applied. It is, moreover, a fine application in dysenteric affections. SUNDEW, Ros Solis—Called also red root, or youth- wort. Grows in mossy bogs, flowering in July and Au- gust. The whole of this singular plant is acrid, and its juice sufficiently caustic to corrode corns and warts. It is said the juice, projierly mixed with milk, and applied to the skin, will remove freckles and sun-burns. SWALLOWWORT. See Pleurisy Root. TANSY, Tanacetum Vulgare—This plant possesses a warm bitter taste, and may be used as a substitute for hops. An infusion of the leaves is recommended for a ' weak stomach, hysteric complaints, and obstructed men- ses. According to Dr. Withering, its seeds are an excel- lent vermifuge, in doses from a scruple to a drachm, and that if animal substance be rubbed with the herb, it will be effectually preserved from the attack of the flesh fly. THORN APPLE, Datura Stramonium—Has a vari- ety of names, as James-town, or jiinson weed, French apple, stink weed, &c. Its common name James-town weed, is said to have arisen from the circumstance of a number of sailors being violently diseased by ignorant- ly eating the boiled plant at James-town, in Virginia, at its first settlement. It grows among rubbish, and on dunghills, to the height of two or three feet, flowers in July and August. The corolla is funnel-shajied and plated white with a tinge of purple. The capsule is large, egg-shaped, and covered with thorns, which have four divisions, and contain numerous kidney-shaped seeds. The leaves are large, egg-shaped, and deeply indented, of a disagreeable smell, and nauseous taste. Materia Medica. 669 Every part of this plant is a strong narcotic poison; nevertheless, when judiciously administered, it is un- nuestionably one of the most valuable medicines in our possession. Professor Barton considers it a medicine of creat and invaluable powers, especially in cases of ma- nia, attended with little or no fever, or with a cold skin and languid circulation. The form in which he exhib- ited it, was that of an extract prepared from the first leaves, beginning with a few grains, and gradually in- creasing the dose to fifteen or twenty grains. In one case of mania, in a woman, he increased it to sixty erains. In a few weeks it brought on an eruption in various parts of the body, "and she was <"s™ssed,' he observes, "from the hospital, perfectly cured. Dr. Fisher recommends it highly in those cases of mania in voung persons, where the fits occur daily, or monthly, at regular periods, especially if assisted by chalybeates, or such other medicines as particular symptoms require, but advises the free and regular use of it, one or two doses every day. The most convenient form, especial- ly for children, he thinks, is the saturated tincture; the requisite dose may be known by the dilitation of the Dr. Alexander King, of Connecticut, has employed this medicine, in the form of decoction, one drachm of the seeds bruised, boiled in half a pint of water to a gill, in several cases of inflammation of the brain, attended with delirium. The following is one of the cases recit- ed by the doctor. .,,.*, A man of robust constitution, and sanguine habit, about twenty-six years of age, after drinking pretty freely, was seized with a slight paroxysm of the apoplexy, which was followed with a cold fit of fever, attended with a vi- olent pain of the head, and delirium. On the second day I found him delirious, with an inflammation of the brain, or rather the meninges. I bled him largely, so that he even fainted in a recumbent posture, which was succeed- ed by another partial paroxysm similar to the first. I put him on a course of medicine, nearly the same as pre- scribed in a former case. The next day I found no abatement of the symptoms; he bad slept none for two nights past, and was quite outrageous. I then presrib- 670 Materia Medida. cd for him a decoction of the seeds of the datura stramo- nium, and directed the nurse to give him a tea-spoonful every quarter of an hour. I found, on visiting him the next morning, that soon after taking the decoction, he became calm and composed, and went to sleep. I con- tinued the same medicine through the course of the fever, which lasted about seven days, except one day in which I purposely omitted the use of it, in order fully to satis- fy myself as to the operation of the medicine: On that day the delirium returned, and he slept none the night following. The next morning I had recourse to the de- coction as usual, and it produced the same salutary ef- fects as before. In this case, I had a fair opportunity to observe the ■action of the medicine, in an early stage of the disease, which was cooling, anodyne, and sedative. .As a remedy in epilepsy, jirofessor Barton thinks it may be relied on even in the most deplorable cases. A lady, aged fifty-five, having for some months been afflict- ed with alarming attacks of epilepsy, by which her pow- ers of intellect and of articulation were impaired, happi- ly experienced a restoration, by taking one grain of the extract once in twenty-four hours. Although she did not suffer another attack, after commencing the course, she found it necessary to continue it for several months, to remove all apprehensions of a recurrence. A single grain seldom failed to excite unpleasant virtiginious sen- sations, accompanied with efflorescence of her faoe, and some degree of sleepiness. In asthma and spasmodic cough, stramonium is said to have proved essentially beneficial. It is also said to have produced salutary ef- fects in cases of chronic rheumatism, and difficult men- struation. As this medicine is endued with most active powers, it ought to be administered in very small doses at first, and the quantity gradually increased daily, until it produce, in a slight degree, vertigo, or dilitation of the pupil. In the course of my practice, I witnessed the deleteri- ous effects of this plant in a child, who was attacked with convulsions similar to those which attend persons afflicted with the disease termed St. Vitus's dance, ac Materia Medica. 671 companied with delirium, tremor, thirst, glaring eyes, flilated pupil, and considerable efflorescence of the skin. The parents were perfectly ignorant of the cause of the child's sudden indisposition; but from the symptoms, I was convinced it had taken some of the stramonium, and on making the necessary enquiries, learned it had been playing with some of the seeds a few hours before. Im- mediately on visiting the child, I directed the warm bath, and gave it six or eight grains of blue vitriol, which was repeated at the interval of fifteen minutes, be- fore it excited vomiting, when some of the seeds were thrown up. After the ojieration of the emetic, I ad- ministered a large dose of castor oil, which, assisted by stimulating injections, produced in a few hours some evacuations, and the child was entirely relieved from all those distressing symptoms. Domestic practitioners will recollect, that two or three grains of blue vitriol is a full dose for adults; and the large dose given in this case was from persuasion that the child's stomach had been dejirived of its sensibility, through the narcotic ef- fects of the poisonous seeds. The extract may be made by exposing the juice of the jdant to the beat of the sun, or by boiling the bruised seed or leaves in water for the space of four hours; then strain off the liquor, evaporate over a gentle fire, with- out taking off the scum, until it has acquired the thick- ness of sirup: then place it in a warm oven, in anearth- en vessel, until it becomes of a proper consistence for use. The dose is from one to two grains, or more, for an adult. The saturated tincture is prepared by steep- ing one or two handfuls of the leaves in a half pint of spi- rits for a few days. The stramonium has also been employed externally with the most happy effects. In recent wounds, inflam- i mations, or bruises, the leaves, either alone, or united with bread and milk poultice, have been apjilied to the part with manifest advantage. In the form of ointment, which is prepared by simmering slowly the fresh leaves bruised in hog's lard, with about one eighth part of bees- wax, for an hour, and then strained through a coarse cloth, it will be found excellent for the piles, scalds, and I burns. From my own observation it far excels all oth- 672 Materia Medica. er applications I have made to obstinate cutaneous sores, ill-conditioned ulcers, and painful cancerous affec- tions. THOROUGHWORT, Eupatorium Perfoliatum—Is known also by the following names, thorouglistem, cross- wort, boneset, and Indian sage. Tbe firstof these names, thoroughstem, has been imposed upon it from the pecu- liar structure of the leaves which are opposite, and ap- pear as though the stem was thrust through them. It has received the second name of crosswort, by which it is known in many parts of Virginia, from the position of the leaves, each pair of which take their origin from op- posite sides ofthe stein, so that they cross each other near- ly at right angles. 1 am at a loss, says professor Bar- ton, to refer tbe word boneset to its real origin; but I pre- sume the jilant received this name from the great relief which, on many occasions, it has been found to afford to persons labouring under a violent remitting and other fe- vers, in which the bones are greatly pained. The resem- blance ofthe leaves of this plant to those ofthe common sage, was long ago remarked by the botanists. Hence the name Indian sage, by which the eupatorium is known in some parts of Pennsylvania. This plant flourishes in wet meadows, and other moist places. The stalk is hairy, and rises from two to four feet. The flowers are white, and appear in July and Au- gust. The leaves at each joint are horizontal, saw-edged, and rough, from three to four inches long, and about one inch broad at the base, gradually lessening to a very acute point, of adark green, and covered with short hairs. This plant possesses very active powers, and has been exhibited with uncommon advantage in intermittents, re- mittents, and other diseases of debility. When exhibited in the form of a warm decoction, a handful of the herb boiled in a quart of water, a wine-glassful every two hours, has proved peculiarly beneficial, says professor Bar- ton, in fevers, by exciting a copious perspiration. In • larger doses it proves emetic, with which view it is used in some parts of the United States, as an excel- lent remedy in intermittents. The dried leaves in pow- der, in doses of twrelve or fifteen grains, are said to ope- Materia Medica. 673 rate gently on the bowels. Every part of this plant may he advantageously emjiloyed in practice. The flowers, as a tonic bitter, are deemed equal to the flowers of camo- mile, for which they might be substituted on many occa- sions. This medicine has also been found very efficacious in cutaneous diseases. In a peculiar and distressing affec- tion of the herpetic kind, which was formerly very com- mon in Virginia, and there known by the name of James River ringworm,* professor Barton states, from the res- pectable authority of Dr. Thomas Knox, of Culpepper county, Va. that a decoction of this plant drank daily, for a considerable time, made a perfect cure. A wine- glassful of the expressed juice of the green herb drank every hour, is celebrated as a certain^cure for the bite of a rattle snake. The bruised leaves should be applied to the part. THROAT ROOT. See Avens. THYME, GARDEN, Thymus Vulgaris—Is one of the most powerful aromatic plants, and as such, is fre- quently employed in the form of tea, in those complaints where medicines of this class are indicated. TOBACCO, Nicotiana Tabacum—This "obnoxious luxury," is a medicine of the most uncommon powers; being emetic, cathartic, sudorific, diuretic, expectorant, narcotic, and antispasmodic; hence its utility in a varie- ty of diseases. A table-spoonful of an infusion, one ounce in a pint of boiling water, will excite vomiting; however, as it has no peculiar property as an emetic, and its operation is attended with severe sickness, it is not often employed with this view. As a purgative, it is employed in the form of clysters, in all cases of obstinate costiveness. Exhibited in this form, in the quantity of two or three ta- ble-spoonfuls of the infusion, mixed to half a pint of milk * This disgusting disease prevailed mostly among the inhabitants on James ltiver. It attacked the thighs, the scrotum, and especially the paats immediately adjacent to the amis. It extended its ravages inta •he rectum and perhaps much further. 85 674 Materia Medica. or thin gruel, it has frequently afforded almost instanfa neons relief in violent colics, after other medicines had proved ineffectual. If this quantity procure no relief, nor excite giddiness nor nausea, the injection may be repeated every half hour, with the gradual increase of tho infusion, till one or other of these effects takes place. By this mode of proceeding, the violent effects of tobacco may always be avoided. As a diuretic, it has on many oc- casions proved an invaluable remedy, as in ascites and other dropsical affections, also in gravel, or difficulty of making water. In those cases, according to Dr. Fowler, the dose for adults should be from sixty to one hundred drops ofthe infusion in a tea-cup of water twice a-day, about two hours before dinner, and at bed time; it being obser- ved to disagree the most with the stomach in a morning fasting. And such is the difference between the morn- ing aiid night, that almost every patient will require to take one-fourth, and some one-third more in the forenoon than in the evening, in order to enable them to bear the dose with equal convenience. The common dose just mentioned, relates only to adults of an ordinary constitu- tion; for it deserves particular notice, that between con- stitutions which are very nervous and irritable, and those which are very robust or torpid, or long accustomed to the use of tobacco, the dose will admit of very great and surprising alterations. A6 an expectorant, in asthmatic cases, unattended with inflammatory symjitoms, this medicine has frequently afforded relief. In cases of tetanus, or lock-jaw, injections of tobacco infusion, says Dr. Mease, have been used with success. They not only produce evacuations from the bow- els, which are generally obstinately constipated, but tend to a relaxation ofthe violent spasms so peculiar to this dis- ease. On this account, he suggests the propriety of giv- ing it in the dreadful disease produced by the bite of a mad dog. Besides the internal use of tobacco in the above diseas- es, it is likewise commended for its virtues externally employed. In the tooth-ach, a piece of lint moistened with the expressed juice of tobacco, has often acted as a charm in mitigating the pain. In obstinate ulcers, an ointment, or the dried leaves of tobacco, steeped in wa- ter, and applied to the part affected, have been attended Materia Medica. 675 with beneficial effects, after the usual remedies had failed. In the itch, and obstinate cases of cutaneous eruptions, the tobacco infusion, as a wash, apjdied two or three times a-day, seldom fails of effecting a radical cure. In that detestable distemper, called lousy evil, to which many j children are subject, though from neglect of cleanliness, adults are sometimes afflicted with it, the infusion has effected a radical cure, in several instances, after prepa- rations of mercury, and other applications, had failed. It will be found equally destructive to crab-lice, if ajipli- ; ed two or three times a-day to the parts which they in- fest. In cases of worms, tobacco externally applied is de- serving the highest estimation. Professor Barton states, that the leaves pounded with vinegar, and applied in the shape of poultice to the region of the stomach and abdo- men, have often discharged worms, after powerful anthel- mintics had been exhibited internally in vain. We ought not to be surprised, says he, at this effect ofthe tobacco, since we know that the same vegetable applied externally, is often efficacious in inducing vomiting. Accordingly, says he, I have for some years been in the habit of ap- plying tobacco leaves to the region of the stomach of per- sons who have swallowed large quantities of opium, and other similar articles, with a view of destroying them- selves. It is well known, that in these cases the stomach is often extremely inirritable, insomuch that the most powerful emetics have little effect in rousing that organ into action. Here, as an auxiliary at least, the tobacco, in the manner I have mentioned, is certainly very useful, and in many instances ought not to be neglected. In further testimony of the efficacy of tobacco exter- nally applied, in the most formidable diseases, I cannot forbear inserting at length, a letter addressed to the Ed- itors of the Medical Museum, by a gentleman of distin- guished medical attainments and surgical knowledge.— Preceding this letter, is a minute detail of the case, re- lated by an Italian physician, of a young woman, long afflicted with an abdominal swelling, producing violent convulsions, which, after having baffled the most effica- cious means, was radically cured by Dr. Cutbush, seni- or physican of the American Marine Hospital, at Syra- cuse, in the year 1805. 676 Materia Medica. "Sir,—In consequence of the earnest solicitations of the parents of the young woman, whose case is above stated by one of her physicians, she was brought to my house in Syracuse to be examined. I received from her- self and parents a history of her case, which correspond- ed very nearly with the above statement. Her parents informed inethey had consulted thirty-three physicians and surgeons of Najiles, and different parts of Sicily, without receiving any advantage. Some were of opinion that the swelling was owing to a collection of water in the uterus; others in the ovaria; others, that it was an enlarg- ed liver; finally, two or three were strongly impressed with the idea, that it was an extra-uterine foetus, which produced all the distressing symptoms above stated. On examination, I found a very large swelling, extending from the epigastrium in a diagonal direction to the an- terior spinous process of the right ilium. The tumour had a number of inequalities on its surface; no fluctua- tions could be felt; she could not bear it pressed without suffering great pain. I must confess I did not give any decisive opinion in the case, it being perfectly new to me, and especially after the numerous contradictory opin- ions and practice of the first physicians of Naples and Sicily had failed in giving relief. She had been twice under the liberal use of mercury in Najiles and Syracuse; in the latter place, by the direction of a surgeon belong- ing to Lord Nelson's squadron, when his lordship was there in 1798, without beneficial effect. From this his- tory and examination, I entertained no hope of relieving her, but the solemn entreaties of her parents determined me to make trial of a remedy, which I had found useful in discussing obstinate tumours, and which finally termi- nated a disease that had been the source of great distress to the unfortunate female, and which, doubtless, proved the disease to have been an hydropic affection of the uterus, or right fallopian tube, though no undulation could be discovered. I directed the leaves of the nicotiana, recently collected, to be stewed in vinegar, and applied to the abdominal swelling. The first application produc- ed nausea, vomiting, vertigo, great depression of muscu- lar strength, copious perspiration, and a loose state of Materia Medica. 677 the bowels. Her pulse became very slow. In conse- quence of the violence of the above symptoms, it was not long continued; but on the succeeding day, it was re- peated morning and evening, and produced all the above symptoms, but in a less degree, attended with an immoder- ate flow of water from thejvagina. The application was continued twice a-day for one week, when its effects on the system were less powerful; but I was informed, with the most rapturous expressions, that the tumour had di- minished very much. The day following, a priest was despatched to inform me, that the water was continually running from her as she walked her room. The reme- dy was continued about twenty days, but the swelling disappeared entirely before the fourteenth. No medi- cine was given, excepting a small quantity of opium or wine during the day. When the application of the to- bacco was omitted, her abdomen was perfectly soft, and she could bear it pressed without pain. She was occa- sionally attacked with syncojie, and complained of a want of appetite; I advised a bandage to be applied around her body, a course of tonic medicines, a generous diet to be gradually increased, equitation, (riding) and cheerful company. I saw her in October, 1805; she informed me that all the functions of her body were natural; her coun- tenance was florid and cheerful. April 1, 1806, I was informed she remained in good health. "It is difficult to account for the modus operandi of to- bacco in this case, unless the violent commotion, which it excited in the system, ruptured the cyst which proba- bly contained the water. I conceive the external appli- cation of tobacco, as a remedy in many diseases, de- mands more attention from physicians than it has gener- ally received. In obstinate constipation of the bowels, I have applied tobacco stewed in vinegar or water, with the greatest success; even after powerful cathartics, ene- mata of different kinds, injections of tobacco smoke, or the infusion of the plant have failed; and conceive it pre- ferable in many cases of ascites, to the common mode of administering it internally in the form of tincture or infusion. "I am, Sir, with esteem, yours, "EDWARD CUTBUSH." 678 Materia Medica. Happy if this plant "of many virtues" could always be exerted to beneficent purposes, and for which, no doubt, it was intended by the all wise and benevolent Creator: but, alas! we are constrained to deplore not on- ly the idle and expensive, but too often fatal abuse of it, by snuffing, chewing, and smoking, practices which can- not be too severely censured, especially in young per- sons, and those of weak digestion, consumptive or deli- cate habits. When used in either of those forms, by persons unaccustomed to its use, it will, in small quan- tities produce stupor, giddiness, and vomiting: but, like spirits, opium, and other narcotics, the use of it may be introduced by degrees, so that its peculiar ef- fects, even from large quantities employed, seldom ap- pear. TOE ITCH. See Moorwort Broad-leaved. TOOTHACH-TREE. See Prickly Ash. TOUCHWOOD, Boletus Igniarius—Called also punk. It is a spongy substance, growing on the white oak, pine, and hickory trees, generally used for catching fire with flint and steel. The heart of that which grows on the oak, reduced to a powder, and applied to violent hemor- rhages from wounds, is said to be an excellent applica- tion to stop the bleeding. TREFOIL, WATER, Menianthes—Grows about twelve inches high, in marshes, swamps, and wet mea- dows. It bears many elegant flowers, in a spike, which are sometimes white, but commonly rose-coloured on the outside, and in the inside finely fringed,' the leaves are three together, resembling our garden beans. A drachm of the powdered leaves is said to operate up and down. An infusion of the leaves, two handfuls to a quart of boiling water, in doses of a tea-cupful two or three times a-day, is esteemed a useful medicine in chro- nic rheumatism, in scorbutic complaints, and in all im- purities of the blood. TULIP-BEARING POPLAR. See Poplar, White, Materia Medica. ^7^ TURMERIC. See Bloodroot. UNICORN ROOT, Aletris Farinasa—Grows in mea- dows, and on the sides of mountains, about six or seven inches high; leaves spear-shaped, lying on the ground, and are green all the winter. The flowers grow on the stalk from the ground, which hang down at the top when fully blown; the root is whitish, full of small fibres, about the thickness of the end ofthe little finger, and crooked at the end. The powdered root, in doses from a halt to a tea- spoonful is said to afford relief in hysteric, and flatulent f or wind colic. A large handful ofthe root steeped in a quart of spirits, in doses of a wine-glassful three times a-day, is highly esteemed by some as a valuable remedy in chronic rheumatism. VALERIAN, WILD, Valeriana Officinalis—Grov/s a- bundantly in the vicinity of the Ohio river. It rises two or three feet high—the leaves in pairs, large, hairy, and of a dusky-green colour—flowers stand in large tufts on the top of the branches, of a pale whitish-red colour. The root, which is the part used in medicine, consists of a number of slender fibres, matted together, and at- tached to one head, of a brown colour, having a strong and unpleasant smell. Valerian has long been recommend- ed by the most learned physicians as a medicine of great use in nervous disorders; and is particularly serviceable in hysteric cases, as well as in epilepsy, proceeding from ' a debility of the nervous system. According to Dr. Withering, it is an excellent medicine in cases of habitual costiveness. It should be given in doses from one to two tca-cupfuls or more, in jiowder, three times a-day. It seems most useful when given in substance, and in large doses. VINE, GRAPE, Vitis Vinifera—Several species of this valuable shrub grow in the United States. The suc- cess which has attended the attempts to cultivate foreign and native grapes, sufficiently jirovc that our climate is perfectly congenial to the cultivation of the vine, and, that with very little attention, we might supply ourselves abundantly with cheap and wholesome wines. 680 Materia Medica. Wine certainly is most excellent to prevent, as well as to cure diseases. A prudent use of it, when genuine, I can say, from my own experience and observation, admi- rably conduces to health. It will be found particularly beneficial to the weak and aged, and to those who are ex- posed to a warm and moist air, or to a corrupted one. It exhilarates the spirits, quickens the circulation, promotes digestion, invigorates both the body and mental faculties, and thereby renders persons less susceptible to disease. As a medicine, wine is a most grateful and valuable cor- dial in languors and debility, in which it is found to raise the pulse, support the strength, promote perspiration, and resist putrefaction. Hence we cannot appreciate too highly this reviving liquor, wliich justly merits the title of "donum Dei," gift of God. Were we to have less re- course to ardent spirits, and instead of continuing in those abominable practices of drinking before dinner, to take a few glasses of wine after dinner, we should find "our account" in it. During my long residence in Savannah, and exposed as I was alternately by my professional pur- suits, to the scorching sun and chilling night air, I was never attacked with the prevailing fever, incident to that climate, which I ascribe almost entirely to the daily use of the jiurest and best wine. In further corroboration of this fact, I will with candour state, that, when from un- foreseen reverses of fortune, I was induced to remove to the more healthy situation, as I thought, of Washington, not a season has elapsed, but some one or other of my family has suffered severely with the bilious or nervous fever, which I cannot but ascribe, in a great measure, to our not drinking such good wine as we were accustomed to at the southward. There are many persons in good circumstances, who object to the daily use of wine, as being too expensive.— To such I would recommend it as economy. Besides the very great satisfaction which would naturally flow from having a healthy family, money is often saved by a pru- dent use of it. To illustrate this, it is only necessary to state, that several families at the southward, who were in the habit of paying annually large accounts for medical at- tendance, inquired of me how it was, that myself and fami- ly enjoyed such perfect health, while they were sickly.— Materia Medica. 681 1 remarked, that it was principally owing to drinking good wine, and assured them, though against my interest, if they would but pursue my plan, they also would enjoy good health. Some of them adopted my plan, wliich car- ried conviction with it; for on the following year, and af- terwards, they enjoyed much better health, were, enabled to attend to their business, -and found the expense of the wine saved in their physician's bill. Others again object to the habitual use of wine, as not congenial to their constitution, observing, that whenever they entertained, or dined with, their friends, they were either induced from politeness or persuasion, to drink as the rest ofthe company,* from which their heads were uni- formly affected, and they always felt disagreeable on the following day. This objection is at once refuted, by sim- ply stating, it is my wish to impress on my readers the use, but not the abuse of wine, which no man more hearti- ly than myself abhors, especially in young persons, whose readiness to take glass for glass with their elders, is to me one of the most lamentable spectacles in nature. The excessive use of this stimulant, as well as every other, is most certainly injurious to the system, and ought, there- fore, to be carefully guarded against by every rational person. It deserves also to be noticed, that the same quantity of wine which would produce intoxication in one person, would have little or no effect on another; and there is also a wide difference between taking it on an empty stomach, and on a full one. One glass, taken an hour or two be- fore dinner, will affect the head, in most cases, more than a pint after dinner. In like manner, a half pint of adul- terated or impure wine, will produce unpleasant sensations, when a pint of genuine Madeira will have no other than • The following anecdote will at once show the absurdity of pressing our friends to drink more wine than their appetites crave. A foreigner w as invited to a party, consisting, a9 he was told, of English philosophers, of whom he conceived a great deal. After a very plenteous dinner, the cloth was cleared, and the bottles were placed on the table. He was pressed after five glasses to drink on, but the stranger persisted in as- suring die company, he felt no drought. These philosophers began then to be angry, and the foreigner rang the bell, and insisted on ano- ther course, for they ought as much to eat, as he to drink, against incli- nation. 86 682 Materia Medica. the pleasing effect of invigorating the constitution. The apprehension which some persons entertain, that children, early accustomed to wine, will be apt to become drunk- ards, is without the smallest foundation whatever. On the contrary, it is a lamentable truth, that we daily see persons, who were restrained in the early period of their lives, from drinking wine, toddy, or table drink, in the presence of their parents, become perfect sots after they arrived at the age of manhood. It is one of the greatest commendations of wine, that we never see those who dai- ly indulge the use of it become drunkards. This is veri- fied, not only in France, but in many parts of our Union. In Charleston, Savannah, and Augusta, the inhabitants generally make use of wine; the consequence of which is, they are sober, discreet, and, notwithstanding the climate, are healthy. It is a rare thing indeed to see a drunkard of any description in the streets of those cities. Whether it be owing to drinking less of ardent spirits, or a better police, I will not pretend to say; but it is the fact, and would that I could, with equal propriety, make the same remarks of the metropolis of the United States, where drunkenness, among the lower class and negroes, reigns triumphant, throwing open, as it were, the flood-gates of every species of vice. "Vice is a monster of so frightful mien, As, to be hated, needs but to be seen; Yet seen too oft, familiar with her face, Wc first endure, then pity, then embrace." Pope. It is also worthy of remark, that among the genteel cir- cles in Charleston, Savannah, and Augusta, you will hardly meet with an instance of a gentleman drinking any thing before dinner, or pressing bis friends to take more wine after dinner than they feel an inclination for; how- ever, this is only what might be expected of those not ex- celled by any society on earth, either for polished manners, or true hospitality. "Experientia docet," experience teaches, is my motto, and as I speak from this alone, I feel conscious ofthe rectitude of my heart, in earnestly recom- mending to my fellow-citizens, both old and young, the Materia Medica. 683 daily and prudent use of genuine wine, at least during the sickly season, and in unhealthy situations, without any fear whatever of becoming sots. That the tenderest infant may be benefited by it, I am convinced from my own practical observations; but if higher authority be re- quired, I will conclude with the following sentiment ofthe late Professor Rush. It is remarkable, says he, that the children of persons in easy circumstances, who sip occasionally with their parents, the remains of a glass of wine after dinner, are much less subject to disease, than the children of poor peo- ple, who are without the benefit of that article of diet. Having said so much in praise of the generous juice of the grape, and considering it, as I sincerely do, one of the choicest medicines in the Materia Medica, I cannot do otherwise than present my readers with the following most approved method for making American wines, taken from the Domestic Encyclopedia, as well as the mode of detecting adulterated wines. Grapes must be fully ripe before they are gathered; gather them in a fair day, when they are perfectly dry; and take away all the rotten and unripe grapes, for they spoil the wine. .If your vintage be large, and you gather more grapes than you can mash and press out in one day, let them be gathered without bruising, for bruised grapes soon attract an unsavory taste, and hurt the wine; however, if they are mashed the same day they are ga- thered, the bruising will do no hurt. Chaptal advises to cut off the tails of grapes very short with a pair of scissors, and to choose none but sound grapes, and those clusters which are best exposed, rejecting those which have been sheltered, and near the ground, and to prefer those which ripen at the bottom of the vines.__ They are then to be put into small baskets to prevent the loss of juice, by the superincumbent weight; and when full they ought to be put in carts, or on the backs of men or horses. I would advise the gathering of them to be directed by some grave discreet person; for as this work is done gene- rally by servants and children, it is made matter of pas- time and frolic, and many grapes are torn off, and either 684 Materia Medica. bruised or scattered on the ground, to the no small dam- age of the owner, both in the loss of fruit, and in hurting the wine. These things should be impressed on the minds ofthe gatherers before they begin, that every thing may be done regularly and in order, by which means more work will be done, and to much better purpose. If white frosts happen before some of your grapes arc fully ripe, let them still hang on the vines, and they will grow ripe, rich, and high flavoured; but they must be ga- thered before the weather be so bard as to freeze the grapes, for that will spoil them: the light frosts that only kill the leaves do not hurt the fruit, unless it be such as are late rijie; these should be carefully covered from all frosts, they should grow against walls or board fences fronting the south or south-east, and at night be covered with mats or frames thatched with straw, which should be so contrived as to be set up to cover the fruit or let down at pleasure. As the wine made from black grapes has a different management from that made of white grajies, I shall be- gin with the white; these then must be gathered, as I men- tioned before, in a fair day, when the grapes are perfect- ly dry; and both the rotten and unripe grapes be careful- ly plucked off from every bunch; the clusters are then thrown into the mash vat, and two or three men, accord- ing to the quantity, having washed their feet and legs ve- ry clean in bran and water, get into the vat and trample and mash the grapes thoroughly, so that none escape. Chaptal says, as a general rule, that the grapes must be equally pressed, to insure a uniform fermentation: and the vat filled in 24 hours, to avoid the inconvenience and im- perfections arising from a successive series of fermenta- tions, and when unexpected rain suspends the collection of the grapes, the juice of those already collected and placed in the vat, must ferment separately. The first and second pressing being mixed together, is put into hogsheads, and filled within four inches of the bung, that it may have room to work and ferment, the casks placed in some warm room or dry cellar. Then having a small spile fixed in the middle ofthe head ofthe cask, the third or fourth day, draw a little of the wine in a glass, and if it be pretty fine draw it off immediately Materia Medica. 683 into a clean dry well-scented cask, the larger the better, so you have wine enough to fill it, which you must do within two inches of the bung, and stop it close, leaving only the vent-hole open for a second fermentation; after a few days it will work a second time, but not so much as at the first; if your wine be strong and good, which you may know by the age of your vineyard, and by the good- ness of the seasons, it will be best to leave the bung-hole open for this second working; the wine will be the better, for strong wines require a greater fermentation than weak wines, and the stopping ofthe bung-hole checks the work- ing, and prevents weak wines from spending themselves too much; on the contrary, if strong wines have not a tho- rough working, they are apt to grow thick and ropy; by this you may form a proper judgment what degree offer- mentation is proper for the wine that is under working, and govern yourself accordingly. Three or four days af- ter the second fermentation begins, carefully watch your wines every day, again try them in a glass, and if they be pretty fine, prepare a cask sweet and good, burn a good large brimstone match in it, and as soon as the match is burnt out, whilst the cask is full of smoke, draw off the wine into it; now fill up your cask to the brim, and bung it up tight, and stop the vent-hole; the smoke of the brim- stone will hinder any further fermentation; and this is called stunning or sulphuring; then make a mortar of clay, and horse-dung mixed up with strong flaxseed jelly, and covering the bung and vent-hole close with it, let it stand till it is fit for use. When you first rack off, if you have any old wine that is rich and good, of the same kind or colour, put four or six gallons of it, and two gallons of good bran- dy, into your cask; this quantity is sufficient for an Eng- lish hogshead, and then rack off your wine into it for the first time; this will greatly strengthen and preserve it. When wine is in fermentation, all the gross parts are thrown up to the top of the cask or vessel that it fer- ments in, and there meeting the air, they contract a harshness. If then they are suffered to pass down through the body of the wine, which they certainly will do as soon as the fermentation is over, they will communicate 686 Materia Medica. those evil qualities to the wine. For this reason, draw off your wine both times before the fermentation be quite over. These general rules are of great conse- quence. I now pass on to the making of red wines from the black grapes. Red wines have a different management from the white; the whole of one or even two days tread- ing or mashing, where the vintage is great, is thrown into a large vat, the must, stalks, skins and all, and stands in some warm dry place or cellar. The vat is covered close with sheets or blankets, or both, and thus it remains, according to custom, from four to seven or even ten days, according to the coldness or heat of the weather. This is done to obtain a strong fermentation, in order to give a deeper colour to the wine; and this is the only end proposed by it; the manager of this work visits the vat twice a-day, and in a glass views the co- lour of the wine, and tastes it; if the tincture be not deep enough to his mind, he knows by the taste of the wine, whether it will stand a longer fermentation; if it will not, he contents himself with the colour it has, and draws and presses it off, and fills it into casks, leaving about two inches from the bung, for a second fermentation.— When the second fermentation is over, which generally happens in four or five days, he draws it off into clean well-scented casks, and adds to it six gallons of good old wine and two gallons of brandy to an English hogs- head, which contains from 60 to 63 gallons. Where the same kind of wine is not to be had, he makes use of port wine. He then fills the cask quite full, and bungs it up tight, leaving only the vent hole open to let out the generated air. Note: When I say, where the same kind of wine is not to be had, he makes use of Portugal wines, it is mentioned for our practice, not that the French make use of such wines, for they always have wines enough of their own of the same kind. Besides the main pulp or core of the grape, which is white in black grapes as well as others, there sticks to the inside of the skin, a considerable body of rich pulp, of a deeper dye in some than in others. This pulp gives the colour to the grape: this same pulp also gives the colour to the wine, for the same grape is capable of mak- Materia Medica. 687 ing white wine as well as red wine; if the main core which is first trod out, be only used, the wine will be white; but if the red pulp be mixed with it, it makes it of a rich purple colour; as this is a clear case, tbe great point of improvement is, to dissolve or extract this rich pulp without injuring the wine. That the present me- thod is tbe best and most effectual to that purpose, I can by no means think; the violent fermentation through which the wine is made to pass, in order to procure the tincture, must exhaust the spirits in a very great degree, and leave the body in a weak and languid state, and subject it to harshness, to turn eager or vapid in a short time; I think I have reason to conclude, that if the husks or skins, after four day lying in the murk, were taken out, and thrown into the mash vat, and trod over again, and especially if some of the must, or rather wine, be now and then thrown over the husks, in order to wash away the pulp, that a full tincture may be obtained, without torturing the wine, as the present manner is, and without running so great a risk of spoiling it. Another method,by Joseph Cooper, Esq. of Gloucester coun- ty, New Jersey.—I put a quantity ofthe comb from which the honey had been drained, into a tub, and added a barrel of cider, immediately from the press: this mixture was well stirred, and left for one night. It was then strained be- fore a fermentation took place; and honey was added un- til the strength of the liquor was sufficient to bear an egg. It was then put into a barrel; and after the fermentation commenced, the cask was filled every day, for three or four days, that the filth might work out at the bung hole. When the fermentation moderated, I put the bung in loosely, lest stopping it tight might cause the cask to burst. At the end of five or six weeks, the liquor was drawn off into a tub, and the whites of eight eggs, well beat up, with a pint of clean sand, were put into it: I then added a gallon of cider spirit; and after mixing the whole well together, I returned it into the cask, which was well cleansed, bunged it tight, and placed it in a proper situa- tion for racking off, when fine. In the month of April following, I drew it off into kegs, for use, and found it equal, in my opinion, to almost any foreign wine: in the opinion of many judges, it was superior. 688 Materia Medica. This success has induced me to repeat the experiment for three years; and I am persuaded, that -by using clean honey instead of the comb; as above described, such an improvement might be made, as would enable the citi- zens of the United States to supply themselves with a truly federal and wholesome wine, which would not cost a quarter of a dollar per gallon, were all the ingredients procured at the market price; and would have this pe- culiar advantage over every other wine, hitherto attempt- ed in this country, that it contains no foreign mixture, but is made from ingredients produced on our own farms. Adulterated Wines.—Wines may be adulterated by a variety of substances. The object proposed to be accomplished by this fraud, is to mask some of their de- fects, and to give them colour, odour, or strength.— Among the substances employed, there are some, the use of which is attended with no danger; others on the con- trary are more or less poisonous, and cannot be swallow- ed without giving rise to serious accidents which may of- ten be followed by death. This consideration has induc- ed us to state the methods whereby it may be determin- ed whether the wine has been adulterated. Sugar of lead, cerusse, and still more frequently li- tharge, are mixed with acid or sharp tasted wines, in or- der to render them less so, and these substances do in fact give them a sweet taste. Of all frauds this is the most dangerous. White wines, adulterated by preparations of lead, of- fer, independently of their saccharine astringent taste, ma- ny properties by which we may detect them. They redden but slightly the tincture of litmus, because the acid they naturally contain is saturated by the oxide of lead. Sul- phuric acid (oil of vitriol) and the sulphates (or salts form- ed by the union of sulphuric acid,) such as the sulphate of so- da (Glauber's salts,) sulphate of magnesia (Epsom salts,) dissolved in pure water, and mixed with these wines, render them thick and muddy; in a short time a white precipitate is found at the bottom of the vessel in wliich the exepriment is made. This deposit does not disap- pear upon the addition of water.—Muriatic acid and Materia Medica. 689 the muriates, as muriate of soda (common salt,) when dissolved in pure water, and added to adulterated wine, also occasion a heavy white precipitate, which may be dissolved in twenty-five or thirty times its weight of wa- ter. The sub-carbonates of soda, potash, and ammonia i act in the same manner. The white precipitate they throw down is insoluble in water, but is dissolved in a very singular manner by pure nitric acid.—The chromic acid, and the croniate of potash occasions a precipitate of a very fine canary yellow colour.—Sulphuretted hy- drogen, and the hydro-sulphates, as liver of sulphur, turn white wines sophisticated with lead of a black co- lour, and at the end of a few minutes throw down a black deposit.—If we collect upon a filter, and dry the precipitates obtained by the means just indicated, and if, after having mixed them with powdered char- coal and caustic potash, we expose them in a crucible to a red heat, during half an hour we obtain a metallic but- ton, easy to be known; first, by its deep blue colour; se- cond, by the facility of marking it with the nail; third, by the quickness with which it is dissolved in aqua-for- tis, forming thereby a liquid salt of a sweetish taste, and having the property of being precipitated of a white co- lour by the sulphates, the hydro-chlorates, and the carbo- nates.—Pure potash, soda, and the volatile alkali mix- ed with these wines, cause a white precipitate.—Evapo- rated in a capsule at a boiling heat, they leave a depos- it, which being heated to redness with powdered char- coal, furnishes at the end of thirty or forty minutes me- tallic lead. This property is sufficient to prove the pres- ence of lead in wines. Red wines, when adulterated with the preparations of lead, are never of so deep a colour as before the adulte- ration; they are of a pale red. We may prove the exist- ence of lead in red wines, by the aid of the substances directed to be used for white wines. It is however ne- cessary to observe, that ammonia causes a dirty green- coloured precipitate, when mixed with red wines wliich contain lead; on the contrary, in white wines the precip- itate is white.—That the hydro-sulphates may lead us into error, if we confine ourselves to the superficial ex- amination of their action.—That these substances detect 87 690 Materia Medica. the presence of lead in red wines, by throwing down a black precipitate, is true; but the same substances, when mixed with the greater parts of red wines, produce the same effect; they become dark, and finish, by deposing flakes of a deep violet colour. It is necessary then, when we wish to decide upon the test furnished by the hydro-sulphates, to add that; the black precipitate they form, when mixed with red wines, indicates the presence of lead, if, after having been dried upon a fil- ter and calcined with potash and charcoal, it leaves a button of metallic lead. Wines adulterated by Alum.—The object of this adul- teration is to render tbe wines redder and less changea- ble; and to give them an astringent taste. The danger of this fraud is generally known; digestion becomes jiain- ful, vomiting from time to time, obstruction of the bow- els, and piles, are the result of drinking wine thus adul- terated. Of all the methods proposed to discover the presence of alum in wine, the following appears to mer- it the preference. By evaporating several pints of wine we obtain a reddish mass, composed of alum, and the colouring matter, and tartar, which make a part of the wine. This mass being dissolved in a large quantity of water and made to boil with some charcoal of the linden- tree,* a liquid almost without colour is obtained. If the liquid be filtered, and then evaporated by a gentle heat, until a thin crust is formed upon the surface, it be set in a cool place, the tartar will crystallize and the super- natant fluid will hold the alum in solution. This fluid ought to have a sweetish astringent taste, and throw down a white precipitate, upon the addition of ammonia, or caustic potash; that formed by this last body ought to be soluble by an excess of potash. A solution of barytcs, its acetate or muriate, ought to render it thick and oc- casion a white precipitate, insoluble in water and nitric acid. Wines adulterated with Chalk.—Some persons are in the habit of adding chalk or lime to red or white wine, having a disagreeable acidity, with a view of saturating the acetic, or tartaric acid, and thus by the combination Or any fresh-made charcoal. Materia Medica. 691 ofthe chalk or lime with the acid, destroy their sharp taste. Wines treated in this manner are really much safer, but they may give rise to disagreeable symptoms if they contain too great a quantity of the acetate of lime This fraud may be discovered by the following means:—Evaporate a quantity of the wine in an open vessel, or if the spirit be desired, let it be distilled: when the fluid is reduced to the consistence of a sirup, add a few ounces of distilled water, agitate the mixture for ten or twelve minutes and filter the liquid, which will be found to contain acetate of lime, formed by the acetic acid of the wine, and the lime or chalk which has been added. The tartar which the wine contained will not be dissolved but will remain upon the filter. VIOLET, RATTLE SNAKE—Grows about four inches high, on the banks of rivers, and in pine woods; leaves grow in a cluster from a stalk, oval-shaped, fleshy, and full of small veins; flowers of a pale blue colour. An infusion of this plant, a handful to a quart of boil- ing water, taken in doses of a tea-cupful three or four times a-day, and some of the green leaves bruised, and applied twice or thrice a-day to scrofulous tumours, or ' king's evil, is said to be an infallible remedy. VIOLET, SWEET, Viola Odorata—Is cultivated in our gardens; leaves heart-shaped, notched, flowers deep purple, and odoriferous. A tea-spoonful of the powdered herb is celebrated as a mild laxative. To children, a strong infusion or decoc- tion formed into a sirup with molasses, honey, or sugar, in doses of a wine-glassful, will be more acceptable. VIRGIN'S BOWER—Grows about two feet high, near ponds and low pastures; leaves opposite in pairs, and terminated by an odd one; the flowers somewhat resem- ble the appearance of feather tails. A small handful ofthe leaves infused in a quart of boil- ing water, and given in doses of a gill three times a-day, is said to be very beneficial in venereal sores, or cuta- neous erujitions of long standing, particularly if the sores are washed with the same. The bruised green leaves 693 Materia Medica. have been apjilied to ulcers, as an cscharotic, to destroy fungous or proud flesh. VIRGINIA, OR BLACK SNAKE ROOT, Serpenta- ria Virginiana—Grows in rich woodlands, from seven to nine inches high, leaves heart-shaped, flowers of a pur- plish brown colour. The root is composed of a number of strings, or fibres, issuing from one head, and matted together, of a brownish colour on the outside, and pale or yellowish within. It has an aromatic smell, and a warm bitterish pungent taste. It promotes perspiration, raises the pulse, and re- sists putrefaction. Hence it is especially adapted to the low and advanced stage of typhus or nervous fever. It may be given in the form of infusion or tea, a handful to a quart of boiling water, in doses of a tea-cupful, or in powder, from ten to thirty grains every two or three hours. Conjoined with the Peruvian bark, or any of its substi- tutes, it is an admirable remedy in obstinate cases of the ague and fever, and other disorders of general weakness. In cold phlegmatic habits, it has also been exhibited in the form of tincture, and when united with double the quan- tity of dogwood bark, or berries, it affords a good bitter. Professor Barton observes, that a strong decoction ofthe root was used with great benefit as a gargle in a putrid sore throat, which prevailed in New Jersey. Externally applied, the decoction has been found to ' enre the itch. WAKE ROBIN. See Cuckow Pint. WALNUT, WHITE, Juglans Alba—Affords one of the finest cathartic medicines in the whole American Ma- teria Medica. The inner bark, boiled for several hours, then strained and reboiled to the consistence of thick ho- ney, forms the best preparation of this invaluable medi- cine. A common sized pill or two at going to bed, is ad- mirable to remove those costive habits, which occasion headachs, loaded stomaches., colics, &c. And in increased doses, say double quantities', it will be found a sovereign f medicine in dysentery, bilious fever, and all other com- plaints requiring aperient medicines, more especially if Materia Medica. 69B combined with equal quantities of calomile. I cannot quit this extract without most heartily recommending it to every American family to keep it constantly by them. The bark of the root is excellent to raise a blister, therefore may be substituted for Spanish flies. WATER CRESSES—Grow in running brooks and wet ditches. The green herb, eaten as a vegetable, and the express- ed juice in doses of a table-spoonful two or three times a- day, is an effectual remedy for the scurvy. WATER TREFOIL. See Trefoil, Water. WHITE BRYONY—Grows in low meadows and swamps; the stems twist about bushes, and shoot outto a great extent; the leaves pointed, irregularly toothed, very large, diminishing gradually to the top; flowers of a yel- low green, which produce a red berry; the root is white and large. A very strong decoction of the root strained, and then simmered slowly by the fire, until it become of the con- sistence of honey, is said to be a good purgative medicine in doses from one to three tea-spoonfuls. WHITE WOOD. See Poplar. WILLOW, Salix—Professor Barton thinks that our willows possess nearly the same virtues that have been ascribed to those of Europe, and that they might be sub- stituted for the Peruvian bark. The bark of the white willow, smooth willow, and crack willow, so called from the remarkable brittleness of its branches, collected when it abounds with sap, has been successfully employed in intermittent or ague and fever, in doses of one or two drachms. The broad-leaved willow is said to possess greater virtues than either of the above. This species may be distinguished by the shape of its leaves from all others, except the bay-leaved willow. The leaves of the latter are smooth and shining, of a deeper green, and have not the downy appearance on the under surface, wliich is so remarkable in this. It is found in woods and hedges, 694 Materia Medica. on hilly situations, and delights in cold clayey moist grounds. A strong decoction of this bark resembles port wine in colour. It is astringent to tbe taste, and somewhat bit- ter. According to Dr. Wilkinson, it is a remedy of great efficacy in most cases where the Peruvian bark is indi- cated. He directs one ounce and a half (a handful) of the bark to be infused in one quart of water for six hours, then boil it over a gentle fire for a quarter of an hour, and strain for use. Of this, the ordinary dose is a wine- glassful three or four times a-day. But in ague and fever, the dose may be repeated every third hour in the interval of the fit. WINTERBERRY. See Alder, Black. WINTERGREEN. See Calico Tree. WOOD BETONY—Grow s about a foot high in up- land woods, and old pastures; the stem square and hairy, the leaves opposite, and hairy, the flowers in spikes of a purple colour. An infusion of tbe herb, a handful to a quart of boiling water, in doses of a tea-cupful every two hours,is said to f be serviceable in rheumatic or gouty affections. WORMSEED. See Jerusalem Oak. WORMWOOD. See Mugwort. YARROW—Grows in dry pastures and along the sides of fences, about afoot high; leaves pointed, flowers white, tinged with a little purple beneath. A handful of the tops of yarrow infused in a quart of boiling water, in doses of a tea-cupful three or four times a-day, is reputed to be a valuable medicine in the dysen- tery, bleeding piles, and restraining immoderate flow of ■ the menses. A table-spoonful ofthe expressed juice tak- en twice a-day, and the herb bruised, or in the form of poultice, is said to have cured a cancer of the breast.— The green leaves pounded, and applied over a bruise', dis- sipates it in a few days. Materia Medica. 69£ DIRECTIONS, Respecting the Collection and Preservation of Vegetable Substances. Herbs and leaves are to be gathered in dry weather, after the dew is off them, and are to be freed from decay- ed, withered, or foreign leaves. They are usually tied in bundles, and hung up in a shady, warm, and airy place, or spread upon the floor, and frequently turned. If very juicy, they are laid upon a sieve and dried by a gentle de- gree of artificial warmth. They should be dried in such quantities at a time that the process may be finished as quickly as possible; for by this means their powers are best preserved; the test of which is, the perfect preserva- tion of their natural colour. Flowers ought also to be collected in clear dry weather, after the dew is off. immediately after they have opened. They should also be dried nearly as leaves, but more quick- ly, and with more attention. As they must not be expos- ed to the sun, it is best done by a slight degree of artificial warmth. Barks and woods should be collected when the most ac- tive part ofthe vegetables are concentrated in them, which happens in spring and in autumn. Spring is preferred for resinous barks, and autumn for those that are gummy. Barks should be taken from young trees, and freed from decayed parts, and all impurities. Seeds and fruits are to be gathered when ripe, but be- fore they fall spontaneously. Roots which are annual, should be collected before they shoot out their stalks or flowers. Those which are worm- eaten or decayed are to be rejected. The others are im- mediately to be cleaned with a brush and cold water, let- ting them lie in it as short a time as possible; and the fibres and little roots, when not essential, are to be cut away.— Roots which consist principally of firbres, and have but a small top, may be immediately dried. If they be juicy, and not aromatic; this may be done by a moderate heat; but if aromatic, by simply exposing them, and frequently turning them in a current of cold dry air. If very thick 696 Materia Medica. and strong, they are to be split or cut into slices, and strung upon threads; if covered with a tough bark, they may be peeled fresh, and then dried. Such as lose their virtues by drying, or are directed to be preserved in a fresh state, are to be kept buried in dry sand. The proper drying of vegetable substances is of the greatest importance. It is often directed to be done in the shade and slowly, that the volatile and active parti- cles may not be dissipated by too great heat; but this is an error, for they always lose infinitely more by slow than by quick drying. When, on account of the colour, they cannot be exposed to the sun, and the warmth of the atmosphere is insufficient, they should be dried by an artificial warmth less than 100° Fahrenheit, and well ex- posed to a current of air. When perfectly dry and fria- ble, they have little smell; but after being kept some time, they attract moisture from the air, and regain their pro- per odour. 697 THE stw&sagfis trntwrn* No radiant pearl, which crested fortune wears, No gem, that twinkling hangs from beauties ears. Not the bright stars, which night's blue arch adorn, Nor rising sun, that gilds the vernal morn, Shine with such lustre as the tear that breaks For other's woe, down virtue's manlv cheeks. Dabwik. Indigent Sick.—Having in my professional duties so often witnessed the most grievous sufferings of the sick for want of suitable nourishment, and this occurring too not unfrequently in respectable families who have been reduced in circumstances, I feel it my duty, since it is not foreign to the subject, to call the attention of those in affluence, throughout our numerous cities and extensive country, to extend the arm of charity to the indigent sick, in their respective neighbourhoods. While feasting in their own houses, let them listen to the voice of humani- ty, and not forget the "house of mourning," where the lone widow and her orphans pine in sick and starving solitude. It is not easy to estimate the good which may be done to suffering humanity by beneficent acts of this kind. What a treat to the sick instead of coarse food, to have a comfortable bowl of soup, arrow root, sago, panado or custard! And what a cordial to a person labouring under protracted disease, instead of simple water to have a glass of good porter, ale, cider, or wine, which nature craves in this exhausted state. It is a well known fact that a rarity sent unexpectedly has often been the means of re- 88 698 Tfie Nurse's Guide. calling long lost appetite, and thereby rescuing from an untimely grave a valuable life. Indeed there cannot be a greater object of charitable commisseration than a per- son confined to the bed of sickness, without the means of obtaining suitable nourishment. Nor are the indigent alone the grateful receivers; for in the houses ofthe weal- thy a real good sick cook is rarely met with; and many who possess all the goods of fortune have attributed the first return of health to an apjietite excited by what is called good kitchen physic. How important an advantage in overcoming disease is a nutritious diet! Nor is this the only good to be derived from acts of charity, for we have frequently seen a fond mother denying herself the necessary quantity of food that she might the better jiro- vide for her sick children, reduce that strength upon which the welfare of her family essentially depends. In faith and hope the world will disagree, But all mankind's concern is charity; All must be false that thwart this one great end, And all of God, that bless mankind, or mend. Pope. In the preliminary observations of this work [See Pages 25 and 26] we stated facts illustrative of the important advantages resulting from good nursing and dietting. The frequent occurrence of fatal effects when this is neglected imperiously demands that I should present to my readers the most approved rules which ought to be understood by every nurse, as well as to exhibit the mode of preparing such aliments as are most projier for the sick; in order that the trammels of ignorance in nurses if possible may be broken, and simplicity of diet and gene- ral management become an. increased object of our at- tion. But trust me, when you have done all this, Much will be missing still, and much will "Be amiss." Mixton. Duty of a Nurse.—Before we proceed further on this subject, it may be necessary to observe, that none should The Nurse's Guide. 699 be nurses unless they possess honesty, sobriety and fidelity. The more equal and cheerful they are in their dispositions the better provided they keep at their proper distance, and never incommode the patient with idle chit chat, or any thing that can occasion sudden alarm. They ought to be expert in the execution of their office, yet without bus- tle or noise; the track being easily kept when once got into, and the objects to be attended to but few. "To watch the "afflicted" with anxious care, The lurking symptoms of disease detect, And with the aid of sweet nutritious food, Or potent herb, or kindly drug, to aid Oppressed nature in her arduous task Be thine! and thine the grateful rich reward Of conscious duty done—a mead more fair Than all the laurels which bedeck the brow Of modern Csesar." The office of a nurse, however trifling it may appear, if well known and rightly performed, is unquestionably of great benefit to mankind. To prove this fact it is only necessary to appeal to every skilful Physician, whether, when the plan prescribed by him hath been punctually observed, he has not commonly seen the dis- ease either yielding readily to the remedies, or termi- nating in its usual period, without any mysterious or dif- ficult symptoms arising through the course of it. Whereas on the contrary, when his plan hath been altered, as for in- stance, when the medicine hath not been taken at the ap- pointed time, when improper diet has been given instead of that directed, when the air in the rooms and many other er circumstances have been improperly attended to, whe- ther he has not then known the disease to be either aggra- vated, or diverted from its course often terminating fatal- ly; when, if no such errors had been committed, there was the highest probability of the patient's recovery. Air and Temperature.—It being a well known fact that the life of every animal depends as much on air as on diet; and its health also as much on the goodness of the for- mer, as on that of the latter, care should be taken what 700 Jhe Nurse's Guide. of rooms we sleep in, but more especially so when confin- ed by sickness. It is a misfortune that the poor as well as the slaves are constrained from necessity to sleep in low dwellings, and many of them in the same room, by which due attention is not generally paid to cleanliness; hence the air becomes impure and extremely offensive. Others again accustom themselves, sick or well, to the curtains drawn. This is equally detrimental to health, for the air being thus con- fined, becomes contaminated, and so offensive as to be dis- agreeable to any one entering the room from the fresh air. How much more so then must this be the case in sickness, wliich tends greatly to destroy its purity. In warm weather it is necessary to keep a window open day and night, during the whole course of the dis- ease, but in this case the nurse must take care that the pa- tient is not exposed to either a damp or violent current of air. Whenever a fire is required, it should be kept up, and regulated according to the nature ofthe disease, and state of the weather. The room being brought to a due heat should never be suffered to cool suddenly, for the air ought to be kept as temperate as possible. When the general exhaustion is great, the temperature of the apartment should not by any means be permitted to be so low as to endanger an attack of chilliness, as in this case a rapid reduction of the animal heat may speedi- ly be fatal, by sinking the heart's action. In some in- stances an exposure to the cold air, in getting up to the night chair, has been the cause of a shivering fit, under which the patient died in a few hours; but death will rare- ly happen, if some warm stimulant be immediately ad- ministered internally, and sufficient warmth applied to the extreme parts of the body. Chills and Fevers.—It is too prevailing a custom in the cold fit of an ague, or when the patient complains of chilliness, for the attendants to heap great loads of bed clothes which never fail to produce difficult or oppressed respiration. In such cases warmth should be restored by applying warm flannels to the stomach and abdomen, and the same or warm bricks to the feet. Recourse should also be had to friction with a flesh brush .or flannel on the extremities. The Nurse's Guide. 701 It is vulgarly imagined that heat is obsolutely neces- sary to promote perspiration, and under this absurd idea, heating and stimulating drinks are given by way of cor- dials which readily induce delirium or a more obstinate fever. Tbe fact is this, when the pulse is quick and the body hot, sweat can only be induced by lessening the ac- tion of the pulse, and heat ofthe body. And this can on- ly be accomplished by strict observation of a cooling re- gimen. In some cases, it is necessary, that the sick person should be kept out of bed as much as possible; and placed so, as to face the current of air; tbe body being defended sufficiently by the clothing, to prevent any inconvenience being experienced. It should be recollected however as we have already noticed, that in the stage of collapse or when the exhaustion is great this practice is not admissi- ble. But there is much less reason to fear this practice will be too frequently adopted; than that it will be neg- lected, in those cases in which it is recommended. For, too often, in this point, are the wishes of the physician opposed, and his directions disobeyed; the langour of the patient, and his unwillingness to be removed, with the prejudices against a practice so novel, forming, very of- ten, almost insuperable obstacles. Indeed it is very diffi- cult to persuade those, who have not witnessed the effects resulting from this mode of practice, that it is not neces- sary, for every person in a fever to be kept closely con- fined to his bed, under a load of bed-clothes and supplied with heating drinks. It frequently happens, therefore, that no sooner has a physician left the room, than the patient is supplied with warm liquors, the windows and curtains are closed, and the bed-clothes, which had been removed, are replaced. Such opposition to the directions of a physician, viewed in the most favourable light is high- ly censurable; being in a great measure, the effect of ignorance, it is all that prevents it from being really crim- inal. Nurses should therefore be on their guard, and neither deviate themselves from the rules laid down, or permit any person at the expense ofthe patient's life to interfere with what might be considered their duty, otherwise their conscious will upbraid them as murderers. 702 The Nurse's Guide. It is to be hoped by means of this treatise, ignorance will no longer be a cloak for omissions, and that one uni- form method will be attained in the management ofthe sick, which will unquestionably be of vast importance to mankind. Cleanliness.—It is certainly of great moment to the sick to have their bed and bedding kept clean as possible, and their linen frequently changed that it may not be- come foul or offensive. Such ofthe bed-clothes, as are not changed, should in diseases of a putrid nature be exjiosed to a current of air, since, by their known capacity for re- taining effluvia, they may become so loaded with conta- gious and putrid matter, as to prove infectious to the at- tendants, and perhaps to impede the recovery of the pa- tient. In summer it is much more healthy to sleep on oratress- es than feather beds, which are apt to make persons be- come faint and languid. The best materials for making matrasses are, clean horse hair, Carolina moss properly cured, corn husks split, or straw. When a bed is unsettled, or a patient's head uncomfor- tably low, or when his feet are pushed from under the bed-clothes, he should be raised in bed, and the bed, bol- ster, and covering shook up and smoothed. The patient's face and hands are to be washed every morning. And when he is no longer ahle to assist him- self, his face, breast, hands, and arms, must be frequently sponged with vinegar and water. The floor should be kept clean and occasionally sprinkled with vinegar, par- ticularly before it is swept, and on no account should any thing the least offensive be suffered to remain in the room. It is also the duty of the nurse to pay great attention to the state of the patient's mouth. When his tongue and gums, are covered with a brown or dark crust, she must wipe them with a bit of flannel moistened with salt and wa- ter, two or three times a-day; or if this cannot be accom- lished she must put a thin slice of lemon3without the rind, in his mouth. The patient is often unable to swallow from the dry and shrivelled state of his tongue; in such cases, the nurse, before offering him drink, should put a tea- spoonful of lemon juice and water or vinegar sweetened The Nurse's Guide. 703 into his mouth, after which, the scum upon his tongue will become softened in a minute or two and then he will drink with ease. DELIRIUM.—When during great derangement of mind a patient insists upon leaving his bed, the nurse must en- deavour to calm him; or if that should fail, she may speak with authority, but she is not on any account to use forci- ble restraint. The nurse must wrap his legs in a blanket, put on his bed gown or cover his shoulders, and permit him to sit on his bed, or even to go to the fire, till the vio- lence of his derangement shall abate. When indulged in this way, he will, in general, soon return to the bed of his own accord. In the putrid fever, delirium is one ofthe most constant and alarming symptoms, and the removal of it depends much upon the nurse or attendants. We have seen a temporary stop put to the patient's raving, by mak- ing him drink, or upon his discharging his urine or faeces: f■>:■ being then unconscious of thirst and other natural wants, he is therefore ignorant of the means of satisfying them; and when he does so, he fancies he is about some- thing else, which is the subject of his delirious thoughts. This observation leads to a material practical purpose; for it follows from it, that unremitting attention should be given to the patient's feelings, and all his possible wants, as those natural notices, and instinctive cravings, whirh occur in health, are now wanting, in consequence of the depraved state of sensation. The following excellent passage will be found in Le- vant's Chapter on the Synochus Putris (Nervous Fever.) As soon as the delirium comes on, the pain subsides, or at least the jiatient does not complain of pain, or seem to feel any; but reply in a hurried manner, when asked how7 he does, that he is very well; according to the observation of a French physician "Quand le malade repond, je me porte bien, ce seul mot suffit, ill n'est pas plus a* lui."— When the patient answers that he "is very well," this alone convinces me, says Dr. Cheyne of Dublin, that he is no longer himself. In all these cases, the patient en- deavours to get out of bed, to sit up, or even to walk about from one room to another; but unhappily the attendants are solicitous to confine him to bed, and to load him with 704 The Nurse's Guide. bed-clothes; nay, he is frequently kept struggling for two or three days together, with two strong people lying upon him continually. Now to prevent all this misery, I know no method equal to what is here recommended; namely, let the patient have his clothes put on, and be placed in an easy chair; let his head be shaven, washed with vinegar, and covered with a linen cap. When he is tired of the erect posture, let him lie along on a couch, or upon the bed, with his head high. Let his diet be cooling, and his body kept open by glysters, repeated occasionally. Let this method be persisted in till his delirium goes off; or till the pulse subsides, and he seems exhausted; then perhaps he will begin to dose, or slumber on his chair, which will do him no harm, and wben he is inclined to go into bed, let him lie down. By this method, adds Dr. C. I have recovered great numbers of people, when 1 was suffered to conduct them in the hospital; and I do believe some have perished by an opposite treatment, that might have been saved. Medicines.—Although it is admitted the cure of dis- eases depends very much upon the right choice of medi- cines; yet, it cannot reasonably be expected that these will produce the desirtd effect unless they are punctually taken agreeably to the directions given. It has oftentimes occurred, that when aperient powders containing calomel has been prescribed, and directions given that they should be administered in sirup or molass- es, the physician, in making the necessary enquiry on the following day, has been told by the nurse that they had no effect upon the bowels. How was the medicine given? In tea, sir. Why was it not administered agreeably to instructions? Because the patient preferred taking it in a liquid, and I thought it would answer as well. By thus changing the vehicle, the calomel being heavier than the tea, was left at the bottom of the spoon, and as it was not swallowed could not of course have any purgative ef- fect. In like manner, the patient or nurse frequently thwarts the intention of the physician by making use of the medicines prescribed irregularly, so that if there is any particular action to be kept up on the system it is rendered abortive, and blame cast where it should not rest. The Nurse's Guide. 705 It is not unusual for medicines, though ever so well adapt- ed to the case to excite nausea and retchings immediately after each dose is taken. Hence a prejudice arises directly against the medicines, which being taken for the cause, it is condemned and set aside. The consequence is the disease becomes more aggravated. Cases may happen, wherein but if one medicine is neglected, itcan never be adminis- tered again jiroperly, and consequently the patient may either be lost, or greatly injured. It is therefore the duty ofthe nurse, when a physician prescribes in whom confi- dence can be placed, strictly to adhere to the curative pro- cess he selects, as without such attention yEscuIapius him- self might fail. It commonly occurs, through the course of many dis- eases, particularly fevers, that the patient hath little or no inclination to eat, till nature has gained the victory. But this not being rightly understood by either him or his attendants, an outcry is made that he will never have an appetite, whilst he takes medicines. Hence the reme- dies are discontinued; yet the ajipetite doth not recover, nor does the case grow better, but rather worse. The reason is obvious, if they would but only observe, that as the disease is cured, the appetite in consequence will revive. Again, it not unfrequently happens in diseases wliich are obstinate, requiring a long course of medicines, that the patient becomes impatient and discontinues the use of the remedies. And in such cases, it is too common, that the patient becomes prejudiced against his physician and mistrusts his ability wholly, though perhaps he has been conducted by him through the most difficult stages of his illness, and not uncommonly sends for another, who if not so honest as to undeceive him, enjoys the honor that was due to the former. By those observations we do not mean to skreen any unskilful or improper use that may be made of medicine, or to raise it into higher esteem than what it deserves; on the contrary, it will ever be found that he who knows his business best, will make it his constant care to heal with fewest medicines; and will always be most ready to resign his patient to diet alone, so soon as he knows it can be done with Safety. 89 706 The Nurse's Guide. During a long spell of sickness it not unfrequently oc- curs, that good natured friends are in the habit of recom- mending nostrums, each on the supposition that their own is infallible. When the patients are credulous, as is too often the case in lingering diseases, they readily grasp at any relief, however monstrous the proposition may ap- jiear; the consequence is, that in nineteen cases out of twenty, the medicaments of which they are composed are utterly unfit for the disease, and consequently prove deleterious in their effects. It too frequently occurs that insuperable difficulties of another kind arise. For, there are some persons bred up with strong prejudices, and an excessive like or dis- like of certain things, and cannot easily be persuaded to comply with what is thought the most proper method of cure, namely, a particular regimen, bleeding, vomiting, &r. And thus their lives are often lost, or if they sur- vive, the future period of their existence is rendered very miserable by some consequent disease remaining fixed in the constitution. Again, we often find, with res- pect to children who have been much indulged, when the physician ascertains the nature of the disease and pre- scribes suitably to the case, be will very likely be told by the parents, if he expects any medicine to be gotten down, it either must be nicely flavoured, or absolutely without taste. Or should he advise topical bleeding by leeches, he will more than probably be told, however necessary their application may be, it is a remedy which must be declined, for the very sight of them would throw the child into convulsions.—And as to a blister, the infliction of this torture on such delicate skin could not be endured; for so soon as any pain from its action was produced, it would be directly torn off. Placed under such limitations, it can- not be expected, however capable and anxious the physi- cian may be to procure relief to his patient, that much advantage can be obtained from his prescriptions. He therefore either declines his attendance, or acting within the bounds to which he is limited, be does little more than alleviate some of the more distressing symptoms, whilst he has the mortification to witness the almost uninterrupt- ed progress of the disease. The Nurse's Guide. 707 Leeches.—As these little animals are depended on for the removal of very dangerous diseases, and as they often seem capriciously determined to resist the endea- vours made to cause them to adhere, it will be proper to give a few directions, by which their assistance may, with more certainty, be obtained. This useful ally to the physician, it may be remarked, is as little fond of the taste of physic as the physician can be himself. The introducing a hand, to which any ill flavoured medicine adheres, into the water in which they are kept, will be often sufficient to deprive them of life; the application of a small quantity of any saline matter to their skin, immediately occasions the expulsion of the contents of their stomach; and what is most to our pres- ent purpose, the least medicament that has been applied, remaining on the skin, or even the accumulation of the matter of perspiration, will prevent them from fastening. The skin should therefore, previous to their application, be very carefully cleansed from any foulness, and moisten- ed with a little milk. The best mode of applying them is by retaining them to the skin in a small wine-glass, or the bottom of a large pill box, when they will, in general, in a little time, fas- ten themselves to the skin. On their removal, the rejec- tion of the blood they have drawn may be obtained by the application of salt externally; but here, for the sake of those to whom we are so much indebted, it may be ne- cessary to remark, that a few grains of salt are sufficient for this purpose; and that covering them with it, as is sometimes done by nurses, generally destroys them. It sometimes hajqiens, that the blood will continue to flow from the orifice made by a leech longer than is desirable; and sometimes children have been nearly lost from the inability of the attendants to suppress the discharge. In such cases the blood should be washed off clean, and the point of the finger pressed moderately hard on the orifice, when the blood will cease to flow. A small compress may then be applied to the wound, which may be retain- ed by the point of the finger as long as the blood appears upon withdrawing the pressure; remembering, that no more blood need be suffered to flow, than is thought ne- cessary; since all that is required to prevent it, is patiently to persevere in the necessary pressure. 708 The Nurse's Guide. It sometimes occurs on the ajiplication of leeches to the fundament, in order to relieve the piles, that they get into the rectum. If that accident should happen, an in- jection of a solution of common salt is the proper reme- dy; but the animal is soon gorged, and then may be des- troyed. Glysters.—As the use of glysters is also of great impor- tance in the cure of many diseases, and as nurses are not al- ways conversant even in this part of their office, it may be proper to give some directions relative to the administra- tion of them, which may be done in the following manner. The bed being prepared with a sufficiency of clothing to keep it dry, the patient must, he jilaced on the side across it, with the knees forward, and then covered decently; the glyster being likewise jirepared, and brought to that moderate heat called milk warm, must be poured into the bladder and secured by tying the opening; which being done and the jiipe anointed, the whole must be jilaced in the bed near to the patient. The nurse must now pass the point of her left forefinger, the nail being cut short, close to the anus, or a little within it, and then slide the pipe along this finger, till the greatest jiart of it is entire- ly introduced. In doing this the pipe must be directed a little backwards, taking care not to push it against any part so much as to cause pain. When thus introduced, its outer end must be held fast with one hand, whilst with the other she takes hold of the string, and pulls out the cork; which done, the bladder must be grasped with both hands, and the contents forced up, keeping the pipe in its place at the same time. When the glyster has been pressed out of the bladder, the pipe must be instantly with- drawn. A large pewter syringe is more convenient to adminis- ter an injection; and some of them are so constructed that the patient may use it himself. Diet.—In the cure of diseases, experience proves how much depends upon the choice and administration of diet. We see one series of disorders, wherein the ap- petite, either from a bad habit or some morbid effect, craves such things chiefly as have a tendency to height- en the disease. Another series, in which the whole fab- The Nurse's Guide. 709 lie being fully engaged and struggling v ith the disease in order to conquer it, the stomach, till in that conflict nature gets the better, loathes every kind of aliment, ex- cept such as is fluid. And we see in the third class, the * stomach not affected, hut dispensing with all kinds of food. Yet these being taken indiscriminately, the dis- ease is not only nursed, but the medicines usually the most efficacious in curing it, are rendered entirely in- effectual. The nurse should therefore be extremely cautious how she deviates from the diet which has been prescribed, as fatal consequences may arise from what may seem to have been but a trifling variation. The stomach must never be oppressed with much at a time, about half a pint being enough, and that should be re- jieated only as nature indicates. This will generally he known by the patient's desire or dislike of it. We say generally, for in some cases where there is great weakness, insensibility, or both, the jiatient may not be able to give such indication. And there are cases, especially fever that terminates badly, where the patient's thirst is insatiable. In either of these exigencies the nurse must proceed with discretion; that is in the former she must rouse the patient every hour or two, and give a cupful or half a pint of such drink as directed; and in the latter she must give drink more frequent, but small quantities at a time. But it should be observed that whenever patients fall into a tranquil slumber, they should hardly ever be disturbed to give them drink or food until five or six hours shall have elajised. Such a repose is most desirable, and will sometimes renovate nature, when her faculties had before seemed prostrate beyond the jiower of recovery. It is a vulgar error, and a very common one too, that a sick person is to be. supported by rich broths, by pas- try, or by solids. The outcry is that the doctor will starve him. Hence a variety of dishes is prepared to tempt the sto- mach to take food, and in order to |irovoke the apjietite pickles are frequently given. The patient from extreme kindness of friends or officiousness of the nurse, is tcazed with repeated urgings, to try to take a little more, un- 710 The Nurse's Guide. til the stomach has received so much as to produce effects directly opposite to those intended. Even after the disease is conquered, and the appetite begins to crave, it is always advisable to feed the patient sparing- ly for several days. Unlimited indulgence in the ar- ticle of food, is a source from wliich a multitude of dis- eases arise in health; then how much more deleterious in its effects, must this be the case in a state of convales- cence. At this crisis, it is indeed a nice point to avoid giv- ing the patient too much or too little nutriment; but even here perhaps excess is the most dangerous extreme.— Great anxiety to preventthe sick from sinking, often indu- ces their attendants and friends to give much more food than can possibly be digested, and it often lies as an of- fensive load upon the stomach, or induces an exhausting vomiting or diarrhoea. When the weakened condition of the digestion or assimilative organs are considered, it cannot but appear, even from that reason, that small por- tions of plain, simple food, given at stated intervals, will best supjiort the remaining strength of the system, and this is really confirmed by experience. In preparing all kinds of aliment, it is essentially ne- cessary to be very cleanly, but more esjiecially in that for sick pcojile, the stomach being often so greatly weak- ened and disordered by the disease, as to render it diffi- cult to find out by way of diet, what is agreeable to the natural powers, and suitable to the case. The nurse, who ought to be the cook, with respect to this part of diet, may select, from the articles enumerat- ed for the sick, such aliments as are suitable to the case. It is advisable that a choice be made of the things most likely to agree with the patient; that a change be provided, as invalids require variety; and that they should succeed each other in different forms. Conclusion.—I believe I have now comjileted the task that was allotted me, and sincerely hope, notwithstanding its imperfections, the improvements I have made to this sixth edition of the "Medical Companion," will greatly enhance its value, and be productive of much comfort and good. So long as sickness is a concomitant of hu- manity, so long will a work of this kind retain its estima- The Nurse's Guide. 711 tion. By persons in health the possession of such a book may not be sufficiently prized; but when sickness finds access to a beloved wife or child, it will doubtless be read with pleasure and considered in reality a valuable and acceptable companion for the sick chamber. It is not to one description of persons alone that the Medical Companion will prove useful, but to every class of society. Many familes are ignorant even of the mode to prepare the various articles of diet suitable for the sick, and with such this part of the work, as a Family Assistant, must be of incalculable value. To the in- quisitive mind, the attentive perusal of this book, from the beginning to the end, will be found to contain so many interesting facts, as will not fail to prove a source of rational and instructive entertainment. To diffuse medical knowledge, is the mosteffectual mode of checking the career of empiricism; and indeed, so obvi- ous is this, that it is surprising to find heads of families pay so little attention to the perusal of books of this kind, wherein they might obtain such information as would enable them to detect ignorant pretenders in the healing art, as well as afford them the very great satisfaction of rendering that assistance in the management ofthe sick, which humanity often loudly calls for. Such knowledge is also highly useful, on the one hand, in prevent- ing unnecessary apprehension respecting symptoms by no means dangerous; and on the other, in giving the alarm, where delay migbt be injurious or fatal. And, again, there are situations in which a little medical knowledge may be of essential consequence to the comfort, or even the life ofthe patient, before regular assistance could be procured. 712 Sage Tea.—Take of the leaves of green sage,plucked from the stalks and washed clean, half an ounce (a handful,) loaf sugar an ounce, outer rind of lemon peel, undried, a quarter of an ounce, or a little lemon or lime juice, boil- ing water two pints. Infuse them in a mug or pitcher, covered, for half an hour, and then pour off the tea.— When the sage is dried it must be used in a less propor- tion than that above. In the same manner teas may be made of balm, ground ivy, catmint, rosemary, southern wood, &c. The lemon peel or lemon juice being omitted or not, and the sugar lessened or increased, as occasion requires. Lemons or apples cut in slices, tamarinds, currants fresh or in jelly, cranberries, dried whortleberries infus- ed in boiling water, sweetened with sugar?or sirup, these may be so prepared and varied in form as to suit every taste, and to answer the purpose of pleasant, cooling and salutary drinks in all febrile complaints. Such drinks should always be kept in a covered vessel. Bran Tea.—Take of bran, fresh ground, two hand- fuls; molasses or honey, one spoonful; boiling water, six pints.—Mix them well, and when they have stood cover- ed about three or four hours, strain off the tea. Flaxseed Tea.—Take of flaxseed, one ounce, white sugar one ounce and a half; lemon juice two table-spoon- fuls; boiling water two pints.—Infuse them in a pitcher some hours, and then strain off the liquor.—An ounce of liquorice shaved, may sometimes be used instead of the sugar. Camomile Tea.—Take of camomile flowers, one handful; boiling water, one gallon. When they have stood covered about half an hour, strain off the tea. If the drinking this tea is to strengthen the stomach, it must be made stronger, as for instance, about a quarter of an ounce to a pint. Diet for the Sick. 718 Lemonade.—Take of the outer rind of fresh lemon peel, about one drachm; lemon juice, one ounce; double refined sugar, tvvo ounces; boiling water, a pint and a half. When they have stood in a vessel about ten min- utes, strain off the liquor. Orangeade.—Take of the fresh outer rind of Seville orange, one drachm; orange juice, two or three table- spoonfuls; white sugar, one or two ounces, or enough to make it of an agreeable sweetness; boiling water, one quart. When they have stood in a pitcher about ten minutes, strain off the liquor. Imperial Drink.—Take of cream of tartar, one drachm; the outer rind of fresh lemon or orange peel, half a drachm; loaf sugar, one ounce; boiling water, two pints. When they have stood in a pitcher about ten min- utes, strain off the liquor. Barley Water.—Take a handful of either pearl barley, or the common sort, wash it clean first in cold, and afterwards in boiling water, then simmer it in a quart of water for an hour; when half done, put it into a bit of fresh lemon peel and a little sugar. Rice water may be prepared as above. Toast and Water.—Toast slowly a thin piece of white bread till extremely brown and hard, but not the least black, then plunge it into a jug of cold water and cover it over an hour before used. Pectoral Diunk.—Take of common barley and rai- sins stoned, each two ounces; liquorice root, half an ounce; water, two quarts. Boil the water first with the barley, then add the raisins, and afterwards near the latter end of the boiling, the liquorice. The decoction then will be fully completed, when one quart only of the liquor will be left after straining. Arrow-Root Jelly.—Mix a large spoonful of the powder with a tea-cup of cold water by degrees, then pour this into a pint of boiling water, stirring it well, and 90 714 Diet for the Sick. when it boils it is finished. A little sugar and nutmeg may be added. Or prepare it as directed under the head of Arrow-Root.—[See Materia Medica.] Sago Jklly.—Take of sago, washed well, one large spoonful; water, near a pint. Boil them gently, stirring often, till the mixture is smooth and thick; then add two spoonfuls of wine, a little nutmeg and sweeten it to the taste. A bit of lemon peel added to it when boiling, gives it a nleasant taste and flavour, and with some patients it agrees better when boiled in milk. Tapioca Jelly.—Choose the largest sort, pour cold water on to wash it tvvo or three times, then soak it in fresh water five or six hours, and simmer it in the same until it becomes quite clear, then put lemon-juice, wine, and sugar. The peel should have been boiled in it.—It thickens very much. Calves Feet Jelly.—Boil two calves-feet in one gallon of water till it comes to a quart, then strain it, and when it is cold, skim the fat entirely off, and take the jelly up clean; if there is any settling at the bottom leave it. Put the jelly into a sauce-pan, with a pint of moun- tain wine, half a pound of loaf sugar, the juice of four large lemons, and the white of six or eight eggs, beat up the whisk; mix all well together, set the sauce-jian upon a clear fire, and stir the jelly till it boils. When it has boiled a few minutes, pour it through a ffannel bag till it runs clear. Have now ready a large china basin, with some lemon-peel in it, cut as thin as possible, let the clear jelly run upon them while warm, and from these it will acquire both an amber colour and an agreeable flavour.— Afterwards it may be poured into glasses. Boiled Flour.—Take a pound or tvvo of fine flour, tie it up as tight as possible in a linen rag, dip it repeatedly in cold water, and dredge the outside with flour till a crust is formed around it, which will prevent the water soaking into it while boiling. It is then to be boiled till it becomes a hard dry mass. Tvvo or three table-spoon- fuls of this may be grated down and boiled in milk and Diet for the Sick. 7L' Water to a jiroper thickness and sweetened to the patient's taste, and a little nutmeg or other spice may be added. This forms an excellent food in dysentery and in bowel complaints in children. Water Gruel.—Take of the coarse part of corn meal or grits, two haudfuls; water three quarts; boil it till on- ly two quarts remain, then strain off the liquor, and sea- son it to the palate with salt, sugar and nutmeg, to which may be added a sjioonful or two of wine. Or, take of oatmeal, two large spoonfuls; water, one quart; mix them well, and boil them about ten or fifteen minutes, stirring often; then strain the gruel through a sieve, and add sugar and salt enough to make it agreea- ble to the taste. When it is designed as a meal, dissolve it in a little butter, and then add bread and nutmeg as oc- sioji requires. Rice Milk.—Take a large tea-cujiful of rice, wash- ed nicely; water one pint; boil it for about half an hour, then add a quart of new milk; let it simmer over a slow fire till it is sufficiently done, and then add to it a little sugar and nutmeg. Treacle Posset.—Take of milk one point, put it on the coals till it just begins to boil, then add two or three table-spoonsful of treacle or molasses, stirring the milk as it is poured in. When mixed it is fit for use. Panado.—Take of bread, one ounce; mace, one blade; water, one pint—Boil them without stirring, till they mix and turn smooth, then add a little grated nutmeg, a small piece of butter, and sugar enough to make the mix- ture agreeable. When butter is not approved of, two spoonfuls of wine may be used in its stead. Or, Set a little water on the fire with a glass of white wine, some sugar, and a scrape of nutmeg and lemon-peel; mean while grate some crumbs of bread. The moment the mixture boils up, keeping it still on the fire, put the crumbs in, and let it boil as fast as it can. When of a proper thickness just to drink, take it off. 716 Diet for the Sick. White Caudle.—Take of oatmeal, tvvo table-spoons- ful; water, one quart; mare, two or three blades; three or four cloves.—Mix them well together, boil them about fifteen minutes, stirring often, th mi add a few slices of the outer rind of a lemon; when the mixture has boiled about fifteen minutes, strain it through a sieve. As it is used, add to it white wine, grated nutmeg, white sugar enough to make it agreeable to the patient. Toasted bread is to be added likewise, as the appetite may re- quire. Or, Put into a pint of fine gruel, made of coarse com meal, or grits, while it is boiling hot, the yolk of an egg beaten with sugar, and mixed with a large spoonful of cold water, a glass of wine, and nutmeg. Mix by de- grees. Some like gruel, with a glass of table beer, su- gar, &c. with or without a tea-spoonful of brandy. Flour Caudle.—Into five large spoonfuls ofthe pur- est water, rub smooth one desert spoonful of fine flour.— Set over the fire five spoonfuls of new milk, and put two bits of sugar into it; the moment it boils, pour into it the flour and water, and stir it over a slow fire twenty min- utes. It is a nourishing and gently astringent food. Rice Caudle.—When the water boils, pour into it some grated rice mixed with a little cold water; when of a proper consistence, add sugar, lemon-peel and cinna- mon, and a glass of brandy to a quart.—Boil all smooth. Bread Soup.—Take the upper crust of a roll, the drier the better; or two or three crackers, cut or break them into pieces, and put it into a sauce-jian, with a pint of water, and a piece of butter about half as big as a wal- nut; boil them well, every now and then stirring and beat- ing them, till the bread is mixed; then season the soup with a very little salt, and pour it into a basin. Egg Soup.—Take of water, one pint; the yolk of an egg; butter, the bigness of a small walnut; sugar enough to make it agreeably sweet. Beat up the yolk with the wati-r, and then add the butter and sugar. Stir it all the time it is upon the fire: when it begins to boil, pour it to Diet for the Sick. 717 and fro between thesauce-pan and mug till it is smooth and well frothed, and then it will be fit to drink. Beef Tea.—Cut one pound of lean beef into thin slices or shreds, and boil it in a quart of water for twenty minutes, taking off the skum as it rises. After it grows cold the liquor should be strained, in which state it re- sembles a light infusion of green tea, has a very grateful flavour, and is more strengthening than other broths. Chicken Broth.—Take a middling sized chicken, divide it into two parts, pat one half into a sauCe-pan, with a quart of water seasoned with a little salt; as the scum rises take it off; then may be added a small bundle of parsley, and a crust of bread; when they have boiled about three quarters of an hour, the parsley may be taken out, and the broth will be fit for use, or it may be used seasoned only with salt. Mutton Broth.—Take of mutton, one pound; water, three pints.—Put them into a sauce-pan, and set it upon a clear fire, throw in a little salt, and as the scum rises take it carefully off with a spoon; then add a small onion, if there is no objection to it, and a little parsley. Boil till the meat is very tender, then take it out, pour the broth into a basin, and when cold, skim the fat part which is congealed on the surface, entirely off; after which a part of the broth may be warmed and given to the patient as often as needful. A little boiled rice or barley may be added here occasionally. Calvks-Feet Broth.—Boil two feet in three quarts of water, to half; strain and set it by; when to be used, take off the fat, put a large tea-cupful of the jelly into a saucepan, with half a glass of sweet wine, a little su- gar and nutmeg, and heat it up till it be ready to boil, then take a little of it, and beat by degrees to the yolk of an egg, adding a bit of butter, the size of a nutmeg, stir all together but do not let it boil. Grate a bit of fresh lemon peel into it. Boiled Pigeon.—Take one pigeon, drawn, and wash- ed very clean; boil it in a sufficient quantity of milk and 718 Diet for the Sick. water, that is, about half a pint of each, for fifteen min- utes. When thus prepared, it may be taken out, and cat with the following sauce:—Take the liver parboiled, bruise it fine, with a little parsley boiled, and finely chop- ped; melt some butter, and mix a little of it first with the liver and parsley, then add the rest, and pour the whole upon the pigeon. To rroil Pigeon.—After cleaning split the backs, pepper and salt them, and broil them very nicely; baste with butter, and serve as hot as possible. Roast Pigeons—Should be stuffed with parsley, ei- ther cut or whole, and seasoned within. Serve with pars- ley and butter. Partridges and other birds may be dressed as above. Bread Pudding.—Take, of crumbs of bread, about half a pound; new milk, about three quarters of a pint. Pour the milk boiling hot upon thebread, and let it stand about an hour covered close up; then add the yolks of two eggs, well beaten; a little grated nutmeg; about a spoonful of rose water; a little salt, and sugar also if agreeable; beat the bread well, and mix the whole to- gether with a spoon. Tie it then close up in a clean linen cloth, and when the water boils, put it in; boil about three quarters of an hour, then take it out, lay it upon a plate, pour over it some melted butter mixed with a little moun- tain wine, if there is no objection, and sprinkle a little sugar over all. Batter Pudding.—Rub three spoonfuls of fine flour extremely smooth by degrees into a pint of milk; simmer till it thickens, stir it in two ounces of butter, set it to cool, then add the yolks of three eggs; flour a cloth that has been wet, or butter a basin, and put the batter into it; tie it tight, and jilunge it into boiling water, the bot- tom upwards. Boil it an hour and a half, and serve with sweet sauce. If approved, a little ginger, nut- meg and lemon-peel, may be added. Diet for the Sick. 719 Rice Pudding.—Wash and pick some rice, throw among it some pimento finely pounded, but not much; tie the rice in a cloth, and leave room for it to swell. Boil it in a quantity of water for an hour or two. When done, eat it with butter and sugar, or milk. Put lemon peel if you please. It is very good without spice, and eaten with salt and butter. Or, Swell the rice with a very little milk over the fire, then add some more milk, an egg, sugar, all- spice, and lemon peel. Bake in a deep dish. Potatoe Pudding.—Take eight ounces of boiled po- tatoes, two ounces of butter, the yolks and whites of two eggs, a half pint of new milk, one spoonful of white wine, a morsel of salt, the juice and rind of a lemon beat all to froth; sugar to taste. A crust or not as you like. Bake it. Custard Pudding—Mix by degrees a pint of good milk with a large spoonful of flour, the yolks of four eggs, and a little pounded cinnamon. Butter a basin that will exactly hold it, pour the batter in, and tie a floured cloth over. Put in boiling water over the fire, and turn it about a few minutes to prevent the egg going to one side. Half an hour will boil it. Wine Whey.—Take of new milk, two pints; water, one pint; white wine, one gill. Put the milk and water into a saucepan, well tinned, and set them upon a clear fire, and when they begin to boil, throw in the wine.— Boil them about fifteen minutes, during which time as the curd, or cheesy part collects, take it off with a spoon, and if the whey is not clarified enough with this quanti- ty of wine, add a spoonful or two more; then boil it a little longer and skim it, by which means it will become sufficiently fine, and then it may be poured into a basin for use. Or, Put half a pint of new milk on the fire; the moment it boils up, pour in as much sound raisin wine as will completely turn it, and it looks clear; let it boil up, then set the saucepan aside till the curd subsides, and do not stir it. Pour the whey off, and add to it half a 720 Diet for the Sick. pint of boiling water, and a bit of white sugar.—Thus you will have a whey jierfectly cleared of milky particles, and as week as you choose to make it. Mustard Whey.—Boil one ounce and a half of mus- tard in powder, in a pint of milk, and an equal portion of water, till the curd be entirely separated, after which the liquid is strained through a cloth. This preparation is one of the most pleasant and efficacious forms in which mustard can be given. A tea-cupful sweetened with su- gar taken three or four times in a day, is exceedingly beneficial in low fevers as a cordial diaphoretic. Vin- egar and lemon whey may be formed in the same man- ner as wine whey. Alum Whey.—Boil two drachms of powdered alum in a pint of milk till it is curdled; then strain out the whey. This astringent preparation is often em|iloyed with advantage in uterine hemorrhage and in diabetes. The dose is two or three ounces, or as much as the sto- mach will bear, several times in the day. Having finished, as far as the limits of this work wil uermit, a general detail of the practice of domestic medi- dne, adapted to the climate of our country, it now only remains to notice the medicines requisite for family use, and to point out the best forms of prescribing them, in the treatment of the different diseases, described in the pre- ceding parts of this work. The following table of medicines will be found suffi- cient to answer every purpose of domestic practice, and the expense will^be found nothing, compared to the great advantages which must result from being constantly sup- plied with them. To render the work still more com- plete, I have, in this table, annexed to the medicines, their doses according to the age of the patient; observing, however, that whatever general rule may be given, it can only be applied with reference to the habit and state ot the patient. The judgment of the jierson who adminis- ters the medicine must therefore be exercised in this res- pect It will be found that the constitution is often at- tended with certain peculiarities, both in relation to me- dicine in general, and also to certain substances particu- larly, which knowledge is only to be obtained by experi- ence. EXPLANATION OF WEIGHTS AND MEASURES. 20erains - - - make - - 1 scruple, jo grains ... 1 drachm, 3 scruples " _ . . X ounCe, 8 drachms ----- . 16 ounces.......P ' A tea-spoonful is equal to 60 drops or 1 drachm. A table-spoonful is the measure of half an ounce A large wine-glassful is equal to two ounces. 91 A WAIM %W MWBWWMB F8MR &&WEL*T W3M* WITH THEIR DOSES AND QUALITIES ANNEXED. & These doses must be increased, or diminished, according to the strength and habit ofthe patient. Medicines. Arsenic, solu. of, Antimonial wine —as a diaphoretic \Alum Aloes Arrow root Balsam capivi Balsam Turlington Barley J Bitters [/ Borax Bajk, Peruvian, Mult. From 19 to 15 5 to 12 drops 3 to 4 drms. 26 to 60 drps 5 to 15 grains 5 to 20 grains 5 to 10 dfbps 3 to 3J drms. 20 to SO drops 4 to 12 grains 4 to 18 grains 20 to 80 drops do. do 2 to 4 drms. From 15 to 10 4 to 8 drops 2J to 3 drms. 15 to 40 drops 3 to 10 grains 3$ to 15 grs. 17 to 60 drops do. do. 15 to 40 drop do. do. 1 to 3 drms. I to 2 drms. From 10 to 6 3 to 6 drops 2 to 2i drms. 2 to 30 drops 2 to 7 grains 3 to 12 grains 12 to 30 drops do. do. From 6 to I 2 to 5 drops i to 2i drms, 10 to 20 drops IJ to 5 grains 2 to 10 grains 10 to 20 drops do. do 30 grs to 2 dms 30 to H drms 25 to H drms',20 to 1 drm. 15 to 40 grains From 4 to 2 1 to 4 drops 1 to 2 druis S to 15 drops 1 to 3 grains IJ to 8 grains From 2 to $ to 3 drops I to 1$ drms 6 to 10 drops 8 to 15 drops do. do. 12 to 30 grains to 10 drops do. do. Under one. i to 2 drops i to 1 drm 4 to 8 drops do. do. Qualities. 10 to 25 grains 6 to 16 grains Tonic. Emetic. Diaphoretic. Astringent. Cathartic. Nutritious food. Corroborant. Corroborant. Nutritive. Stomachic. Deterg. externally. Tonic and antisceptic Medicines. Calomel Camphor Cream of tartar Caustic vol. alk. liq Gorrosive sublimate Columbo Chalk, prepared Camomile flowers Castile soap Castor oil Essence peppermint Elixir vitriol iEther vitriolic Flaxseed Ginger Gamboge 0 to 30 grs 4 to 20 grains 4 to 12 drms .> to 2 drms 10 to 60 grains 25 to 50 grains Adult. 10 to 25 grs 3 to 15 grains 4 to 8 drms £ to 1$ drms 20 to 80 grains 4 to 12 drms 10 to 50 drops 15 to 40 drops I to 2 drms 5 to 25 grains 6 to 12 grains From 19 to 15 8 to 20 grs 2 to 10 grains 3 to 8 drms £ to 1 drm 10 to 50 grains 20 to 45 grains 20 to 60 grains 3 to 10 drms 10 to 40 drops 12 to 35 drops $ to 1 i drms 5 to 20 grains 5 to 10 grains From 15 to 10 6 to 15 grains 2 to 6 grains 2 to 5 drms 25 to 50 drops 8 to 40 grains 16 to 40 grains 7 to 35 grains 15 to 35 grains 20 to 50 grains 3 to 8 drms 8 to 30 drops 10 to 30 drops 30 dps to ldm 4 to 18 grains 4 to 8 grains From 10 to 6 5 to 12 grains 2 to 4 grains 2 to 4 drms 20to40drops|15 6 to 25 grains 12 to 30 grains 15 to 40 grains 2 i to 6 drms 6 to 20 drops 8 to 20 drops 18 dps to 1 dm 3 to 15 grains 3 to 6 grains From 6 to 4 12 to 30 grains 2 to 5 drms 4 td 15 drops 6 to 15 drops 15 to 50 drops 3 to 12 grains From 4 to 2 4 to 10 grains 1 to 3 grains 1 to 3 drms to 30 drops 5 to 20 grains 10 to 25 grains 4 to 15 grains 7 to 20 grains 10 to 25 grains 1 \ to 4 drms 3 to 12 drops 4 to 10 drops 12 to 40 drops 2 to 10 grains From 2 to 1 3 to 8 grains 1 to 2 grains h to 2 drms 10 to 20 drops 2 to 10 grains 5 to 12 grains 8 to 20 grains 1 to 3 drms 2 to 10 drops 2 to 6 drops 8 to 30 drops 2 to 8 grains Under one. 1 tc 5 grains h to 1 grain J to 1 drm 5 to 10 grains 1 to 2 drms 1 to 6 drops I to 4 drops 5 to 10 drops 1 to 6 grains Qualities. Active purgative. Stimulant. Pooling aperient. Stimulant. Anti-venereal. Stomachic and tonic. Absorbent. Stomachic & antisep. Attenuant and deter. Purgative. Carminative. Tonic. Stimulant. Pectoral & obtunding Aromatic. Purgative. Medicines. Adult. From 19 to 15 From 15 to 10 From 10 to 6 From 6 to 4 From 4 to 2 From 2 to 1 Under one. Qualities. Gum Arabic Hartshorn, spirit Honey Ipecacuanha Jalap Lunar Caustic Laudanum Magnesia Manna Nitre Nitric acid Oil of olive Opium Ointment, simple i to 1| drms 15to 30 grains 15 to 40 grains 1-6 to 3 grains 20 to 60 drops i to 2 drms 1 to 2 ounces 10 to 30 grs $ to 3 grains J to 1 drm 12 to 25 grs 10 to 30 grs 1-6 to 2£ grs 15 to 50 drops £ to 1J drm 1 to 1£ ounce 10 to 25 grs i to 2 grains 20 to 50 drops 10 to 20 grs 8 to 25 grains 1-8 to 2 grains 12 to 40 drops 20 grs to 1 dm £to 1J ounce 8 to 20 grains J- to 1 grain 15 to 30 drops 8 to 15 grains 6 to 20 grains 1-10 to 1J grs 10 to 25 drops 15 to 50 grs i to 1 ounce 5 to 12 grains 10 to 15 drops 6 to 12 grains 5 to 15 grains 1-10 to 1 grain 8 to 20 drops 10 to 40 grs 3 to 6 drms 2 to 10 grains 5 to 10 drops 5 to 10 grains 4 to 12 grains 1-12 to £ grain 5 to 15 drops 8 to 30 grains 2 to 4 drms 2 to 8 grains 3 to 8 drops 4 to 8 grains 3 to 8 grains 3 to 8 drops 6 to 20 grains 1 to 3 drms 1 to 6 grains 1 to 3 drms 2 to 6 drops 1 to 5 grains 2 to 5 grains 2 to 6 drops 4 to 10 grains J to 2 drms 1 to 4 grains 1 to 2 drms Obtunding, Stimulant. Pectoral. Emetic. Purgative. Stimulant. Anodyne. Absorbent. Mild aperient. Diuretic and febrile. Tonic and antiscor. Obtunding and open Anodyne and antisep Cooling and healing. ------.-, mercurial Discutient. Medicines. Adult. From 19 to 15 From 15 to 10 From 10 to 6 From 6 to 4 Fi om 4 to 2 From 2 to 1 Under one Quulilies. Ointment, Basilicon Paregoric Elixir Pink Root, Carolina Rhubarb Powdered Rattle Snake Root Rust of Steel Red Precipitate Sugar of Lead Spanish Flies Salts ^Salt of Tartar Spirits of Turp. Sal Ammo. Vola. ---------, crude Senna Spirits of Lavender 1 to 4 drms 15 to 50 grs 5 to 25 grains 1 to 6 grains 4 to 16 drms 10 to 30'grs 5 to 20 grains 30dpsto2dms 1 to 3 drms 12 to 45 grs 4 to 20 grains 1 to 5 grains 4 to 14 drms 10 to 25 grs 5 to 15 grains 25dpstol£dm 1 to 2 drms 10 to 40 grs 3 to 15 grains | to 4 grains 3 to 12 drms 8 to 20 grains 4 to 12 grains 20 dps to 1 dm 50dps to 1 $dm 8 to 30 grains 2£ to 3 grains $ to 3 grains 2 to 8 drms 6 to 12 grains 4 to 10 grains 15 to 50 drops 30 dps to 1 dm 6 to 25 grains 2 to 10 grains i to 3 grains 2 to 6 drms 4 to 8 grains 3 to 8 grains 12 to 40 drops 20 to 50 drops 5 to 20 grains 1 to 6 grains 1 -6 to 2 grains 1^ to 4 drms 3 to 6 grains 2 to 6 grains 10 to 30 drops 15 to 30 drops 4 to 12 grains i to 2 grains 1-8 to 1 grain 1 to 3 drms 2 to 4 grains 1 i to 4 grains 6 to 20 drops 3 to 20 drops 2 to 10 grains J to 2 drms 1 to 3 grains 1 to 3 grains 2 to 10 drops Digestive. Anodyne & pectoral Vermifuge. Mild cathartic. Diaphoretic. Tonic. Escharotic. Astringent and tonic Blistering, Cathartic. Absorbent and febn Stimulant. Stimulant. Discutient. Purgative. Cordial. Medicines. Adult. From 19 to 15 From 15 to 10 From 10 to 6 From 6 to 4 From tto% From 2 to I Under one. Qualities. Sulphor flour Tamarinds Tartar emetic Turner's cerate Tincture of Steel ------rheumatic —— bark ■ rhubarb —— foxglove ——— cantharides ------columbo ——— myrrh Vitriol, white 2 to 8 drms 2 to 6 grains 8 to 18 drops J to 1 ounce 2 to 6 drms 4 dms. to 2 oz-10 to 60 drops 10 to 50 drops 1 to 4 drms 20 to 60 grs 2 to 5 grains 10 to 20 grs 2 to 6 drms 2 to 5 grains 6 to 15 drops 4 to 6 drms 2 to 5 drms 4 dms to l^oz 10 to 50 drops 10 to 45 drops 1 to 3 J drms 18 to 50 grs 1J to 4 grains 10 to 18 grs 1 to 4 drms 2 to 4 grains 5 to 12 drops 2 to 4 drms 1 i to 4 drms 3 to 8 drms 8 to 40 drops 10 to 40 drops 1 to 3 drms 14 to 30 grs 1 to 3J grains 8 to 15 grains 1 to 3 drms 1$ to 3 grains 4 to 10 drops 1 to 3 drms 1 to 3^ drms 2 to 6 drms 6 to 30 drops 8 to 30 drops 40dpsto2idm 6 to 15 grains i to 2 grains 6 to 10 grains J to 2 drms 1 to 2 grains 3 to 8 drops $ to 2 drms 1 to 3 drms 2 to 5 drms 5 to 20 drops 6 to 20 drops 30dpsto2dms 4 to 10 grains i to 1 grain 3 to 6 grains 20 grs to 1 dm $ to 1 grain 2 to 6 drops 20 to 60 drops J to 2 drms 1£ to 3 drms 4 to 15 drops 4 to 15 drops 20dpstol£dm 2 to 5 grains 1 to 4 grains 10 to 40 grs £ to 1 grain 1 to 5 drops i to 1J drms 1 to 2 drms 2 to 12 drops 2 to 5 drops 15dpstoldm 1 to 3 grains 1 to 3 grains 5 to 20 grains ito 1 grain 2 to 3 drops 20 to 40 drops 20 to 40 drops 1 to 8 drops 1 to 5 drops 10 to 40 drops Aperient. Cooling, laxative. Emetic. Healing. Tonic. An ti-rheumatic. Tonic. Mild cathar. & stojia. Diuretic. Stimulant. Tonic. Detergent Emetic. Tonic Escharotic Stimulant Sc stomach, ■ blue Virginia Snake root A VA»® W MBBICTSTAm ©MI^OTf»» WITH THEIR DOSES AND PROPERTIES. Compositions. Adult. From 19 to 15 From 15*o 10 From 10 to 6 From 6 to 4 From 4 to 2 From 2 to 1 Under one. Properties. Antimonial powders 8 to 15 grains 8 to 13 grains 7 to 12 grains 6 to 8 grains 4 to 6 grains 3 to 5 grains 2 to 4 grains 1 to 3 grains Diaphoretic. Anti. solu. or mix. 3 to 6 drms 3 to 5 drms 2 to 4 drms 1 j to 3 drms I to 2 drms J to 2 drms J to 1 drm \ to 1 drm Diaphoretic. Anodyne sudor, drps 60 to 100 drps 60 to 90 drops 50 to 80 drops 40 to 70 drops 30 to 60 drops 20 to 50 drops 10 to 30 drops 5 to 20 drops Anodyne 8c sudorific. Ahsorbent mixture 4 to 8 drms 4 to 6 drms 3 to 5 drms 3 to 4 drms I to 3 drms lj to 2$ drms 1 to 2 drms ^ to 1 drm Absorbent. Absor. and aperi. mix 3 to 4 drms 2 to 4 drms 1 to 3 drms \ to 2 drms Absorbent & aperient Anti-dysenteric mix. 6 to 12 drms 6 to 10 drms 5 to 8 drms 4 to 6 drms 3 to 5 drms 2J to 4 drms 2 to 3 drms 1 to 2 drms Anti-dysenteric. Astringent mixture 5 to 8 drms 4 to 8 drms 3 to 6 drms 2J to 4 drms 2 to 3 drms 1£ to 2 drms I to 2 drms | to 1 drm Astringent. Cathartic mixture 6 to 12 drms 6 to 10 drms 5 to 8 drms 4 to 6 drms 3 to 5 drms 1\ to 4 drms 2 to 3 drms I to 2 drms Cooling cathartic. Camphor powders 10 to 15 grs 10 to 12 grs 8 to 12 grains 6 to 10 grains 5 to 8 grains t to 6 grains 3 to 5 grains 2 to 4 grains Slimu 8c diaphoretic. Camp, julep or mix. 6 to 8 drms 5 to 8 drms 4 to 6 drms 3 to 4 drms 2 to 4 drms 1 to 3 drms 1 to 2 drms \ to 1 drm Stimulant. Decoc. or infus. bark 2 to 6 ounces 2 to 5 ounces 1J to 4 ozs. U to 3 £ ozs. 1 to 3 ounces 1 to 2 ounces 6 to 12 drms 1 to 8 drms Tonic. Decoction of Seneka 6 to 12 drms 6 to 10 drms 5 to 8 drms 4 to 6 drms 3 to 5 drms 2i to 4$ drms 2 to 4 drms 1 to 3 drms Diaphoretic. Diaphoretic drops 1 to 3 drms 1 to 2 drms 1 to 1 & drm § to 1 drm 20 to 40 drops 15 to 30 drops 10 to 20 drops 5 to 10 drops Diaphoretic. Compositions. Diuretic mixture Dover's powder Febrifuge powders Febrifuge mixture Infusion of Columbo Lime water Pectoral mixture P Purgative electuary S Saline mixture S Spirit of mindcreru; S Sirup of flaxseed 1 Tonic powders 1 Vitriolic solution Adult. \Fvom 19 to 15 2 to 4 ounces 2 to 4 ounces 10 to 20 grs 8 to 15 grains i to 12 drms I to 3 ounces 1 to 4 ounces 4 to 8 drms 8 to 16 grains 8 to 13 grains 6 to 10 drms I to 3 ounces 1 to 3 ounce I to 7 drms From 15 to 10 2 to 4 drms h to 3 drms 6 to 8 drms 6 to 8 drms • to 8 £rms 15 to 50 grs 4 to 6 drms 5 to 8 drms 5 to 8 drms 5 to 8 drms 2 to 3 ounces 0 to 12 grains 7 to 10 grains 5 to 8 drms I to 2 ounces I to 3 ounces 3 to 0 drms 1 i to 3 drms t to 7 clnus 4 to 7 drms 4 to 7 drms From 10 to 6 From 6 to 4 12 to 40 grs 10 to 30 grs 3 to 5 drms |2 to 4 drms lito 3 ounces 5 to 10 grains 6 to 8 grains 1- to 8 drms 1 to 2 ounces 1 to 2 ounces 1\ to 5 dims 1 to I drms !■ to 6 drms Ho G drms L to 6 drms 8 to 25 grains 2 to 3 drms From 4 to 2 1 to 2 ounces I to 8 grains 4 to 6 grains 4 to 6 drms J to 2 ounces i to 2 ounces 2 to 4 drms 1 to 1 A drm 3 to 5 drms 5 to 5 drms 3 to 5 drms 6 to 20 grains ! A to 2 J drms 1 to 1.] ounce 3 to 6 grains 3 to 5 grains 3 to 5 drms 4 to 1 ounce J to 1 ounce 1 j; to 3 drms ^> to 1 drm 3 to 4 drms 3 to 4 drms 3 to 4 drms 4 to 12 grains 1 to 2 drms From 2 to 1 i to 1 ounce 2 to 4 grains 2 to 4 grains i to 4 drms i to 6 drms l to 6 drms 1 to 2 drms \ to 1 drm 2 to 3 drms I to 3 drms 2 to 3 drms 1 to 6 grains I to 2 drms Under one. I to 1 drms J to 1 grain I to 3 grains 1 to 4 drms 1 to 4 drms 1 to 2 drms J to 1 drm 1 to 2 drms I to 2 drms I to 2 drms 1 to 3 grains J to 1 drm Properties. Diuretic. Diaphoretic. Febrifuge. Febrifuge, Tonic. Absorb, and Tome. Obtunding. Purgative. Diaphoretic Diaphoretic. Pect. and Obtunding Tonic. Astringent. 729 EMETICS, Are medicines which excite vomiting, and are usefully employed in fevers of almost every species, especially when accompanied in the commencement with nausea, vomiting, and other symptoms indicating a disordered state of the stomach. They cleanse the stomach of its noxious contents, and prepare the way for the reception of other remedies. As a general rule, emetics should always be given on an empty stomach, and in the morning. They act with ereater certainty, and with less distress to the patient. They will, however, answer very well in the evening.-- In ordinary cases, administer the medicine in divided quantities, so as to guard against too violent an effect, and encourage its operation by drinking freely of warm Wfttcr To check inordinary vomiting from too large a dose of emetic medicine, give laudanum, combined with some cordial, apply fomentations to the pit of the stomach, and sinapisms to the extremities. Chicken water copi- ously drank is sometimes useful, by turning the action downwards. When these fail, anodyne injections may be resorted to, and a large blister should be put on over the region of the stomach. Of the emetics, the mildest are ipecacuanha, the anti- monial solution, and antimonial wine in broken doses. The most active and expeditious, are the white and blue vitriol. Where poisons have been swallowed,one or oth- er of these should be given in very large doses, and re- peated every fifteen minutes until the desired effect be ob- tained. [See Thorn Apple, and Poisons.] 92 730 Dispensatory. Antimonial Solution.—Take of tartar emetic, six grains? water, half a pint; spirits of lavender, thirty drops; sugar, one lump,—IVIix. Dose for adults a wine-glassful every fifteen minutes, which should be encouraged by drinking freely of warm water, and afterwards turned downwards by taking a bowl of thin gruel made very salt. CATHARTICS, Are medicines wliich, by quickening the peristaltic mo- tion increase the evacuations of the intestines, or, as may happen, induce purging. Cathartics differ very materi- ally in their degree of activity; some operating mildly, while others are more violent in their effects. The for- mer is usually distinguished by the title of laxatives, and the latter by that of purgatives, the harshest of which, are called drastic purgatives. The primary and most obvious effect of cathartics, is the evacuation of the bowels. These are liable to various accumulations of a morbid nature, which remaining, dis- turb health, and frequently excite or confirm disease.— Cathartics, in relieving the bowels, under such circum- stances, extend also their operation upwards, and bring down, in many instances, the contents of the stomach. To this may be added, that tiie strong impression which they impart to the liver and pancreas, excite these glands to invigorated efforts, and tke result is a vast increase of their respective secretions. It is in this way, that con- gestions are removed, biliary calculi dislodged, and jaun- dice and other affections from organic obstruction, cured. They also subdue the pulse, equalize excitement, and render important service in the management of the fe- brile and inflammatory cases. Exhibited in the com- mencement of almost any febrile affection, they will of- ten arrest its progress, and during the subsequent or more advanced periods, they are sometimes daily repeat- ed, and so far from weakening, add to the strength of the patient. As in the case of emetics, give the medicine on an empty stomach, and either in the morning or at bed time—By doing this, we prevent its being rejected, and secure a much more easy and effectual operation. And Dispensatory. 7-31 it should be recollected, as cathartics are of very different properties and modes of operation, they should careful- ly be selected according to the circumstances of the case. Laxatives.—Of this description are castor oil, sweet oil, magnesia, calomel, neutral salts, sulphur, cream of tartar; as also the cathartic mixture, and the aperient and diaphoretic pills in broken doses. Cathartic Mixture.—Take of glauber salts, one ounce and a half; lemon juice or sharp vinegar, one ounce; wa- ter half a pint; sugar, a sufficient quantity to sweeten it.—Mix. Or, Take of cream of tartar finely powdered, and manna, each one ounce; water, half a pint.—Mix. Dose for adults, a wine-glassful every hour till it operates. Antihilious, or Aperient and Diaphoretic Pills.—Take of calomel, jalap, each twenty grains; tartar emetic, two grains; sirup or mucilage of gum arabic, sufficient to form a mass; make eight pills. Dose for adults, two at bed time, and the dose repeated every two hours in the morning until it operates sufficiently. Or take three in the morning, ond one every hour until the desired ef- fect is obtained. Purgatives.—The drastics are the gamboge, aloes, calomel, jalap, rhubarb, and senna, the purgative in- fusion, purgative powder, stimulant purgative pills, and purgative electuary. The distinction, however, be- tween laxatives and purgatives, is by no means easy, since by diminishing or increasing the dose of the for- mer, they may, with some propriety, be considered as belonging to the first or second class. Purgative Infusion.—Take of senna, and manna, each half an ounce; salts, one once; ginger, one drachm; boil- ing water, one pint. Dose for adults, one gill every hour or two, until it operates. Purgative Powder.—Take of calomel, jalap, each twenty grains, to be taken in the morning; in sirup or molasses by adults. 733 Dispensatory. Or, take of rhubarb, vitriolated tartar in fine powder, each one drachm; mix well together, and divide into four powders. One taken going to bed, and another in the morning, will be found an efficacious remedy, whenever it is required to cleanse the stomach and bowels, of bil- ious and other offensive matter Stimulant Purgative Pills.—Take of calomel, gamboge, ©ach one drachm; sirup, sufficient to form a mass. Beat them together, and then make twenty-four pills. Dose for adults, from three to six. Or, Take of calomel, aloes, rhubarb and soap, each one drachm; sirup or mucilage of gum arabic, sufficient to form a mass.—Beat them well together and make forty- eight pills.—Dose for adults from four to eight. Or, Take of calomel, jalap, each one drachm; powder- ed ginger and soap, each half a drachm; mucilage or sirup sufficient to form a mass—divide into thirty pills. Dose for adults from four to eight. Aloetic Pills.—Take of Socotorine aloes, in finest powder, one drachm and ahalf;castile soap, one drachm; ginger, half a drachm. Beat them well together, and then add mucilage or sirup sufficient to form a mass— which is to be made into forty-eight pills. Dose for adults, two at bed time, or a sufficient number to keep the bowels in a regular state. Purgative Electuary.—Take of jalap, one drachm; cream of tartar, one ounce; sirup or molasses as much as will give the whole a proper consistence. Dose for adults, from one to two tea-spoonsful in the morning, to keep the bowels in a soluble state. DIAPHORETICS. In the common language of the schools, the term dia- phoretic, is restricted to those articles only which pro- mote the insensible perspiration; and such as occasion sweating, are distinguished by the appellation of sudori- fics. But, as in the medicines arranged under these ti- tles we can discern no difference, except in the degree of Dispensatory. 733 force, or what arises from the manner of administration, we shall comprehend the whole under the head of dia- phoretics. To promote perspiration it is essentially necessary that the patient should be confined to his bed. Let his pulse and the temperature of the body be carefully watched.— It is a principle settled and fully recognised, never to re- sort to diaphoretics in fevers of an inflammatory species, till arterial action and general excitement are considera- bly reduced by previous venesection and evacuations by puking or purging. After this direct depletion, diaphor- etics then come in with great advantage, and will com- monly either mitigate or completely arrest the progress of the disease. In the exhibition of diaphoretics give diluent drinks, unless the stomach is irritable. This remark particular- ly applies to the antimonial preparations, and some of the combinations of ipecacuanha. The temperature of the drinks must be regulated by that of the skin. The lat- ter not being high, they should be warm, or even hot, but if the contrary prevails, they must be given cold. In the low stages of disease, while pursuing the dia- phoretic plan, studiously avoid purging, unless circum- stances imperiously require this remedy. It is very apt, in this state of the system, to check sweating, and to bring on an aggravation of the complaint. It does this by diverting action from the surface to the intestines, and by exposing the patient to cold. Diaphoretic Drops.—Take of sweet spirits ' of nitre, antimonial wine, each one ounce—Mix. Dose for adults, a tea-spoonful every two hours. If the stomach is in an irritable state, add only half the quantity of anti- monial wine. Antimonial Wine.—Dose for adults, twenty drops eve- ry hour or two, till the proper effect be produced. Saline Julep or Mixture.—Take of lemon juice, one ounce; volatile sal ammoniac, one drachm, or salt of tar- tar, four scruples. After the effervescence, add sirup, two tea-spoonsful; simple cinnamon water, or tea, half an 734< Dispensatory. ounce, or spirits of lavender, thirty drops; spring water, six ounces.—Mix. Dose for adults, two table-spoonsful every three hours. Effervescing Draught.—Take fifteen grains of salt of wormwood, or volatile sal ammoniac, dissolved in a table-spoonful of water, in one cup; in another, two large tea-spoonsful of lime juice, or lemon juice, or one table-spoonful of very good vinegar, with one or two ta- ble-spoonsful of water, sweetened; pour one to the other, and let the patient drink them immediately while they effer- vesce. When madewithfreshlimeorlemon juice, this is an elegant, pleasant and useful medicine in all fevers, and peculiarly effectual in removing nausea, and vomiting; it may be repeated every two or three hours. Spirit of Mindererus.—Take of volatile sal ammoniac, two drachms; lemon juice or vinegar, half a pint, or as much as may be sufficient to saturate the volatile alka- li.__Mix. A dose to be taken every two hours. Antimonial Solution.—Dose for adults, a table-spoonful every two hours as a diaphoretic. (See Emetics. J Antimonial Powders.—Take of tartar emetic, three grains; nitre, two drachms.—Mix, and divide into twelve doses.__One dose to be taken every two or three hours by adults. In obstinate cases, the addition often or twelve grains of calomel to the above recipe, will render the medicine more salutary. Febrifuge Powders.—Take of ipecacuanha, two scru- ples; nitre, two drachms—Mix and divide into twelve doses.__One dose to be taken every two or three hours by adults. Febrifuge Mixture.—Take of nitre, two drachms; lemon juice or vinegar, one ounce; water, half a pint; su- gar, a sufficient quantity to sweeten it.—Mix. A wine- glassful to be taken by adults every two hours. It will be rendered more active by the addition of two drachms of antimonial wine. Dispensatory. 735 Dover's Powder.—Ipecacuanha,powdered, opium, each N one drachm; vitriolated tartar in powder, one ounce.— The greatest possible pains should be taken to grind the mass to a completely fine powder. Nitre may be substi- tuted for the vitriolated tartar when that is not at hand. This powder is the most efficacious sudorific we possess. It is an admirable remedy for quieting the bowels, when af- fected by the exhibition of mercury, or any other cause. Dose for adults from ten to twenty grains every three or four hours. Camphorated Powders.—Take of camphor, two scru- ples; nitre powdered, two drachms.—Moisten the cam- phor with spirits, and after reducing it to a fine powder, add the nitre. Divide into twelve doses. One to be ta- ken every two or three hours by adults. Anodyne Sudorific Drops.—Take of laudanum hall1 an ounce; antimonial wine, one ounce.—Mix. Dose for adults, two tea-spoonsful at bed time. Anodyne Sudorific Bolus.—Take of opium, one grain and a half; ipecacuanha, ten grains; sirup or mucilage, sufficient to form a bolus. Or, Take of opium, one grain and a half; tartar emet- ic, one grain; or golden sulphur of antimony, two grains; mucilage sufficient to form a pill. To be taken by adults. at bed time. For children the best means of procuring a perspira- tion is the tepid bath, succeeded by the use of a table- spoonful of saline julep, or the diaphoretic drops, every hour for two or three times. Besides the warm bath the external stimulating dia- phoretics are, friction, rubefacients, and blisters, which excite copious partial perspiration, previous to their vesication. There are many vegetable substances which belong to this class of medicines particularly the Virginia and sene- ka snake roots, sarsaparilla, thoroughwort, &c. [See Materia Medica.] 736 Dispensatory. DEMULCENTS. Demulcent Drinks—Are those which sheath the acri- mony of the humors, and render them mild, such as flax- seed tea, marshmallow tea, mucilage of quince seeds, pith of sassafras, slippery elm, [See Materia Medica'] and gum arabic. A solution of gum arabic is made by boil- ing one ounce of picked gum arabic, in little more than a quart of water, until it be dissolved. All these are use- ful to sheath and defend-very sensible parts from the irritation of acrid humors, as is the case in a tickling cough, and common* lax, or bloody flux, heat of urine, &c. in all wliich, the natural mucus of the parts is defective. ABSORBENTS. Absorbent Medicines—Are such as correct acidity in the stomach. Calcined Magnesia.—One or two tea-spoonsful to be taken occasionally mixed in milk or mucilage of gum arabic, by adults. Prepared Chalk.—A tea-spoonful to be given in the same manner as magnesia. Lime Water.—A. wine-glassful, with an equal quan- tity of new milk, to be taken occasionally by adults. Absorbent Mixture.—Take of chalk prepared, half an ounce; gum arabic powdered, white sugar, each two drachms; water, four ounces. Dose for adults, a table- spoonful every two or three hours. Absorbent and Aperient Mixture—Is made by adding one drachm of rhubarb in powder, or half an ounce of the tincture of rhubarb to the above recipe. Or, Take of prepared chalk, magnesia, each half an ounce; sugar, two drachms; rub them well together, then add mucilage of gum arabic, two ounces, weak cinna- mon tea, four ounces—Mix. Dose for children from one to tvvo tea-spoonsful. Dispensatory. 737 DIURETICS, Are remedies to promote the urinary discharge, which may take place, either by stimulating the kidneys, or by an invigoration ofthe powers of absorption, and es- pecially in rases of dropsical effusion, it hence appears, that diuretics are of two species, though, in whichever mode they operate, it is by an action primarily on the stom- ach, extended to the absorbents or kidneys, accordingto the affinity of the article to the one or other of these parts. Mild Diuretics.—Of this class of medicine, nitre, by reducing the force of circulation, will be found eminently useful in febrile cases. Dose, ten or fifteen grains, for adults, every two or three hours. Conjoined with cam- phor as in the camphorated powders, its diuretic effects, in some cases, is increased. Dulcified Spirits of Nitre.—Dose for adults, half an ounce, every three or four hours. Unless this medicine be given in large doses it will excite perspiration, rather than act as a diuretic. It is chiefly valuable in the cases of children. There is, indeed, scarcely any medicine which, in their com- plaints we can substitute in its place, and it may be given to them, in the same proportion even io the earliest peri- ods of life. Cream of Tartar.—Dose for adults, half an ounce dis- solved in a pint and a half of water, to be taken through- out the course of the day. It must be gradually increas- ed as the stomach becomes accustomed to it. Of all the diuretic medicines, this is perhaps most fitted to those cases of dropsy which are accompanied with in- creased or febrile action ofthe pulse, though it here some- times operates more effectually when combined with jal- ap, as in the form of laxative electuary. [See Cathartics.] Dose for adults, two tea-spoonsful every three or four hours, where we wish to evacuate large accumula- tions of fluid, and here an abstinence from drink must be enjoined. 93 738 Dispensatory. Salt of Tartar—Is considered, by some practitioners, a valuable diuretic, in doses of half a drachm, dissolved in water, three or four times a-day. By combining it with the infusion of columbo, or-some of the bitter tonics, Hs efficacy is very much improved. Thus exhibited, it is said to increase the diuretic effect, while at the same time it invigorates the system generally. Parsley.—The common parsley of our gardens is an- other valuable diuretic. A strong infusion of the roots in doses of a cupful every two or three hours, is well adapted to relieve the ordinary suppression of urine. It is customary to unite with the parsley the seeds of the water-melon* Diuretic Infusion.—Pound a handful of the kernels of pumpkin seeds or melon seeds, with a small quantity of hard white sugar, to a smooth paste; then add a quart of boiling water, and a quarter of an ounce of salt-petre, or half an ounce ot sweet spirits of nitre, and rub them well together. This is a pleasant and mild diuretic, particu- larly useful where the discharge of urine is attended with heat and pain. A tea-cupful may be taken every hour or two, by adults. Diuretic Pills.—Take dried squills in fine powder, cal- omel, each half a drachm; mucilage of gum arabic, suffi- cient to form a mass, and then make twenty pills; two of which to be taken at bed-time. These pills powerfully promote urine, and are very efficacious in carrying off cold, phlegmatic humours, in all dropsical swellings.— When the squill alone is given, it may be taken in doses of two or three grains, three or four times a-day, in the form of pills, by adults. OU of Juniper.—Dose for adults, ten drops in gruel.— [See Materia Medica. See also under this head, wild pars- ley, wild carrot,foxglove, and tobacco.] Stimulating Diuretics.—The Spanish fly promotes, as well as restrains, the urinary discharge. Exhibited in a state of excitement, or at any time, in small doses, it Dispensatory, 739 most commonly occasions strangury. But, taken in a reverse state of the system, or in large doses, it as con- stantly proves diuretic. Thus, in the weaker forms of dropsy, two, three, or four drachms of the tincture, giv- en in divided doses during the twenty-four hours, will produce the most copious evacuations of urine. EXPECTORANTS. Expectdrants have been defined those medicines which facilitate or promote the excretion of mucus or other- fluids, from the pulmonary system. Expectorants are employed when the mucus is too thin and acrid, when too viscid, or when the excretories are not sufficiently irritable to propel their contents. Where the mucus is thin and acrid, inflammation generally ex- ists, and in such cases mucilaginous drinks, as flaxseed tea, mucilage of gum arabic, or slippery elm, iceland moss, or sirup, liquorice, antimonials, and nauseating medicines, are employed. Oils differently prepared, and jellies, are also useful. Independent of inflammation, the mucus is sometimes too thin and acrid, from too great irritability of the vessels of the branchial glands, and we then employ opiates and stimulating medicines, as mus- tard, horse-radish, seneka, squills, garlic, Indian turnip, meadow saffron, and tobacco. [-See Materia Medica.] When the expectoration is too viscid, or the vessels not sufficiently irritable to assist the excretion, expectorants, strictly so called, are useful. These are the more stim- ulating medicines just mentioned; to which may be added all the variety of foetid gums and the turpentines, includ- ing the balsams. Steams of warm water, impregnated with vinegar, aromatic herbs, and sether, are adapted to the same purpose. Nitric Lac Ammoniac.—Pour very gradually two drachms of nitric acid, diluted in eight ounces of water or two drachms of ammoniac, and triturate them in a glass mortar till the gum is dissolved, forming a milky fluid. Of this a table-spoonful may be taken every two or three hours in sweetened water. Laudanum in some rases may be usefully added. 7-tO Dispensatory, Pectoral Mixture.—Gum ammoniac, two drachms; sirup of squills, half an ounce; la idanum, fifty drops; spring water, six ounces. Reduce the gum to pow- der in a marble mortar and gradually add the water, and triturate till the gum is dissolved, then strain from the impurities and add the other articles. Dose, a table- spoonful every two or three hours for adults. Or, Take of sweet oil, one ounce; rain or soft water, half a pint; salt of tartar, five grains; white sugar, half an ounce. Dissolve the salt of tartar and the sugar in the water, and afterwards add the oil, ft hen, by agitat- ing the phial, a mixture will be formed of cream-like appearance. To this add paregoric elixir half an ounce. Dose a table-spoonful every hour or two. Pectoral Emulsion.—Take of oil of almonds, or pure sweet oil, one ounce; barley water, six ounces; best white sugar and gum arabic powdered, of each half an ounce; laudanum, forty drops. Inrorporate the sugar and gum arabic together in a mortar with a small quan- tity of the barley water, then gradually mix the oil and afterwards add by little at a time, the remainder ofthe water with the laudanum. One or two table-spoonsful of this emulsion may be taken frequently. Or, Take of best purified honey, pure sweet oil, of each two ounces; fresh lemon juice, one ounce; sirup and paregoric, each half an ounce. Mix, to form an emulsion. Dose a tea-spoonful whenever the cough is most trouble- some. Cough Mixture.—Take of paregoric elixir, one ounce: powdered gum arabic, one ounce; simple water, two ounces; sweet spirit of nitre, two drachms; antimonial wine, one drachm.—Mix and dissolve. Dose, one table- spoonful to be taken whenever the cough is troublesome. But in the first stage of catarrh, when inflammatory symptoms are present, this and all opiates are impro- per. Or, Take of elixir paregoric, one ounce and a half; intimonial wine, sirup of squills, each one ounce; lac am- moniac, four ounces; sirup bal. tolu, one ounce. Dose, iialf a table-spoonful every two or three hours for adults. Dispensatory. 741 Or, Take of tincture of opium, one drachm; wine of ipecacuanha, half a drachm; oxjmcl of squills, half an ounce.—Mix. Dose, for adults, a tea-spoonful every two hours while the cough is severe. Domestic Remedies for Whooping Cough.—Dissolve thirty grains of salt of tartar in a gill of water, add to it ten grains of cochineal finely powdered, sweeten this with fine sugar, and give an infant a tea-spoonful four times a-day. To a child of two or three years old two tea- spoonsful, from four years and upwards, a table-spoonful or more may be taken. The relief is said to be immedi- ate, and in general within five or six days. Or, Take equal portions of new milk, and the ley strained from hickory ashes, of which one table-spoon- ful may be given every hour through the day to a child of seven or eight years old. This remedy is also strong- ly recommended. Pectoral Lozenges.—Take of purified opium, two scru- ples; tincture of balsam of tolu. two drachms; sirup, com- posed of one part of water, and two parts of white sugar, four ounces; refined Spanish liquorice, previously mois- tened with a little warm water, so as to make it soft; gum aHhic, in fine powder, each two ounces and a half; eme- tic tartar eight grains. Rub the opium and the emetic tartar with the tincture and the sirup until the former is perfectly dissolved, then add the liquorice, softened with warm water, and whilst beating them together, gradual- ly sprinkle in the gum arabic. Divide the mass into lo- zenges or troches, each weighing ten grains, and exsiccate them gradually in the air. One may be put in the mouth and gradually dissolved, every hour or two when the cough is troublesome. Nitrous Lo%enges.—Take of purified nitre, two drachms; refined sugar, reduced to a fine powder, six drachms; pulverised gum tragacanth, three drachms.—Beat these together with a small portion of water, until they are in- tiiriately mixed, and form a coherent mass, which may be divided into moderate sized troches or lozenges, to be dried by means of a gentle heat. In cases of quinsy or 742 Dispensatory. sore throat, one of these lozenges frequently put in the mouth and suffered gradually to dissolve, will be found very beneficial. ANODYNES. Anodynes are medicines which ease pain and procure sleep. Opium.—Of all the articles of the Materia Medica, this is, perhaps, the most extensively useful, there being scarcely one morbid affection, or disordered condition of the system, in which, under certain circumstances, it is not exhibited either alone or in combination. Opium, the product of the poppy, with some persons leaves un- pleasant effects, and with such, the lettuce opium [See Materia Medica] should be employed. Opiate Pills.—Take of pure opium, and powder of cin- namon or ginger, each twelve grains; mucilage or sirup sufficient to make them into twelve pills.—Dose for adults, one or two at bed time. Anodyne Draught.—Take of laudanum, a tea-spotfc- ful; sirup, two tea-spoonsful; cinnamon or herb tga, one ounce.—Mix. This to be taken at bed-time by an adult. When laudanum disagrees in the ordinary quan- tity, it may often be given with much advantage in dos- es of five or six drops every hour till the proper effect be produced; or it may be given in vinegar whey or con- joined with the antimonial wine, as in the form ofthe ano- dyne sudorific draught. [See Diaphoretics.] As laudanum is extremely prejudicial to children, it ought not to be administered to them except under pecu- liar circumstances. Instead of its internal use, a little of it should be rubbed on the back-bone; or the same ef- fects may be produced by rubbing on that part a tea- spoonful of anodyne balsam. When laudanum is prescribed by way of injection, the proportion must be more than double what can be given by the mouth. Dispensatory. 743 Paregoric.—Dose for adults, one or two tea-spoonsful in a cup of tea or gruel. ANTISPASMODICS. As the causes of spasms differ essentially, the remedies must equally differ. Bleeding, mercury, warm bathing, blister, opiates, camphor, volatile alkali, musk, castor, asafoetida, garlic, sether, wine and spirits, bark, steel, and other tonics, are the remedies usually resorted to. In the choice ot these we employ the sedatives and foe.tids to shorten the fit; and the stimulants and tonics to prevent returns. Gum Pills.—Take asafoetida, three parts; gum amo- niac, two parts; camphor, one part; beat them very well together, and with as much sirup as is necessary, make into pills of the size of a common pea, from three to five may be taken at a dose, and repeated as often as shall be found necessary; not, however, exceeding three or four doses in a day. This is a powerful anti-spasmodic, and very useful in all nervous and hysterical complaints.— When it is wished to render the mass purgative, which is generally proper, add as much socotrine aloes as of camphor. CORDIALS. Glass.of wine, or a little brandy toddy. Compound Spirits of Lavender.—Dose for adults, a tea- spoonful on a lump of sugar to be dissolved in the mouth, and gradually swallowed. Cordial Mixture.—Take of aromatic spirit of harts- horn, two drachms; compound spirit of lavender, three drachms; cinnamon water, two ounces; spring water, three ounces.—Mix. The dose for adults, a table-spoon- ful now and then. Cordial Draught.—Take of volatile tincture of valeri- an, one drachm; simple sirup, water, of each four tea- 744 Dispensatory. spoonsful.—Mix them together. To be taken at once by adults. Cordial Drops.—Take of paregoric elixir, volatile tincture of valerian, of each equal parts.—Mix them to- gether. Dose one tea-spoonful in a glass of water for adults. For children the best cordial is white wine whey. STIMULANTS. In relation to general stimulants, there is a distinction too important to be overlooked. We have a set distin- guished by great diffusibility, and which, nearly as soon as exhibited, occasion universal excitement over the body; and there is a second section, by which tone is im- parted, though very slowly, and by a long administra- tion. The diffusible are very transient in their effects, while such as are more gradual in their operation, pro- duce permanent, or enduring impressions, and are called tonics. As in the administration of stimulants, we hope to overcome an existing action by exciting a new and stronger one, it is obvious that they can only be resort- ed to with any hope of advantage, in the feeble shapes of disease, or in more violent forms, reduced by previous evacuations. But, in determining the exact point at which to commence the use of stimulants, we may also be aid- ed by watching their operation. Being ill-timed, they commonly produce pain in the head, or delirious wan- derings, or morbid vigilance, or stricture of the breast, restlessness and anxiety, with a hot dry skin, parched tongue, and a quick, small, and corded pulse. In the administration of stimuli, we should endeavor to graduate the article to the state of excitability. This is a point of infinitely greater importance than is commonly imagined. It is not always the most active article produces the greatest effects. In the low states of disease, we have witnessed, in some instances, more effects from wine whey, than strong toddy. This pro- ceeds from the article being in unison with the condition ofthe system. Dispensatory. 745 Narcotics.—That the purer narcotics are endowed with a stimulant power, is very satisfactorily proved, by the operation of opium. Exhibited in a moderate dose, the purer narcotics ex- cite activity both of body and of mind. But to com- mand their stimulant power, they ought to he given in small doses, frequently repeated, and gradually in- creased, and the excitement which they enkindle is thus sustained. But when the design is to mitigate pain, or to procure sleep, or to relieve irritation, or deaden sen- sibility, they should be exhibited in a full dose, and at more distant intervals. It should be remembered that the indications chiefly, which narcotics are capable of fulfilling, are to excite and support the actions of the system, to assuage pain, and allay irritation, to relieve spasmodic affections and to induce sleep, and to check the morbidly increased secretions and excretions. Volatile Sal Ammoniac.—In a great variety of febrile affections this medicine has been prescribed, though it is in the low, or typhus fevers, that it is chiefly em- ployed. In one respect the volatile alkali differs from every article of the class to which it is attached, and it would seem from all other medicines. The peculiarity to which we allude is this, that the excitement it raises approach- es more nearly to that of healthy action, and hence it may be recurred to earlier than stimulants generally, in the inflammatory affections, and with greater safety in mixed cases so equivocal or obscure, as to render uncer- tain the propriety of stimulation. It may be given in the shape of a pill or julep, in the dose of five or ten grains, every hour or two, according to circumstances. The best form however is the latter, which may be made agreeably to the annexed prescription. Take of volatile sal ammoniac, two scruples; gum ara- bic, white sugar, each one drachm; oil of cinnamon, five drops; spring water, five ounces.—Mix. Dose for adults, a table-spoonful every two hours. Camphor.—No medicine, perhaps, has been prescribed for a greater variety of purposes than camphor. In ev- 94 746 Dispensatory. cry modification of febrile action, when approaching to the typhoid state, camphor has been resorted to, and not without success. It excites perspiration, quiets ner- vous irritation, removes delirium, and abates the force of the disease. Camphor is best exhibited in the form of julep or mixture. Camphorated Julep or Mixture.—Take of camphor, one drachm; gum arabic, two drachms; white sugar, half an ounce; water, half a pint. Moisten the camphor with spirits, and after reducing it to a powder, add the gum arabic and sugar, and then by degrees pour on the wa- ter, while triturating them together in a mortar. Dose for adults, a table-spoonful every two or three hours. Or, Take camphor, one drachm; myrrh, half a drachm; white sugar, two drachms; spring water, six ounces.— Dose for adults, a table-spoonful. The mixture thus made, is perfectly transparent and very palatable. Of late, however, the solution, or rather suspension of cam- phor in milk, has nearly superseded all other preparations ofthe medicine in practice. It is made by simple tritu- ration. The dose of Camphor is from five to ten grains, to be repeated once in tvvo or four hours, according to circumstances. Pills of Camphor and Asqfoztida.—Take of camphor, asafoetida, each one drachm; moisten the camphor with a few drops of alcohol, unite them together, and make thirty-six pills. It is sometimes advisable to add half a drachm of calomel to the above. This is an admirable combination as well as camphor united with opium, for that species of mania, excited by frequent intoxication. Dose for adults, two pills every three or four hours. Spirit of Turpentine.—This is one of the most active and diffusible of stimulants. In the typhus or low fe- vers, when other diffusible stimuli are given, much may be expected from turpentine. It promptly relieves gout in the stomach, and is particularly suited to periodical colics, arising from flatulence. The dose of the spirit Dispensatory. 747 of turpentine, in those cases, is about a drachm, to be re- peated, more or less frequently, according to the nature ofthe disease, and the best mode of giving it is alone, or with a small portion of water. By attempting to blend it with mucilage or any such vehicle, it seems in some degree to be volatilized, and is thereby rendered more pungent to the fauces, and difficult to swallow. Aromatics.—Ginger, cinnamon, cloves, nutmeg, all- spice, and all the aromatics are more or less stimulant. Wine.—As a cordial and tonic, wine is often directed in various chronic cases, attended with debility, and al- so in the convalescence from acute diseases. Compared with ardent spirits, the action of wine is infinitely less injurious in a state of health, and as a remedy in dis- ease, it evinces the same superiority. The effect it pro- duces is slower, and more permanent, combining also qualities, which while they blunt the ardency of the stim- ulus, afford no inconsiderable portion of nutriment, by which the system is sustained and invigorated. In ex- hibiting wine we are cautiously to regulate its adminis- tration by the effects it manifests, since, urged too far, it might induce indirect debility, and thus cause irreparable mischief. Wine may always be considered as doing good, when it renders the pulse fuller, slower, and stronger, when it removes or lessens delirium, calms irritation, and composes to sleep. But if, on the contra- ry, it accelerates the pulse, flushes the countenance, in- creases the temperature of the skin, excites thirst, aggra- vates delirium, or restlessness, and thus occasions an exarerbation of the disease, the evidence of its injurious tendency is no less decisive, and we should at once with- draw it altogether, or reduce the quantity. ASTRINGENTS. Astringent Medicines are employed for checking hemor- rhages, and immoderate evacuations of every kind. Infusion of Roses.—Upon a large handful of dried red rose-leaves, pour a pint of boiling water; let them infuse half an hour. 748 Dispensatory. Infusion of Oak Bark.— Upon a handful of white oak bark, shred fine, pour a quart of boiling water; let it stand one hour, then boil a few minutes. Infusion of Galls.—Upon a quarter of an ounce of galls, pour a quart of boiling water; let them infuse one hour, then boil for a few minutes. A small quantity of cinna- mon adds greatly to the flavour of this and the oak bark; and acidulating any of them with the acid of vitriol, ren- ders it more efficacious; they should be taken cold, to the quantity of half a gill, or a wine-glassful, every hour or two. Astringent Decoction.—Take of cinnamon three drachms; Peruvian bark, one ounce; spring water, three pints.— B >il these together till only one half remains; then strain off the liquor after it has cooled, and add elixir vitriol ol, one drachm. Dose for adults, two ounces thrice a-day. Astringent Mixture.—Take of the infusion of gall, four ounces; prepared chalk, tvvo drachms; laudanum, forty drops.—Mix. Dose for adults, a table-spoonful every three or four hours. Or, Take of tincture of kino, prepared chalk, each half an ounce; laudanum, forty drops; boiling water, four ounces.—Mix. Dose for adults, a table-spoonful every two or three hours. Vitriolic Solution.—Take of white vitriol, three drachms; alum, two drachms; spirit of lavender, half an ounce; boiling water, one pint.—Mix. Dose for adults, a large table-spoonful every morning on an empty stomach, with- out diluting it, and in some cases to be repeated every six hours. When evacuations are required, the quantity of alum may be diminished, or even entirely omitted; and when great astringency is required, the quantity of alum is to be increased, and the vitriol to be diminished. Pills of Sugar of Lead, Src.—Take of sugar of lead and ipecacuanha, each six grains; opium, one grain; sirup, sufficient to form a mass. Divide in four parts; one pill to be taken every three hours, until the hemorrhage ceases. Dispensatory. 749 Anti-Dysenteric Mixture.—Take of lemon juice or best vinegar, two ounces; common salt, as much as the acid will dissolve; strong mint tea, half a pint; white sugar, sufficient to sweeten it.—Mix. Dose for adults, a wine- - glassful every two or four hours. TONICS. Tonic Medicines are those which increase the tone or strength of the body. In the widest acceptation of the term, this class of remedies are extremely extensive, since it includes every means which invigorates the pow- ers of life. Among the means to overcome debility, or to invigorate the system, is a properly regulated diet. The diet should always be accommodated to the state of the system; and whatever may be the nature of the case, the patient should eat much more frequently than the common meals. The stomach has been pronounced, by a very sagacious observer, to be in one respect like a school boy, who is always doing mischief when not emplojed. After recovery from acute diseases, it should at first consist of the lightest vegetable matter, and especially the farinacious articles, such as rice, tapioca, arrow root, and sago. To these may succeed eggs, oysters, game, and the white poultry, and finally, ham, beef, and mut- ton. As a general rule, solid food is preferable to fluids. It is usually more comfortable to the stomach, and re- stores strength with greater rapidity. In selecting the articles of diet, the palate of the person himself should be consulted, since the pleasure which is received in eat- ing, is of itself no ordinary stimulus, and particularly to a very debilitated system. Next to diet, in point of efficacy as a tonic, are the warm and cold baths. Though different in temperature, they produce effects not very dissimilar. Each when ju- diciously managed, will very rapidly, in many instances, invigorate the body. [See pages 23 and 24.] As a tonic, exercise is undoubtedly among the most decisively useful, and has been divided into two parts, active and passive. It is proper in extreme debility, or in the first stage of convalescence from an acute disease, 750 Dispensatory. to begin with the second species. This consists chiefly of frictions, which may be made with a naked hand, or with a brush, either alone, or with the addition of sojne stimulating matter. To rub at least once a-day for half an hour or more, the whole body with fine dry salt, cre- ates a universal glow, renders the skin smooth and florid, imparts vigor to the muscles, improves appetite and the powers of digestion, and in all its tendencies is highly salutary. When the patient is able to take exercise, let the mode be adapted as much as possible to tbe seats of debility or disease; but be careful of fatigue. Medicinal Tonics.—Of this class, nature has been lavish in her supplies. Two of her kingdoms at least, are ex- uberant in articles, possessed of such powers, viz. the vegetable and mineral. Peruvian Bark—Is one of the best strengthening re- medies: it may be taken in powder alone, or conjoined with one fourth of the Virginia snake-root, in doses of a tea-spoonful five or six times a-day. When the doses are to be frequently repeated, as soon as one is taken, put another, with a small quantity of wine or water, in- to a glass, by which means it will become equally and universally moist, and may be mixed more easily and more smoothly. As many persons cannot take the bark in substance, it should be exhibited in infusion, or decoc- tion. Cold Infusion of Bark.—Mix one ounce and a half of bark in powder, in a quart of water; let it stand twenty- four hours, occasionally shaking the bottle, and then strain off the liquor. Dose for adults, a wine-glassful every two hours. Decoction of Bark.—Put two ounces of coarsely pow- dered bark into a quart bottle of water, which, after be- ing corked, is to be placed in a pot of water, and boiled for two or more hours. This is a very elegant prepara- tion, and one of considerable efficacy. The dose of the decoction for adults, is a wine-glassful every two or three hours. Dispensatory. 751 To correct some inconveniences occasionally produc- ed by the bark, it is frequently combined witli other re- medics. When it excites vomiting, or oppresses the sto- mach, cinnamon, or some aromatic, must, be added: when it purges, opium: when it induces constipation, rhubarb; and where there is much acidity ofthe stomach, magne- sia, or small portions of the mineral or vegetable alkali. As children cannot be indnced to take the bark in suffi- cient quantities it should be administered in the form of glysters united with a little milk or flaxseed tea, to which may be added a little laudanum. Applied externally by means of a bark jacket, [See page 200] it will be found to have as salutary an effect as when exhibited internally. Columbo.—Dose for adults, in powder, a tea-spoonful to be given in mint tea or water. Infusion of Columbo.-—Take of columbo bruised, one ounce; boiling water, one pint. Dose for adults, a large wine-glassful every two hours. This bitter is peculiarly serviceable in cases of weak stomachs and bowels, at- tended with lax, and abounding in bilious crudities. Infusion of Gentian.—Put half an ounce of gentian bruised, and two drachms of orange peel, in a pint of cold water for twelve hours, then strain; when used in hot weather, add half a gill of brandy. Dose for adults, a wine-glassful three times a-day Bitters are properly considered strengthening remedies, when not continued too long; they improve the appetite and strengthen the stomach and bowels, but a constant and long continued use of them, or any one tonic, is generally prejudicial. The black oak bark, the dog wood bark, the wild cher- rv tree, the thoroughwort, [See Materia Medica] claim our attention as tonics. Mineral Tonics.—Iron on its operation on the system evinces all the effects of a powerful and permanent tonic, no medicine perhaps leaving behind it such lasting im- pressions. The indications, therefore, that it is calcu- lated to fulfil, ate numerous and important, most of which, however, are embraced within the sphere of chro- nic debility. 753 Dispensatory. Iron Filings—If made with a fine file, will require no other preparations; the dose for adults, is six or eight grains, or about as much as a common pinch of snuff, with an equal quantity of powdered ginger, to be mixed in sirup or molasses, and taken two or three times in a day. In this simple form, iron acts as well as in any more laborious preparation. It is a most useful tonic in all pale and relaxed habits, subject to watery swellings; pa>«it ularly for children of this description, with pale fa=es and distended bellies, whose complaints are fre- quently accompanied by worms. The doses for young and old, provided the filings are made with a fine file, may be much the same, as no more acts than what is dissolved. The rust and tincture of steel are employ- ed with the same view. Tonic Powders.—Take of columbo in powder and rust of steel, each one ounce; unite them well together in a mortar, and then divide into forty-eight doses—One to be taken by adults, thrice a day. Tonic Pills.—Add to half an ounce of the tonic pow- der, a sufficient quantity of mucilage, to form a mass, and make pills of an ordinary size. Three or four of them or the number constituting a dose, to be taken thrice a-day. In cases of debilitated stomach an equal quantity of powdered ginger may be added to the above. Chalybeate Wine.—Put rust of steel, one ounce and an half; orange peel and gentian root, each hall an ounce, into a bottle of wine. The vessel containing these in- gredients is to be exposed to the sun, or near the fire, for three days, and to be repeatedly shaken during this time. This preparation is an excellent stomachic and agreeable tonic. Dose for adults, two or three tea- spoonsful thrice a-day. Blue Vitriol, or Sulphate of Copper.—The fourth of a grain, united to a small portion of opium, given three or four times a-day, gradually increasing the dose, is cele- brated as a valuable remedy for obstinate intermittents. White vitriol in doses from three to five grains for Dispensatory. 753 adults, in the form of pills, is also considered highly use- ful as a tonic. Solution of Arsenic—This is a valuable tonic, and may be given with perfect safety cautiously administered to every age. Nitric Acid, as well as Elixir Vitriol, given in doses from ten to twenty drops in a glass of sweetened water thrice a-day, will be found very pleasant and useful ton- ics. They speedily quicken the appetite, and restore tone to the digestive organs. ALTERATIVES. Alteratives—Are those medicines supposed to correct the acrimony which appears on eruptions of the skin and in removing venereal complaints. These are almost ex- clusively mercurials, assisted by the warm bath, sarsa- parilla, mezereon, slippery elm, lobelia, [See Materia Medica] nitric acid, tar water, &c. Mercuriul Pills.—Take of calomel, one drachm; opium and tartar emetic, each ten grains; crumb of bread, a small quantity; sirup, or mucilage of gum arabic, sufficient to form a mass. Divide into forty parts—One pill to be taken night and morning by adults. Mercurial Solution.—Take of corrosive sublimate, twenty-four grains; laudanum, half an ounce; spirits one pint and an'half.—Mix. Dose for adults, one table- spoonful morning and night. Calomel—In doses of one or two grains, given every nieht or every other night, drinking with it the following diet drink. These together, make a powerful alterative for blotches on the skin, foul eruptions, and all other cases, in which the object is to remove obstructions, and sweeten the humours. An occasional warm bath greatly promotes their good effects, whilst at the same time it contributes to prevent the mercury attacking the mouth and bringing on salivation, which, during the use of mer- 95 751 Dispensatory. cury, must be carefully watched and guarded against, by avoiding cold, and suspending the medicine, from time to time, for a few days. Alterative Diet Drink.—Boil one ounce of the borings of lignumvitse, and two ounces of split sarsaparilla in three pints of water, until it comes to a quart, then strain it through linen, to be drank in one or two days, by di- vided doses. The sarsaparilla, wliich is the least effica- cious, is by far the most expensive article in this diet drink, it may, therefore, be omitted, adding in its place half an ounce more of lignumvita?, or two ounces of pars- ley roots. In either case, a small handful of stoned rai- sins, or two or three sliced figs, or half an ounce of li- quorice root, will render it more agreeable. Nitric Acid diluted.—Take of nitric acid, two drachms; water, one quart.—Mix. As this acid is not always to be got of equal strength, it would be best to make a quart of water as sour with it as can be drank, which quantity sweetened, may be taken daily by adults, in doses of a wine-glassful every hour or two. To prevent its injuring the teetii it should be sucked through a quill, or its sharpness may be obtunded by washing the mouth with milk, or mucilage of gum arabic. Nitric acid is diffusible in its operations, pervading every part of the system, and imparting more or less vigor to all the functions. It is, hence, an exceedingly useful remedy in a great variety of affections. Of these, perhaps, the most striking are certain forms of inflam- mation ofthe liver; to most glandular diseases, it is in- deed well adapted. Where there is too mucii debility to justify the use of mercury, or when it has already been used ineffectually, it is unquestionably the best medicine that can be administered, and therefore should be uni- formly employed in such cases. TINCTURES, ELIXIRS, ETC. Laudanum—Take of purified opium, two ounces; brandy, two pints. Digest for eight or ten days, fre- quently shaking the bottle, then strain off the tincture. Dispensatory. 755 Tincture of Rhubarb.—Take of rhubarb, three ounces; lesser cardamom seeds, or ginger bruised, half an ounce; brandy or rum, tvvo pints. Digest for eight or ten days, and then strain. Tincture of Bark.—Take of Peruvian bark, powdered, two ounces; orange peel, and Virginia snake root, each half an ounce; brandy, or rum, two pints. Digest for eight or ten days, and strain. Tincture of Columbo.—Take of columbo root, bruised, three ounces, brandy, two pints. Digest for several days, and strain. Tincture of Foxglove.—Take of dried leaves of fox- glove, one ounce; brandy, half a pint. Digest for a week, and filter through paper. Tincture of Cantharides.—Take of cantharides, bruis- ed, two drachms; brandy, one pint. Digest for seven or eight days, and then strain. Tincture of Myrrh.—Take of myrrh in powTder, one ounce and a half; spirits, one pint. Digest for seven days, and strain. Paregoric Elixir.—Take of purified opium, flowers of Benzoin, camphor, and essential oil of aniseed, each two drachms; brandy, two pints. Digest for eight or ten days, frequently shaking the bottle, and then strain the elixir. Turlington's Balsam.—Take of Benzoin, three ounces; balsam of tolu, one ounce; aloes, half an ounce; brandy, two pints. Digest for seven dajs, and strain. Rheumatic Tincture.—Take of gum guaiac, vitriolated tartar in powder, each three ounces; spirits, two pints. Digest for eight or ten days, and strain. A dose to be taken twice or thrice a-day. Bitters.—Take of gentian root, two ounces; orange peel, 758 Dispensatory. and coriander seeds, each one ounce; brandy, two pints; Digest for several days, and then strain. Camphorated Spirits.—Take of camphor, two ounces; brandy, one pint. Mix them together that the camphor may be dissolved. Antimonial Wine.—Take of tartar emetic, one drachm; boiling water, two ounces; wine one pint. Dissolve the •tartar emetic in the water, and when cold add the wine. Dose for adults, two tea-spoonsful every fifteen minutes, until it excites vomiting. To hasten its operation the pa- tient should drink freely of warm water. As a diaphore- tic it may be given in doses from twenty to thirty dropsy every two or three hours. • Domestic Remedies for Rheumatism.—Take of sarsapa- rilla, walnut shells, each half a pound; antimony, half an ounce suspended in a bag; water, three quarts. Simmer slowly by the fire down to two quarts. Strain and use a pint in broken doses daily. Or, Take a large handful of rattle-snake root, bruised; spirit, one quart: let it steep by the fire for several days, frequently shaking the bottle. Of this a wine-glassful is to be taken night and morning. Saturated Solution of Arsenic.—Take of arsenic in pow- der, about one drachm; water, half a pint. Boil it for half an hour in a Florence flask, or in a tin sauce-pan, let it stand to subside, and when cold, filter it through paper. To two ounces of this solution, add half an ounce of spirit of lavender. A dose to be taken twice or thrice a-day. Lime Water.—Pour two gallons of water gradually upon a pound of fresh burnt quick-lime, and when the ebullition ceases, stir them well together; then suffer the whole to stand at rest til) the lime has settled; after which strain off the clear liquor, and keep it in vessels closely stopt. Calcined oyster-shells may be used instead of quick-lime. Dispensatory. 757 Tar Water.—Pour a gallon of water on two pounds of tar, and stir them strongly together with a wooden rod. When they have stood to settle two days, pour off the water for use. Caustic Alkali, or Soap Lees.—Mix two parts of quick- lime, with one of pot-ashes; and suffer them to stand till the lixivium be formed, which must be carefully filtrated through paper, before it be used. If the solution does not- happen readily, a small quantity of water may be addedJ to the mixture. PR Itch Lotion.—Take of corrosive sublimate, one drachm; crude sal ammoniac, two drachms; water, one pint and a half.—Mix. Solution ofCrudesal Ammoniac—Dissolve half an ounce of crude sal ammoniac in one pint and a half of cold wa- ter, and then add half a pint of vinegar. Saturnine, or Lead Water.— Take of sugar of lead, two drachms; vinegar, one ounce; water, one pint and a half. Mix. WARM AND DISCUTIENT LINIMENTS. Opodeldoc—Take of castile soap, powdered, three ounces; camphor, one ounce; brandy, one pint. Digest the soap in the spirit by the fire until it is dissolved, and then add the camphor. Volatile Liniment—Is made by mixing one part of spi- rit of hartshorn with two of sweet oil, good hog's lard, or fresh butter from the churn; they should unite into a uni- form, white, soapy mixture; and if they do not it is owing to thelspirit of hartshorn not being sufficiently caustic.— When lard or butter are made use of, they should be first melted; they may then, like the oil, be mixed with the spi- rit of hartshorn, by shaking them together in a phial. Camphorated Oil.—Take of camphor, half an ounce; olive oil, two ounces. Moisten the camphor with a lit- 758 Dispensatory. tie spirit, and then rub it in a mortar with the oil until dissolved. Anodyne Liniment—Is prepared by adding half an ounce of laudanum to two ounces of either of the above liniments. Mindeterus's Spirit—Applied warm by means of a soft iflannel, very powerfully tends to discuss an incipient tu- mour or other inflammatory swellings. Ether.—Pour about a tea-spoonful into the hollow of the hand, and immediately apply it over the part affect- ed, keeping the hand on the part until the ether be eva- porated, or as long as the patient can bear tbe heat it ex- cites. No remedy so suddenly and effectually removes cramps and all spasmodic pains. Warm Plaster.—Take ofthe gum plaster and Burgundy pitch, each one ounce; of blistering plaster, one ijuarter of an ounce; melt and mix them together. This is a most useful application whenever it is required to keep up a constant perspiration, and gentle irritation ofthe skin, over any particular part affected with rheumatism or any internal pain, unattended with external inflammation. Charcoal Powder.—Put lumps of charcoal a second time into the fire until they are red hot; then take them out, and as soon as they become cool, blow off the exter- nal ashes, and immediately reduce them to a fine powder, which must be kept in a corked bottle. This powder is admirable for correcting bad breath, as well as arresting the progress of mortification. EYE WATER. Take of vinegar, one ounce: spirits or brandy, half an ounce; rosi' or spring water, half a pint. The strength may be diminished or increased, according to circum- stances. This is a useful application to weak watery eyes, or to remove the pain and sense of pricking, expe- rienced in the globes of the eyes, after they have been fatigued by close attention to some one object. Dispensatory. 759 Another.—Take of sugar of lead and white vitriol, each twenty grains; spring water, half a pint.—Mix. After the sediment is formed pour off the clear liquor, with which wash the eyes repeatedly during the day, and at bed-time apply a thick fold of linen or cotton rag moistened with it over the eyes. Another.— Take of corrose of sublimate from two to four grains; water, half a pint.—Mix. This solution may be used in general with great advantage in syphy- litic or scrophulous cases, where the eyelids have been long affected with chronic inflammation. ASTRINGENT WASHES. Take of lime water, half a pint; brandy, four ounces. Mix. Or, Lime water, half a pint; corrosive sublimate, fif- teen grains.—Mix. Or, Lime water, half a pint; tincture of myrrh, one ounce.—Mix. Or, Make a solution, either of lunar caustic, or blue vitriol in water, of sufficient strength to produce a little smarting. To be applied on lint to the sore. Solution of Kali.—Dissolve from one to two drachms of salt of tartar in half a pint of water. To be applied as above. GARGLES. Common Gargle.—Take of barley water, or flaxseed tea, half a pint; crude sal ammoniac, one drachm.— Mix. Or, Sage tea half a pint; vinegar, half an ounce; nitre, one drachm; honey, one ounce.—Mix. Or, Take of decoction of barley, one pint; nitre, six drachms; honey, three ounces.—Mix. These are mild, cooling applications, and very serviceable at the com- mencement of inflammatory affections of the tonsils and fauces. Gargle of Borax.—Take of borax, two drachms; flax- seed tea, or mucilage of quince seed, six ounces; honey, 760 Dispensatory. one ounce. The borax gargle is very much in ase as a mild detergent in apthous affections in children, and for removing superficial inflammatory ulcerations of the gums; especially if attended with a copious secretion of saliva. Linseed Gargle.—Take of flaxseed tea, twelve ounces; honey, two ounces; elixir of vitriol, half a drachm — W here mild astringents are indicated, this gargle will be found to answer very well. Astringent Gargle.—Take of sage tea, or infusion of roses, half a pint; vinegar and honey, each two ounces; alum, half a drachm.—Mix. Or, Infusion of oak bark, half a pint; honey, one ounce; alum, half a drachm.—Mix. Detergent Gargle.—Take of astringent gargle, half a pint; tincture of myrrh, from half an ounce to an ounce. Mix. Or, Take of corrosive sublimate, three grains: dissolv- ed in spirit of wine, half an ounce; and then add decoc- tion of bark, six ounces; tincture of myrrh, half an ounce; honey, one ounce.—Mix. In venereal cases of long stand- ing the tonsils and uvula, or part of the fauces, are found in a state of ulceration; in which case, besides the internal administration of mercury, the parts should be frequently washed with the above gargle. INJECTIONS FOR GONORRHOEA. Take of white vitriol and sugar of lead, each one scru- ple; mucilage of gum arabic, or common water, half a pint.—Mix. And after standing ten or fifteen minutes, strain off the clear liquor. An ordinary syringe full, to be thrown up the urethra six or eight times a-day after making water. Or, Dissolve fifteen or twenty grains of white vitriol, in half a pint of mucilage of gum arabic or water. To be used as the above. Or, Dissolve one grain and a half of corrosive subli- mate in half a pint of water. To be used as above. D 'spensatory. 761 Or, Take of mercurial ointment, one drachm; sweet oil, one ounce.—Mix. This injection should be warm- ed previously to using. These injections may be made weaker or stronger, ac- cording to circumstances. The first and second injection are decidely the best in recent cases. When the sodding of urine is troublesome, four drops of muriatic acid to two ounces of water, or one part of acetated ammonia to eight or ten of water, are often useful as injections. In obstinate cases of gonorrhoea the mercurial injec- tions as above will lie found most beneficial: and in ob- stinate gleets, the following have, been emplojed with very happy effects. Injectio'' of Tea.—Take of green tea, one drachm; boiling water, six ounces; macerate in a close vessel till cold, and strain. Or. Take of kino in powder, two drachms; alum, one drachm; mucilage of gum arabic, one ounce; spring wa- ter, one pound.—Mix and strain. Injection of Capivi.—Take of balsam of capivi, one drachm; mucilage of gum arabic, half an ounce; rose or spring water, six ounces. Rub the capivi and mucil- age well together, and add the water. This, as well as the preceding injection, is perhaps better fitted for fe- males, when a discharge is kept up from a relaxed state ofthe folds ofthe vagina, whether arising from gonor- rhoea, from too frequent coition, or from the fluor albus or whites. At the commencement of gonorrhoea, the irritation is of- ten so great as to occasion the greatest possible distress; the urethra then being so exquisitely sensible that the slightest distension of its orifice or canal, e\ en by fluids of the blandest nature, gives the most exquisite pain. The urine in such cases is scanty and high coloured, and whenever it is passed aggravates all the symptoms, leav- ing an increased desire to pass more urine, attended with a burning smarting pain. The intention of cure, then, would be to lessen the inflammation of the parts by re- moving the distension, and of diminishing the stiniu- 96 762 Dispensatory. Iating Properties of the urine. With this view, besides evacur.tjng medicines and diaphoretics particularly the camphorated powders, leeches should be applied to the under part of the urethra along its whole course, and cold saturnine, applications to the penis. GLYSTERS. Simple and Emollient Glyster.—Milk and water in equal part-*. Flaxseed tea. Mallow tea. Infusion of quince seed. Barley water. Mucilage of gum arabic, or slippery elm. Thin starch. From half a pint to a pint of either of these should be administered a little more than milk warm.— Tney are useful and efficacious where mere relaxing and emollient effects are required; the addition of the mucil- aginous substa1 c~vous, irritable. Nostrum, a patent or other medicine, the composition of which is kept se- cret by the proprietor. ORLO \"G, considerable longer than broad, and narrowed though rounded at the ends; as the leaves ofthe daisy. Obund, to blunt. Edematous, swelled, as in a dropsical state of skin. Opiates, medicines wliich promote sleep, as opium. Ophthalmia, a disease of the eyes. Ovate, or oval, egg-shaped. PINCRE4S, the sweet bread. Paralytic, relating to palsy. Paroxysms, a periodical fit or attack. Pectoral, medicines adapted to cure diseases of the breast. Pedicle, a short foot- stalk, or partial fruit-stalk, being that part of a com- pound or branched fruit-stalk, which is the immediate support of a single flower, or floret. Pelvis, the bones at the lower part of the trunk ofthe body. Perennial, continuing for several years; at least more than two, and regermi- nating several years succesively. Pestilential, infectious. Petals, the leaves which constitute the blossoms or flowers are so called to distinguish them from the other leaves of the plant. Phlegmatic, relaxed and abounding with phlegm. Phlogistic, inflammatory, Phthisical, consumptive. I'i'ch, napkin, clout. Placenta-cake, see after-birth. Plethoric, of a full habit. P'rui'tidf, fulne>s of blood. Precarious, doubtful, uncertain. Predisposition, susceptibility of disease. Premature, too hasty, too early. Preternatural, unusual, not natural. Primary, original Prolapsus, the falling down or out. Proximate cause, the immediate cause of disease. Ftyatism, a copious flow of spittle. Puerperal, of, or belonging to child-bed. Pulmonary, belonging to the lungs. Purulent, matter of good quali.y. Pus, matter. Pustule, a purple or small swelling. Putrescence, rottenness. QUARTAN, returning every fourth day. Q.a'ckening, the motion of the child felt by the mother in the womb. RECTUM, the straight gut in which the faeces are contained. Red gum, an eruption so called. Refrigeration, a chill, coldness. Regimen, regulation of food, air, exer- cise, &c. Remote cause, the inducing cause of dis- ease. Repletion, the act of filling the body with food. Resolution, a termination without sup- puration. Resolvtnts, dissolving medicines. Respiration, the act of breathing. Resuscitation, reviving, bringing to life. Retention, the retaining some natural discharge. Rheumy, an acrid discharge. SALINE, consisting of salt. Salint, spittle. Sanatitie healing. Sanguiferous, carrying blood. Saponaceous, soapy. Saturnine lotion, lead water. Scorbutic, of, or belonging to scurvy. Scrofulous, of, or belonging to the king's- evil. Secondary, not primary; a secondary fe- ver is th t which occurs after a crisis. Glossary. 771 Secretion, the separation of fluids from the body. Secundines, the placenta, and mem- branes. Sedatives, composing medicines. Segments, the small part of a leaf cup or petal, included between the inci- sion. Semen, the seed. Serous, thin, watery. Serrated, notched like a saw. Sinapism, a poultice made of flour, mus- tard and vinegar. Slough, the parts that separate from a sore. Solitary, only one in a place; as, but one flower on a fruit stalk, or only one fruit-stalk proceeding from the same part of a plant. Solube, loose, laxative. Spasm, cramp, convulsion. Specific, an infallible remedy. Spear.shaped, applied to a leaf, signifies that it is shaped like a spear or lance. Spherical, globular. Spike, a head or ear, as in rye, barley, wheat, &c. Spine, the back bone. Stamina, the constitution or habit ot body. Stimulant, irritative medicines. Stomachics, medicines for the stomach. Strangury, a difficult)' of making water. Striated, channelled, furrowed. Stupor, a suspension of sensibility. Styptic, a medicine stopping the dis- charge of blood. Sudorifics, medicines to promote sweat- ing. , Suppository, a candle, or any other sub- stance or composition, introduced in- to the rectum to procure stool. Swooning, fainting. _ Symptomatic, a disease not primary, but arising from another in contradistinc- tion to idiophatic. Syncope, a fainting or swooning. TECHNICAL, belonging to arts. Temperament, a peculiar habit of body. Temperature, state of the air. Tertian, returning every third day. Tetany, the lock-jaw. Tonic", bracing, strengthening. Topical, local, confined to the diseased part. Tumour, a swelling. Tv.rgescence, an over fulness. Type, a mark. Typhus, a genus of fever comprehend- ing those called nervous, yellow and putrid. UL CER, a sore, generally ill-condition- ed. Umbel, a composition of flowers, in which a number of slender fruit- stalks proceed from the same centre, and rise neurly to the same height, so as to form a regular surface at the top. Hemlock, carrot, and low parsnip are examples. These are said to be um- belliferous plants. Umbilical cord, the navel string. Urethra, the canal which conveys the urine. Uterine belonging to the womb. Uterus, the womb. Uvula, the palate. VACCINE, vaccinous, belonging to, or matter of the cow-pox. Vagina, the passage to the womb. Valetudinarian, a weak sickly person. Vuriolus, small-pox matter. Vascu ar, belonging to the vessels Veoicle, a liquor to make medicines in. Venous, belonging lo the veins. Ventilation, a free admission or motion of air. Venomous, ? ;sonous. I iruient, > Vermifuge, worm-dispelling medicines. Vertigo, giddiness. Vesicating, blistering. Villous, shaggy, rough, hairy, Virous, poisonous matter. Viscera, the entrails. Viscid, glutinous, tenacious. Vital, the seat of life. WHITES, the discharge from the womb. Whorls, this term is applied either to branches, leaves, or flowers, when they grow all round their respective stems, resembling in some measure the spokes round the nave of awheel. Page. ABDOMEN, or belly, description of 51 Abortion, general observations on 484 ______prevention . . 487 Abscess, See Tumour. Absorbent medicines . 736 ------mixture, doses of . 727 ------how prepared . . 736 Absorbent and aperient mixture, doses of - . • 727 ------how prepared . 736" Acid, nitric, tonic and alterative 753,754 ------muriatic, useful in nervous fever ... 229 ------vegetable antiscorbutic 394 447 25 544 508 Page. Anger, dangerous effects of . 132 ——— melancholy instances of 133 ■^—- advantages of repressing 135 ------wonderful effects of music in subduing . . 136 Animation suspended 405, 406, 534 Acidity, See Heartburn. Admonitory hints to ladies Advice to masters ■ to parents After-pains After-birth, caution respecting 495 ______mode of extracting . 503 Agaric, See Touchwood. Acrimony, useful in jaundice, &c. 585 Ague and fever 198 Air, its influence on the blood 68 ------ on the body . . 70 _—- necessity for its renewal 73, 77 ______confined, bad effects of 73, 540 ______warm, relaxes the body 80 ______damp, checks perspiration 81 ______the most wholesome . ib. ______impure, how restored 72, 79, 239 Air and temperature, how to be reg- ulated in sickness . _. 699 Alder black, tonic and antiseptic 585 Aloetic pills, how prepared . 732 Alteratives, observations on . 753 Alterative diet drink . 754 Alum doses of • • 722_ ,______curd, how prepared . 76o ______whey, how prepared 720 ______- root, useful in cancers 586 Alvine discharge, or stools prog- nostic in fevers • 256 Americans, patriotism of . 179 Anatomical description of the hu- man body, concise and very in- teresting • • 29 Ancle, dislocation of 4o5 Angelica, good aromatic 586 Animal heat, depends on the circu- lation of the blood __________depression of, how to be restored . - 213, 49 233 742 758 727 Anodynes, observations on Anodyne liniment, how prepared Anodyne sudorific drops, doses of -----'._____________how prepared 735 ——---------Bolus, how prepared ib. Antibilious pills, how prepared 731 Antidysenteric mixture, doses of 727 —_------------how prepared 749 Antimonial wine, doses of . 722 _______________how prepared 756 ----------powders, doses of 7 27 ------------------how prepared 734 ----------solution, doses of 727 -----------------how prepared 730 Antiphon promised to do upon souls what Hippocrates did on bodies 125 Antispasmodics, observations on 743 Antipathy to certain remedies, con- sequences of 20, 701,705, 706 Anus, imperforate . . 555 -----falling down of . 415 Aperient medicines, importance of in fevers . . 211,730 Aperient and diaphoretic pills, how prepared . 731 Apopletic fits . . 344 Apetites, three kinds of . 85, 708 Apple Peru, See Thorn Apple. Apthse, or thrush . 564 Arbutus, See Bearberry. Ardent spirits, utility of 92, 2.11 ---.--------abuse of, destructive to body and soul 150,152 Aristides, his goodness condemned 144 Arms, description of . . 31 --- dislocation of . . 434 ----fracture of 439 Armstrong, Dr. his observations on the use of stimulants in fevers 232 Arria, her invincible love 107 774 Index. Arrow root, very nutritious 586, 713 Arsenic solution, doses of . 712 ----------------how prepared 756 Art of preserving health 67 Arteries, their use explained . 34 Asarabacca, useful in whooping cough . 587 Askew, his singular recovery 122 Asthma, treatment of 362 Astorgas, sups on the heart of his mistress . . 115 Astringents, observations on 747 Astringent mixture . 74b ---------doses of . . 727 ---------gargles . . 760 ---------washes . . 759 Athenians, the instructions they re- ceived in matters of religion 191 Atmosphere, component parts of 70 Avarice, injurious to health 1*5 -------fatal instances of . 1.6 - the advice of Hippocrates 117 Avens, tonic and antiseptic 587 Azote, or corrupted air 71 BACK-BOXE. description and use of 31 Backach brake See Fern Female. Baker, Professor, deservedly ap- preciated . . 584 Balm, useful in fevers 5h8 Balsam capivi, doses of . 722 --------— remedy for gonorrhoea 385 ------Turlington's, how prepared 755 Barberry, useful in dysentery, &c. 588 Bark, Peruvian, caution in the use of 201 -------------jacket, how prepared 200 ------------cold infusion of 75'J ------—- d3COCtion of ib. ■------------tincture of . 755 Barley water, how prepared 713 Barrenness . . 530 Barton, professor, his noble efforts to serve his fellow citizens 584 ------ professor, his unbounded liberality . 14 ------ testifies the efficacy of oak bark in gangrene 643 ------of poke weed in rheumatism 652 ____— of thorn apple in epilepsy, &c 670 ------of tobacco to dislodge worms *75 Bastard ipecacuanha, See Ipecacuanha. Bashfulness, an evidence of virtue 165 Bath, cold, when proper . 23 ----warm, efficacy of 24, 38 Bayberry, useful in jaundice 588 llearberry, useful in gravel, &c. ib Beaufort, II. his dread of death K'9 Beauty, wonderful effects of 4+7 Beauty, how to preserve it 448 Bearing down of the womb . 521 6> d-room, observations on . 81 Beech drops, See Broomrape. Beef tea, how prepared . 717 Beer, recipes for . . 624 Beggar, anecdote of • . 95 Benne, yields a good sallad oil 589 Bethroot, useful in hemorrhages ib. ile, the manner in which it is se- creted, and use of 56 Bilious fever, ... 205 -----its fatality in Washington, &c. 210 - — prevention of 218 Bind weed, See Potatoe Wild. Bird, colonel, celebrates the bas- tard ipecacuanha as an emetic 628 Bites, of musquitoes . 408 -----of venomous animals . ib. -----of mad dogs . . 410 Bitters, how prepared - 755 ----dangerous effects of . 22 Bitter sweet, See Nightshade. Blackberry, remedy in dysentery 589 Black snake root, See Virginia snake root Bladder, description and use of 57 -------distended, cause of retro- verted womb . 477 Bleeding at the nose . 323 Blistering plaster, how prepared 764 ________________substitutes for See Crow-foot, Cuckowpint, Meze- roon, garlic, hone raddish, Blood, circulation of . *6 -----how it is recruited 55 Blood-letting, how performed 441 ________.---rules to be observed, 213 [22:5, 242 Blood root, emetic and diaphoretic 590 Bloodwort, useful in hemorrhages ib. Bloody Kiux .... 3*1 Boerliaave, Dr. verifies that religion conduces to health 188 Boils or tumours . 417 Bolea, capt. his singular mode of tak- ing revenge . . HO Bonaventur, his admiration of a beau- ful woman, .. 114 Bones ofthe human machine, anato- my of.....31 Boneset, see Tboroughwort. Bowman's root, See Indian Physic. Box-wood, See Dog wood. Brain, seat of .... 39 Breasts, anatomy of . . 45 ------inflammation of 512 ______swelling of in infants 550 Index. 775 Bread soup, how prepared 716 ----- pudding, how prepared 718 Breath, bad, how to correct it . 309 Breeding sickness . . . 474 Broomrape, useful in cancers, &.C. 591 Brown; Professor, his remedy for tetanus .... 357 Buboes.....392 Buck Thorn, good purgative/' 592 Burch, capt. cured of an abscess of the liver by onions . . 644 Burdock, purifies the blood . 592 Bernet saxifrage, useful in asthma, &c. ib. Burns or scalds . . 412 Butter fly Weed, See Pleurisy root. Butternut, See Walnut. Button snake root, useful in gangrene 593 Burleigh, Lord, his just remark on the subject of religion . 192 CALDWELL, Professor, the man- ner he preserved the health of his son ..... 81 ------- his opinion respecting worms . . . 575 -------deserving high commen- dations . . . 584 Calico tree, remedy for itch, &c. 594 Calimus, good aromatic . . ib. Calomel, doses of • • 723 Calves feet jelly, how made 714 ----=---- broth, how made . 717 Camomile stomachic . . 591 --------tea, how prepared 712 Camphorated powders, doses of 727 ----------how prepared . 735 ----------mixture . 727,746 ----------liniment . . 757 ----------spirits . . . 756 Cancer .... 419,526 Cancer root, See Broomrape. Candleberry myrtle, See Bayberry. Caraw ay, excellent aromatic . 595 Carrol, Mrs. cured of a bilious fever by porter . . • • 209 Carbonic acid, or fixed air 72 Carrot wild, diuretic . . 595 -----poultices, how prepared 766 _____corrects foetid ulcers . 595 Cartilages, description and use of 32 Castor Oil, doses of . . 723 --------how made • . 595 Cataplasm of mustard . . 765 ----.----of common salt ib. -------- of alum . . ib. Gatarrh.or cold . . . 258 Cat gut, remedy for worms . 596 Cathartics, rule's for their exhibition 30 Cathartic mixture, doses of . 727 ---------------how prepared 731 Catheter, manner of introducing 338 Caustic Alkali, doses of . . 723 -----------how prepared 757 Caution to Parents . . . 546 ----.----Masters . . 25 Celedine, useful in cutaneous affec- tions, &c. .... 596 Cellular membrane, description and use of ... 39 Centaury, good stomachic . 596 Chalk, prepared, doses of . 723 Chalmers, Mrs. her alarm at a large dose of calomel . . . 578 Chapman, Professor, his great zeal in diffusing knowledge . . 581 -----------------his treatment ofthe epidemic 277 —---------------testifies the efficacy of seneka in menstrual ob- struction ...- 659 ----------------of balsam ca- pivi in gonorrhoea . . 385 Charity, a god-like act . . 698 Chancres .... 392 Chalybeate wine, how prepared 752 Charcoal powder, how prepared 758 -------poultice, how made 766 Charlemagne, Emperor, his noble conduct . . . 106 Cheerfulness, consistent with reli- gion . . . 1&9 Cherrytree wild, excellent substitute for Peruvian bark . . 596 Cheyne, Dr. his mode of treating de- lirious patients . . . 703 Cheselden, Dr. his just remarks re- lating to the study of anatomy 30 Chesterfield, Lord, his observations relating to dress . . 170 Chicken Pox ... 320 Chicken water, how made . 717 Chick-weed, red, remedy for hydro- phobia .... 597 Chilblains .... 412 Child, position of in the womb 471 Child bed, management of . 503 -----— diseases of . . 507 Children, management of . 533 ———— diseases of . . 549 Chills and fevers, vulgar mode of treating . . . 700 Chin-cough .... 579 Chlorosis.or green sickness . 456 Chocolate, properties of . 92 Cholera Infantum . . 571 ------Moibus ... 371 Chordee . . 385 Chremes, story of, an instructive les- 776 Index. son to the intemperate 86 Christian, his consolation in distress 126 --------enjoys the greatest felicity 181 Chyle, the manner it is conveyed 54 Cider, when wholesome . 91 Cinquefoil, useful in bowel com- plaints .... 597 Circulation of the blood, how per- formed .... 48 ■ ---state of, prognostic of dis- ease . . . 251 Clap.....383 Cleanliness, promotes health and preserves beauty . . 173 ----------the foster mother of love 174 ----------its importance in sick ness . . 25,702 ---------— importance of, during the period of childhood 539 Cleavers, See Goose Grass. Clinias, calmed bv music . 135 Cline, Dr. his advice on the dress of children .... 168 Clothing of infants . . 535 Club Foot, management of . 555 Clysters, See Glysters. Coakum, See Pokeweed. Cock-up-hat, useful in the yaws and venereal disease . . 598 Coffee, properties of 92 Cohush, remedy for rheumatism, &c. 598 2I Disposition of children, how to be managed . . • 515 Diuretics, rules for their exhibition 737 Diuretic infusion, doses of . 728 ---------------how prepared 738 -------pills, how prepared ib. Dock water, purifier of the blood 604 Dogwood, best substitute for the bark ib. Domestic remedies for whooping . cough 741 98 778 Index. •-------for rheumatism 7:6 Dorsey. Professor, his remedy for sore eyes . 291 ----------_____ account of his death . '280 Dover's powders, how prepared 735 ---------------doses of . 728 Downie, Dr. esteems blood root an active emetic . . 590 Dragon's claw, See Fever root. Dragon's root, See Cucko-w pint. Drastic purges . . . 731 Dressing of infants • 168,535 Dress, love of, natural to the sex 169 ----neglect of, improper . 171 —— advantages of wearing flannel 172 Dropsy . . . 375 ■ ofthe ovarium . 5>ip how made . 716 Eginardus, anecdote of . .106 Elder, common, mild aperient 605 -----wine, how made . . ib. Elecampane, expectorant . 6l)6 Elegy, on the death of col. Jesse Ewell . . 374 -----onadelidedgirl . . 390 Elixir paragoric, doses of . . 725 ---- how prepared . . 755 Elixir, vitriol, doses of . . 723 Elm, American, remedy in dysentery 606 Emetic weed, excellent emetic 607 Emetics, rules for their exhibition 729 Empirics, cause of their increase 19 ,, — cures on which their fame is built ... 21 Enthusiasm, a source of delusion 181 Envy, nature of . 142 ----'-- its baneful effects . . 143 -----antidote against . Ill Epicurus, his dread of death J 28 Epidemic . 275 Epileptic fits . . 315 Ergot, expedites delivery . . 608 Eruptions ofthe skin . 395,563 Erysipelas . 322, 5f>2 Ether, vitriolic, doses of . 723 Essence of peppermint, doses of ib. Evacuations, importance of . 60,103 Evergreen, S?e South Sea Tea. Excretory vessels, use of . . 35 Excoriations or galling . 552 Exercise, promotes health 93, 540 --------absolute necessity of 96 --------mode of prescribing in sickness . . 749 Explanation of weights and measures 721 External mode of producingsweating244 Expectorants, rules for their exhibi- tion ... 739 Eye, description of 40 Eye water, how prepared . 758 FUNTIXG FITS . 317 Falling of the fundament . . 415 ------ ofthe palate . . V*8 ------ down of the womb . 521 Fallopian tubes, their situation & use ">8 Fa.se Lovers, detestible characters 116 ---- conception . . . 527 ---- pains ... 480 Fanaticism, dangerous consequences of, if not checked on its first ap- pearance . . 182 Fashion, its excess disgustful 169 Fear, its origin . . 127 ----turns tiie hair grey . 1 '8 ----produe-es insanity . . tb. ----the best remedy against 130 ----superstitious, foundation of 5'5 Feather beds, should Oe of en aired 1 '2 Feather tew, promotes perspiration 6 9 Febrifuge mixure, how prepared 734 --------powders do . ib. --------doses of . . 7'2S Feeding of children . . 538 Feeling, one ofthe senses described l3 Feet, description of 32 Fennel sweet, pleasant aromatic 6 '9 Fern, female, useful in coughs 609 ---- male, remedy for tape worms 610 Fever bush, useful in fevers ib. -----root, US' ful in febrile disease ib. Fevers in general . . 195 Fibres, description of . . 3i Figtree, a mild caustic . 611 Finger, dislocation or fracture oflia [439 Flag blue, active cathartic . 611 ----sweet, See Calimus. Flannel, great preservation of health 172 Flatulence in infants . 567 Index. 779 Flaxseed sirup, how made 612 ——— tea, how made . • 712 Flea bane, diuretic and sudorific 612 Flies, potatoe, equal to the Spanish 655 ----how collected . • *b. Flooding in labour . . 502 Flowei-de-luce, See Fag Blue. Fluor albus or whites . 464 Flour caudle, how prepared 716 Flowers, pernicious effects of 80 Flux root, See Pleurisy Root. Fond, the most proper for children 82 ----the manner it is received into the stomach and digested 51,54 ----rules to be observed in tak- ing . . 84,89,708 Fox-glove, a valuable medicine in consumption and dropsy . .612 Fractures, of the limbs . 436 -------ofthe small bones 439 ------— of the ribs . . 44d French apple, See Thorn Apple £16 Frost wort, useful in kings evil 616 Frozen limbs, management of ' ^69 Fumitory, useful in cutaneous dis- eases . . 616 GALEN, how he became converted 29 Galling of infants . ■ • 552 Gall bladder, description and use of ^56 Gamboge, doses of • • "23 Gaming, a horrid practice . .155 , . melancholy occurrence of 156 ------good effects of timely advice 157 Gangrene . ■ 429 Grant, Dr. celebrates elm in dysen- tery . • ■ 606 Gaol fever . . .220 Garget, See Poke Weed. Gargles, how prepared . 759 Garlic, stimulant and excites blisters 616 Gentian, stomachic . . . 61" Ginger, doses of 723 Ginseng, diuretic . . - 617 Glands, their use ... 35 Gleet. ... 387 Glossary • • • J67 Glyster, simple and emollient 762 ______ common . . . ib- ----- stimulating . • ib. .----- anodyne . • 763 _____ turpentine ■ ib. i nourishing . . ib. ------ mode of administering 70S Goats rue, See Cat Gut. Golden thread, See Mouth Root. •onorrhcea '■■ 383 Goose grass, useful in gravel com- plaints .... G18 Gout ... 380 ----Doctor, anecdote of . ib. Gratitude, the most exalted virtue 184 Gravel . .336 Green, General, account of his death 2»0 Green sickness . . 457 Grief, injurious to health . . 123 ----deep, induces insanity & death 124 ----its best remedy . . 125 Grimes, Dr. his mode of administer- ing the Pride of China . . 675 Grinding pains, advantage of 496 Gripes in infants . . 567 Grog blossoms . - . 404 Ground Holly, See Bearberry. Ground pine, useful in rheumatism, &c. . . . 618 Ground pink, remedy for worms ib. Guinea pepper, See Pepper Red. -----worm . 410 Gum pills . . 743 Hamilton, honorable Paul, his des- cription of button snake root 593 -------of the pleurisy root .651 -------ofthe squirrel ear 666 -------his mode of administering the May apple . . 635 --- Archibald, lieut. account of his death . . 593 Hammock, Dr. celebrates hops in ul- cers . . . 624 Harriet, her unhappy fate 112 Hartshorn, spirits, doees of . 724 Hare lip, management of . . 554 Hart's tongue, remedy in diarrhoea 618 Harvey, his sublime sentiments 30 Hatred, destructive to mind & body 137 Head, description of 39 ----injuries of . . 436 Head-ach , . .304 Heart, description and use of . 46 -----the grand organ of circulation 47 Heartburn, . . . 363,475 Heart Ease, useful in cutaneous dis- eases . . . 619 Heitrt snake root, an emetic and dia- phoretic , ib. Ht .1. note, remedy in cutaneous dis- eases . . • 621 Hemlock, useful' in many obstinate cases • • • ib. Hemorrhoids or piles . . 330 Hemorrhoidal ointment . . 764 Henbane, useful in convulsions 622 780 Index: Herb Bennett, See Avent. i Trinity, See Hearts Ease. Hernia, or ruptures . 413 Hiccup . . 360 Hill, Dr. his affrontery . . 6j1 Hippocrates, his desire to cure cov- etousness . . . 146 Hives or croup . .. 5?7 Hoarhound, useful in coughs 62") Hoarseness . 266 Hog bed, promotes the menses 623 Holwell, col his account of the black hole in Calcutt 1 .76 Holy thistle. See Thistle Holy Hooded widow herb, antidote to ca- nine madness . . 6?3 Hope the source of human happiness 117 -----its great influence m the state and disorders of the body 119 —— ill grounded often tricks the owner . • 120 Hop Beer, how made . . 624 Hops, anodyne and antisceptic 623 Horse-radish, stimulant . 626 Hosack, Dr. a distinguished botanist 581 Hospital, a cheap plan recommended to planters . . .26 ., ought 110:0 to be established in all our sea port towns ib. Houseleek, useful in burns and stings of insects . - 626 Hunger, panful sensation of explain- ed . - i • 54 Human machine, the consistency and harmony of the different parts described . • 60,65 Hunter, Kev. Dr. slept comfortably under snow . • 98 Husbands, great affection of some 109 ________cruelty of some . 152 Hydrophobia ' .410 Hygieine, or the art of preserving health ... 67 Hypochondriac disease . . 352 H.pocrisy . • 181 Hyssop, useful in asthma, 8cc. 627 Hysteric fits . • 348 IDLENESS, the bane of all human virtues ... 95 Ice plant, useful in fits . . 627 Imagination, force of . 119,473 Immoderate flow ofthe menses 461 Im >erforated, anus . ■ 555 _____ ----vagina ib. Impe-rul drink . . 713 Impiety, consequences of 189 Impudence, truly disgusting 166 Inability of sleeping . 236,479 Incontinence of urine . . 335 Index ... 773 Indian Hemp, useful in rheumatism, &c. . 627 -----Physic, a safe emetic ib. -----Tobacco, See Emetic Weeds. -----Turnip, useful in Coughs 628 Indigent sick, too much neglected 697 Indigestion . . 365 Indigo VV eed, an emetic &.pathartic 628 Indolence, source of disease 93 Infants, management of . . 533 ------diseases of . . 549 Infection, means of arresting its pro- gress . . . 2>9 Inflammation of the brain . 278 ---------ofthe lungs . 2^6 ---------of the liver . 297 ---------ofthe stomach . 299 —-------of the intestines . 301 --------- ofthe kidnies . 3o2 ---------ofthe bladder 303 ---------■ of the breasts . . 512 ---------of the womb . . 515 -----ofthe eyes . . 290 Inflammable air, the mode of cor- recting .... 78 Inflammatory fever . . 241 Influenza . . . 258 Infusion of roses . 747 ____ . of oak bark . 748 _______of galls ib. -------of Peruvian bark 750 -------of columbo . 751 -------of Ger.tian . . ib. Ingenhouz, Dr. his remarks on the properties of plants : . 79 Inhalations • • 265,331 Injections for gonorrhoea . 760 __-------of tea . 761 _________of capivi . ib. inj tries of the head, &c. . 436 Intemperance, a suicidial practice 147- __________ a miserable refuge from misfortune 148 ____________dangerous consequen- ces of . 150,151 _____________instauces of persons being reclaimed 154 Intermittent or ague and fever 198 Intestines, use of . .52 Intoxication, ludricous description of 404 ----------how to be treated 405 Inversion ofthe womb ; 510 Index. 781 Ipecacuanha, doses of 724 Iron filings, doses of - • 752 Issues . . . 441 Itch . . .397 —— lotion, how prepared . 757 Iv_\ , See Culico Tree JALAP, doses of . • 724 James town or Jimson weed, See 'Thorn Apple. Jaundice . . .401 -------infantile . . 560 Jealousy, horrid effects of . 115 Jerusalem oak, a vermifuge 629 Joan, queen of Naples, murders her husband . . 116 Jones, Dr. hon bears testimony of the efficac) of cotton to scalds 413 Jo\ , facilitates the cure of diseases 121 ----excessive, fatal instances of 122 Juniper, an excellent diuretic 62S KELLIE, Dr. his remedy forthe ague and fever . . 203 Kidneys, their use . . 57 King, Dr. testifies the efficacy of thorn apple in affection of the brain 669 Kingston, Sir William, his cruel mode of taking revenge . 138 Kings evil . 400 Knee, dislocation of . . 435 Kollock, Dr. testifies the efficacy of the Pride of China as a febrifuge 658 Labour . . 488 Laborious labour . . 497 Lacedemonians, politeness of 166 Laceration of the parts . 509 Lambkill, See CaUco Tree. Lassitude, prognostic in fevers 253 Lavater, his remarks on females 108 Laudanum, doses of . . 724 ----------how prepared . 754 Lavender, thrift, emetic _ expecto- rant . • 629 Laurel, See Calico Tree. Lawrence, capt hisdyinginjunctions 179 Laxative medicines . 731 Leeches, mode of applying, preserv- ing them, and checking the dis- charge of blood . ♦■ 707 Legs, description of . . 37 ---- fractures of . . 437 Lemonade, how prepared 713 L( nion tree, antiseptic . 630 how to preserve the juice ib. Lettuce, garden, an excellent ano- dyne . 631 _—- wild, a powerful diuretic 632 Lichen, useful in coughs 632 Life root, remedy for the gravel ib. Ligaments, description and use of 32 Lightning, how to recover persons apparently killed 406 Lime water, how prepared . 756 ---- doses of . 728 Lime-kiln, d; ngerous effects of 78 Lind, Dr. gives evidence ofthe won- derful influence ofthe passions of the mind on the state and disor- ders of the body . . 119 Little, Dr. celebrates the May apple as an excellent purge 635 Liver, description and use of 56 Lobelia, useful in venereal complaints 632 Lochial discharge . . 5u8 Lock jaw . . 357 Longings . 214,455 Looseness, or cholera infantum 571 ---------in pregnancy . 476 Love, definition of . . 105 -----powerful influence of 106, 107 [108,109 ---- propitious love, conducive to health . 110 -----disappointed renders the soul frantic 110,112 Lover, false, an abominable charac- ter . 116 Louisa, German lady, an affectionate history of . .110 Low spirts . 352 Lumbago . . 312 Lungs, description and use of 46 MADDER . 633 ————— useful in visceral obstruc- tions ib. Magnesia, doses of . 724 Magnolia, beneficial in rheumatism, &c. . . 633 Maiden hair, useful in coughs, &c. 634 Male fern. See Fern Male. Malignant fever . . 220 ---------sore throat •• • • 284 Mallow, useful in dysentery & gravel 634 Management of female complaints 450 -----------of child bed 5!/3 ——^— of children • • 533 -----------of the sick • • 697 Mandrake, an excellent purgative 635 Manna, doses of • • • • 724 7«« Index. Marsh mellow good emollient 635 Marsh rosemary, See Lavender Thrift. \;aeria Medica . . 5b3 Mason, T. esq. celebrates pleurisy root in inflammatory diseases 650 Masterwort, tonic and aromatic 635 May Apple, See Mandrake. Mayrant, col his description ofthe samson snake root . . 662 Mayweed, stomachic . . 636 M'Cormick col D. testifies the effi- cacy of peach leaves in bilious fever 617 Measf-, Dr. deserving of high praise 581 ------testifies the efficacy of alder as an antiseptic . 585 Measles . . .318 Mechanism of the human body, its structure, consistency and har- mony . 62, 65 Meconium, observations on . 5>6 Medicine, the importance of possess- ing some knowledge of . 19 . —necessary cautions in the use of . . -21, 2 i ————— subject to abuse 18 ---------the necessity of being taken agreeably to direc. tions . 704 Membran. s, description and use of 35 Menstruation, access of . 45u ------ . cessation of . 453 ------------painful . 454 ——— suppression of . 456 -------------profuse . . 461 Mercurial pills, how prepared 753 ----------solution . . ib. __—---ointment . . 764 Mezereon, useful in venereal com- plaints & cutaneous affections 636 Midriff, description and use of 50 Miliary fever . . 320 ----- eruptions . .518 Milk fever . . 509 ■---------blotch . . 561 Milk or silk weed, useful in gravel, _c. . . . 6.6 Milk wort, useful in colds . 637 Milledge, hen. Joiin, cultivates the benne . . 589 'Miller, Dr. testifies the efficacy of ar- senic in lock jaw . . 358 Milkwaste, See Maiden Hair. Mind or soul, observations on 44 Mindererus's spirits, how prepared 758 Mint, See Pepper Mint. Mineral tonics . 7a 1 Miscarriage 484 Misleto, useful in fits . 637 Mitchell, Professor, deserving high commendation 584 --------celebrates the elm in seve- ral di eases . . 606 Modesty, its great influence 162 Mole, or false conception . 527 Moore, Dr. cites a case relative to imagination . . 473 Moorwort, remedy for toe itch fc37 Motherwort, useful in nervous affec- tions . . ib. Mortification . 429 Mountain tea, useful in asthma, &c. 638 Mouthroot, remedy for the thrush ib. Mugwort, a uood stomachic t- )8 M ulberry tree, an excellent purgative 639 --------wine, how made . ib. Mullein, good for the piles ib. Mumps . . . 2;>9 Muriatic acid, remedy in nervous fever . . . 229 Muscles, description of . . 33 Mustard, an excellent stimulant and useful in a variety of disorders 639 ■ whey, how made . 720 Music, powerful effects of . 136 Mutton brotb, how made 7l7 NARCOTICS, observations on 745 Natural passages, imperforated 555 Navel cord or string, manner of ty- ing it . . ;93,535 —---------------presentation of 502 Neapolitan, manifests unbounded love for his wife . 109 Nervot s fever . . 220 ----——----how to arrest its pro- gress . . 239 Nerves, description and use of 33 Nettle rash . . .896 Nettle stinging, an excellent stimu- lant, both internally and externally 640 Nightmare . . . 361 Nightshade, See Poke Weed. ----------dead I \, useful in palsy epi.epsy, &c. , 641 Nipples, sore . 513 -------mode of preventing 514 Nitre, doses bf . 724 Nitric acid, diluted . 754 -----fikc ammoniac, how prepared 739 Nitrous lozenges how prepared 741 Nostrils, description and is? of 12 Nostrums, dangerous consequences of 1J, «7> Nurse, duty rf b9i Index. 783 ------caution to 701, 704,709 Nurs 's guide . • 697 Nurting of infants . • 544 --------bad, fatal effects of 26, 698 -gO'id, its importance to man- kind . . 699 Nutrition, best for children . 537 0\K, an excellent astringent, tonic and antiseptic Oaths, consequences of Obstnicted menses Ointment, simple ---------saturnine __—----basilicon .____----mercurial ---- . ■ hemorrhoidal --------- tar . . ---------itch thorn apple Omentum or caul, description of Onions, remedy in croup, &c. Opiates, caution in the use of Opium, doses of Opodeldoc, how prepared Orange tree, anti-scorbutic ------wine, how m ide Original imperfections . Ovaria, or ovaries situation and use Oxygt n, or pure air PECTORAL mixture, or emulsion, dos s of - how prepared 642 190 456 763 ib. ib. 764 ib ib. ib. 671 56 641 2?1 724 757 645 ib. 553 59 71 Pagan religi n, account of Pains ofthe back, thighs and abdo men. in pregnancy Painful menstruation Palate, elongation of Palmer, Mr. anecdote of Palpitation ofthe heart ___________in pregnancy Pa sv Pancreas, or sweet bread its use Panado, now made . • . Papa' , See Custard Apple. Pupoose root, See Cohush. Paraphymosis Parents, caution to P»~»goric elixir, doses of . . ---how prepared 728 710 125 479 454 2h8 382 359 476 350 57 715 386 516 725 755 Parrot killed by eating the berries of the Pride of ' hina . 657 Parsley, leaved, yellow root, a good stomachic . • 64" ■ wild, useful in gravel com- plaints . 2'*' Passions, the active forces ofthe soul 104 Patent medicines, whydangerous 19, 75 Patriotism, definition of . . 176 ----------of Themistocles 19 Prejudices ill consequences of 20,706 Pregnancy, signs of . 468 ----------force of imagination in 473 ----------diseases of . . 474 Preliminary observations . 17 Preternatural labour . . 499 ———^^— instances of safe delivery without the assistance of art . . 500 Prickly asb, remedy in rheumatism, &c. . . . 656 ------Pear, remedy for corns and cutaneous eruptions . ib. Pride, ambiguous, signification of 159 ■-----excess of . . 160 Pride of China, remedy for worms, scald head, &c. . . 656 Progress of labour . . 49 J Prognostics of fevers . . 247 ——----of impending diseases 218 Prometheus, his story relating to in- temperance 149 Prostr-te glands, situation and use of 59 Ptolomeus, cries for joy . 122 Puccoon, See Blood root. Puerperal fever . 519 • Pulse, its action described from in- fancy to manhood . . 219 Purgative infusion, how prepared 731 ---------powders . . ib. -— electuarv, doses, and how prepared . 728,732 ---------pills ib. Purging of infants . 536 Putrid fevers . 2 a) Putrid sore throat . 284 QUACKS, cause of their increase 19 Quaker girl, her attraction 174 Queen ofthe meadows, diuretic 658 Quince tree, mucilagenous and as- tringent . . . ib. Quinsy, or inflammatory sore throat 2b 1 RADISH, anti-scorbutic" . 658 Raleigh, sir \\ alter, his forbearance 135 Ramsey, Dr. his melancholy death 427 Rand, Dr celebrates foxglove in spitting of blood . 611 Rasberry, dissolves tartar on the teeth ... 659 Rattle-snake root, remedy in croup and cold . ib- ———_—------ violet, See Violet. Rayschachius, his sudden death from grief 124 Recovering persons apparently drowned . . . 405 -----r- killed by lightning 406 Red gum . . . 559 Regimen, absolute necessity of be- ing strictly attended to in sick- ness . 26,708 Religion conduces to health lo0 -------important to guard against extremes . . 181 -------purifies our enjoyment in life . 185 - gives a check to our pas- sions . . 189 -------the reverence which hea- thens paid to it . 191 Remittent, or bilious fever 205 Respiration, prognostic in disease 252 Revenge, horrid instance^ of taking 138 --------the advice given to the Romans . . 1 '<9 —:------an entertaining account of taking . . 140 Rheumatism . . 309 Rheumatic tincture, how prepared 755 Khodian, singular account of one barbarously treated . . 120 Rhubarb, wild, See Potatoe wild. -------doses of . . 725 Ribs, description and use of . 31 Rice milk, how made . 715 ----caudle, how made * 716 ----pudding, how made . . 719 Rickets . . . 50 Ricketson, Dr. his mode of extracting opium . 6)4 Ring worm . • 398 Rose, or erysipelas . . 562 -----'mild, laxative . . (60 -----willow, remedy in gleet, &c. 6'">1 Routs, dangerous tendency of 73 Rue, produces blisters, &c. . 661 Ruptures . . 413,556 Rush, Professor, verifies that wine is a preventative ot i.iseas-e . 6 3. ——- an account ot his death 211 Index. 785 Bust of steel, doses of 725 SAGE, was supposed to prolong life 661 ------tea, how made . 661,712 Sago jelly, how prepared . 711 Sailor, American, singular patriotism ofone . . . 179 Sailors, deserve the best treatment 26 ------too inattentive to health 218 Sal ammoniac volatile, doses of 725 -------------crude, solution of 757 Salt of tartar, doses of . . 725 Salinejulep, or mixture, doses of 728 -----------how prepared . 733 Samson snake root, remedy in dys- pepsia . . 662 Sanicle, American, See Alum Root. Sarsaparilla, good for rheumatism, &c. . 663 Sassafras, purifier ofthe blood ib. Saturnine, or lead water, how pre- pared . . 757 Scald head . . .399 Scalds and burns . . 412 Scarlet fever . 321 Schirrus, or cancer . 419 Sciatic 312 Scrofula, or king's evil . 400 Scull cap. See Hooded Widow Herb. Scurvy ... 394 Scurvy grass, antiscorbutic . 663 Sea Sickness . 403 Secretory vessels, their use . 35 Seminal weakness . . 383 Senna, American, excellent purga- tive . . . 663 Senses, the external senses are those of seeing, hearing, tasting, smel- ling and feeling They are inlets of innumerable pleasures . 40 Separation of the share bones 510 Setons and issues . . 441 Sexual weakness . . 464 Shippen, Dr. William, father of the Pennsylvania University 280 Ship fever . 220 Shaw, Professor, account of his death 646 Shiverings, in child bed . 5^7 Sight, one ofthe senses . . 43 Sickness and vomiting of infants . 565 Sinapisms, how prepared 640, 705 Skin, the functions of, explained 35 .____diseases of . . 395,559 Skoke, See Thorn Apple. Skunk cabbage, remedy in asthma 664 Slaves, brntaUy murdered 133 99 ------the manner they ought to be treated . 25 Slave trade, abominable practice 76 Sleep, concise history of . 99 ------consequences arising from too much or too little lOu. 541 ------after dinner, whether advisa- ble 101 ------accompanied with talking or walking . 102 -•-----signs of, in fever . 2r>3 Slow fever . . . 220 Small pox . 316 Smell, one ofthe senses . 43 Snuffles . . 58 Soap wort, valuable in jaundice, &.c. 665 Socrates, his maxim . 86 Solander, Dr. his advice to travellers :n extreme cold weather . 96 Solution of arsenic, doses of 722 ---------------— how prepared 756 -------of crude sal ammoniac 757 -------of kali . 759 Somnambulism, or somniloquism 102 Sore eyes . . 290,552 Sore nipples . . 513 Soul, immortal . 44 Sorrel, antiscorbutic . 665 Southern wood, See Mttgnort. South sea tea, diuretic . 665 Spaniards, their cruelty to Indians 134 Spanish woman, her extraordinary hope . 120 Speech, blessing of .43 Spence, Dr. testifies the efficacy of fox glove in consumption 612 Spikenard, good in gouty complaints 666 Spirit of Mindererus, how prepared 734 -----of turpentine, mode of admin- istering it . . 746 -----of lavender, doses of . 725 Spitting of blood . . 3-'4 Spleen, description of . . 57 ------enlargement of . . 199 Spleenwort, See.Maiden Hair. Spotted fever . . 220 Sprains and bruises . . 431 Spruce laurel, See Mezerton. Squirrel ear, antidote against the bite of serpents . . 666 Stevenson, Dr. his remarks on bowel complaints . 341 ------------his very singular mode of treating a hypo- chondriac . 353 Still born infants, mode of recovering 531 786 Index. Stimulant purgative pills 732 Stimulants, their mode of exhibition 741 Slings of insects . . 108 Stink weed, See Thorn Apple. Stomach, description and use of 51 Stools, prognostic in diseases 256 St. Anthony's fire . . 322 S rangury . # 336, 476 Strawberry, cooling and laxative 667 Stroke of the sun . 28u Structure of the human machine 29 Sugar of lead, doses of . 725 Sumach, common, antivenereal 667 Sulphur, doses of . . 726 Sun dew, removes freckles, &c. 668 Superstition, a source of delusion 18] Suppression of urine . 33C, 47%6 Sutures, mode of applying . 426 St. Yitus's dance . .51 Swallow wort, See Pleurisy root. Swallowing Of pins . . Ill Swelled leg . . 511 Swelling ofthe feet in pregnancy 478 -------ofthe head in infants 550 -------of the breasts in infants ib. -------ofthe scrotum in infants 551 Swine pox . 320 Sympathy, the manner it is excited 50,55 TABLE of medicines for family use 722 -------of weights and measures 721 Taliaferro, John, esq. his remedy for whitlow . * . 417 Tansy, vermifuge . . 668 Tapioca jelly, how prepared 714 Tartar emetic, doses of . . 7-6 Tartar on the teeth, how to remove and prevent it . 309 Tar water, how prepared . 757 Taste, one of the senses 43 Tt a. properties of . . 92 Teeth, management of . 3C9 Teething . 569 Tendons, description and use of 33 Tetany, or lock jaw . .35' Tetter, or ringworm 398 Thatcher. Dr. entitled to praise 584 Theodcsius, emperor, his anger sub- dued by music . . 136 Thighs, description of . 31 ------ dislocation of • 435 .------ fracture of . 437 Thomas, Dr. testifies the efficacy cf cayenne in putrid sore throats 2£6 ----------of charcoal to stop bleed- ing at the nose . 324 Thomas, D. G. bears testimony of the good effects of Calico tiee in diarrhoea 594 Thorax, or breast, description of 45 Thorn Apple, remedy in mania, epi- lepsy, &c. . . 668 ------case of a child swallowing the seed . 670 Thornton, Dr. cultivates ginseng 617 Tboroughwort, useful in fe\ers 672 Throat root, See Avcns. Thyme, good aromatic . 673 Thrush, or sore mouth . 564 Tincture of steel, doses of 726 --------myrrh, how prepared 755 --------of rhubarb, doses of 726 -------------------how prepared 755 --------of bark . . ib. --------of columbo . ib. --------of fox glove . ib. --------of cantharides . ib. --------rheumatic . ib. --------thebaic, or laudanum ib. Tinea, or scald head . . 399 Toast and water, how made 713 Tobacco, useful in colic, &c. 673 Toe itch, See .\foot-wort, broad leaved. Toes, dislocation or fracture of 435 Tongue, description and use of 43 -------appearance in fever, of con- siderable importance as a prognos- tic . . .254 Tongue-tied, how to be cut . 551 Tonics, observations on . 749 Tonic powders, doses of, &c. 728 -----pills, how prepared . 752 Tooth-ach . 308 Tooth-ach tree, See Prickly .l:ih. Tooth rush . . 561 Topical blood-letting . . 442 Touchwood, excellent styptic 678 Travellers in winter, caution to 96 Treacle posset, how made . 715 Trifoil water, emetic and cathartic 678 Troup, hon. G. M. testifies the effi- cacy of peach-tree in fevers 647 ---------------his deafness cured 307 Tulip bearing poplar, See Poplar white. Tumours, or boils . . 417 Turlington's balsam, how prepared 755 Turmeric, See B ood root. Turner's cerate . . 764 Twins . . 501 T\ phus fever . 220 ULCERATION ofthe navel 551 Index. 787 Ulcers . . 421 Ureters, description and use of 57 Urethra, description of . 59 Urine, prognostic offever 255 ------difficulty of . 336, 476 Unicorn root, useful in colic, &c. 679 Uterus, description of 58 VAC' INE disease . 313 Vagina, or neck of the womb, des- cription of . • 58 -------------protusion of 521 Valerian, wild, useful in nervous dis- orders . . 679 Vanity, effects of . 158 cure of . 161 Vapours, or low spirits . 352 Vegetable substances, when to be collected . . 695 Vegetation of plants, corrects impure air Veins, their use Venereal disease — prevention of 79 34 383 393 079 Vine, grape, cultivation of Violet rattle snake, remedy for scro fulous tumours . 691 _____ sweet, mild laxative ib. Virgin's bower, useful in cutaneous affections . ■ ib. Virginia, or black snuke. root, pro- motes perspiration, and cures ague and fever - . • 6-9 Volatile, sal-ammoniac, mode cf ad- ministering - - -745 ______linimei.t, how prepared 7 57 Vnriol, white, doses of - 72ti Vitriolic solution, doses of 728 _______________how prepared 718 Vital air - - 71 Voltaire, his conversion - \?9 Vomiting and purging - 371 _____—in infants - - 565 Wake-robin. See Cuchow pint. Walnut, v\ hite, an excellenteathartic 692 Warm-bath, virtues of Warm and discutient liniments _____plastt r Wans and corns Washing of infants Washington, Gent r; death Washington, Vrs. I,, her miraculous ^ recovery • • ^lo 24,38 757 758 416 539 ccount of his 283 Water cresses, antiscorbutic 693 Water trefoil, See Trefoil water. Water, impure, how to correct it 91 Water gruel, how made . 715 Watery head . 575 Watery rupture . . 557 Wayne, Gen. account of his death 381 Weakness ofthe stomach . 365 Weaning . . . 542 Weems, Dr. his prescription 369 ---------account of his death ib. W ells, dry, danger of , 77 Whitlow 417 Whites . . 464 White gum 560 White caudle . . 716 White bryony, good purgative 693 White wood, See Poplar. Whooping cough . 579 V\ illow, astringent and tonic 693 Wistar, Dr. celebrates the nitric acid in liver complaints 299 ---------account of his death 280 Withering, Dr. testifies the efficacy of foxglove in dropsy . 615 \\ ind and costiveness of children 566 Wine, excellent to prevent as well as to cure diseases ■ . 680 ----use of, is economy ib. ----abuse of, injurious . 081 ----receipts for making 653 ---adulteration of, how to detect 688 ----cautitins in administering it in fevers . • 231,747 ____whey, how prepared . 719 Winterberry, See Aliter black. V\ intergrecn, See Calico tree. Womb, description cf _____falling clown of -----inversion of Wood betony, useful in rheumatism Woodhouse,' Professor, account of his death Worms Worm seed, See Jerusalem Oak. Worm wood, See Mugwort. Hounds, Wrists, relocation of 58- 521 510 694 646 574 421 435 YARRC'V. remedy for cancers 691 Yeast, its utility in nervous fevers 225 ------corrects focted ulcers 624 _____receipt for making - 625 Yellow fever. See Bilious fever. Yellow, gim - - 56 / THE Author of the "MEDICAL COMPANION," notifies the public that, at the instance of many of the purchasers of his book, he has prepared a number of Medicine Chests, on an improved plan, and particularly adapted to accompany this work. The chests are divided into six rows, and when opened, display their bot- tles, of various sizes, all handsomely labelled, and rising one above the other as if placed on shelves. The first row present six pint bottles, containing Castor Oil—Opodeldoc- Tincture of Rhubarb—Antimonial Wine—Rheumatic Tincture—and Parego- ric. The second row presents seven 10 oz. bottles, containing Calcined Mag- nesia—Peruvian Bark—Columbo—Prepared Chalk—Jalap—Rhubarb and Nitre. The third row presents seven half pint bottles, containing Sweet Oil- Spirits of Hart-horn—Spirits of Nitre—Sirup of Squills—Spirits of Turpen- tine—Tincture of Bark—and Laudanum. The fourth row presents nine 6 oz. vials, containing Ipecacuanha—Sal Tar- tar—Gum Arabic—Camphor—Alum—Spirits of Lavender—Balsam Capivi, Elixir Vitriol—and Nitric Acid. The fifth row presents twelve 3 oz. vials, containing Ether—Tinctur.e of Myrrh—Tincture of Cantharides—Tincture of Fox Glove—Tincture of Steel—Tincture of Asafcctida—Essence of Peppermint—Solution of Arsenic, Rust of Steel—Crude Sal. Ammoniac—Vol. Sal. Ammoniac—and Sugar of Lead. The sixth row presents sixteen 1 oz. vials, containing White Vitriol- Blue Vitriol—Opium—Calomel—Tartar Emetic-Borax—Corrosive Subli- mate—Red Precipitate—Lunar Caustic—Oil of Wormseed—Oil of Aniseed, Turlington's Balsam—Tooth-ach Drops—Aloetic, Antibilious, and Asafoetida Pills. . . , , Besides a large drawer, with divisions, containing scales and weights— mortar and pestle—spatula—lancets—syringes—injection pipes and bags— the various plasters and ointments—Epsom Salts—Senna—Manna—Cream Tartar—Sulphur—Liquorice—Arrow Root—and Sago. Of the Medi- cines most frequently used, there will be an extra supply enclosed in the chests, and ingredients for renewing the Tinctures. Thus making an assort- ment of Medicines, sufficiently complete, as to furnish an appropriate reme- dy for every disease. The author also warrants them to be genuine, and it will be found that his price is below the retail prices in any city of the United States. It is hardly necessary to observe, that all prudent and benevolent persons at the head of families, must feel the duty and importance of keeping such a chest in his family, not only for the great saving of time and expense of send- ing on every trivial occasion, for a distant physician, but also for the exceed- ing pleasure of thereby possessing the decided advantage of meeting a'dis- ease with a suitable remedy at its first attack; for there can be no doubt that 790 Medicine Chests. thousands have perished, not because there were no remedies, but because these remedies were at such a distance, that the patient was lost before they could be brought to him. It is a well known fact that the hero of Stony Point, the brave General Wayne, after his defeat ofthe Indians on the Miami, was suddenly taken off by a gouty spasm in the stomach, which might easily have been removed, had it been practicable to obtain any ordinary stimulus in due time. What numbers have died miserably of cholera morbus, for lack of a vial of laudanum, with proper directions to use it? How many fond mothers have hung distracted over their children, struggling under the croup, or s •■ ol len with the poison of serpents, when the former might so easily have been cured by an emetic, and the latter by caustic volatile alkali, or lunar caustic. The heart breaking tragedies that occur in families, merely for the want of ap- propriate remedies in cases of alarming disease, are too frequent not to be fresh in every memory. It were, therefore, a God-like act in all persons of tolerable circumstances, to keep a medicine chest, not only for the benefit of their own families, but also for their sick and indigent neighbours, who often suffer, and even per- ish, for want of proper medicines seasonably administered. These Family Medicine Chests have been inspected and recommended by some of the most distinguished Physicians in our country, stating on priuci- ples of reason, their exceeding importance to all families. And these their testimonials have been so fully confirmed by experience, that the honorable William H. Crawford, Commodore Porter, Governor Spring, and many of the most respectable inhabitants in the vicinity of the Metropolis, after full trial of their utility, have often and publicly declarea that they would not be without them on any consideration—and even in a pecuniary point of view they have been amply re-imbursed the expense; for that within a few months during the ickly season, they saved more than double the cost ofthe chests, and with very little diminution of their contents. The Public ivUl duly appreciate the value of these FAMILY MEDICINE CHESTS on reading the recommendations of the following eminent Physicians. I have seen and examined the .Medicine Chests of Doctor James Ewell, and consider them a valuable acquisition to every family, and very cheap at the price for which they are offered. JO.-Ki'H K.KNT, M. D. of the House of-Representatives U. Slates Washington City, March, 1820. I have examined with much attention the Medical Chests offered for sale by Doctor James Ewell of this City. The medicines have been prepared and arranged with much neatness and taste, and have been put up with a strict regard to their safety and preservation. Their genuineness will not be doubted by any acquainted with the well established character of that gen- tleman, both as a man, and a Practitioner of Medicine. I lake pleasure in recommending them to the heads of families in town and country, not only as affording an ample supply of all the medicines usually given in the cure of diseases, but as promoting economy in a pecuniary point of view; for, it will be found, he sells his Medical Chests le*s than the contents of them would cost at the retail prices in any of our Cities, and very considerably less if furnished by a Medical Practitioner in the common course of practice. JAMES JUNKS, M. H. ofthe House of Representatives U. State*. Washington, March, 1820 Medicine Chests. 791 Having attentively examined Dr. James Ewell's Medicine Chests, I give it as my opinion, that they would be a valuable acquisition to every family.- The Chests are differently constructed, and t'ae Medicines much better ar- ranged • han any thing ofthe kind I have seen, and being particularly adapt- ed to accompany his "Jjedical Companion," I stvongly recommend them to all heads of families. THOMAS H. HALL, M. D. of the House. Representatives U. States. Washington City, March, 1820. I have examined Doctor James Ewell's Medicine Chests.ind can say with strict propriety, I have seen nothing of the kind to equal th»n. The medi- cines appear to be of the best quality, and the selection and arrangement prove that the Doctor has bestowed much time, and attention o» the subject. I unhesitatingly recommend them to the heads of families. Th»y will find in possessing those Chests, they will not only have the means oV repelling disease at its first approach, always at hand, but will evidently be practising true economy, as these medicinesare below the common retail pricts in Ci- ties. I would abo advise every family to possess Dr. Ewell's "Medical Compan- ion." If it were necessary at this day to speak of this work, 1 could join heartily in its commendation. But as it has long since been recommended to the attention of the public by Medical men ofthe first talents and stand- ing in our country, I am not vain enough to suppose that any thing I could say is wanting to give it an extensive circulation. J. S. SMITH, M. D. of the House of Representatives of U, States. Washington City, March, 1820. I have with some attention examined Doctor James Ewell's Medical C/iesis which he prepares forthe use of families, and find them handsomely furn- ished with a good collection ofthe best articles for practical use. Every in- telligent man by the aid of his bo: k, and this assortment of medicine,' will be able to select an appropriate remedy for a long list of human maladies; which bv timely application may save much distress both of body and mind. And I do not hesitate to recommend his selection of medicines as being the best chosen assortment I have ever examined for the purposes they are de- signed. JOEL ABBOT, M. D. ofthe House of Representatives U. States. Washington City, March, 1820. I have examined minutely and with much satisfaction the Medicine Cbesls put up by Doctor James Ewell, of Washington City, and believe that they are superior both as to the extent ofthe assortment, and the genuineness ofthe medicines, to any I have ever seen. The arrangement of the chests is drf- 79& Medicine Chests. ferent from those generally offered to the public, comprising in a neat and co i pact form not only a greater variety of medicines, but the quantities bet- ter proportioned to the uses for which families generally require them__ indeed it may be said that the medicine chests of Doctor Ewell contain every thing necessary for domestic practice, most a Ivantageously arranged, and as an accompaniment to the ".Medica' Companion," would unquestionably be a valuable possession to every family. WILLIAM TKRRILL, M. I). ofthe House of Representatives U. States. Washington, March, 1820. The reputatior which his MEDICINE CHESTS have acquired, having already roused hespi-il of impostors, Dr.JZ. feels it his duty to inform the Pub- lic, that infutvre his agents ttill carry artijicates with the Seal of Washing- ton annexed. CONDITIONS. Tljese chests, made of mock mahogany, finely varnished, about two feet long, and nearly as deep, with good locks and keys, and strong brass mount- ings, will be put at the moderate price of $50—Chests made of cherry wood, and handsomely varnished, with double flint glass and ground stopper bot- tles $75—Elegant mahogany cases, with glass stopper bottles of much larger size $100. Orders from any part ofthe United States, will be attended to. And not- withstanding the profits on tbe chests, are so inconsiderable, as not to justify additional expense; yet, as their dissemination will unquestionably be attend- ed with public benefit, and may hereafter ensure their extensive sale abroad at a liberal price, they will be sent until the year H04, without an additional charge to any of our Sea Port Towns, or to Wheeling or Pittsburgh; and from thence they will be warranted to undergo land carriage any distance, without the breakage of a bottle or injury ofthe chest. Washington, JVov. 20M, 1892. / . ,_t