85-16862








1
Observations 
from
Dr. Duncan’s Lectures
on the 
Practice of Medicine 
-by-
In: L. Thompson
in the Years 
-1789 & 1790-






1
Duncan’s Lectures 
Lecture 1st 
Gentlemen, 
I have already delivered 
several lectures introductory to our employment 
here for this Winter Session: But 
before entering on the proper Business of our 
Course, I propose to bestow still another Lecture, 
recommending to your Attention a few of those 
Books from which you will receive the greatest
aid in studying. -
In lecturing during the Winter Session, I propose,
as formerly, to treat both of the Theory and Practice
of Medicine; and any one who is acquainted with
the extent and intrinsic value of these Subjects, will
readily conclude, that it is not within the limited 
Space of a few Months, that he can acquire such a
knowledge of them as will enable him to practice
with Confidence or Success. Every Man of 
Enquiry, Humanity, or Integrity, who enters upon
the Practice of Medicine must submit himself to 
be a Student for Life and if he possesses a mind
open to Convictions in awakened by a true
Spirit of Improvement, the Hours which he spends
in Study will afford him both Pleasure and Satisfaction.-
This, I hope, will be a sufficient Apology 
for pointing out to you, when I recommended to you
the perusal of useful authors, more work, than




2
even the most industrious Student is able to undertake 
during the present Winter. But if what is
now suggested serves to direct the future Courses
of Students, either here or at future Places; the 
present Lectures will not be misapplied.-
By industry and care in the perusal of useful
Authors, you may appropriate to yourselves-
the Discoveries of former Ages, the result of 
unprejudiced Experience and useful Observations.
But at the same Time it is by no means to be
imagined that everything admitted to print is
good or useful.
While Catalogues therefore of Authors are so
great, it must be matter of Consequence to 
young Students to point out those Authors,
from whose Writings they may obtain in the 
most compendious view of knowledge acquired
in any Branch. The proper execution of this 
Task however, would require not only the most 
extensive Reading, but the most judicious in
Discernment. And therefore the view now to 
be given is in many respects very imperfect:
This Defect however I shall afterwards have 
in my power in some degree to remedy, when I 
come to treat of particular Subjects, either in
the Theory or Practice for under each I shall
have occasion to mention those authors 
whom the most interesting facts, and the 
most important Observations may be derived. 
At present it is my intention merely to point




3
out to you a few of those Systematic Writers, who
would naturally fall to be mentioned under many
different Subjects; and whose Writings may, I think,
be consulted with the greatest Advantage on every
different Respect, Principle & Practice of Medicine.
In doing this, I shall, as in the Histories which they
give of medical Systems, follow pretty nearly the
order of Time; and shall mention those Authors
from whom the most compendious view of the
knowledge of particular periods is to be derived.
I need hardly repeat that the Periods to which I allude
are the Aras of the Grecian, Roman, Arabian and
Modern Literature. Nor need I add, that the -
Moderns availing themselves of the knowledge
of the Ancients, and copying from their Works,
have endeavored to improve upon them. From
the former therefore we may obtain the Discoveries
of the letter.
At the same Time, he is no man of Enquiry or
Industry, who will not wish to derive knowledge, in
some Degree, from original Sources. He indeed, 
who judges of the the Writings of the Ancients, by the
Theories they contain; or who tries them by any
fashionable mode of Theory, will think them of
little value. But if overlooking theories/ which
however in my opinion [are] is not more absurd, than





4
than following many of the most fashionable -
modes of Theory) he who wishes to know by what
marks Diseases are to be known; and by what Remedies
they are to be cured, will derive much-
Instruction from the Writings of the Ancients.
Many of them may be read and consulted with 
great Advantage, and there is hardly any Practitioner,
who will not reckon it his Duty to have consulted
the Fathers of the Physic.-
From the Writing of the Hippocrates, you will
derive true. Knowledge of the State of Medicines [illegible] among
the Greeks. Hippocrates was a most accurate observer
of Diseases, and which he describes with much
attention, and lays down methods of Cure well-
deserving imitations even of the most improved
Moderns.-
But of all Circumstances, his chief Excellence
consists, in what Respects the Prognosis, or Prediction 
of Events. It must indeed be acknowledged,
that he has mentioned many Things, as ~
fortelling, particular events, not strictly well
founded; yet on this subject, he is not surpassed
by any succeeding Writer. His whole Works, as ~
well as different pieces of them, have gone ~
thro' numerous Editions, and have been published






5
with extensive Commentaries. One of the most -
correct and best Editions is that published by -
Vanderlinden Professor of Medicine at Leyden.
Of the particular parts of his Works, the Best are
his Aphorisms, and History of Epidemic Diseases.
On the former many Commentaries have been made,
but that of De Gortez is entitled to preference. And
of the latter a faithful and accurate Translation 
into English was lately published by Dr. Farr
with many important Notes and Observations.
Next to the Writings of Hippocrates, I can have -
no hesitation in recommending to you, those of -
Celsus. In his truly elegant Work, De Medicin is
not only the best medical Latin, but the most -
compendious view of the Practice of Physic in
all its Branches among the Romans.-
Amongst the numerous Editions of Celsus, it
has, by various reasonings, been keenly disputed
to which the preference is to be given; in so much
that it has been the subject of an Elaborate Dissertation
in the Memoirs of the French Academy.
Perhaps however there is not a better Edition, among
all those of more modern Date, than that published
by Dr. Almeloveen of Leyden.-
Another Roman Author, whose Writings it ought to
be your Business to peruse is Cælius Aurelianus,
not indeed on account of his Style, for




6
in his Days, the Roman language had passed its
greatest purity, and you’ll find a greater Difficulty 
in understanding it, than if written in
a more elegant and better Language. To these
objections it must be allowed, that the writings
of Cælius are in some degree Liable; But they
are principally valuable as containing the -
Sentiments of every preceeding Author of Eminence;
both on acute and chronic Diseases;
And particularly for the Account which he -
gives of the Principles & Practice of Medicine.
The best Edition of Cælius, is that published
by Dr. Haller. -
If on any particular subject, you wish to
be acquainted with the opinion of the Arabians.
I would advise you to consult Avicenna
and the best edition I have seen, is that published
about the beginning of last Century, by
Paulinus. But upon Observation, I find that
his Works, consisting of two volumes, are crouded
with Terms, which you will find very difficult
to understand, and I need hardly add, that it is-
rather to be consulted, than read with Pleasure.
Many of the Publications of what may be called
the dark Ages, might be recommended to your
notice, as matters of curiosity: almost every
thing they contain, however, is to be learned to 
more advantage from Writers of a later Date-




7
After the Ancients already recommended to your
Attention, I next intend to mention some Moderns,
of these some deserve being consulted, for the- 
knowledge which they give of Antiquity; others 
for their own judicious Reflections and Observations;
and here the first I would point out to 
your Notice is Sonerlus.-
He, it is true, is a voluminous, and tedious Writer,
but the high and just Encomiums bestowed upon
him by Boerhaave sufficiently recommends-
him to the Attention of every Medical Practitioner.
His Works are to be considered, as the first valuable 
System after the Revival of Literature.
From his long and successful Practice, it may
readily be supposed, that his Works are enriched
with many useful Observations of his own, -
yet he is principally valuable for the view -
which he gives of more ancient Literature. While 
thoroughly acquainted with the medical Learning 
of the Greeks and Romans, he was also Master
of all the intermediate Ages. And if you wish to 
understand the Controversies which for a long 
Time subsisted; between the followers of the Galen
and the Chymists, you will from his Works - 
find the best view of it: While at the same  
Time, his Writings are to be considered as giving 
the Philosophy as well as the medical Knowledge
of the Age in which he lived viz. 16th Century.



8
Next to Sonerlus, I would advise you frequently 
to consult, and even to read & consider; the Works
of Hoffman. He, it is true, is a still more -
voluminous Writer; and has treated of so many 	
different Subjects so little connected with each 
other, that the laborious task of reading his - 	
whole Works is not to be advised. – 	
But I need say nothing further in favor of the 
Medic. Ration. Systema, than that I consider 
it to be upon the whole, the best System of a 
Theory and Practice of Medicine yet extant;
and in bestowing upon it, due Motion and -
consideration; your Time will be, by no means,
misspent. I may also mention, that now, you
have access to the most valuable parts of it;
in an abridged English Translation by the 
late Dr. Lewis, which was lately published.
After what is said however, and of the different 
views which are given; you will not suppose
that I would wish you to confine your attention
to anyone, particular System. Nor can 
that of Hoffman be, by any means, considered 
as without Imperfections. -
Much advantage may be derived from comparing
with his Sentiments, the Thoughts of other 
great Masters, on the Same Subject. [Andalth?]





9
Boerhaave's System is in some respects, -
unfashionable, and is certainly in many -
respects ill founded, yet, know, that there is
none which I can with greater Confidence -
recommend to your Attention; even in the 
short Text Books which he published, both 
on the Theory and Practice of Medicine, -
much judicious observations are to be found.
But for a compleat view of his Systematic -
Writings, you must have recourse to the -
Commentaries of Van Swieten on his Aphorisms;
where you will also find a distinct 
View of the greatest part of the Discoveries
and Improvements made in Practice in -
modern Times. And altho a tedious, yet it is 
an ingenious & valuable practical Work, either in the -
original or Translations, particularly that 
published at Edinburgh, which is much 
more correct than the London Editions, and 
cannot be too warmly recommended to those 
even but beginning in medical Studies. -
While Van Sweiten has thus furnished us -
with an useful & Complete View of Boerhaave's
practice; Dr. Haller has bestowed very great 
Attention on the Theoretical part of his Course;
Under the Title of Dialect. Acadam., he has 




10 
published a very exact Copy of the Commentaries,
given by Dr. Boerhaave himself, and 
in Notes he has superadded his own opinion 
and Conclusions drawn from the Experiments
then made. –
Since that however, his Experiments, as well 
as the Deductions drawn from them have been 
greatly extended; and therefore in preference to 
the Works now mentioned, I must recommend 
to you his Elementa Physiologiæ, And those
who have neither leisure nor Opportunity, 
to read or consult large Writings, may with 
advantage have recourse to a compendious -
view of it in the Primæ Sinææ. -
While [illegible] I make mention of eminent Foreigners, 
I must also take notice during
the present Century, several very eminent Physicians 
have flourished in Britain, whose
Writings will deserve the most careful perusal.
And at the Head of the list, I may mention an 
Author, who as far as he has gone, is inferior to
none; I mean, Dr Sydenham the Hippocrates
of Britain, who is not indeed strictly to be considered 
as Systematic; yet in the Course of his -
different Works, he has treated of almost every
Disease. Of the various Editions of his Works, 
one of the best is that published at Leyden, 




11
and from a very complete Index to it, printed 
under the Direction of Dr. Boerhaave, what 
he says of any Subject will very readily be
found but; While at the same time, Accuracy 
of Observation, and propriety of Practice with 
respect to each Disease, is such, as to merit 
particular Attention.
Of later date than Sydenham, are several
Authors still living, whose Writings cannot be 
too strongly recommended; I mean Lind, -
Pringle & Cleghourn; the latter treats indeed
only of a few practical Subjects; but these
are of the most interesting nature, and -
deserve particular Attention; And all -
have written within such a Compass, that a 
careful perusal will be no very difficult
Task. –
In the Method. Introduct. of Dr. McBride
we have a Work which treats more extensively 
both of Theory & Practice. And altho' I am far
from considering it as unexceptionable, yet 
in my opinion it will deserve your Attention
and Perusal.-
I need hardly make the same Observations 
with Regard to the first Lines of Dr. Cullen;
even after the Publication of four volumes,





12
yet indeed there are many important Genera
still not included, but as far as they go, they
give a very distinct view, both of [the] his opinion,
and practice. –
Let me also recommend to your perusal,
that small part of the Elements of Practice, 
published by the late Dr. Gregory; it must 
indeed be viewed but as a Fragment of an intended
Work, yet it's merit is such as must 
make us regret that untimely Death of
the Author, which prevented the completion 
of it ~ A still more full and complete
view of his practical Doctrines, and indeed of 
those also of other medical Teachers at this 
Place, is to be had from the Inaugural Dissertations 
of Students. For although very great 
merit is often due to the student himself 
yet in those which treat of practical Subjects,
the most interesting observations, must 
necessarily be derived from some other -
Source; and indeed these works are generally 
valuable; as they contain the Doctrine & 
practice of some Professor or other. -
Of late Years Graduations are so numerous 
at this place, that many Dissertations are 
to be had on almost every Disease; and of 
course in the Perusal of all, you would





13
have numerous Repetitions. But you
will find a judicious and useful Selection 
of one on each Disease in the -
Systema Medicine lately published by 
Dr. Webster. And in the Thesauris by
Mr. Elliot, many judicious Treatises are
to be found [both] on [the] Subjects both of a 
Medical and Speculative Nature. 
From these different Authors, much useful
Information occurring almost every 
Particular both in the Theory and Practise
of Medicine, may be obtained. In almost 
all of them however is one Source of useful
Information in Practice, but very little -
attended to, that is, the accounts of Dissections
in Morbid Cases. – On the Subject, 
the great Work of Morgagni, De Causis et
sedibus Morborum, per Anat. indigatis; -
above all claims Attention. A Number of 
his Dissections are truly Advantagious, while 
at the same time, he has described them with 
the utmost accuracy and Precision, both by
the Symptoms of the Patient while alive, &
Appearances after Death. -




14
But altho' this Work be deservedly in high 
esteem, yet much also may be learned from
the Historia Anatom Medicine of W.
Lieutaud He enjoys the advantage of 
giving short and concise views. And besides
his own Dissections, he also gives those of 
almost every other eminent Anatomist,
and the whole are arranged & digested with 
very great Judgment. -
The practical Authors already mentioned,
have followed very different Orders, & each -
indeed has followed a method, in some -
measures peculiar to himself. While most 
have treated of the principle Genera, yet none 
have attempted to give a complete view of 
all the Genera, to which the Body is subject;
or to arrange those already treated of,
in such a manner as to points out distinctly 
their Relation & Difference. This is long 
since done with great Accuracy in the -
vegitable Kingdom, and has often been -
hinted at with regard to diseases; 'till
very lately however none even attempted 
any Nosological System, the advantage
of which would be very great, nay almost 
totally sufficient for our own Days -





15
In the history of this Part of Medical Science
however, I cannot here propose to enter,
as hitherto there are but very few writers 
on that Subject, & in my opinion, much
is yet to be done before we can reap from it 
all the Advantages, which it is capable of 
affording – But with a view to obtain -
these as far as it if yet gone, I must first 
and principally recommend to your Attention, 
the Nosologia Methodica of Sauvages;
there is great difference however between
the first and last Editions. The best I have 
seen is that printed at Amsterdam in [410]
in 1768. Besides the full account it contains 
of the Species as well as Genera it is every 
where replete with useful Practical Observations. 
But altho' I reckon Mr. Sauvage's,
which was the first, as being still the best 
Book upon the Subject, yet I would also very 
strongly recommend to you, the Synop. -
Nosolog. Method of Dr. Cullen. In the 
latest Edition, you have a Collection of Definitions 
of the Genera of Diseases given 
by all other Nosologists; & he has also given 
more just & accurate Definitions of 
his own, than any former Writer, on that Subject.




16
But he has nowhere touched on the practise,
either with respect to Genera or Species. This 
however forms the most valuable part of the 
great work or Sauvages; & indeed it is particularly 
important as pointing out the 
variety of Treatment, which some Diseases,
as arising from different remote Causes, will
require. A Circumstance to which the Cautious 
Practitioner will ever pay the most 
scrupulous Attention. -
I am far from imagining that it will be 
in the power of any Student of Medicine,
to bestow Attention & Perusal on all, ye different 
Authors now mentioned, during the 
Course of a Winter Session. I mark them 
out merely as what i think, from merit 
deserve your first Attention, in the Study 
of Theory & Practice of Medicine. And as 
far as you have leisure to consult them, 
either now or hereafter, you will, in many 
respects find advantage from reading them, 
rather together than separate, i.e. consult 
what has been said by each on ye same 
Subject. By this means, & by a diligent 
Comparison of the different Sentiments
you will have the best chance of arriving at 






17 
Truth; & will most effectually [rivet] in your 
own Minds, those important Facts, which you 
will find of the greatest Service in actual 
Practice. But altho' I consider those [what] I have -
mentioned now as the best Systematics; yet I am far
from imagining you can derive from them, true 
opinions on every Subject. - Many others 
who have Written Systems on the Theory and 
practice of Medicine, might be mentioned -
to you, & as well deserve your Attention; but 
besides Systems, very few particulars in Physiology,
and there is almost no Disease, which 
has not been professedly treated of, by particular 
Writers. –
I shall therefore concludes recommending Books 
by mentioning one, from which you may obtain 
ye fullest Information, as to the Aid to be had
on any particular Subject, the Method.
Studii Medic. of Dr. Boerhaave, as published
by himself; but at the same time, it is a -
superficial Work, and that from necessarily - 
wanting, what has been done since his Time. - 
which renders it highly defective. But in the 
Edition published by Dr. Haller, you have a 
full List of all the valuable medical -
Authors, to a very late Date. -




18
It is proper also to observe that value of Dr. 
Haller’s Edition is very greatly increased by ye 
Index to it published by Dr. Pereboom, & if 
any of you should think of purchasing the 
Work; this Circumstance ought to be attended 
to, as many Copies are without the Index ~
While however recommending, Boerhaave’s 
or rather Haller’s Method. Studii, I must at 
the same time observe that his greatest or 
last Work, the Biblioth. Medicinæ, in which 
he was engaged at the time of this Death, -
will, when completed, be much superior, - 
and this, not withstanding his Death, may 
soon be completed, as the Materials were put -
into the Hands of Dr. Tribolt of Berne, a
Physician well qualified for the undertaking.
During Dr. Haller’s Lifetime, he had not only, finished
ye Biblioth. Botan. Anatom. Chimi. &c.
but had advanced as far in the last part of the 
Bibiotheca Medic. as to bring it down to 1647;
so that there remains only the Arranging of Materials, 
respecting Authors who have written during 
last Century. -
In this Work, as far as I can observe, no
Practical Author, who has wrote during ye Period 
thro' which it extends, is omitted; & the Characters






19
Characters of each, are delivered with no less Candour -
than Judgment. To this then when compleated 
by a proper Index, you may have recourse for 
the View of Assistance to be had in studying 
any particular Subject. 
With these Observations then on medical 
Authors, who may be consulted with the greatest 
Advantage, in the Study of the Theory & 
Practise of Medicine, I conclude the preliminary
part of my Lectures. And for the 
particular Plan which I shall hereafter -
follow, I may refer you entirely to the Heads 
of Lectures, published as a Text Book. -
I may only observe that my Labour here is chiefly 
calculated for the use of those, who are but beginning 
the Study of Medicine, yet I hope, that 
to all who honor me with their Attendance, I 
may be productive of some pleasure and Instruction.-
I am conscious of the arduous nature of the 
Task, I have undertaken; yet at the same time, 
I am satisfied that I am not alone to blame, 
if Students of every Rank who bestow proper 
Attention, do not derive from them an adequate 
Return, and I flatter myself with the hopes, that 
those who are attentive prgress in this Place,





20
when afterwards engaged in Practice, will 
have some pleasure and Satisfaction in reflecting, 
that during their stay at Edinburgh
for medical Instruction, they did not neglect 
that opportunity of Improvement which is 
here offered -






21
Order 1st Humoralia or
Effusions of Fluids into Cavities.
The Fluids of the Human System, are 
secreted in [the] different Cavities, for the 
various purposes of Nature; but these - 
Fluids may enter into Cavities wch. are not 
intended by nature to receive them & Effusions
of this kind will induce various -
morbid Affections, which compose this 
Order of Diseases. -
Genus 1st Anasarca.
This Affection has received different Appellations 
by different Nosologists. But this 
diversity principally arises from the different 
Stages of the Disease. I consider Anasarca
as a Dropsy of the Cellular Membrane, either 
confined to a particular part, or diffused
over the whole Body. I comprehend under it
the Leucophlegmatia, which, tho' made a -
distinct Genus by some, yet it is a great Impropriety.
When the Affection is local, the 
Term Anasarca, in its strictest Sense, may -




22
not be proper, but where water is effused to a 
Morbid Degree, it may as well be termed -
Anasarca as Leucophlegmatia, so therefore 
think that Mr. Sauvages made a very improper
distinction; by making these two distinct Genera.-
Symptoms. In giving an Acct. of the Symptoms 
in Anasarca, I shall mention these
occurring where the Affection is general.-
The first Symptoms which takes place, (if 
it does not proceed from a local Inflammation)
is a diminution of the Urine at least it is 
not in proportion to the quantity of Fluid 
taken in; this is soon accompanied with a slight 
Swelling about the Feet and Ancles, particularly 
at Night, & especially if the Patient
has walked much thro' the Day, but generally 
disappear in the Morning. These -
swellings soon advance up the Legs. The Urine
is disposed to assume a dark, & sometimes a 
Wheyish Colour. -
As the Swelling advances, Respiration becomes
affected. There is a remarkable Paleness
& Transparency on the Surface of the 
Body; the Skin becomes dry, & in some measure 
less sensible, ye heat seems diminishes to -





23
the Touch, yet the Thermometer shows it to 
be pretty natural. The Patient gradually -
loses his Strength & becomes inactive; his 
Thirst increases, & his Appetite diminishes.
A Troublesome Cough comes on, without copious
Expectoration; the Cough is most severe 
when the Patient lies, in an horizontal Posture;
his Sleep when occurring is not refreshing;
At length the Dysphnea become so difficult, 
that he can breath only in an Horizontal
posture; his pulse now becomes -
more frequent and irregular; and great Sickness 
occurs, & deliquum animi frequently 
ensures. -
Tho' this is the common progress of the -
Diseases; yet sometimes it terminates in Recovery,
and sometimes in Death. -
A termination of this Disease in Death, 
happens chiefly from an Affection of the
vital Functions, as difficulty of Respiration,
& circulation thro' the Lungs, wch.
is not always connected with the Swelling 
yt appears obvious on the rest of the Body,
but wth. that quantity of Fluid effused in 
the Cellular Substance of the Lungs, for 
ye obvious swelling is sometimes very great,




24
when the Respiration and Circulation are not 
affected, and vice versa. Tho' ye excretions
especially ye Urine and Sweat are diminished,
yet the Discharge by the Belly is but little 
affected, as there is generally a Tendency to 
Costiveness. It is singular, that, tho' the -
Thirst is considerable, the Tongue is seldom
parched till the Occurrence of Fever -
The Hate of the Fluids has seldom been examined;
Venæ section being in most Cases very 
improper: In the begining the quantity of Tenum
is greater than Natural, but as the Disease 
advances, the Serum diminishes in -
Quantity, and near the End of it is said to be 
less than natural, especially where the -
Swelling is increased from drinking much 
[fluid], which is not a rare Occurrance -
Diagnosis. From the history of this Affection, 
there can be little Difficulty in determining 
the Character of the Disease. The principle 
marks, by which we distinguish it from other 
collections of watery Fluids are 
1st A colourless Swelling, pitting on Pressure,
and wch. begins in the Extremities. -
2d. A considerable Degree of Thirst. -






25
3d. An Affection in the Discharge of the 
Urine - And 
4th A Difficulty of Breathing. ~
When these Symptoms are combined, there 
can be no Danger of confounding this Disease
with any other. But the three last occur.- 
with other Diseases arising from effusions 
of Blood, Air &c. And except where Affections
happen to the Cellular Membrane from Fat,
Air, &c. we can seldom be deceived; but from-
the Swelling leaving a Pit on pressure, and 
the Transparency alone may determine it.
It is remarkable that towards the last Period
of Pregnancy, swellings of the lower Extremities
take place, which require a different 
Treatment from Anasarca; but a distinction
may be easily made here by attending to
the Swelling of the Abdomen, Absence of ye
Menstrual Discharge, Quickening of ye Child, 
& other Symptoms of Pregnancy.-
There are likewise Swellings occurring in 
Convalescence after other Diseases as -
Scrophula & Scurvy, may be distinguished 
by attending to ye preceding Disease, & these 
are seldom accompanied with any Scarcity 
of Urine.- 
An Effusion of the watery kind occurs -



26
locally after Erysipelas, but this is ye consequence 
of Inflammation, and requires little treatment.
Other Watery Effusions likewise occur, which 
are easily distinguished by ye preceeding Fever, 
& ye circumscribed appearance.-
Sometimes Swellings take place, under the 
Name of Ecchymosis, from the Effusion of 
Blood into the Cellular Membrane, but these 
are distinguished by their Colour. In general, 
all Swellings attending Scurvy may be distinguished 
by ye Colour, the Blood effused, is 
generally in a state of Degeneracy; but if 
the Colour be natural, the Disease may be 
known by ye Fatid Breath and Spongy Gums. 
The Appearance in Emphysema resembles 
that in Anasarca; but where there is a -
Collection of Air, there is no Scarcity of 
Urine, or Increase of Thirst; besides these
Swellings depending on Air are more Elastic
and have a crackling Noise. 
Sometimes Swellings resembling Anasarca
take place, from an Accumulation of Fat, in 
the Cellular Membrane. Beef Fat does not 
give the Pit on pressure wch. Water does, besides
Fat is more gradual in its progress and does 
not subside on changing Posture, therefore 
there is little danger of mistaking Dropsy for it.




27
A Collection of fat is commonly found in -
Robust & healthy constitutions; whereas -
Anasarcous Swellings are met with in spare
and meagre habits.
Remote Causes. Anasarca may occur at 
any period of Life, but more generally in those 
advanced in Years, especially when past 50.
It is more frequent in females than in Males,
wch. probably depends on ye Constitution, and 
mode of Life, wch. makes them more lax & debilitated;
this constitutes the Leucophlegmatic
Temperament. It is sometimes Hereditary
& Congenital. It is observed to attack 
those bred to sedentary Employments, those 
drinking much Spirituous Liquors, & those 
who have been much purged; & it may also 
arise from Salivation. In such cases, the 
Disease may occur without any exciting 
Cause; but with Habit, there mostly occurs, 
some particular Accident. 
Exciting Causes. None is more frequent as 
an Exciting Cause; than an Obstruction of 
accusstomed Evacuations. In this Way, it
occurs from a Suppression of the Menses.
Lochia or Hamorrhages. Sometimes, the
Checking of such Evacuations by particular
Remedies, has given rise to it; as profuse -




28
Sweating by the Bark applied externally; -
Diarrhœa stopt by Opium; more frequently 
it proceeds from Causes checking the Perspiration
& Urine. It is frequently caused by checking
the first, from exposure to Cold, or by cold
Drink, operating on the extreme [Vesicles]. But 
Obstruction to the return of the Venous Blood 
is a more frequent Cause. 
Prognosis. This is more favorable, than 
otherwise, if we take the Disease in Time.
It has often a natural Termination in -
Health, without the Aid of Medicine; as, from
a natural Diarrhœa, from Sweat, and sometimes
from an uncommon Discharge from 
the Salivary Glands. In general, those Patients 
have the best Chance, whose Appetite have
been least impaired, and where the quantity 
of Urine is in proportion to the Drink & is 
of a clear Appearance. In consequence of 
Rupture from Distention, often proceed -
Gangrene & bad Ulcers, but these Ulcers -
sometimes cause a Cure. Where the Patient 
is most subject to relapse, the Prognosis is 
most unfavorable. Great thirst, Difficulty 
of Breathing, (which is often greater, than we 
can suppose they are able to bear) and, when 


 


29
when it attacks those exhausted by preceeding
Diseases, are all unfavorable. But the most 
certain Judgment may be drawn from an -
Attention to ye Causes, wch. if transitory as 
exposure to Cold, we may hope for Relief
but if from Schirrosity, we have great reason
to expect Danger; though some may live many 
Years in this Way, & after all die of some 
other Disease. Every Symptom, tho' ever
so slight, should be attended to, there is no -
Instance we should think trifling, the most 
powerful means may be often insufficient. 
Dissection. From this little can be learned, 
with respect to what gives rise to the disease
in general. In the Writings of Morgagni -
there are Instances of Anasarca proving -
fatal, tho' few Cases have occurred purely Anasarcous,
as often Obstructions & Schirri have 
been found combined. - When it arises 
from obstructed perspiration seldom have 
those been found any morbid Affections of 
the other Viscera.– The Water is commonly 
found in the Cellular Membrane; but from 
long continuance it may be [found] effused 
into other Cavities. The Water is found to 
contain little coagulable Matter. The Blood 


 


30.
as far as has been ascertained is more watery -
than natural; but as the Disease advances, this 
diminishes. Lieutaud found the Blood of a dark 
colour as if exposed to Fire; but in Morgagni
the appearance is different, he found it very
fluid & few Polypous Concretions.
Authors. Anasarca is a Disease peculiar 
to no Man or Nation and was known as early
as the Days of Hippocrates, who distinguishes
it from Ascites. Dr. Donald Monro has -
given the best Treatise on Anasarca. -
Proximate Cause. It appears that this -
Disease occurs in debilitated Habits, principally 
taking place in consequence of the 
action, of the Causes obstructing Circulation, 
or restraining Discharges. But of all the effects
from obstructed Circulation, or suppressed
Discharges, a disposition to Serosity, is the 
most frequent. We may then expect an uncommon 
Quantity in those Parts which - 
receive a watery Fluid in a sound State. 
Whether this arises from Organic Pores, 
Exhalents or inorganic Poses, the operation 
of the Causes must be the same. The Absorbents
carry off this Fluid from the Cells
& if in proportion to the Effusion; there [the] would



 


31
be no Dropsy; but in this Disease, these Vessels
are much debilitated, & restrained from Action.
But by other Circumstances, it would seem, yt.
their power of Action is in proportion to the 
demand made by the System. As the blood 
in this Disease is already full of this Serum,
there is [the] less occasion for it. Thus, it appears
from the remote causes, that an increased Exhalation,
and diminished absorption are the Consequences;
and thus we Account for the Operation
of all the remote causes. But unless we expect
a Rupture of the Lymphatics & that from a 
great Branch, there is no Apprehension of general 
Dropsy, because the full Operation of others
will counteract this; hence by an increased Exhalation,
& want of proper Absorption, the -
joint action of the remote causes, promotes
a serious Effusion into the Cellular Membrane;
which constitutes the Proximate Cause.
Ratio symptom: The colourless & elastic 
Swelling taking place in the Complaint, -
proceeds from Distension of the Cellular Membrane, 
in consequence of Water diffused thro' -
it's Cells, wch. first appears in the Cellular Membrane
of the Legs, in consequence of the Communication 
of the Cells & from their depending
Situation, the Swelling generally disappears


 


32.
appears in a Morning, from the Horizontal
position of the Patient all Night. -
The difficulty of Respiration attending this 
Disease is caused by the impeded Circulation
thro' the Lungs, arising from the Distension of 
the Cells of the Lungs with Water. -
The Scarcity of Urine is not a Symptom
of Dropsy, but the Effects of the Accidents inducing 
it, & in the progress of the Disease, it 
arises, from the Blood being deprived of it's
Serosity.– The first arises from the peculiar
Wants of the System from the Blood -
losing its Serosity; and when the demand for 
absorption is great, the Absorbents are incapable 
of acting from the great debility 
induced, & the Compression they are exposed 
to. When a gradual failure of Circulation
occurs from Compression, if not relieved 
very soon terminate in Death. – 
In Anasarca, a natural Termination in 
recovery often happens either by an increased
discharge of Urine or by Sweat, 
or Chronic Diarrhœa, or by the Rupture
of the Part; & sometimes a Recovery takes 
place, when attended with Fever, as it evidently 
increases the Action of the Absorbents. – 



33.
Prevention. There is no Complaint, which we 
should have earlier Recourse to prevent; than
Anasarca; & it is one of those Diseases, which 
are more easily cured, in their incipient State,
than prevented; but when attended wth. Schirrosities,
it cannot easily be got the better of. -
In preventing this Disease, the great Object 
to be held in view to correct the Diaphlogistic
Diathesis in the System, by a nourishing Diet,
& Exercise, & to encrease the Natural Discharges
of Perspiration, &c. And when there is any -
Tendency to a Leucophlegmatic Diathesis or
Temperament, it is necessary to support the Discharge 
by the Surface, & to avoid exposure to 
Cold by proper Cloathing. Particular Attention 
is to be paid to the State of the Urine, & in case 
of Scarcity to have recourse to proper Remedies. 
But notwithstanding every precaution, the 
Disease will sometimes come on, & then
the Cure must be attempted. -
Cure. The general plan of Cure may be 
referred to two Heads. -
Ist. The Evacuation of Water already effused. -
II. The Prevention of a fresh Accumulation.





34.
The first of these Indications may be 
obtained two Ways. 
1st. By natural Outlets from the Cellular
Membranes. Or, 
2dly. The Water may be carried of by Artificial 
Outlets, made in the most depending 
part; & this will be easily obtain'd, as the 
Cells communicate wth. each other
The Second Indication, the prevention of a 
fresh Accumulation, may be accomplished;
1st. By supporting a due Degree of Action 
in the Absorbents. 
2d. By keeping up a proper Discharge by 
the Serous Excretions. 
3d. By instituting artificial Outlets, wch.
ought to be continued after the Cure is apparently 
performed. And 
4th. Above all, by removing the Leucoplegmatic
Diathesis. -
The accomplishment of most of these
Ends may be expected, chiefly from Friction. -
The Remedies recommended in this Disease, 
may be referred to three Heads. -








35
1st. Those acting chiefly in promoting Absorption. 
2d. Remedies which have the peculiar Property
of evacuating from the Cellular Membranes. 
And;
3d. Remedies which have their chief Effects
in removing the Leucophlegmatic Diathesis. – 
But before we speak of particular Remedies;
we shall say something of the 
Regimen. The Ancients recommended the 
greatest Abstinence and thought no other -
Treatment necessary; and they give us Histories
of Cases, where the Disease has been 
cured by Abstinence alone. That this may 
sometimes prove useful I will not deny; but 
in general it will not be found to answer. -
Others recommend a nourishing Diet; and
indeed we have nothing to fear from the Stimulant
quality of Animal Food, as it assists
in strengthening the Action of the Absorbents. 
But so far as nourishing Diet is found to produce
Thirst, it will be hurtful, it being commendable 
to cause as little Thirst as possible. In 
some Cases the Appetite is impaired, & then, its 





36
is often dangerous to indulge the Patients especially 
if greatly subject to vomiting. In 
some stages of Anasarca, patients have a strong 
propensity for food, & then they ought to be 
indulged in it. -
If much has been said with respect to low 
Diet, still more has been said with respect 
to abstaining from Fluids. When Thirst occurs, 
some advise to quench it with the Use of 
different Fruits, rather than Fluids, as they 
increase the Saliva in the Mouth. I would 
not advise a liberal use of Fluids, yet I am 
inclined to think they are not so hurtful
as many have imagined; & I have no doubt,
that many of the Diuretics fail, for want of 
proper diluents, & when once they promote
a great Discharge from the Kidneys, they -
will be serviceable; but when they do not 
produce Increase of Urine at least equal
to the quantity of Drink, they are inadmisssable,
& may produce bad Consequences. – 
Mr. Basier orders a Pill for Dropsies, which he 
says has a much better Effect, when join'd 
with the use of Diluents. 
When Diluents are necessary, they are 
productive of the utmost Advantage by 






37.
being combined wth. some Stimulant - But 
Practitioners must regulate their Modes by 
the Effects produced, according to the Increase
of the Secretions; & in order to judge more
exactly of the Proportion, it is advisable to 
have the quantities of Fluids taken in & discharged,
ascertained by Measure. -
In Anasarca the Skin is generally dry & 
cool, hence we must have recourse to warm 
Clothing; Flannel Shirts, Drawers, &c. -
Particular Remedies. We shall first 
treat of these Remidies that act highly, as promoting 
Absorption. Friction wth dry Cloaths,
this is not so stimulating as when we join to 
its Use, acrid Substances, but where there -
appears a great degree of Torpor, we may -
have recourse to stimulating Powders, as -
Mustard &c. But when we use these the 
Friction should not be very great, as they may 
be apt to vesicate, wch. may being on ulcerations,
& wd. prevent their farther Use. -
With the Friction, we may use lubricating 
Substances, as Linseed meal, wth. Oil &c. -
but some Objections have been started to -
this, as stopping up the Pores; but the Advantages






38.
Advantages we derive, from being able to use more 
Friction, & engage the Attention of the Patient
wch. makes them continue the Use of it longer, &
more regularly than they otherwise would be
disposed to do, over balances the Objection. 
Compression was recommended by the Ancients;
but it never can be useful unless
in local Affections of the lower Extremities, 
wch. seldom occur. It may be used too, where 
the Swelling is great, for preventing a Rupture 
of the Teguments, wch. is sometimes apt 
to take place. -
To promote Absorption, Exercise has 
been recommended in all Ages, by Walking,
Sailing, Riding &c. - The Sailing is 
recommended by Cælius [Aureliasus], to 
this is joined the Advantage of Sea Air.
A Saline Atmosphere may act as a Stimulus 
to the Absorbent Vessels; but this
is scarcely to be recommended where the 
Patient can bear other Exercise; the best 
perhaps is on Horseback, or in a Carriage;
but when it cannot be afforded Walking on
Foot, in the open Air, may be of Service, 




39.
Emetics have been used; by the Action of 
these, the Water has been known to have been 
discharged; They may act perhaps by promoting 
Perspiration, but their Chief Effect
is by promoting Absorption, especially in 
recent cases arising from Cold. They must 
generally be repeated, & friction used during 
the Intervals. -
We next treat of these Remedies, more particularly 
adapted, to evacuate Water from 
the Cellular Membrane. These may be divided
into Cathartics, Diuretics, & Diaphoretics. -
The Cathartics debilitate more than Diuretics, 
yet where they can be used, they are preferable. - 
In Anasarca, a variety of Purgatives have 
been used, the Ancients used the more drastic, 
as Elaterium, Gamboge &c, but these
of late have been much in Disuse, & the 
more frequent are, Calomel & Jalap conjoined;
but of all the Cathartics, the best are those 
that operate at the same Time by Urine, 
hence the Crem. Tart. has been much used; - 




40.
It has been given both in Solution, & in -
Substance, in Electuary joined to Jalap or -
Gamboge, & in Infusions with Tamarinds & 
Sena, but the Electuary seems best. Often 
when we want to purge we give it in small
Doses, frequently repeated, joined to an Aromatic,
as Cinnamon, Nutmeg, or Ginger; in
this Way, besides proving laxatives, it acts
as a Diuretic, & is not so apt to produce 
the Coldness when taken into the Stomach, 
which neutral Salts very often do, when 
taken by themselves. -
The Operation of Diuretics seems very 
uncertain, & their Strength has not been 
well ascertained; they may be prevented 
from Operating, by various Accidents in 
the Habit, & it often happens that Diuretics
cannot be made to operate at all, hence
when the Patient is strong we would scarcely 
have recourse to them, but only where Debility 
occurs with a scarcity of Urine; these are 
often joined wth Purgatives, as also Emetics, 
but these cannot be used so frequently, as 
they weaken the Patient. The Saline Diuretics
operate the most quickly, as Sal Diuretic.


Rx. Vini Nicotiana 3ii Ac. Font.
Aq. Menth. Syr Simp. aa ℥ij m. 
Capt. ℥ss ter de die -



41.
Ol. Tartar. p. Deliq. but the best & most 
expeditious is ye Spt. Nitr. D. from gH
xx to xxx in Water. But more permanent 
effects may be had from the Stimulating
Diuretics as Garlic, Squills, &c. The best 
preparation of the last is dried Root. 
from 1 to 10 Grains; Calomel has sometimes
been given wth. it, & appears a good Combination;
The best addition to take off its -
nauseating quality is Extr: Gentian.
With these we must sometimes use diluents 
& the Decoct. [Junip.] may be employed 
as a Diuretic: As to Cantharides, I never
used them, but I think they act more 
upon the Neck of the Bladder, than the 
Kidneys, & thus produce Strangury and
Bloody Urine. - Tobacco was first introduced
in this Disease by Dr. Fowler; It is 
given either in the Form of a Vinous, Spiritous or -
Watery Tincture; The Proportion 3i to lbi
of the Menstruum. The Dose is from 10,
or 20 to 100 Drops. It acts as a Diuretic, 
but every Stomach will not bear the Use of it.




42
Diaphoretics are sometimes necessary, when 
the Anasarca arises from obstructed Perspiration. 
The best are the Pulvis Doven, & 
Warm Bath which not only excites Sweat, 
but by acting as a Stimulus increases the 
Powers of the Absorbents. The Vapour Bath 
has likewise been recommended. -
We come next to speak of Evacuations
by Artificial Outlets, but the Objections
to these are, that they relax the Solids, and yt.
the Wounds made, often terminate in Gangrene. 
But there are some Cases in which 
relief cannot be obtained in any other Way,
when that happens Blisters ought to be 
applied, particularly if the Patient be 
troubled wth. a Cough, & in this Way the -
Discharge will be very great. Incisions,
or Issues, (wch. are still worse) can never, I think 
be necessary, unless when the Swelling 
is so great as to threaten Rupture, wch. is -
certainly worse than any of the Artificial 
means. In this case we have recourse 
to a lesser evil to prevent a greater -







43 
A late method has been proposed (vol. 4)
the Application of Cabbage Leaves, with a 
view to promote transudation. thro' the Skin;
They are often used after the Blister to promote the Discharge, & they 
act certainly similar to it. I have tried it
but did not perceive any good effects from 
it however 'tis a very innocent Practice. 
As the evacuation is not ye most difficult 
part of the Cure, we are obliged to have 
recourse to other Remedies, to remove
the Leucophlegmatic Diathesis, which 
may be looked upon as a debilitated -
state of the Solids, and perhaps an Irritability
of the Vascular System; hence 
Tonic Remedies come to be useful. -
This End may be best answered by a generous 
Diet. Nothing is to be dreaded from the 
Stimulus of Animal Food, when it is fresh 
and plainly Dressed; but perhaps in very 
debilitated habits at first it is best to administer
it in Strong Broths. Cordial an 
restorative Drinks are also necessary, the 
Use of Wine shd. be enjoined & these of the
astringent Kind as Claret or Old Port, which






44
should be used undiluted. For common -
Drink, Gin & Water is best: If malt Liquors
are used they shd. be of the more substantial
kind as Porter. - But of all methods, 
the best is the Use of moderate Exercise
in the open Air, as it increases the Tone 
of the Solids, promotes Digestion & appetite
for food & likewise supports due & regular 
Excretions. - But besides Regimen, 
some Medicines (strictly so called) are of 
use; the chief of these is the Bark. It
may be given in the Interval, when other 
Medicines are not used, (as purgatives &c.) 
either in Substance, Infusion, or Decoction.
In some cases other Bitters will sit 
best on the Stomach. And in many Cases
Chalybeates are useful. These by some, 
particularly Dr. Fowler of Bath, who 
introduced the use of Tobacco in this
Disease, are preferred to the Peruvian Bark, 
the best preparation of Iron is the 
Rubigo Martiv [illegible].










45
Genus II. Hydrocephalus
Under this Term, Writers have comprehended
two Diseases, The Hydrocephalus 
Externus & Internus, & no doubt -
these agree in one particular, both depending 
on Water in the Head; yet in ye
Nature they are more different than -
many Species of the same Genera. -
Under this Term, we may comprehend 
three Species, wth. greater Propriety than two.
1st. The Hydrocephalus of the Integument,
wch. may be considered as a circumscribed 
Anasarca -
2d. The Hydrocephalus of the Cranium, where
the Water is between ye Dura Mater & Brain.
3d. The Hydrocephalus of the Ventricle.
But we shall only treat here of the latter
Species as being the most dangerous, & 
having the most urgent Symptoms. -
This has been divided by Dr. Quin into Acute
& Chronic & I think, with propriety, tho' I






46 
do not agree with him in the Reasoning upon 
the Subject. -
History. In this Disease the Symptoms
are not the Same thro' the whole Course. 
The first Stage is ushered in by Loss of Appetite
with a peculiar Paleness of Countenance, 
& generally the Patient loses his 
Plumpness; afterwards there occur Headach
& Quick pulse thro' the Day, & in the
evening febrile excerbations, with a white
Tongue Thirst & Vomiting. After these have
continued long, the Pain becomes more fixed
in the Head, either on the Crown, or immediately 
above the Eyes, wth. Gripes, Costiveness,
& commonly great Dejection of Spirits, Inactivity, 
Watchfulness, & a great Aversion to 
Light; wth. these also there are many Symptoms
as if the Patient had Worms, he picks 
his Nose, & grinds his Teeth. -
In the second Stage, the Pulse sinks below 
its natural Standard, with uncommon Drowsiness
but the Sleep is not at all refreshing;
This appears from ye Patient moaning in his 







47
Sleep. When free from Drowsiness the Vision 
appears to be affected, first by squinting 
& afterwards by double Vision; the Patient, 
not being able to bear a strong Light. 'Tis 
likewise after attended wth. Delirium & the 
Urine deposits a furfuraceous Sediment.
In the third Stage, the Pulse becomes very 
irregular and after very quick so as not
to be able to number the Pulsations; the 
Drowsiness is converted into absolute Coma,
& Insensibility; now also occur Delirium 
& Incoherency of Speech, the Eyelid seem
to be Parylized & the Pupils much dilated,
wch. will not contract wth. the strongest Light 
but does by the Application of ardent Spirits,
&c. An Inflammation of the Tunica
Conjunctiva takes place, partial Flushings
of the Face, dullness of hearing
Convulsions in the Legs, Arms, & Face, wth. 
Subsulsus Tendinum, difficulty of Deglutition,
& laborious & interrupted Breathing,
wch. soon terminates in Death. When 
the Disease has this termination it is -
generally by Convulsions. -





48.
Diagnosis. Hydrocephalus of the Cranium 
is born with Infants, & may be distinguished
by the Size of the Head & dilation of the Sutures.
Where the Water is lodged in the Ventricles, there
is no external Appearance, hence in the very 
early Stages, it is impossible to know the 
Disease; but from some particular Circumces.
we may make a probable Conjecture. We
should endeavor to distinguish & from -
attacks of Fever, & from Worms; It may be 
distinguished from the former by it's slow
progress, besides the Type of Fever ushering
in Hydrocephalus, is irregularly attended 
wth. vomiting once in two or three Days.-
The Presence of Worms rarely give rise to -
such Fever, as attends Hydrocephalus, & ye
Gripes in cases of Worms are more severe;
the Appetite is also voracious, and the Stool,
glairy. When this Disease advances farther, it is attended
wth. slow Pulse, double Vision, Coma
Dilatation of the Pupil & Convulsions; -
when all these occur, we can have little
Doubt in pronouncing the Disease Hydrocep.
Remote Causes. We are much at a loss 
with respect to ye remote causes; were these





49
known, the Disease might be less frequent, as 
it wd. be easier to prevent yn. cure it. It seems
necessary for ys. Disease if there occurs a peculiar
predisposition wch. is confined from Birth
to ye Age of ten Years, there are very few Instances 
of it occurring later – It wd. seem to be 
hereditary, for tho' the Parents may not have 
died of it, yet often many Children in the 
same Family are affected wth. it – It is said
to be connected wth. peculiar make, as a 
large Head; but in my practice I have not 
observ'd the Disease occur oftener here; yn. in
Cases where the Head was not large; nor is it 
connected to a dull & Lethargic Disposition, 
as has been observed by some. It may perhaps 
depend upon a Leucophlegmatic Temperament,
as it often succeeds tedious chronical Affections. -
Exciting Causes. The most probable of 
these are; Injuries done to the Head at Birth,
or by accidents after. It may occur from Obstructions 
to particular Excretions, & perhaps
from a great degree of Cold applied to ye Head, wch.
last I think may produce great effects before the 
Bones are united, therefore the most probable 
method of preventing this Disease, is by keeping 





50
the Head of the Child well covered till a complete 
Ossification has taken place. -
Method of Cure. The first means to be 
used is for the evacuation of ye Water, & this is
to be done either by natural or artificial 
Outlets. Where Water is in the Ventricles, Punctures
seem to accelerate Death, hence are not 
to be used. As the Brain is furnished wth. Lymphatics,
if these could be affected, the Water 
might be absorbed. The only means then of 
evacuating the Water [seems to] must be by Stimulants
& [Evacuants] among the first are -
Blisters & Errhines, & the last Cathartics &c.
The Cathartics shd. be given in strong Doses
Jalap [either] in Substances joined wth. Calomel,
is recommended, but the best [way] method of exhibiting 
it is in Tincture wth. an equal Quantity of
Symp. It shd. be given in small Doses, at short
Intervals. The Syrup & [illegible] may be 
given & Crem. Tartar is a good Remedy –
Blisters are perhaps the only remedies frm. wch.
we may expect relief. They sh'd be applied to 
yt part of ye Head where there are most Sutures,
and shd. be kept running thro' the whole course 
of the Disease; I have seen very good Effect 
from the Application of them. -




51.
Errhines have been proposed frm. the serous 
Discharge they occasion, & from the agitation 
they throw the Body into – The best are a 
few grains of Pulv. Hernutal. or Asarrum.
With a view of increasing the Action of ye
Lymphatics. I wd. recommend the use of Electricity,
from it we know yt. perspiration & 
Sensibility are increased; in ye way then it 
may increase the Energy of ye Lymphatic 
System. - Opiates have been recommended 
by Dr. Dawson; but as their Effect is only 
temporary I think little good can be expected
from them. [Mercury] A great many happy
Effects have been produced by Mercury, given 
so as not to occasion Salivation, & I think 
it one of the most probable remedies conjoined 
to ye Use of Blisters. It may be
used in ye Way of Unction. -







52
Genus 3d. Hydrothorax.
This is a genus where water is effused into 
the Cavity of ye Breast -
History. When this Disease is best marked
it is ushered in by a sense use of Weight abt. ye
Diaphragm, wth. pain at ye Cartilage Ensiform
this extends even to ye Stomach & often to the 
Shoulder: After this a slight Dyspnea occurs,
wch. increases gradually, particularly wn.
in an horizontal Posture, often very violent 
during sleep, wth. an inexplicable uneasy 
Sensation, succeeded by palpitation; wth. these
appear all ye sensations of Leucophlegmatic
Diathesis, scanty Urine, slight Swelling
of the Feet & Ancles at Night, & more frequently 
than in other Dropsies, swellings of the 
Hands accompanied wth. Stupor & Numbness
of ye Arms, wth. these also a Cough occurs, at first
wth. a little Expectoration. This differs from 
ye [Water] Matter expectorated in Catarrh being more 
watery, & this by degrees in augmented & often 
appears bloody, resembling [w?] occurs in Peripneumony.
Slight Febrile Symptoms take 






53
place, particularly Exacerbations towards Evening,
wth. increase of Palpitation & great Difficulty 
of Breathing, unless in an erect Posture; often
cold Sweats supervene; the Pulse quick, small &
intermittent; at last Circulation & Respiration
are so far affected as to induce Syncope & even 
Death. –
During this Complaint yre are few of the Functions, 
but wt. are affected, Appetite is impaired,
ye Desire for Liquor is augmented, tho' the Thirst 
is not very great. During the Progress, ye Pulse 
becomes quicker & intermits often ye Heat 
is augmented at times, tho' ye Patient for ye
most Part feels cold; there is a remarkable 
Inequality of Heat, particularly in ye Extremities;
where Paralysis often occurs. Interrupted
Perspiration constitutes a considerable 
part of ys Disease; this becomes difficult 
when in a recumbent Posture, & particularly 
distressing when lying on one Side, especially 
wn. Water is only on one Side of ye Chest, & wn.
this is ye Case, it may be known by percussion.
Tho’ ye Urine is scanty it is not so high coloured
as in Ascites. With ye Thirst, ye Tongue is seldom 
dry or white, unless ye febrile Symptoms run high.
The Belly is rather bound; the State of ys can seldom 
be determined from ye use of Purgatives.





54.
The Disease is generally of some Weeks duration,
before it proves fatal, sometimes Months, 
but where ye Water is confined within ye Pericardium,
it has proved fatal in less yn two Weeks. 
It generally affects those who have passed ye
Prime of Life & are of debilitated Habits, & is 
common to both Sexes. Pradisposition to it 
may be acquired by many Circumstances, as by
a sedentary Life, ye too free use of Spirits, spare
& poor Diet, & moist Climate; It sometimes occurs 
after [Disorders] Affections of ye Breast as Peripneumony
& Asthma; & commonly in Schrophulous Habits;
& sometimes it happens from Injuries -
done to ye Breasts or from Cold. 
Cure. This consists in ye evacuation of Water 
already effused & in ye prevention of a fresh 
accumulation. The most ready method of 
evacuating water seems to be by ye Paracentesis
of ye Thorax, but I think ys a dangerous 
Operation & ought only to be used in very urgent 
Cases. Blisters & Issues are preferable to all
other artificial Outlets; I have seen many 
very good effects from ym; But it must be 
allowed they sometimes fail. Emetics have 
been recommended, but we ought to be very 
cautious in giving ym. as a palpitation &c may







55
be ye effect of Aneurism, Polypus &c in wch. -
case they would prove immediately fatal; at 
the beginning of ye Disease, they may be used 
wth. Advantage & ye best Medicine we can give 
wth this view is ye Digitalis Purpurea. The 
best method of giving it is in [Infusion] Decoction, 
3iij of ye dried Leaves to ℥xij of water, boild
to ℥viij , a Table Spoonful of wch. shd. be given 
for a Dose, until it produces a vomiting. A
stronger Decoction yn. ys. has likewise been 
used viz. 3iv of ye dried root in ℥viij of
Water. Dr. Witharing who first introduced 
ys Medicine gives it in smaller Doses,
wch. he finds to answer better; he uses an 
Infusion of 3i of ye Dried Leaves to ℥viij
of Water, wch. he gives so as not to produce
Nausea, & he finds it acts as a powerful Diuretic;
he likewise gives wth. it some Tonic -
Medicine - [illegible] has been likewise 
had to Cathartics & Diuretics; among ye former, 
Jalap & Gamboge have been mostly used, 
& among ye latter, Squills, Neutral Salts, Vegitable
Alkali &c – Mercury has sometimes 
been used wth. Success. -






56
Genus 4th. Ascites.
Of all Dropsies, ys is the most distinctly mark'd
& is most frequent in Occurrence.
The Symptoms of ys Disease are Pale Countenance
wth. slight febrile Exacerbations,
Thirst, impaired Appetite, Urine scanty &
higher coloured yn natural & often slight - 
Swellings of ye Legs – afterwards ye Belly
enlarges gradually & wn. yt gets to any great
size ye patient is troubled wth. frequent & dry 
Cough, wth. Dyspnea, & Fluctuation is discoverable;
at length ye Belly becomes of an Enormous 
Size, while ye superior Parts appear
more spare yn. natural. The Thirst becomes 
intense & ye Urine deposit a sediment, like 
Brickdust, The Pulse hard, tho frequent & 
small, & generally the Belly is bound. –
Ascites may be distinguished from Lymphanites,
because ye latter is attended wth. a peculiar 
Tension, hardness & sound; & great relief is 
afforded from breaking of Wind, wch. does not 
happen in Ascites. It is difficult to distinguish 
between ye true, & incysted Ascites, except
yt in ye latter ye Patient increases withot. any 
evident affection of ye System & ye Appetite
lasts longer – 






57
This Disease may occur from preceeding Disorders, 
especially Jaundice; but ye most common
Cause is, from ye immediate exposure 
to cold, when ye Body is over heated or from 
cold Drinks. – As few Diseases are more 
liable to a return, we should [generally] have 
great doubt in our Prognosis & it should 
generally be looked upon as dangerous. It 
is a good Symptom wre. ye Thirst is moderate 
& ye urine [is] of ye natural Colour, & ye –
Stools copious & watery; But we have ye
best hopes where ye Viscera are sound & not 
Schirrus – Supervening Jaundice is a bad 
omen, &, tho' a Looseness in ye early Stages of 
ye Disease is favourable, yet in the latter 
Periods it is to be dreaded – Violent Cough is 
also bad. – When Paracentesis has been performed,
yr is a favourable Chance if ye Water
is transparent & high coloured; but whre.
it is very limpid & a speedy accumulation 
takes place, if glairy & viscid or has a putrid 
smell, it is very bad. - In some Instances
ys Disease may be prevented. Whenever 
Schirrhus of ye Liver occurs, we may [be]
presume yt Ascites will follow, hence we shd.
endeavor to prevent it by giving Mercury, 
Cicuta &c, & friction of ye Abdomen.






58
When ye Disease has gone on to greater -
length we must attempt ye Cure - first by ye
discharge of ye accumulated Fluid – 2dly. By 
removing ye Accidents yt give rise to obstruction,
& 3dly. To give Vigour to ye debilated System. 
With a view to obtain ye first, ye Operation [crossed out]
[been] of ye Paracentesis has been much used;
but I think it ought only to be had recourse
to when the Body is very much distended, 
as in ye early Stages more success maybe
derived from other Evacuations – Emetics
have been much recommended, but ye Evacuation
by Cathartics is preferable, tho' in 
some Cases, they may both be used at Intervals 
between each other. When Emetics
are adviseable ye. utmost advantage maybe
derived from ye Use of Ipecacuana, as from 
ys we may be certain of full vomiting. In 
cases where we find relief from ym. we may 
repeat ym. but if we find no relief, we ought 
not to persist in yr. Use. - Among ye Purgatives, 
the first wch. presents is ye Elaterium, 
this was much used by ye Ancients, & has lately 
been revived wt great Success: The best way of 
giving it is by joining it wth Cremor, Tartar;
but prior to use we ought to try more gentle 
Cathartics –





59
Black Hellebore has also been recommended, 
we should begin the use of it wth. a small Quantity
& extend it gradually, & during ye use
of it ye patient shd. drink plentifully of 
diluting Liquors; but it ought not to be 
given where there is any external Inflammation. 
Good effects have otherwise arisen from
Gamboge & Scammony conjoined wth. Cream
of Tartar; But wt. I have seen ye best Effects
from is Jalap, it is sometimes given wth
Calomel & Nitre, but the best method of 
exhibiting it is wth Cream of Tartar, wch. 
is ye Basis of Wards Purging Powder. –
Many Advantages may be derived from Diuretics
in ys Disease as they may be continued 
much longer than either Cathartics
or Emetics without induging 
Debility, but they will not always have a good Effect [crossed out]
without these be sometimes given in ye Course
of yr Use – Of all Squills seem to be the 
most certain, & ye best method of giving ym. 
is in Pills made of ye dried Root, combined
wth. Extr. Gentian. They have sometimes- 
succeeded when combined wth. Calomel. Sr.
John Pringle has warmly recommended the 
Vegetable Alkali; he gives daily gr. x dissolved






60
dissolved in an Infus. Absynth. & ℥ij of Holland 
Gin. – I have seen good Effect produced 
by ye Colchicum Autumnale, it has 
not so great a Tendency to nauseate as ye -
Squills, tho' it often brings on a Looseness.
It is usually given in ye form of an Oxymel, 
about ʒi 4 [illegible] indies, but I think ye..
dried powder preferable in the form of Pills.
What has been called ye sweating Plan, has 
been used; for ye purpose recourse has been 
had to [crossed out] Dovers Powder & ye warm Bath. On
the whole I am inclined to give ye preference
to Cathartics & Diuretics jointly, rather 
yn other Evacuants - The best 
method of promoting ye action of ye Absorbents
[of] is by long continued friction & Exercise;
but as ye friction on ye dry Skin,-
wd. be apt to excoriate it, we may interpose
some unctious Substance, wch. may be 
impregnated wth. Camphor &c. - But it 
becomes necessary to add vigour to ye System 
after ye Water is evacuated, & ys is to be done 
by Tonics, such as Bark, Chalybeates, Cold
Bathing &c, but these are inadmissable when 
any of ye effused Fluid remains & in Schirrhus; -
therefore Bitters & Aromatics are safer, wt. Animal 
Food, Moderate Use of Wine & Exercise -


+ The swelling in general retains the natural 
Colour tho,' in some occasions there is peculiar 
Transparency, or slight red. -
The chief Distress arises from Dyspnea -



61
Genus 5th. Emphysema; or 
Effusion of Air into ye Cellular Membrane. 
This Disease is sometimes confined to 
particular parts, as ye Eye Lids, Scrotum,
& all ye Organs of Generation; but in all 
Cases where, + it affects System in general. +
It may readily be distinguished from 
Anasarca by ye crackling Noise, wch. is occasioned 
by pressure, & by it not retaining 
the pressure of ye Fingers, besides ye Figure
of ye swelling is not altered by changing 
ye position of ye Body; & this Disease generally 
begins at ye Chest, & is extended in 
every Direction. It may be distinguished
from præternatural Quantity of Fat, by
it’s not pitting, or giving any Noise, & it -
is generally less tense & more gradual in 
its progress – The Causes of ys Complaint
are various – It sometimes arises from ye
immediate action of Hysteria; it is also 
often induced by febrile Complaints, both 
Putrid & Intermittent; It may also be occasioned 
by ye Bite of some Noxious Animal;
tho' the most common Cause is ye Communication
of ye external Air, wth. ye Cellular
Membrane by any means whatsoever; & ye.
x it is of any Consequence, 





62
Air of ye Lungs wch. is ye most important.
It is dangerous when ye Swelling of ye Surface
extends far; but much more so when
ye vital functions, particularly Respiration
are affected: in wch. Case, tho' there be 
not much Air in ye Cellular Membrane
on ye Surface of ye Body, yet we may suppose 
it has entered ye Cellular [Substance] Texture
of ye Lungs. -
The Cure must be directed two ways, –
1st. By ye Removal of Air from ye Cells or 
Cavities, in which it is [effus'd] lodged. x
2dly. By ye prevention of a further Introduction. -
Hence when it occurs from
other Diseases, we must use Remedies in 
order to counteract these, when from Hysteria 
by medicines calculated to remove it &
when from Putrefaction, by ye Cortex Per. –
Electricity &c. – When it arises from ye introduction
of Atmospheric Air, from Wounds
of ye Trachea or Lungs, or from external Injuries, 
Medicines will be of little Consequence. When 
it arises from Rupture of ye Trachea, Compression 
may be of service, but if ye Lungs are 
wounded, nothing but ye Parachentesis will 
afford any Relief. – 




63
Genus 6th. Tympanites.
This Disease begins wth. a pain & Tension 
about ye Loins, a bound state of ye. -
Belly followed by pain & swelling of ye
Abdomen; this Swelling sometimes advances
gradually, at other times its progress
is very quick; in a short time the 
Teguments become tense & elastic, as the 
Head of a Drum whence it has it's Name;
& on percussion it sometimes sounds like
a Drum. This swelling is often attended
wth. Cough withot. Expectoration, want of Appetite, 
Sickness & Vomiting, Waste of the 
Body & often a yellow Tinge; frequent 
but vain efforts, to discharge Wind; no 
sleep during ye night; Breathing much affected;
but worst when lying on either
Side; often Palpitation & Anxiety, Dimness 
of Sight, & sometimes Vertigo; wth these 
also occur great Irregularities of ye Pulse, 
ye Urine is little affected, sometimes insensibly
discharged in small quantity, 
the bound State of ye Belly generally continues
thro' ye whole of ye Disease, and is increased



64
increased towards ye End; & ye excrementitious 
matter discharged is of a dry & firm consistance; 
at last everything taken is discharged
by vomit; wch. soon ends in [illegible]
or Inflammation & Death. The Duration is 
very uncertain, in some cases & ends in 
a few Months, but more commonly continues 
for many years. – We have already 
shown, when treating of Ascites, how Tympanites
may be distinguished from yt. 
Disease. It may be known from Diseases
of ye Viscera, by ye Uniformity & Elasticity
of ye Swelling, & often by ye Sound, 
but even where yt. is wanting, it may be 
characterized by ye relief obtained from 
ye Discharge of Flatus. It most commonly 
attacks Females & often after delivery;
& is common wth. ye sedentary & studious
& those who live on farinaceous &
Liguminous vegitables. Great Thirst, -
much oppression, a sense of pricking-
Heat, swelled & Ulcerated Legs are bad Symptoms.
When ye Pain is very violent, there 
often occurs Stranguary or Ischemia & sometimes
bloody vomiting -



65
It may perhaps be more easy to prevent
yn. to cure this Disease, & its progress is generally 
so gradual, yt it may be combated in
its incipient State. As ye least Air is extricated
from solid Animal Food, & from
pure Water or Spirits & Water, hence in such 
an Affection as ys. ye Aliment should be 
properly accommodated; & to prevent a
fresh extrication of Air, we shd. endeavour
to preserve a proper Tone of ye Alimentary 
Canal, & Integuments of ye Abdomen. This 
may be brought about, by proper Exercise
in dry & free Air & of moderate Temperature -
In regimen we ought to avoid 
all acid & acescent Vegitables, & Narcotic 
Druggs wch. tend to weaken ye Alimentary 
Canal; but it is sometimes weakened from 
causes formed in ye Stomach, as Ingesta &c.
When ys is ye Case we must endeavor to remove
ym. by gentle Aperients, as small doses of
ye Pulul. Aloct. But it often happens yt this 
will prove ineffectual, hence we must use 
other means for supporting [crossed out] Tone by stimulating 
Diet, Tonics, Bitters, Aromatics,
& Astrigents; The chewing of Bark or Rhubarb





66
is sometimes useful. When ye Disease is 
advanced we must attempt something 
towards ye Cure; wth ys view Cathartics have 
been recommended, & in general mild 
ones, as Manna, Oil of Almonds, Ol. Oliv.
Ol. Ricini &c. but I think yre shd. be added 
to ye Use something stronger as R. Jalap.
It has been a more common practise to 
make Use of stimulating Carminatives.
& ye Best are Nutmeg & Cardamom. The Ag
Menth. Pip. is a good Medicine wth. ys view,
& ye best substitute for a dram, I have know
several persons who wd. have fallen Sacrifices
to dram drinking had it not been for ye Medicine.
Some advantage may be derived
from stimulating Antispasmodics, as 
Castor & Assafœtida; ye latter may not only 
be taken by ye Mouth, but thrown up by
way of Glyster, or applied as a plaister to
ye region of ye Stomach. Perhaps better Effects
may be obtained from ye application
of Blisters. – As a topical Application 
some have advised fomentations of Chamomile 
Flowers or Germander to ye Abdomen. 
Punctures of ye Abdomen have also 




67
been recommended, but I think this a dangerous 
Operation, wch. ought only to be attempted
in desperate Cases. Some have likewise advised
puncture of the Intestines ymselves, but 
a practitioner, when ys is necessary, ought rather
to look upon ye Disease as incurable &
only use palliative Medicines. I think Electricity, 
from its known use in Paralytic
Affections ought to have a tryal, as yre. seems 
here to be a Paralysis.-




68
Ord: 2. Epischeses or 
Obstructed Discharges-
The Human Body while it continues
in health has a variety of Evacuations, -
some of which are certain & permanent,
others are confined to particular Periods,
& these Discharges are suited for a variety
of Purposes; hence ye Symptoms from -
Obstruction must be very dissimular
but as they all ultimately tend to produce 
Discharges, there is some general Analogy
between ym & hence they may form an Order
of Diseases. Yet when Obstruction takes place 
merely as a Symptom, ye primary affection 
cannot fall under our notice, consequently 
few will be treated of here. The most obvious 
Discharges are by Stool & Urine; hence yse. 
claim our first Attention -
Genus 7th. Obstipatio.
This Disease generally begins wth. a Sense 
of Weight & Tension about ye under Part of 
ye Belly, wth transient Pains, & an Appearance 




69
of Wind; The Appetite is diminished & these 
occurs a disagreeable Taste in ye Mouth to 
ye succeed anxiety & Sickness wth. Headach,
the Skin becomes hotter yn natural wth. quick 
pulse & great Thirst. The Head-ach often constitues
Vertigo & Tinnitus Aurium; often a 
suppression of Urine, wch. sometimes appears 
bloody. All yse. Symptoms increase till at
length Inflammation comes on & Ileus 	
puts an end to ye Patients Life. This Disease 
may arise from a variety of Causes. It
mostly occurs wth ye Melancholic & Hysteric, 
& is frequent wth ye sedentary & Studious; but 
more commonly arises from ye State of ye
Ingesta, from too much solid food, from ye 
sparing Use of diluents, & from rough Wines;
yet it may originate from profuse Discharges 
of Urine &c. & is often ye effect of certain in 
Remedies. – When ye Pain is severe & a local 
Hardness in any part of ye Abdomen, it is 
bad, also when frequent vomiting, as from ys
we may dread Ileus, – It often happens
yt more can be done for ye prevention of 
ys Disease yn for ye Cure; 10th ys view we must 
avoid ye use of Acescent, Astringents Sedative, 





70
Foods & yse. particularly having effects as -
purgatives, for ye Intestines, in consequence
of too great an action at one Time, will be
less disposed tox it another; hence it becomes
necessary to use for aliment, mucilaginous
demulcent & oleaginous Vegitables,
but above all to drink plentifully of Diluents,
wch. in proper quantity have so good an
Effect in keeping ye Body open, yt Dr. Cullen
in his Materia Medica ranks cold Water
among ye Cathartics. – The Cure consists in 
ye Expulsion of ye fœculent Matter; wth ys.
view ye saline Purgatives have been mostly 
used, particularly ye Sal. Glaub., but its
nauseating quality is apt to make ye
Stomach reject it I’wd therefore rather advise
ye new Invented Soda Phosphorate
wch. is much pleasanter Medicine, & answers
ye purpose effectually. Cream of Tarter
proves sometimes a good medicine. But wn.
these fail we must have recourse to Aloes,
Gamboge, Scammony, Colocynth &c – Ol.
Ricini has been much recommended, ye
best way of giving it is in Doses a ʒi ad ℥i 



71
by itself, but if it can not be taken ys way, 
it may be joined to an Acid & Sugar, or made
into ye form of an Emulsion, by means of 
Alkali- When more powerful Stimuli die
requisite Calomel may be combined with 
other Cathartics – But it sometimes happens
yt no medicine can be [con]retained on ye Stomach;
when yt happens Saline Glysters must 
be had recourse to; These only act on ye Rectum;
therefore wn. ye fœculent matter is lodged 
high in ye Intestines, Injections of Tobacco
Smoke is ye best remedy – I have 
known, ye Semicupium or Warm Bath -
have good effects. -
Genus 8th Ischuria, or 
Impeded discharge of Urine. 
This Disease we shall divide into Ischuria 
Renalis, & Ischuria Vesicalis;
To ye former we shall refer all those 
varieties, in wch. the morbid Affections depend[s]
either on ye Kidneys or Ureters, & to 
ye latter, where they depend either on ye Bladder
or Urethra.-



72
The Ischuria Renali begins wth. a dull
pain & sense of weight abt. ye Region of 
ye Kidneys – There is always a want of 
the usual discharge, tho' wth great inclination
to pass it; after a short time, there comes on
a loathing of food wth Cardialgia, wch. often
goes as far as Nausea & Vomiting; then – 
Dyspnea wth swellings of ye Anasarcous
kind; at length a Taste of Urine is formed
in ye Mouth, & often Convulsive affections
occur as Hiccup &c, yre are succeeded by 
Anxiety & Febrile Symptoms, Debility,
quick, small & irregular Pulse & augmented
heat. These are accompanied wth.
a great propensity to sleep, they follow wth. Delirium,
Convulsions & Death. – In ye Ischuria
Vesicalis, a sense of weight is perceived abt.
ye Pubes & Bladder; wth a constant propensity 
to pass Urine; & a circumscribed Tumor
appears abt ye Region of ye Bladder, &
from ye Introduction of ye Catheter a -
discharge will generally take place, wth these occur
many of ye Symptoms of ye Ischuria Renalis.



73
The Causes of this Disease are very numerous;
those wch. acts as inducing predisposition
are, Strokes on ye Os Pubis
& Loins, the Operation of Lithotomy, 
Injuries from Sounding, ye Use of Cantharides, 
Operation for ye Fistula in Ano, 
Cold Drinks & excessive Venery. It may 
be [induced] caused by all ye. various accidents inducing 
Spasm or Paralysis, & ye various 
Causes giving obstruction, either by filling up
ye Ducts or compressing ym. - as collections
of Pus, Caruncles, Calculi, or from indurated 
Fœces or ye Gravid Uterus. –
An Alleviation of Symptoms, sometimes
takes places from a Copious Sweat, & also
from a copious Discharge from ye Salivary
Glands, in wch. Case ye Saliva has a strong 
Taste of Urine; but ye only salutary conclusion
is, from a free Discharge from ye
urinary Organs. -
When Ischuria arises from Spasm, we 
must have recourse to V.S. freely & repeatedly,
Emollient Glysters, Fomentations;
& Nitre has been recommended; but 







74
few Remedies are more powerful yn ye warm 
Bath, but it ought only to be used where
ye Cause is Spasm or Calculus; where ye
Warm Bath cannot be used, Fomentations
of ye Legs, or Pubes & Kidneys, & Bladder of 
warm Water, will answer ye Purpose. On 
ye same principle recourse is had to Opiates, 
& ye best way is to administer large Doses
as 30 or 40 Drops of R. Theb. - Calomel. 
has sometimes been joined wth. it, but I think 
it answers ye purpose as well without it. 
Diuretics are often of service in ye Ischuria 
Renalis, ye best is ye spt. [illegible]. Dulc. except 
wre. it is owing to Paralysis, in wch Case Cantharides
is one of ye most Effectual. -
External Stimuli, such as Cataplasms of 
Garlic, Onions &c. have been applied to 
ye Region of ye Pubes wth Advantage - 
when in ye Ischuria Vesicalis, all yse means 
fail, we must have recourse to Artificial 
Outlets; This may be best done by
ye Catheter wn. it can be introduced; but wn.
it cannot be introduced, ye Water must be
drawn off by puncture, & ys has been 






75
perform'd 3 ways, [by] at ye Paerinœum, the 
Pubes & Rectum, but I think ye first ye
Best. - But as yse. only obviate ye Symptoms,
without making a radical Cure; if ye Obstruction
is in ye Course of ye Urethra,
we ought to remove it by ye Knife, if
yt. can be effected. Sometimes a greater degree 
of Swelling takes place in ye Glans Penis,
[wch. may be so] in wch. Case we may -
apply a small Bougee. Sometimes Caruncles
Ulcers &c in ye Urethra are ye
Cause of ye Disease, in such Cases ye Bougee
ought to be had recourse to; but it 
is sometimes found impracticable to introduce 
it; when ys happens it is recommended 
to remove ye obstructing matter
by Caustic, introduced into ye Urethra
in such a manner, as not to act 
on ye other parts. – Electricity has been 
found one of ye most effectual Remedies
in Cases of Paralysis-



76
Genus 9th. Icterus. 
The first Symptom is yellowness of ye
Tunica Albuginea of ye Eyes; The Nails
also & ye whole surface of ye Body acquire 
a very deep Tinge; The Urine [crossed out] likewise is at 
first of a dark brown, afterwards of a 
reddish Colour; These are succeeded by 
uneasiness at ye Stomach, wch. is encreased
after a Meal, Want of Appetite & Headach,
& often an itchy Sensation on ye Surface.
There also occurs Vomiting wth. Febrile Symptoms,
But of all ye Symptoms, ye most essential
is ye alteration of ye Discharge by 
Stool; the belly is generally more bound 
yn natural, & ye matter discharge is of 
a whitish Colour; afterwards ye Saliva becomes 
tinged wth, a bitter taste in ye Mouth;
and vision becomes so much affected yt. 
all objects appear yellow, but ys does not 
always happen. In very obstinate Cases ye
Skin becomes even black.-



77 
The yellowness of ye Eyes may take place	
where Icterus does not subsist as in the Chlorosis,
& bilious vomiting in ye latter ye.
whole surface of ye Body may be tinged;
but it may be known from ye first by
ye urine & [illegible] ye last by ye Stools. -
This Disease may be caused by any accidents 
giving rise to ye Obstruction of 
ye Biliary Ducts, from uncommon Viscidity
of ye Bile, Sordes in ye Duodenum,
Spasm of ye Biliary Ducts or Intestinal 
Canal Schirrhus & Tumors in ye neighborhood 
of ye Biliary Ducts, Inflammation 
& Coalition of ye Sides of ye Ducts but 
mostly from Calculi in ye Gall Bladder or Ducts.
With a view to ye Cure of Disease Emetics 
have been much recommended, & when 
it is owing to Calculi, we ought to have 
recourse to ym.- Ipecacuana & Tart. Em.
together prove ye best, & they ought to be 
repeated at intervals of two or three -
Days; they prove useful in most Intances
of Icterus, but not in all. If,
after ye 3d or 4th Dose, no Calculi are -








78
voided, they ought to be discontinued. If 
ye Disease has been of long standing & where 
it has subsisted uniformly [for] without a 
Intermission, we should not attempt even 
one Dose. In Inflammation also & Spasm
they would be hurtful. - Cathartics are 
sometimes useful, particularly where 
there is an Effusion of a viscid Matter, 
[in] ye Intestinal Canal or Biliary Ducts, 
& also in Spasm & Cases of [illegible]. In wch. Cases we ought to 
use brisk purges as Calomel join'd with
Rhubarb & Jalap, or, as some advise, Saline
Purges, as Glaub. or Sal Epsom. but yse shd.
not be frequently repeated, or any other -
strong Purge. Some advise Manna, Cassia, 
& Tamarinds & they have been found useful. 
Recourse has likewise been had to Soap & 
Bitters, & I have known good effects produced 
by ye common blk Soap dissolved in 
Ale & taken in large Quantities. Aloes
have been joined to Soap, but ye best way 
of giving [of] Aloes seems to be in form of Tincture,
& if ye Disease be attended wth Wind, we 
may join to it Asafœtida. Purgative Injections 
are sometimes useful, where -








72
there is hard fœculent Matter abt. ye
Rectum, or where Hæmorrhoids forbid ye 
Use of Aloes. – Antispasmodics have been 
used, especially Opium & ye warm Bath.
These are suited all Cases, where ye Disease 
arises from Spasm. The Heat of the
Bath shd. be about 82°. & it should be continued
for a long time - Diuretics are 
sometimes useful, & ye best are ye Diluents,
as Infusion of Juniper, Diuretic Decoctions
&c. Raw Eggs have been used wth. Success-
In Case of Calculus in ye Ducts, Dr.
Monro has recommended making an 
Incision & pushing ye Stone either backwards
or forwards, [But] from ye operation there 
must be great danger, & in Case of Schirrhus, 
or adhesion of ye Ducts, no good can 
arise from it – But above all we ought not to -
neglect Exercise, as it is frequently capable of doing
more yn. any Medicine we are acquainted
with- Sometimes Yellowness of ye Skin
remains after ye Cause is removed, in wch. 
Case rubbing wth Vinegar, or ye Steams of it
may used. -







80
Genus 10th. Amenorrhæa or 
Obstructed Menses. -
There are two kinds of this Disease, one 
where ye Evacuation has never occurred, 
and another, where after having taken 
place, it ceases flowing; But in both the
Practice is nearly ye Same. In ye first 
Case, ye Symptoms are most gradual, 
in ye other, most rapid & violent. -
It first occurs wth. a very acute Pain, abt.
ye Uterus, returning at very short Intervals:
Sometimes ye Pain is dull, & more -
constant, & a degree of languor & debility 
ensues wth. a sense of weight, at ye lower
Extremities; the Appetite is bad, & Nausea
& Vomiting occurs; afterwards Pain of ye-
Head, Anxiety at ye Prœcordia, Oppression &
Difficulty of Breathing, Shivering & Flushing 
Heats, ye Countenance becomes pale
& Dropsical Appearances are perceived, to 
yse. supervene Palpitations & Faintings, wch.
soon induce Death. Sometimes ye Symptoms
are constant; at others yre are remissions,
but ye Symptoms return wth. doubled Violence
x
x at ye next Mensturating Period.-








81
These are ye most common Appearances, but 
others frequently occur, as Hæmorrhages at 
ye common Period, from different Parts of ye.
Body, sometimes it ushers in Jaundice, Paralysis
Apoplexy, Dropsy &c. It sometimes causes
Swellings, Ulcers, Cutaneous Eruptions &
Tubercles under ye Skin. The Senses are often 
affected, Idiotism, & Mania often come on.
The Cause of ys Disease is for ye most part owing to Cold, & 
Moisture acting on ye lower extremities, particularly 
during ye Flow; but it sometimes 
arises from Malconformation of ye Parts & imperforated
Hymen. Passions of ye. Mind & Nervous 
affections likewise cause it. -
In order to effect a Cure, we must have recourse
to Emenagogues, but it is often hard
to say what sort, as from ye variety of Indications
ye Cure is much varied. Where 
ye menses never flowed, we ought first to 
examine ye State of ye Parts, & if ye Hymen
is imperforated, we make an Incision with 
a Lancet, but if ye membrane is very thick
a Trocar shd. be used. Where it occurs in time 
of Menstruation or in Hysteria, ye Pediluveum
or Warm Bath, wth. Opium may be used.
Recourse has also been had to Castor & 



Rx. Pulv Cart P. – Rub Tinct.
aa ℥ss – Sumt. Cach. parv. bis indies
Capt. etiam Pil. Aloet. gr. v. om. nocte


82
Asafœtida wth. Advantage, & many other Antispasmodics -
Many Cathartics have been 
used wth. Success, as Calocynth, Jalap, Mercury
&c, but ye Aloctic are ye Best, wch. shd. be exhibited
in ye form of Pills. – Sabrina has by
some been thot. a Specific & it acts very powerfully.
Marrubium has been recommended.
but, I think it has no great power. The Helleb.
Nig. is much given; Two or three Teaspoonfuls
of ye Tincture are generally given twice a Day, but ye
best way is to exhibit a Teaspoonful, as ye
Patient's Stomach will bear it. The Rubia 
Tinctourm has been highly spoken of: I have 
used it but I think without any great Effects.
With some, Tincture of Cantharides is a favorite
Remedy, but I [expect] believe little is to be expected from 
them, as to their affecting ye System in general.
Ligatures on ye Thighs have been used; & may be 
useful where an accumulation in ye Uterus
is wanting, but much Caution is required in
ye Use, as such a Change in ye Circulation may 
cause many morbid Affections. Chalybeates x
are useful, wre Tonics Powers are wanting in ye
System; & ye Cold Bath wre. Atony [crossed out] prevails. 
x & Barks







83
Antimonials sometimes have a good effect. By 
removing obstruction in ye extreme Vessels & 
promoting a free Circulation; but in ye advanced 
Stages few remedies are preferable to Mercurials.
Electricity is very useful, & has an
instantaneous effect frequently. -
Genus 11th. Dyslochia or 
Suppression of ye Lochia
This Evacuation is subject to many varieties 
without Inconvenience, & it generally becomes 
pale & has little Blood abt. ye fifth or sixth.
Day, & abt. ye 9th. Ceases, at other times it stops 
abt. ye 2d. [illegible] ye Quantity evacuated is from 
1. to 3. Sometimes after it is suppressed it begins 
again & wn. it does not it often produces
great danger. – When ye Evacuation is 
suddenly suppressed, the first Complaint is 
pain at ye under Part of ye Belly, succeeded 
by Shivering, hot & Cold Fits, quick Pulses 
Thirst, & a hard Swelling abt. ye Pubes, in wch. may 
be felt strong Pulsation, Uneasiness abt. ye Neck
of ye Bladder, sometimes total Ischuria, - 
Sickness & Vomiting, Pain in ye Mamma wch. [are]
swell & are distended wth. Milk, [crosses out] local Hardness x
sometimes Inflammation & Suppuration take place.








84
The Fever most commonly [has] assumes ye Nervous Type,
wth. Miliary Eruptions & Petechia. At length 
Convulsions & Cold Sweats usher in Syncope,
wch. puts an end to ye Patients Life, [crossed out] sometimes
Apoplexy & Epilepsy. - This Disease is produced 
by several Causes, as exposure to Cold, -
Passions of ye Mind, especially Fear & Anger, Morbid 
Discharges particularly Diarrhea, profuse 
Sweats & Astringent Medicines used to stop the
profuseness of ye Discharge, Hysteria, & it is sometimes occasioned 
by tight bandages put on after Delivery.
Spasms frequently cause it, as of ye Os Uteri &c-
In regard to ye Cure V. S. has been much recommended, 
& is more frequently practiced yn. it -
ought to be, it is only Allowable wre. there is -
great Fever, & Inflammatory Symptoms of 
ye Uterus &c. If a buffy Coat appears on ye Blood,
it may be repeated, especially if ye Patient finds 
any relief from it. [crossed out] Diaphoretics have
given relief; when they are used we shd. employ
ye mildest: Tartar Emetic is ye best; it may be 
used either wth. ye Saline Julep, or combined wth.
Opium; but in ye last form is most useful.
Fomentations of ye Legs; & Region of ye Uterus, 
wth. Emollient Glysters, are frequently of great Service.







85
Opiates [shd.] may be employed in case of Pain or Restlessness, 
but we shd. not be too free wth. ym. on acct.
of their binding quality. The Flores Maiticalles
are much employed, & have been greatly recommended
by Dr. Gregory Sen. but of ye Medicine
I can say nothing, as I have not experienced it. -
Compression of ye Belly must be 
attended to in all Cases of ye Disease, as it is 
sometimes owing to ye bandage not being tight 
enough, tho' more frequently to ye contrary.-







86
Order 3d. Profluvia or 
Increased Discharges.-
In adopting ye Order I have followed every
Novological Writer; however when we 
consider ye different Intentions of Nature, 
it is evident yt ye Symptoms must be varied
from ye nature of ye Discharge, & more especially 
from yse. wch. never occurred in a sound 
State. Those wch. occur in an unnatural 
Emunctory are morbid Hæmorrages, wch. are 
well worth Consideration.-
Genus 12th Catarrhus.-
There are two Species of ye the one from -
Cold, ye other from Contagion. Of ye first we 
treat here. Of ys yre are two States, in some 
Cases it is febrile, ending in a few Days, in
others, it degenerates into a Chronic Complaint,
continuing for Years. The two tho' differing a 
little, are yet essentially ye same, being an 
increased discharge of Mucus from ye Fauces,
Trachea, &c. They may be divided into Acute & Chronic. 








87
Catarrh begins with a Sense of Cold & Shivering
alternate hot & Cold Fits succeed each 
other, wth. an uncommon flow of Tears, & Mucous 
from ye Nose; this is succeeded by pain & Inflammation 
of ye upper Lip, & most of ye Membrane 
of ye Nose & Throat: There is sometimes a dry -
Cough, the appetite is impaired, tho' sometimes
peculiarly keen, the Heat increases towards
Night & ye Sleep is restless, Pulse generally 
quick & hard, Belly bound, tho' sometimes
diarrhœa is observed, Urine high coloured, & 
not unfrequently diminished; but yse Symptoms
don’t continue long: in place of a 
thin discharge a thicker is expectorated, ye
expectoration is much easier; & at last becomes
natural. Sometimes yre is degeneracy 
from a healthy to a morbid State; the 
Expectoration goes on easy thro' ye Day, but by
Sleep becomes thick, consequently brt. up wth.
difficulty in ye Morning, wch. causes severe
Coughing, afterwards yre occurs difficulty of 
Breathing, ye Appetite is more impaired, & ye
Cough causes Vertigo & Headache, Pulse becomes 
small & irregular, ye Patient can’t enjoy refreshing








88
refreshing Sleep, his Strength is exhausted, so
as not to be able to bring up ye Matter, & Death
is occasioned by ye accumulation of Mucus
in ye Lungs & Trachea. – The exciting 
Cause is sudden Changes from Heat to Cold, especially 
where ye Application is local & wre. Moisture is 
joined wth. it. - To prevent ys. Disease, ye System 
shd. be strengthened by habitual exposure 
to Cold from ye earliest Ages; but wre. this 
has been neglected, the Patient shd. gradually accustom
himself to Cold, by Bathing, or taking 
exercise in ye open Air. - [crossed out]
To obviate ye Inflammatory Diathesis, in 
ye Incipient State of ye Disease, the Cooling 
Regimen is chiefly to be followed; we therefore 
restrain ye Patient from all fermented 
Liquors, & Animal Food, except Milk, besides 
wch. recent vegitables may be employed; where 
ye Method fails we must use V. S. except in 
Chronic Cases, when [we must] it would be inadmissable.
A gentle Diaphoresis is often very serviceable 
& ys may be obtain'd by Sack Whey, & ye Spirt.
Mindereri accompanied wth. Pediluvium & -
proper cloathing thro' ye Day. -

Rx Vin. Nicot. gr. Ix Mist. Mucil.
℥vj ♏︎ Capt. ℥ƒ ter de die
Capt. Pil. Taillit. gr. v omn. nocte.

89
Demulcents are often useful; of ye Mucilaginous 
ye chiglare, G. Arabic & Tragacanth: of ye Oily, Ol.
Olivar. united wth Water, by means of Alkali; but yse if 
used too freely weaken ye Stomach, Asses Milk is another,
but it is never given in sufficient quantity: but 
few remedies are better yn. Honey. Opiates are good
for allaying ye Cough, but they are only adapted 
to ye Acute State, as they render ye Mucus viscid,
wch. is already too much so in ye Chronic; nor shd.
they be used till after Evacuation. Gentle Laxatives
are often useful, particularly in ye Acute,
but violent Purgatives shd. never be used. Emollient 
Injections have been advised. Blisters &
Issues are ye most powerful means used in ys 
Disease & ought never to be omitted, especially
ye former. – Another set of Remedies are Expectorants,
& yse are often very useful as they -
serve to increase ye Secretion & Excretion by 
ye Lungs; Garlic, Gum Arabic & Squils, are 
the best; Assafœtida has also been used wth.
ys intention; also Emetics wch. sometimes -
prove serviceable, & when used Ipecac shd. be 
preferred. I have found Astringents sometimes 
of service – On ye whole Issues, Emetics & -
Squills, are ye best Remedies. -






90.
Genus 13th. Diarrhæa
This Disease begins wth. want of Appetite and 
preternatural Thirst, with frequent thin Stools.
If these remain long, they are followed by Borborigmi
in ye Bowels, causing Eructations, a 
particular Paleness & Loss of Strength. In ys.
Stage there is no fever, but ye Pulse is more 
strong yn. natural, & in some Cases Intermittent.
Afterwards ye Stools become more watery,
ye quantity is diminished, & yre. is pain both before 
& after, with little Discharge except 
Mucus. then follows Tenesmus, & Blood is 
evacuated in small quantities & pure, not 
like yt. in Dysentery. At length the Disease 
increases, cold Fits appear wth. quick & small
pulse, restlessness, Axiety, & finally Death
supervenes. Frequently a different Termination 
takes place; the Excrement returning 
to its natural State; without the Assistance
of Medicine. - Some Constitutions are -
liable to frequent Returns of ye Complaint, 
upon every little Cold; to prevent wch. a Flannel 
Shirt shd. be worn; In some Cases it is 
Caused by generation of Acids in ye Stomach

Rx. Pulv. Crem. Tartar.
- Rad. Glycyrrh. aa ℥i
- Cort. capia ʒi ♏︎. Capt.
Coch. parv. bis vel ter de die -

91
Stomach, in wch. Case Vegitable Diet & Acessant -
Fruits ought to be avoided. – Emetics are 
proper at ye begining, but Cathartics are often 
more useful, particularly yse. wch. unite a -
binding quality of ye Purgative, hence Rhubarb,
to wch. some advise Ipecac. to be joined.
Glaubers Salt is often beneficial Diaphoretics
are mostly useful, especially wn. ye Disease 
proceeds from Cold; some advise Dover's Powd.
but I think ye more gentle ones, as small Doses
of Ipecac. or Tart. Em. are better. Absorbents
may be used wth. Advantage, those wch. bind 
ye Belly, as Ocul. Cancror. Fest. Ostreor, Lime
Water &c. are most useful in old Persons, or wre.
ye Affection is far advanced; but in Children 
the opening ones are best, as Magnes. Tart. Solub. &c.
Demuculents as Rice & Milk, Sago, Jalop, Harts hour
Jelly, & G. Arab. are often serviceable. Opiates -
are useful after ye Exhibition of Cathartics.-
When ye Patient is debilitated we may have Recourse
to Astringents as Decoct. Campechens. Simaranba,
Succ. Japon, either in Electuary wth Opium & Aromatics,
or in Infusions, & ye Tinct. e [illegible] wch.
I think a good medicine. -






92
Genus 14th. Cholera.
This Disease depends on an increased Secretion 
of Bile. The first Attack is an uneasiness at ye Stomach, 
wth. Eructation, afterwards vomiting of a 
yellow Colour & bitter Taste ensues, sometimes ye -
matter is green, sometimes black &c. This is [crossed out]
attended with pricking Pain at ye Stomach, wch is propagated 
downwards producing Diarrhæa. There is 
an excruciating Pain in ye Belly, wth. a Sense of 
Heat & Thirst, Pulse [irregular] frequent & small, wth cold -
Sweats; at length Spasmodic Affections of ye
Legs & Arms supervene; also an Inclination to 
discharge Urine, in vain, Hiccup, Convulsions,
Coldness of Extremities, & Deliquium Animi.
The common exciting Causes are Acrid Cathartics, -
much Fat eaten, & especially fruits of an Asescent
kind. In order to bring abt. a Cure, we -
ought, in ye first place, to have recourse to 
Diluents, as yse. dilute ye Bile, & facilitate ye
Evacuation of it wth. ye view, ye Decoct. Album,
Chicken Broth Infus. Lini, Milk, & Acidulated Water, have been 
recommended; but I think more Benefit
may be derived from Pure Water at ye Temperature






93
Temperature of abt. 90 Degrees. Diluents may likewise
be useful thrown in by way of Injection;
but yre. ought to be frequent repetitions of them. 
Emetics are very hurtful, & also Purgatives,
unless every [gentle] mild ones. After ye Bile is sufficiently 
evacuated a full dose of Opium, in 
ye form of Pill, may be exhibited; but if ys 
shd be thrown up, we may try Tinct. Rheb. in 
Doses of gH. x or xij repeated every half hour 
for 4 or 5 times. If ye vomiting still continues, 
Saline Draught in ye Act of Efferescence
may be given, or wt. I think better 
is first to throw in ye Alkali, yn ye Acid. We 
may likewise use ye Spt. Lav C. on Lump of 
Sugar, in a Glass of Mint Water, or in Brandy. 
External Applications have been advised, as Therica
but more dependance is to be put on Fomentations
of warm Water, or ye Semicupium;
Ward's Volatile Essce. & Æther wth Laudanm. or Spt. Vin C.
have been used. If Inflammation occurs N.S.-
When ye Disease is overcome we may give Cordial
as Diascordium, Elect. Japon &c; or perhaps Cort.
Peruv., Port Wine, Solid Nutritious Diet, wth. Exercise, 
are of more Consequence.-





94
Genus 15th. Diabetes.
This is an obstinate Disease, & is generally 
found to baffle our utmost Efforts. It begins 
wth. a frequent inclination to pass Urine, wth. - 
Thirst & dryness of ye Mouth, x the Patient voids
from abt. 12H to 20H of Urine, in ye Space of 24 Hours,
while ye Drink is not more yn 8H or 10H. The Urine 
is also less high coloured & more transparent; Generally 
it suffers no Separation by standing, tho' sometimes 
it appears like Whey, sometimes, like -
Milk & Water, & at other times as if it contained 
Oil. But it is changed in no respect more than 
in Taste, wch. is changed from a Saline to a Sweetish 
& ys sweetness increases, as ye Urine increases
in quantity. The Matter giving ye Taste is found 
to be Sugar; & Dr Black has extracted it in ye
form of granulated Honey. The Urine has also 
a strong smell [of] like Violets; but ys is not 
constant, as ye Smell is much influenced by 
ye Food. The Saliva becomes [crossed out] more viscid & 
frothy yn. natural. The Surface feels parched,
& in ye progress of ye Disease, corrugated sometimes
even scaly. All attempt to induce a -
Moisture are commonly in vain. In most Cases
yre is great Costiveness wch increases, as ye Disease 
advances. The Appetite both for Fluids





95
& Solids is much increased, sometimes to great
voraciousness; nevertheless ye Body is emaciated,
& ye Strength impaired. The Patient feels a 
Pain in ye Back & abt. ye Kidneys. Adematous 
Swelling affect the Back Loins & Scrotum
but chiefly ye lower Extremities: these chiefly 
occur, if ye quantity of Urine is lessened by 
strong Astringents. Wth. yse. Symptoms, yre. is 
commonly difficulty of Respiration; & sometimes
towards ye end of ye Disease, febrile attacks 
supervene: the Pulse becomes small &
quick; the Patient complains of Local heat, 
especially in ye Hands & Feet and a burning 
heat thro' the Alimentary Canal. Wth yse. Complaints,
yre. is a great dejection of Spirits; & ye 
Patient is either worn out & dies wth. Hectic Fever, 
or is more suddenly cut off by Convulsions. 
The exciting Causes are Passions of ye Mind, excessive
Venery, frequent Vomiting & Purging, V.S., -
great bodily fatigue, long exposure to Cold, Gouty 
Affections, & I may add, drinking much watery 
Fluids, especially Tea. – Of all ye Remedies -
employed for ye Cure, none are more frequently -
used yn. Astringents, as Lime Water, Vitriolic
Acid, Bristol Water, &c, but Allum seems to be 
ye best, joined wth. Succ Japon. G [illegible] &c. or given




96
in a fluid State, as ye [Serum] Aluminosium.-
Tonics have been employed wth. a view of increasing 
ye Tone of ye System; as Cortex Peruv. Cold Bath, 
Bitters & Exercise - Tincture of Cantharides
is said to have very good effects in ys Disease, by
stimulating ye Kidneys. - Diaphoretics have 
been much recommended, we are told of several
Patients being cured by ye sweating Plan. Dover's
Powder preceeded by ye warm Bath, in a powerful
method of sweating Flannel Shirts may be -
useful. Removal to a warmer Climate is 
said to have cured ye Disease. Emetics have 
been suggested & they may be serviceable at 
early Stages. - External Applications have 
been tried as Cold Applied to ye region of ye Kidneys,
& Belts containing Astringent Substances;
& from ye latter of yse. Dr. Whytt thinks 
he has seen good Effects. Blisters have been 
applied to ye Loins, but without much Advantage.
Upon ye whole, the Cure of ys Disease remains 
to be discovered; I wd. advise ye trial of Metallic -
Tonics, as Cuprum Ammon. Vitriol. Alb. &c. &
perhaps nervous medicines, as Camphor, Musk, &c
might be useful. As a Purgative I wd. recommend 
Ol. Ricini wth. R. of Jalap. & for Diet Fat Meat, 
wth. plenty of Butter, wch. has a good Effect in allaying 
Thirst. -





97.
Genus 16th Cystirrhœa.
This Disease consists in a discharge of Mucus
from ye Bladder wth. ye Urine. - It generally 
begins wth. a frequent Inclination to discharge Urine,
wch. runs in a stream Smaller yn. usual, wth. 
unusual Resistance at ye Neck of ye Bladder &
Pain & heat at ye Discharge. There occurs also a Change
in ye Colour; at ye Commencement it is usually of a 
very high Colour + & wn cooled deposites a peculiar
Matter, sometimes resembling ye White of an Egg; sometimes
appearing of a fibrous Texture & [at other times] as 
if Wool was swimming in it. It sometimes has a 
strong fœtid Smell. With yse. Symptoms, ye -
Strength is gradually lost & ye Constitution 
becomes impaired. Altho' the Progress of ye Disease 
be slow, yet it is not soon counteracted it will
prove fatal, inducing Ulcerations in ye Bladder, 
wch. gives rise to Hectic Fever; & often total Suppression
of urine. - Nothing perhaps is of more 
Consequence towds. ye. Cure of ye Disease, ys. ye proper regulation
of Diet; hence all Stimulating Food must be 
avoided; the Patient shd. be mostly confined to 
Vegitables, but sometimes Milk & White Flesh 
may be indulged in. All Spirits shd. be avoided. -
x but wn. ye. Disease has been of long continuance, it has a whitish cast, resembling Whey. 







98
Opiates are useful to [obviate] mitigate ye Pain & 
Strangury; but it is necessary to join Purgatives 
to them, such as Elect. Lenitiv. Manna &c. but 
they ought never to be used to any great extent,
because they leave ye Parts more irritable, when 
the Effects are gone off. - Hyosciamus has 
been used wth. advantage by Dr. Cullen in ye 
form of Extract; & it appears to be a good Medicine
as it is said to unite an opening wth. a Sedative
quality. If yre. appears to be a Schirrhus of 
ye Bladder, the Use of Cicuta may be [serviceable] advisable. Diluents
& Demulcents may be used to palliate Symptoms.
To [add] brace ye System & restore Tone 
to ye parts, Absorbents & Astringents shd. be 
used: the Absorbents mostly recommended
are Ag. Calcis, Lixivia &c; & as an astringent 
ye Uva Ursi has been much used: But I think 
greater Advantage may be derived from the 
Use of Cortex Peruv. & ye Cold Bath. I wd. also 
advise Astringents to be injected into the 
Bladder; as a weak Solution of Sacc. Saturn &c. 
but we ought to be cautious in ye Use of them.





99
Genus 17th. Leucorhœa or 
Fluor Albus.
This Disease consists in ye Discharge of a 
[Serum] Liquor from ye Vagina and Uterus. The 
Flow generally commences immediately after ye 
Menses & continues at first for 2 or 3 Days. It returns 
both before & after every succeeding Menstruation;
& ye duration of ys. Discharge is increased
every Time, till at length it becomes 
constant. At first ye. Discharge is thin, without 
any inconvenience, except an itching of ye Labia 
Pudendi; afterwards it becomes thick & 
White; at length yellow & sometimes even green,
& yn. it has a Strong Fœtid Smell & is very acrid.
The External parts swell & are ulcerated; & from 
ye fixed pain & purulent discharge we may conclude,
yt. yre. are Ulcers in ye internal Parts. -
During ye Progress ye Patient complains of Lassitude
wth. Pain abt. ye Regio Lumbar. & ye Appetite
is impaired, & yre. generally occurs great Constipation
[crossed out] accompanied wth. Thirst; ye Countenance
becomes pale, & Œdema occurs in various 
parts: At length Circulation & Respiration 
becomes affected; wch. soon terminates in Deliquum
Animi. Sometimes yre. are Marks of 




100.
general Cachexia & hectic Fever puts an End to 
ye patients Life. This Disease is most frequent 
wth. those Women who lead an inactive Life, &
indulge themselves too much in Bed. It is often 
occasioned by Heat, Cold, or Moisture applied 
to ye inferior Extremities - For ye.
Cure, recourse has been had to Astrigents
as Rad. Bistorl. Tormentil Infus. Rosar: -
Simaranlea &c. but I think more advantage
may be derived from yse. of ye mineral kingdom,
particularly yse. wch. have ye Vitriolic Acid for yre. 
basis, as Allum &c. & yse. may be joined to -
vegetables as ye Pulv Styptics with G. Kino & 
Terr. Japon. - Tonics, as Bark & Steel [crossed out]
[crossed out] where they will stay on ye Stomach,
may be very advantageously employed, 
& ye Cold Bath wt. Exercise may be joined to them. Absorbents 
may be useful, wre. Acid abounds in ye
Stomach, as the Testaceous Powders & Lime -
Water. Stomachics too, may be employed as 
Infus. Amar. R: Sucra &c.- Astringent Injections 
have been advised, but they can only be 
serviceable wre. ye Disease is confined to the 
Vagina. When it is [owing] accompanied wth. Plethora,
or if owing to obstructed Menses, Blood letting 
is highly necessary. A gentle Emetic, or two is -
sometimes of Service; as small Doses of Ipecacuana,




101
Small Doses of Rhubarb are sometimes
necessary to keep ye Body open. Diaphoretics used to 
a certain extent, may have good effects by determining 
to ye Surface, but ye most mild should 
be used as Decoct Lignor. Demulcents too, -
where there is [Ardor] urine may be of Service. 
But of all ye means, there is none of greater [crossed out]
importance yn. a proper regulation of Diet;
ys. where Plethora does not subsist, should be
nutritious. All Fat & but Butynaceous matters (Milk
excepted) shd. be avoided; & likewise flatulent Food.
The Patient shd. refrain from Malt Liquors, & any 
Fluid to a great Extent. The best Drink is Wine 
or Spirits & Water, & to a Certain Extent pure -
Wine may be indulged in. The quantity of 
Food must be regulated by ye. State of the -
Stomach. -
Genus 18th. Gonorrhœa
We mean here solely to confine ourselves 
to yt. Affection, wch. is strictly termed Gonorrhœa
Virulenta. - It generally begins wth.
a slight Titillation abt. ye Point of ye Urethra,
seldom before ye 2d. or after ye 12th. Day after Coition.



102
tho' it sometimes does not appear till after Months.
The discharge is at first small in quantity, & of a 
limpid Appearance, & yre. is no pain, but on ye contrary
an agreeable Sensation; wn. ys has subsisted 
for some time, ye Extremity of ye Urethra
becomes swelled, & ye orifice is more open yn. natural,
wth. slight Inflammation, [crossed out] and pricking 
heat, wch. is augmented on ye discharge of Urine. 
The discharge increases, becomes thicker, & assumes
a whitish Cast. Afterwards ye Pain is augmented
particularly behind ye Glans, & yre. occurs an 
uncommon stiffness of ye Penis. The Matter
is now observed to become of a yellow colour,
& sometimes even green. The heat & Pain on 
passing Urine are excruciating & ye Penis is 
subject to frequent Erections x wth. Stricture of ye underpart &
incurvation; ys. is called Cordec. The Disease 
may now be said to have arrived at its height, & 
this generally happens in ye space of 1, 2, or 3 Week. -
After wch. time ye Symptoms gradually diminish,
& under proper Treatment, ye Disease commonly 
terminates in 5 or 6 Weeks.- The above are 
not ye only symptoms; many anomalous ones 
often occur; as violent Strangury, & very often 
it is succeeded by incontinence of Urine: -
Swelling of ye. Testes often occur; likewise Phymosis 
& Paraphymosis, & sometimes Ulcerations 
x especially in ye night.



103.
only ye Glans & Prepuce. The Seguella of ye Disease 
are a growth of Warts on ye Penis, wth. Induration 
& Stricture of ye Urethra; wch. often
happen. - It has been long disputed whether 
ye Contagion giving Gonorrhea is ye Same wth.
yt. giving Lues; or whether they are two different 
Diseases. The latter opinion I have adopted.
For ye Facts on wch. each opinion is founded &c. I 
refer you to a publication by Mr. Bell, wch. is 
now getting ready for ye. Press. - In ys. Disease
something may be done in ye Way of 
Prophylaxis; wth. ys. view ye. Caustic alkali has 
been recommended; but I wd. advise it to be used
[crossed out] wn. deprived of its Caustic quality. A few grs. of Sal. Tartar.
or common Soap may be dissolved in a little 
Water & injected into ye Urethra; & I have known
ys. prevent ye Disease very often; perhaps washing 
wth. Water may be as efficacious. - The 
Cure we must consider as ye Work of Nature,
for unless from some peculiarity of Constitution
or Irregularities, ye Disease has always a natural 
Tendency to a Cure; hence our great Object
is to moderate ye Symptoms. We [may]
must attend to 2 Stages, ye inflammation & 
ye Atomic. To obviate Inflammation, we -
must have recourse to gentle Cathartics, as 



104
Sal. Glaub. - Soda Phoph - Crem. Tart. &c.-
Bloodletting is [also] of service here on ye same 
principles as in other Inflammations; both 
general & Topical have been advised; but ye 
latter is not necessary except in Phymosis & 
Paraphymosis. The Regimen ought to be ye. 
same as in other Inflammatory Diseases. Animal
Food & all strong Liquors shd. be avoided. 
Refrigerants may be used as Nitre to obviate
ye Ardor Urince, also G. Arab.; & Diluents as 
Barley or Toast & Water: When ye Chordee is 
violent Opiates must be had recourse to. If 
ye Glands are much inflamed x Poultices shd.
be applied, & Milk & Water, Ol. Oliv. or Muic. 
G. Arab. may be thrown between ye Prepuce
& Glands, or into ye Urethra.- After ye Inflammatory 
Stage, when ye Atonic comes on, we 
must have recourse to Astringents & Tonics -
Of ye former yse. most in use are ye.
Vitriol. Alb. & Sacc. Sat. from both of which
I have seen good Effects, but we ought to be 
cautious in ye use of ym. & never use ym. in ye
Inflammatory Stage – Of ye Tonics Bark
& Cold Bathing are ye best. - Strictures
of ye Urethra may be treated wth. Bougies. 




105.
Order 4th Cachexia, or Chronical 
Depravations of ye General Habit.
Genus 19th Scorbutus.
This Disease is generally first distinguished
by a pale Countenance attended wth great Lassitude
& Inactivity, & yre. arises [Dys??n?a] & Palpitation
on ye slightest exertion. The Patient also complains
of a Soreness of ye Bones as if they were 
bruised; & tho' ye Sleep is longer yn. natural,
'tis seldom refreshing. At ye Commencement ye Appetite
is but seldom impaired; tho' yre. sometimes 
occurs Nausea & Vomiting, wth. Cardialgia and 
fœtid Eructations. The Belly is irregular, sometimes, 
bound, sometimes, loose; The Discharge also in 
some Cases is fœtid, in others watery, & in a 
third Case bloody. The Urine is at first limpid,
& of a Citron Colour; it afterwards becomes thick
& deposites a white sediment; not unfrequently 
it is of a purple or brown Colour; & deposites a 
lateritious or furfuraceous sediment; in other 
Cases ye Top is covered wth. an Oily Pellicle; & after
it has stood sometime, shining Chrystals are 
found adhering to ye sides of ye Vessel. In ye progress x
ye Gums become affected; they acquire a Colour
+of ye Disease



106
more livid yn. natural, swell & are spongy; yre. is 
also an itchy sensation perceived in ym. & they -
are painful after eating; Hœmorrhages occur 
from ye slightest accident, & [crossed out] often without any 
obvious Cause. The Saliva is secreted in larger 
quantity, & is of a saltish taste. The Surface
of ye Body is now observ'd to require a -
dark & sooty Appearance: The Skin is more 
dry yn. natural, & ye appearance is known by ye.
name of ye. Cutis Anserina, To ys supervene
purple spots mostly on ye Face & Shoulders, wth.
hard Tubercles, not rising above ye Skin, but -
painful to y Touch, Large Livid Blotches occur 
[wth.] on ye lower Extremities: where yse. break 
an Ichor is discharged, & they degenerate into Ulcers:
wch. spread rapidly all over ye System. Hœmorrhagies 
occur from almost every pore of ye
Body, & ye slightest Scratch degenerates into an 
Ulcer. Pains now occur in every part of ye Body
sometimes dull, at others acute; but most severe
in ye Night. Respiration is affected; and 
yre. occurs swellings of ye Muscular parts, especially 
of ye Extremities, & on motion a crackling 
Noise is heard. At last ye joints become 
contracted & immovable; The Skin becomes -
rough & scaly; old Ulcers break out afresh, and 




107
if a Bone has formerly been broken, yre. happens
a dissolution of ye Callus. At ys time ye Patient 
is affected wth. universal Paralysis, & Death ensues
from ye slightest Causes. - This Disease does 
not occur, where ye Thermometer is above 62°. 
In order to prevent Scurvy, regard must be had 
to Cleanliness, Air, Diet & Exercise. When it 
happens at Sea, the Ship shd. be frequently washd.
& sprinkled wth. Vinegar. Fires shd. be made in different 
parts of it, & recourse shd. be had to Ventilators,
Air Sails &c. by yse. means any putrid -
Habitus is destroyed & fresh air brought in. The 
men shd. likewise be made to Wash themselves
frequently & never be sufferd to [lie down] go to [?e?]
yn. wet Cloaths; ys Hammock ought to be exposed
to ye Air every fair Day upon Deck.–
The Men shd. be exercised every Day; but great
fatigue must be avoided. – But of all ye -
means of prevention, ye chief is by attention
to Diet. Meat shd. never be employed wn. putrid,
& fat shd. be avoided – fresh provisions shd. be procured
as often as possible- & vegitables shd. be
ye chief part of ye Diet - Sour Crout is very useful -
As to Drink - Water or Grog acidulated
shd. be drank plentifully - or any acid Liquor -




108.
The Cure must be chiefly trusted to Vegitables
& perhaps none are preferable to Sour Crout & 
Wort.– With a view to ye expulsion of ye Morbific 
Matter, Diaphoretics & Diuretics have
been advised. The first have never been found 
useful but ye. last may be of service, & ye best
are Neutral Salts wch. may be combined wth. Camphor -
When ye Belly is bound recourse must 
be had to Crem. Tart. Manna &c. in shall Doses. -
R. Myrrh. Bals. Traum. Alum &c. may
be applied to ye Gums. & Mel. Agypt to ye Ulcers. -
Genus 20th Scrophula
This Disease is most frequent in Childhood,
seldom making its appearance after ye Age
of Manhood. At ye. Commencement small
hard Swellings are perceived in different 
parts of ye. Body especially behind ye Ears &
under ye Chin: yse increase very gradually
& for a long time retain ye natural Colour.
In Examination we may discover ym. to be 
affections of ye Sympathetic Glands. It may
occur at any season, but most frequent in




109
ye Spring. At first yre. is but slight pain, but 
it is afterwards augmented; & ye swellings become 
discoloured & a fluctuation can be perceived.
At lenght they break & discharge a 
watery [?an??s], wch. continues for a long Times
& if any of ye Ulcers heal. others break out,
'till from ye continual Discharge a wasting
of ye habits occurs, & y patient lingers out
a distressing Life, or is cut off by Hectic
Fever - The swellings may occur in any of 
ye Lymphatic Glands: They do not always suppurate, 
but sometimes degenerate into -
Schirrhus, & continue so for Life: Sometimes
after being long open, they spontaneously -
heal up & do not again break out, & ys. occurs
abt. ye 14th. or 15th. Year. In some Cases other -
Symptoms occur as swellings of ye Abdomen, 
& ye Face, wth. troublesome affections of ye Eyes, & 
by ye Long Continuance of Schrophula, ye Bones 
becomes eroded & Carious: But ye most painful
are yose. swellings of ye Joints called white Swellings 
wch. are looked upon as incurable, & unless
amputation be performed, they generally 
prove fatal.



Rx. Terræ Ponnderosa Muriata gH xx
augeatur gradations ad gH. IX _ Ag. Menth. 
℥ ivs [illegible]: Timp. mucil. G. a. aa ℥i ♏︎
Cap. ℥fs ter de die -
In ye White swelling, Amputation ought to be
performed, as it gives ye Patient ye only Chance.
Tho it sometimes breakout in other parts after 
Amputation. -


110
Wth. regard to ye Cure, ye use of Tea & Mineral 
Waters have been much recommended, & they 
have been used with success; but I attribute it to 
their acting as diluents, more yn. to yr. Impregnations;
& I think diluents may be useful, in washing 
out ye Lymphatics Glands, & thus removing 
Obstructions. – The best Medicines seem to be 
Tonics, as Bark, but I think ye mineral ones
better, as ye Sald. R. Martis, I think I have seen
good Effects from ye Sal Martis joined to Absorbent 
Earths- The Advantage derived from 
yse. led me to suggest ye Use of ye Calx Lina, wch.
may act both as Tonic & Absorbent, & I have 
used ys. in some Cases wth. apparent Advantage.
I have also I think seen [much] some benefit deriv'd
from a medicine lately introduced in practice, 
y Terra Ponderosa Muriata. - Exercise &
cold bathing are very serviceable, accompanied
wth. Amusements. - Sal Soda has been 
much used, but I shd. not expect much benefit 
from it Mercury is often used but I cannot 
say much in its favour. Cicuta has been 
of Service in some Cases, but it is very uncertain:
Poultices of it applied externally may 
be of service. The Fumes of Æther applied to ye ulcers
I think may be of use. Astringent Applications 
have been advised, but I never saw any good from ym.




111.
Genus 21st. Rachitis. 
This begins gradually in Childhood [crossed out]
[crossed out] The first Symptom is an Aversion
to motion, wth. a gradual wasting of ye Body,
wch. soon deprives ye Child of ye Power of walking,
Appetite impaired, Swelling of of ye Belly, as of 
ye Anasarcous kind, wth. frequent Eructations
are observed; afterwards ye Head increases to such 
a size as hardly to be supported, ye Breastbone
is pushed forwards, ye Ribs are enlarged particularly 
at yr. juncture wth. ye Sternum; difficulty 
of Breathing & Cough takes place: ye
Extremities & Spine by degrees bend & shorten,
& ye Bones grow soft. After ys. wth. some patients 
ye Strength gradually recovers, while other languish 
out a tedious Life. In ye beginning ye -
Pulse is unnaturally slow, accompanied wth.
severe Looseness: but towards ye End it becomes
quick, ye Belly is bound, & ye Urine -
scanty. Towards ye end of ye Disease, a peculiar
Cheerfulness is observed, wch. may be reckoned
a symptom of approaching Death. -
In ye way of Cure, Evacuants may be sometimes 
necessary to carry away Sordes &c, & a few 




112
grains of Rhubarb [is ye best] answers best. Issues
have been advised, but I think they must be 
hurtful from debilitating Friction, & Exercise
in ye open Air, may be useful. Bark 
may be had recourse to, & it promises to be 
a good Medicine. Tonics as preparations of 
Iron & Chalybeate Waters have been advised.
& yse. prepared from Copper as ye Cuprom Ammoniacum
may be used wth. advantage: but of all 
tonics none perhaps is of more service yn. cold
bathing. Another remedy, ye oil of ye Liver of 
Skate Fish has been much used of late in ye.
Highlands. It affects ye whole System by exciting 
a temporary Fever wch. may be regulated
at pleasure; the Application is first -
made to ye Wrists & Ancles at Bedtime, & by 
degrees to ye whole body - As to Regimens 
when ye Disease is perceived, ye Child shd. be 
plentifully supplied wth. Milk & ye Nurse shd.
be changed: the Food shd. be nutritious: drink
sparing, & ye Air pure: yt on ye sea Coast is perhaps 
ye best, & likewise Sea Bathing can yn. be 
used. - 



113.
Genus 22d. Syphilis. 
For an acct. of ys. Disease I refer you to Dr.
Astric's Publications, & Mr. Hunter's or if yt. shd. be objected
to an acct. of its Length, I wd. proposed a Treatise
published by Dr. Chapman. -
We may divide ye Symptoms into those depending 
on ye Topical Application of ye Matter;
ye Action of it in ye Lymphatic System; & wn.
it has entered ye Mass of Circulating Fluids. 
The first are Chancres; ye 2nd Buboes, & ye 3d. - 
affections of ye Skin & Bones. - As ye.
Disease depends upon a Virus introduced into 
ye. System; we must endeavor to cure it by
one of 3 Ways - 1st. by Evacuating ye Virus
out of ye system. 2. Destroying its deleterious 
quality while it remains in ye Systems
or 3d. By counteracting ye influence which 
it has on ye general Mass of Fluids. - Of all
ye Remedies none can be compared wth. Mercury, 
wch. under proper Management will rarely fail
of Curing it. It is used both externally & internally. 
ye. best application for Ulcers is ye Solut.

Rx. Calomel. gr. xij Opii gr. vi
Micæ panis ʒss Syr. g. s. g
Mass inpil xij divid Capt: i omni
nocte & mane -

114
[illegible] Sublim. abt. grss in ℥i aqua ys may be 
used to ulcerations of ye Uvula in ye form of 
Gargle wth. G. Grab. [??m?gations] have been 
much recommended in Callous, Ulcers, & I have 
seen it produce good Effects. Buboes ought 
if possible to be resolved, & not suffered to 
supurrate, & ys. is to be brot. abt. by Mercurial
Ointment rubbed on ye [Lymphatics below]
[ye Glands] part. wre. ye Lymphatics of ye Gland
take yr. rise. The best way of exhibiting Mercury 
is internally; but it sometimes happens 
yt. ye [System] Habit is so irritable as not to bear
it; in yt. Case ye Disease must be cured by
Unction. The best preparations are ye [?al] 
Pill of ye. Ed. Pharm. Calomel & Corr. Sub.
& I wd. advise not to salivate ye Patient, but
to keep him in just on ye Verge: in irritable habit, 
we shd. subjoin a small portion of Opium
ye internal use of Sublimate affords ye most
immediate relief in Cutaneous affections 
of ye venerial kind; & is most useful to 
obviate Symptoms. With ye Mercury a Decoction 
of ye Woods wth. 1,2, of 3 Drams of Mezerion
boiled in [illegible], has been found useful.



115.
Sometimes, Mercury produces great Costiveness, 
ys. is to be obviated by gentle Caths. as Ol.
Ricini, Manna, Crem. Tart. &c. or emollient 
Injections – Most commonly however
a considerable Looseness is induced; ys may 
sometimes be prevented by varying ye Mode
of introducing ye [illegible] & using ungt. but if ys.
proves abortive recourse must be had to 
Opiates. Salivation often happens, but ys
so far from doing good, retards ye Cure, yre. fore
wn. it occurs, we must have recourse to Sal.
Glaub. or any cooling Purges. After ye. 
Virus has been eradicated, pains are often felt
in different parts of ye Body; yse. are best
removed by Friction, Exercise & ye Bark.
The best way of removing warts is by ye Ligature,
or Knife, & touching ye part afterwards
wth. Caustic. Regimen ye same as in 
inflammatory Disorders. -








116
Genus 23d. Cancer.
This Disease sometimes begins from ye. 
most trifling Causes, but Schirrhus from
whatever Cause produced [crossed out] is to most
common Origin. Females are ye most
subject to it, & yre. is no part in wch. it may 
not be [crossed out] situated, but it is most commonly 
in ye Mammæ. A hard circumscribed 
tumour is first observed wth. little pain & 
no Change in ye Colour of ye Skin: After it 
has remained yus. for some time, ye swelling
suddenly increases wth. a sense of Itching &
Heat, but no tendency to suppurate; a degree
of Inequality takes place, & ye Tumor acquires
a blue or livid colour: the pain is increased,
ye Lymphatic Glands swell, & ye Veins become
often varicose. This is ye occult state, wch. often 
continues during Life; tho [crossed out] sometimes 
ye patient is carried off by hectic Fever at ys.
Period. But sometimes Rents are perceived in
ye Skin, the Tumor emits a cadaverous smell & 
an open ulceration comes on; the matter discharged
corrodes ye neighboring parts: the Ulcers
soon put on a fungous appearance; the Edges
are livid or blk: hæmorrhagies often happen. 









117	
ye Pains are much increased: ye Body wastes:
ye Patient is watchful: & is sometimes cut off
by Convulsions deliquum animi, but ye most
frequent termination is by hectic Fever. -
We must attempt ye Cure, either by ye Removal
of ye Part totally; or by restoring its -
Vigour. Exterpation I think ye most effectual 
means of Cure, & it ought to be performed in 
ye beginning: but if by delay a morbid State 
of ye Body is produced ys. is not advisable;
we must yre. fore have recourse to remedies
Cicuta has lately been much recommended, 
& I think I have seen it produce good Effects 
in several Cases: ye Extr. of ye Seeds is ye. best 
Preparation. Mercury has been used externally 
& internally: a Solutn. of Sublimate may be 
usefully applied to ye Ulcer. Arsenic I have
used but once & yn. it did not succeed. Solanum
& Mezereon I have never used. Mineral Water 
have been recommended, but I believe they are 
of little Use. I have tried Electricity, but without 
advantage. Externally Applications of Lead
have been found useful; & to correct ye Cadaverous 
smell Carrot Poultices & Fomenting Poultices
are of service. Issues may be of service to 
retard ye Progress of Cancer. In ye last Stage Laudanum
may be used to render Life more easy. -


Vitriolic acid in ye form of Ointment 
with Hogs Lard used externally recommded.

118.
Ordr. 5th. Impeligines or 
Cutaneous Affections.
Genus 24th. Psora. 
This Disease is merely confined to ye. 
Skin; it first appears most frequently between 
ye fingers, & if not checked soon runs 
over ye whole body. It is infectious & touch is 
sufficient to communicate it. It appears 
in Vesicles filled wth. water, wch. have a very itchy 
Sensation; yse. being broke, are succeeded in some 
by a dry Scurf; but in other they break into an 
open ulcer: ys. makes a distinction into 
sicca & humida. - The Chief remedy in 
Psora is Sulphur; & ye internal & external
Use of it shd. be conjoined: the Unge. Sulph.
shd. be rubbed on ye affected parts for 3 or 4
Nights successively, & if ys does not answer, 
may be repeated after a short Interval: The 
Disagreeable smell may be corrected by Ess.
Limon, or by washing ye Sulphur in Spt. -
wch. no way diminishes its activity. I have 
cured sev'ral patients wth. ye Vitriolic Acid - ʒij of 
ye Acid mixed wth. ℥ij of water & ʒi of ye Mixture
taken twice a Day. - Mercury has been 








119
much used, but it is inferior to Sulphur; 
ye best preparation of it is ye Solut. Corr. Sub.
wch. may be used wth. out danger. Mineral Waters 
may be useful on acct. of ye Sulp. they contain.
Lead has been employed, but wth. less
Advantage yn. Sulp. Myrrh has been much 
used in some countries, & I have known it 
Cure after Sulphur has failed; but yre. is 
reason to [think] doubt if ye Disease was not 
of ye herpetic kind. Cathartics shd. be given
in ye Course of ye Cure, to prevent bad effects 
wch. may arise from ye Use of Ointments, wch.
make a Change in ye. Circulation at ye Surface.
Genus 25. Herpes. Genus 26. Lepra. 
Under yse. two Terms, I comprehend all ye
[Complaints] Eruptions, wch. are vulgarly called
Scorbutic, where ye Eruption is moist & has a 
Tendency to ulcerate, I call ye Disease Herpes;
& Lepra where it is dry & scurfy. An obvious
deformity of ye Skin is ye common Appearances
sometimes confined to particular parts: in
some Cases ye. Eruption is florid, sometimes -
white & scurffy; others have yellow Vesicles, wch.

ꝶ. Antim. Crud. ʒss Capt. bis vel ter de die.
& ill. part. affect. Ung. to Citrin -
ꝶ. Merc. Corr. Sabl. gr. x
Ag. Font. lbi. ♏︎.

120.
often run into one another. In some ye Disease
remains fixed for a Times, & [in others] often it terminates
spontaneously, 'tho in many it returns at particular
Seasons, particularly ye Spring. In the 
Cure purgatives are frequently employed & they 
are useful repeated at proper Intervals. Sal. 
Glaub. & Polychrest. are ye best. Sudorifics 
are much used, I have seen good Effects from 
ye. Decoct. [?lmi] & Dec. Liquor. - I think Serpentane 
ye best Diaphoretic. - I wd. strongly 
advise ye internal use of Crude Antimony, 
for from experience I have a great opinion
of it. Mercury has been much used, &
sometimes wth. advantage, as tending to remove 
obstructions & cause a due Circulation. [Veratu??]
has been much employed lately; but I never saw
any benefit from it. Of external remedies ye. 
most efficacious is ye Solut. Sublim. - The 
Vitriolic Acid in ye form of ointment often -
proves a powerful remedy; also Sacc. Saturn. 
Sea Bathing is frequently serviceable. -
Ink is often used particularly to Herpetic 
Eruptions of ye Face. Sulphur has been 
used wth. success. Washing frequently wth. Soap -
may be serviceable. – The Vapour Bath has 
proved salutury, wre. other remedies have failed.








121
Genus 27 Tinea.
This is a very common & obstinate Disease.
It is chiefly confined to ye. scalp of ye Head. It 
sometimes begins wth. slight Ulcerations; but more 
frequently wth. a rawness of ye Skin, from wch. a thin 
matter exudes: ys. soon hardens & forms an Incrustation,
wch. gradually Increases both in size
& thickness: it is generally of a white or greyish 
colour; but sometimes yellow, green, or black.-
After ys. has continued for a long time it sometimes 
happens yt. ye. Hair & Crust fall off; & ye
Skin below is without Ulceration; but generally 
very red & Moist often abt. ye Edges of ye Crust. 
Ulcers are formed, wch. discharge a fœtid Matter.
In ye advanced Stages, ye disease is very obstinate, 
but if taken in ye beginning, may often be easily 
removed; but it is always apt to return. It 
is a Disease of ye bulbs of ye. Hair & may occur 
at any Age; but is most frequent in Childhood.
In order to cure Tinea, we must endeavor either 
to restore a proper Condition of ye Bulbs of ye.
Hair or entirely to remove them. -

The Vitriolic Acid in ye form of 
Ointment is a good Application; also 
Mercury combined wth. it, or ye Nitrous as in ye Cerat.
Citrinum. -
ꝶ Hydrargyr ℥ss solve
in Spt. Nitr. ℥i et adde
Axung. [illegible] ♏︎ or as ys is apt to grow 
hard wth. keeping a double quantity of 
Acid & Mercury may be employed; & an 
equal quantity of Axung. added upon using 
it -

122.
Cathartics shd. be employed at due intervals 
thro' ye Cure, in order to prevent any Symptoms, 
wch. may be ye consequences of external Applications.
The external Applications of Mercurials 
is of great use; & ye. best way of applying it is 
in form of a Poultice made of Bread wth. Corr.
Sublimate; from ys. I have seen very good effects;
& also from ye Use of Aug. Oris rubbed wth. 
some Emollient Ointment. A Solution of 
Hepar Sulphuris has been used wth. Success in 
ye form of Lotion. The Vegetable Alkali in ye 
form of Ol. Tartar has great power in dissolving 
ye Crusts An Infusion of Tobacco has been 
used, but I think bad Consequences may arise
from its narcotic quality. When ye Discharge 
is very great, Dry Powders as Tutia Lap. Cal &c
have been employed; they may prevent ye spreading 
of ye Matter, but are apt to produce Crusts. -
Little is to be expected from Emollients. A Pitched
Plaister produces a radical Cure by removing 
ye Bulbs of ye Hair; but it is apt to excite violent -
Inflammation; therefore a small piece shd. be removed
at a Time Issues may be useful, therefore 
shd. never be omitted. -








123
Ord. 6th. Neuroses - or 
Nervous Affections. -
Genus 28. Apoplexia
The Appearances of ys. Disease are various, 
but I shall describe ye. most general ones. -
It sometimes suddenly attacks apparently 
healthy persons; but is generally preceeded by 
Headach confined to a particular spot, Vertigo, Tinnitus Aurium, Indistinct 
Vision in one or both Eyes, a pricking Sensation
of ye Extremities, &c. yse. may continue for some 
Time; then ye Muscles loose their power, & ye.
Person suddenly falls down, & seems as if in 
a sound Sleep: yre. often takes place involuntary
discharge of Urine & Fœces, & generally 	
of Blood from different Parts: The Face appears 
turgid, ye. Eyes prominent, ye Tongue hangs 
out & yre. is a discharge of Tears: the Limbs are 
generally motionless, tho' sometimes convulsed;
the Breathing is attended wth. a peculiar Noise; ye
Breast is agitated, & ye Pulse is strong; but ye. -
Pulse soon becomes weaker & slower x, & ye Patient 
is at last cut off by Convulsions, or failure of 
Breathing. Sometimes however ye Patient 
x a frothy matter is found abt. ye mouth -



124
recovers; the external Senses first appear by Degrees
& yn. ye internal, & ye motions return: in some 
Cases a great degree of Fever remains, & generally 
yre. is a Paralysis, either of one Side, or a particular 
part, especially ye Tongue. The Mental Faculties
are also left much impaired particularly 
ye Memory: yre. is sometime a recovery from yse., 
but they often remain during Life. This Disease 
is distinguished from most others, by ye total
Abolition of Sense, or by ye Circulation & Respiration 
continuing. Men are most subject to 
it, & at an advanced Period of Life. It sometimes 
depends upon Mal-conformation of ye Body, as
Shortness of ye Neck &c. The Exciting Causes
may be referred to 6 Heads. 1st. Such as give
determination of Blood to ye Head as excessive
Drinking, Vomiting, Coughing &c. 2d. Injuries
done to ye. Skull or Brain, as Fracture or Concussion
3d. Suppression of usual Evacuations,
as ye Stoppage of Urine, or sudden Cure of Cutaneous 
Eruptions, &c. 4th Those things yt Diminish 
ye determination to ye Brain, as great Evacuations. 
5th. Attention of ye Mental Faculties, as long contind.
Grief &c. 6th. Various Narcotics, as Cicuta, Opium, Hyoscyamus
&c. -




125
Blood letting has been much employed in 
ys. Disease & copious Blood letting has, no doubt, 
produced good Consequences if yre. is an Accumulation 
in ye Vessels, V.S. ought to be employed,
& ye best method is to open ye Jugulars: if topical 
Blood letting is employed, Cupping & Scarifying ye 
Temples is best Stimulants, as Volatile Substances 
applied to ye. Nose, Sternutatories, Pricking
wth. Pins under ye. Nails, ye Actual Cautery, &c. have 
been used; & they may be useful, wre. ye Disease 
arises from too great Evacuations; ye Actual 
Cautery & Pricking wth. Pins [is] are thot. cruel, but they
are powerful Causes of Excitement, & ye Patient 
will receive no Injury from ym. Injections 
have been employed, & ye best are Saline 
Matters wth. Turpentine: more stimulant 
ones have been advised, as Coloquinteda, Euphorbium
&c. but if ye Patient recover they will
excite inflammation: Injections of Tobacco 
smoke may be of service. Fomentations of 
ye. Legs may be useful, wre. ye. Disease arise frm.
Compression. Blisters & Sinapisms of Mustard shd.
never be omitted; & Cataplasms of Horse-
radish root &c. may be of service. -
It is of Consequence to have ye. Patient's Body 
kept in an erect posture. -




126
Genus 29. Paralysis.
This Disease begins in different ways: It 
sometimes occurs without any preceeding 
Symptoms; but most commonly advances -
gradually: It is often preceded by several 
Symptoms as Vertigo & Sense of weight in ye. 
Head; ye Patient is dull; memory impaired:
a prickling sensation wth. pain occurs: ye natural 
heat is lessened; ye Pulsations of ye. -
Arteries become irregular; & ye Circulation
languid: at length ye Parts lose yr. Sense & 
Motion: but it sometimes happens yt. there 
is a loss of Sense, while Motion continues
& vice versa: The Disease sometimes 
occurs in ye Superior, at other times in ye inferior 
Extremities; but most commonly 
in one side, or organ. After ye Parts become
thus affected, ye Limb gradually wastes,
& it is sometimes affected wth. Ademia -
It sometimes happens yt. a natural healthy
termination takes place; but it generally 
continues during Life gradually augmenting.
The Cure consists in increasing ye action 




127.
of ye Brain, either by Topical or General [as]
Stimulants. - Where ye Disease arises -
from extravasated Blood in ye Brain or about it.
V.S. may be of great service; but it is inadmissable
in late Periods; & shd. never be repeated
unless manifest advantage is derived from it, 
Purgatives in certain Cases may be useful;
ye Saline in Effusions of Blood & congestion
of ye Brain; & ye Stimulating ones, as Scamp 
Jalap. & Calom. where ye. Disease, arises from 
Torpor & Compression, depending on Serosity. –
errhines have been much used, & have sometimes 
produced even an instantaneous Cure,
Asarum is ye best: Hellebor: & Euphorb. I think
dangerous. Emetics have a great virtue by 
cleansing ye Stomach & evacuating Serosity
& I think ye best of ys. Tribe is Ipecac. & Mustard,
wch. stimulate as well as vomit; but both
yse. & Errhines may be improper wre. ye Disease
arises from Congestion. Rubefacientia, as 
rubbing ye Part wth. flannel impregnated wth.
Volatile Alkali may be of serve; also whipping 
it wth. Nettles– Vesicantra are sometimes useful;
but as they may produce Gangrene, ye -
Rubefacientia are preferable. -






128.
y suppurantia, as Issues are useful by ye. Discharge
they cause. Many Stimuli have been 
employed internally wth. great success, as Sal. 
C.C. Castor, Garlic, Guaiac &c. & a new remedy 
has been introduced ye Arnica Montana,
or German Leopard bane, wch. I am not yet acquainted 
with: The warm bath is sometimes
useful, wre. ye. Disease does not arise from Compression;
ye heat shd. be from 96 to 100°. -
Among all ye remedies none has been more 
successfully employed yn. Mercury; it requires
long application & ye patient shd. be kept on
ye Verge of Salivation. Camphor has been 
serviceable. Electricity has often produced
ye very best effects in Cases of Paralysis ;
& where a Stimulant is wanted it is ye best 
we can use; & I think we way expect more 
Advantage from Shocks than from drawing 
of Sparks: In Cases of Torpor it ought never 
to be omitted; & it ought to be long persevered
in. It may be used along wth. any other 
Remedy. -



129
Genus 30. Epilepsia
In ys. Disease ye. Patients fall to ye. Ground, 
& are incapable of any impression of Objects;
they have violent Convulsions of every -
Muscle of ye Body; ye Respiration ceases 
to be uniform: after some time froth is 
collected in ye Mouth; & yre. are evident -
Symptoms of Congestion of Blood in ye.
Head, ye Countenance becomes livid, ye -
Tongue hangs out of ye Mouth, & if not prevented
is liable to be wounded by ye violent
contraction of ye Muscles of ye lower Jaw,
by wch. ye Teeth are sometimes [crossed out] broke
Thro' ye whole of ye Disease great Delirium
prevails, & Groans & unmeaning Sentences
are uttered; violent Discharges of Urine, 
Fœces & sometimes Blood supervene; & ye Patient in ye. 
end [falls] becomes motionless. These are ye.
common Appearances. Sometimes ye Disease
takes place without any warning; at other 
times yre. are threat'nings for many Days, as 
Vertigo, Headach, dilatation of ye Pupils, &c.
but chiefly ye Aur Epilep wch. is a prickling 
Sensation, beginning in ye Extremities & advancing 
upwards 'till it reaches ye Head; wn.


ꝶ. Vitriol. Alb. g.v. solve in
Aq. Fontana, et præcipn.
en Spt. Vol. Alk. et Sign. Pulvis
Zincum Præcipitatum

130
ye Disease begins as Epilepsy consists in 
a peculiar action of ye. Brain induced by 
Stimuli, ye chief Object towards ye Cure is to 
remove ye Irritability to strengthen ye. 
System. When threatnings of Fits occur, 
they may be anticipated by Antispasmodics;
yse. may be referred to Stimulant & sedative;
both may produce good effects; of 
ye first large Doses C.C.V. may be given,
or rather Others, by wch. I have often seen 
fitts checked. Of ye sedatives are Opium, 
Musk & Camphor, & yse. have sometimes 
good effects; but I think ye Stimulants
preferable. I have seen ye Progress of ye Aura 
Epileptica stopped by Ligatures applied 
above it. And I have seen a fitt prevented 
by ye Jaws being kept open. If ye irritation
arises from the [illegible] of ye Brain V. S. 
may be of use or Refrigerent & Cathartics.
Valerian has been much used & I think it 
a good Antispasmodic - Tonics are of all 
remedies ye most effectual, & particularly 
yose. from ye mineral Kingdom: of yse. Copper
is one of ye Best & it may be given in ye form
of ye Pil. [illegible] but shd. never be taken so as 
to occasion Vomiting or Looseness. The 
Zincum precip. is also a good Medicine. -


ꝶ. Zinci præciss. gr. v.
Pulv. Valer. ℈i ♏︎. Capt. 3 de die.
[crossed out]
[crossed out]
[crossed out]
[crossed out]

131
Genus Convulsio.
Of ys. many Different Genera have 
been marked out, but I wd. comprehend 
ym. all under Character of Chorea, not 
confining it to ye Chorea Sancti Viti. In
ys. Disease ye Senses are entire, & ye voluntary
muscles are principally affected, 
& it attacks many different Muscles alternately;
yre. is at first a particular feel 
like Aura Epilep. but it is never propagated 
to ye Brain. The Cure is conducted 
on ye same general principle as Epilepsy,
& ye same medicines may be used.
Genus 32 Tetanus 
This Disease is not frequent in this 
Country, but often occurs in warm Climates,
& is ye Consequence of external Wounds, 
lying in a damp place - &c - ye irritation
from wch. causes Contractions of particular 
Muscles - When it is occasioned by the 
inflammation produced by Wounds, we must
endeavor to allay ye Inflamn. by topical Applications -
& for ys. purpose Warm Fomentations






132.
are generally used; but I think Saturine 
Poultices wd. be more useful – Deep Incisions 
above ye Wound in order to divide ye Nerve
will often give Relief; but ys. ought to be done
very early, otherwise no benefit will accrue
from it – V.S. may sometimes be of service
in ye Beginning as serving to obviate Inflammation-
but ye greatest Confidence is
generally put in Antispasmodics of ye Sedative
kind as Opium, Musk & ye Warm 
Bath; & from yse. great advantage is often derived -
Opium shd. be given very plentifully:
200 gtt. of L. L. have often been given without
producing greater effects yn. 20 in a healthy 
person: wth. this ye Part. shd. be kept in ye -
warm Bath for hours together. - I think 
Æther may be tried - [illegible] friction is said 
to have produced good effects. - There is a 
Case recorded in ye Med. Com. V. 1st. where ye.
Cold Bath was used wth. Success & I have heard
of other Cases - A locked Jaw has [often] sometimes
been resolved by a strong Electrical Shock. 
When ye Disease arises from Prick &c. immersing 
ye. Part in tepid Oil for 1/2 an Hour is said 
to be an efficacious Remedy. -




133.
Genus 33. Rabies.
This is occasioned by ye Bite of a Mad Animal -
The Wound after heals as soon as a common 
wound – but abt. ye 30 or 40th. Day after
ye Bite, a dull pain is felt in ye Part (tho' ye Disease 
in some Cases does not commence till a long
Time has elapsed, sometimes even after Years)
soon after ye Patient becomes pensive & Melancholy,
shuns Company, & complains of Languor 
& Lassitude, loaths all Food, & is very restless
in ye Night, & subject to frightful Dreams and
Startings - This is ye first Stage. - In ye 2d.
Respiration & Circulation are both affected,
ye Pulse quick, irregular, & fuller yn. natural;
to yse. ye Hydrophobia or Dread of Water supervenes –
ye Patient at first takes Water in
his mouth without ye smallest dread, & is 
astonished to find he cannot swallow it – ye
sensation of a Ball threatening Suffocation.
Soon Convulsions are induced from ye Sight 
of Water or any transparent Substance -
Horrors & Shiverings, take place from solid food
or even cold Air touching ye Pharynx. -
In ye 3d. Stage, a Change in ye mental Faculties
takes place in place of Melancholia a Phrenitic 
Delirium [takes] begins, ye Tone of Voice is
changed – they attempt to bite yse. around ym. -




134
& Froth is observed abt. ye Mouth - They Commonly 
have intervals of Sense at ye time, & desire yse. abt. ym.
to keep away; in ye End a state of perfect Collapse
succeeds & closes ye Scene. - With regard to ye Prevention 
of ye Disease ye first Thing to be done
is ye Excision of ye Part- but if it is impracticable
we shd. endeavor to destroy ye Virus by
ye actual Cautery- & one of yse. Methods ought 
never to be omitted- We may also support a 
discharge of Epispart. or we may use Lotions 
composed of a Solution of Sal Tart. or Caust.
Alk.- Sea or Cold Bathing of any kind has 
been much recommended & may be used 
before ye Hydrophobia commences, but it 
does harm after.- Many Specifics have 
been in great repute particularly Dr. Mead's;
the Tongue wch. is Musk & Cinnabar & of late ye Ormshirh [crossed out] ye
Basis of wch is found to Chalk- any of yse.
I think will be but of little service, however 
they may be timed- Some put great Confidence 
in Mercurial Friction, used so as to affect ye. 
salivary Glands, & I think it is worth making 
a trial of - but ye chief prevention I think
depends upon ye removal of ye part. -

Maniacs will bear without injury a degree
of Cold & hunger, wch. wd. kill another Persons.
ys. is a sure sign of ye disease being present -

135.
Genus 34 Mania – G. 35. Melancholia
These two Diseases I think may be joined;
the chief difference he’s in ye Symptoms,
ye Cure & Causes are ye same, & they frequently 
pass from one into ye other.- The first 
Stage of Melancholia is marked by Gloomyness,
a Disposition to Silence, Dread & Shunning
of Company: & in many yre. is a great Aversion 
to all [Comp] Motion: The Silence is sometimes 
so great yt they will remain in many 
Days without speaking a Word, only now &
then muttering to ym. selves & Moaning 
Sometimes yre. is a gradual recovery of Health,
& not unfrequently ye Disease returns periodically;
in other Cases after subsisting for 
some time it terminates in Mania. -
This is marked by peculiar ferocity, rolling
of ye Eyes, Talkativeness & precipitation 
in talking: Patients take Offence at ye least 
trifle, & passions are attended wth. great Violence 
of Words & Actions: but this is not ye only
State perceived & sometimes they appear very
happy, wch. is specified by Laughing, Singing,
Dancing &c. & they often shew ye most 
brilliant Wit & Shining talents. -



136
In yse. Diseases occurring periodically V. S. is 
indicated, but I think it shd. not be employed
to great Extent. When yre. is a great Determination
to ye Brain, Arteriotomy may be of 
service - Cathartics have often produced 
ye Best affects, & of yse. ye Tart. Solub. is to 
be preferred, & ye best way of giving it is 
in Doses of ℥ss ʒi every hour till it operates-
& repeated every Morning. If Patient 
cannot be made to take ys. Jalap or 
Calom. may be given without their -
knowledge- Emetics of Tart. Em. frequently 
repeated have often good Effects.
Blisters to ye Head are much employed,
but I think Setons in ye. Hd. or Neck better.
Opium & ye warm Bath give temporary
Relief, but cause bad Consequences, yre.
fore I think ought to be avoided: I shd. -
prefer washing ye head wth. cold Water every
morning. Wth. regard to regimen; ye Diet 
shd. Consist of Milk & Vegetables, particularly 
Acessant Fruits. Exercise is particularly 
serviceable, but it shd. not be violent. 
Maniacs shd. I think be treated mildy &
Melancholics shd. have everything done to 
divert ym. – Music is particularly useful.



137
Genus 36 Hypochondriasis
In ys. Disease Patients are particularly troubled 
wth. Diseases of ye Stomach; ye Appetite is 
whimsical, & craves for extraordinary Things;
are Acid Liquor frequently rises to ye Mouth;
there is a burning heat at ye Stomach; & ye Intestines 
are very subject to Wind & Borborygmor
& violent Palpitation of ye Heart occurs which 
much [friten] affrights ye Patient, it first happens 
in ye Night, but afterwards thro' ye Day; ye 
Heat is sometimes suddenly increased at particular 
parts & yre. is often a sense of Cold in ye Extremities
& across ye Back: the Belly is generally 
bound, & yre. is often a discharge of black 
viscid matter: the Urine for ye most part is 
scanty & high coloured, but sometimes ye contrary 
happens. The patient sometimes passes
whole Nights in Watchfulness; & when he does 
sleep, is much disturbed by dreadful Dreams.
Many other Diseases are liable to occur wth. ys.
as Jaundice, Dropsy, Tympanites &c. & in ys.
way it may end in Death; but it is generally 
more troublesome yn. Dangerous, & may remain
during a very long Life. It is peculiar 
to ye melancholic temperament of ys habit is known
by a swarthy complextion, blk eyes & hairs, hard 



138
rough Skin, large Vessels, rigid fibres, & ye passions 
are not easily moved, but when they are, 
permanently. It may be known from Dispepsia 
by ye sadness, fear of Death &c. & from -
Hysteria, because in that yre. is great volatility 
of Temper. This Disease seldom happens before 
ye 30 Year; it is however hereditary; & it is 
chiefly peculiar to ye [female] male Sex -
Most of ye remedies employed in ys. Disease act 
more as palliating yn. curing ye. Disease. The 
Torpor must chiefly be guarded against by 
ye Conduct of Life & Regimen. All Aliment 
producing flatulency must be guarded against. 
Milk Diet is bad as producing an Acid. Animal 
Food is best & yt. salted, as ys Salt may stimulate 
ye Stomach, & it has been observed, yt Patients 
will digest smoked Ham, Beef, &c [but]
sooner yn. Beef Steak: A hearty meal shd. be 
avoided. For Drink, pure water, or with ye Addtn. 
of a little Spirit is best. Exercise is very serviceable, 
particularly riding on Horseback. -
Cold sh. be avoided- ye Disease has often been cured, 
by removing from a Cold to a warm Climate.
Warm Bathing has been recommended, but it 
shd. be moderately employed - I think it a doubtful
remedy- Friction wth. ye flesh brush has 
been of service- Stimulant Antispasmodics 
as Pil. Gum. Tinct Fœtid. &c have been employed,
& as obviating Symptoms, Bitters & Aromatics,



139
but yse. shd. not be pushed too far- I shd. be inclined 
to try Camphor. Absorbents have been employed 
ye best is ye Calcin'd Magnesia. Chalybeates are 
doubtful; I think they may increase ye Disease.
Gentle Emetics may be sparingly employed,
& Obstipatio shd. be gaured agst. by gentle Cathartics 
as Aloes, a Tart. Solub. Ol. Ricin &c.-
All thought & Study shd. if possible be guarded 
agst. & ye Patients Business shd. be an active one,
& wre. he is engaged much without Doors. -
Genus 37. Hysteria.
This is in a great Measure a female Affection,
& if from their mode of Life very frequent,
As its form is very various wd. take up too 
much time in enumerating all ye. Symptoms;
I shall therefore refer to Dr. Whyte, Sydenham,
but particularly to Hoffman. [It may]
[crossed out]
The Chief Symptoms are Affections of ye. Alimentary 
Canal, particular heat, Clavus 
Hystericus & ye Globus Hyst: The most common 
Symptoms in ye fitts are [illegible] violent 
Laughing & Crying: They often resemble Epilepsy,
but are distinguished from it by ye.
Globus, & ye presence of ye Senses.-



140
This Disease generally occurs in females
about ye Time ye menses make yr. Appearance,
& is most common in ye. Sanguine Temperament 
(ys. is distinguished by smooth skin, 
small Vessels, florid Complexion & red hair)
but predisposition may be acquired by all 
Causes inducing Plethora or Irritability. 
To prevent ye accession of a Fit nothing is so 
effectual as a full dose of Laudanum, if 
it does not prevent it, it rarely fails of mitigating 
it. If ys. shd. fail, or if it disagrees -
Musk will often have immediate effects.
Camphor is also of great service in many 
Cases. Vol. Alkal. Spt. is much employed,
but Æther in Doses of gtt. xx or xxx is more 
powerful. Asafœtida (both in Injections 
& by ye Mouth) & [Camphor] Castor are much 
used but they shd. be given in very large Doses.
In ye fitt, immersing ye Hands in cold 
Water, throwing it in ye face &c. shd. not be neglected,
& Vol. Alk., Burnt feathers, Tobacco fumes &c.
are usefully applied to ye Nose. In ye interval 
between fitts, in plethoric habits V.S. is requisite,
but it need not be repeated; & Cathartics 
of ye refrigerant kind shd. be used. Spare Diet 
has often effected a radical Cure. If ye. Disease 
proceeds from relaxation, Tonics as Bark, Chalybeates,
ye Preparans. of Copper & Zinc, & Cold Bathing 
are ye most useful.-



141
Genus 38. Asthma. 
By ys Term we mean wt. is commonly call'd 
ye Spasmodic Asthma. This is distinguished 
by difficulty of Breathing, attended wth. a hissing Noise, and a sense 
of Stricture abt. ye Breast, & by its occurring 
at intervals: the fitts commonly happen in 
ye Night, & ye Patient is obliged to raise himself 
up & open his mouth wide in order to 
breath freely; they are attended wth a dry, shrill Cough, 
[ye Voice is Shrill] & ye Pulse is small, quick & 
intermittent: The Countenance is at first 
pale, but it afterwards acquires a dark & livid
hue: when a fit continues long cold sweats 
break out & sometimes Death ensues. This 
Disease often continues for a great number of 
years. The fitts are various in duration; the 
termination of one is indicated by copious 
Expectoration, or profuse Discharge of Urine &
Saliva. Sir J. Floyer is ye best author on ys.
Subject. In ye Fitt if Plethora exists V. S. shd. be 
employed, but its use is improper in yse. frequently 
attacked by ye. Disease. Fomentations
to ye Breast are often useful, but ye Semicupium
& Pediluvium are preferable, & yse. have 
sometimes terminated a fitt. Æther is often 
productive of very good Effects, it may be used 
both externally & internally, & [crossed out]

Pro Adulto
ꝶ. Æther. Vitriol. ʒii Mucil. G. A. 
Syr. Simp. Ag. Font. ac ℥ij ♏︎.
Cap. ℥ss bis in Die & rep ungt. Dyspn.
nccnon. ꝶ. Zinci præcip. gr. v
Pulv. Valer. Sylv. Hi ♏︎
Capt. vis indiesm-
Pro Infante -
ꝶ. Æther. Vitriol. ℥i Mucil. G. A.
Aq. Font. Syr. Simp. aa ℥ij
♏︎. Capt: ℥ss omni bihorio urgente 
Dyspnæa 


142
also in ye form of vapour, inspired from a Vial 
put in warm Water. Assafœtida & Musk has often good Effects,
& I have seen ye same from fœtid Injections. Opium
is often useful, but it shd. never be employed 
until Bleeding has been premised. Oily
Draughts are said to have produced an immediate
Cure of ye Croup, but I have never tried ym here.
Blisters have been found very serviceable, & 
I think shd. seldom be omitted: Emetics have 
in some Cases proved beneficial. Tobacco -
Steams will often give relief, & I have known
[a] fitts prevented by smoaking a pipe.- 
A fitt of Asthma can seldom be prevented, but 
it may sometimes be much mitigated by 
ye following methods Occasional Causes must 
be guarded agst. as Heat, Cold, & Moisture & Smoke & certain 
Powders wch. will sometimes cause it as Ipecac.
Much may be derived from diets, in plethoric 
Habits spare Diet is best, in weak, a nutritious, 
wth. ye moderate use of Wine. Bark & Chalybeates 
have been found useful, & Copper & Zinc
promise [crossed out] to prove so – Issues wre. a space diet, 
is necessary may be of use, also Cathartics: Some 
advise Mercury, but I cannot say how ys. operates.



143
Genus 39. Dyspepsia 
This Disease is very frequent; ye first 
Symptom is loss of Appetite, & after 
long fasting, ye Stomach appears full;
wch. is occasioned by Wind, as appears 
from Eructations & Borborgmi: Nausea 
& Vomiting often occur, & an Acid Liquor 
rises from ye Stomach; ye food also sometimes 
rises. A great pain is perceived 
in ye Stomach & Intestines, especially wn.
ye Belly is bound, (wch. is mostly ye Case). -
ys. Pain is not fixed, By long continuance 
ys. Disease produces wasting of ye Body,
& sometimes even Death; but it more
frequently ends in other Complaints, 
particularly Dropsy. This Disease may
be distinguished from Schirrhus of ye Stomach, 
because in yt. ye Pain is fixed, & 
yre. is often an evident Tumor. As Dysp.
proceeds from weakness of ye Intestinal Canal,
all flatulent Food, & relaxing substances 
must be avoided. The bound 
state of ye Belly is to be obviated by gentle

ꝶ. R. Amar. Aromat. Ag. Menth. P. [crossed out]
aa ℥ij. ♏︎ Capt. ℥ss ʒ de die
Capiat ager Pil. Aloet. vel Fœtid 
gr v h.s. pro ze mata -
El fi occasio sit Pil. Heb. gr. x. -
ꝶ. Pulv. Columl. ℈ivel ʒss Sumt.
bis vel ʒ de die -


144
Cathartics, & ye best may be determined by 
experiences. Aloes will mostly answer 
best, except in Case of Hemorrhoids. To remove 
Flatus Assafœtida may be joined wth.
ye. Aloes; or Aromatics may be used, & ye.
properest is Ag. Menth. P. – To remove Acidity 
Magnes Calcins may be had recourse 
to. To restore ye. Tone of ye Stomach, nothing 
[crossed out] seems better yn. Astringents, wth. ys view 
ye vitriolic Acid joined to aromatics is 
often employed. Tar Water was long esteemed 
infallible, it is now however little 
used. The Vegetable Bitters are oftener 
employed wth. advantage as Gentian, Centaury
&c. but ye most agreeable Bitter is 
Columbo, it is given from ℈ij ad ʒi-
Rhubarb or Bark chewed in ye mouth
are often serviceable. Chalybeates are 
sometimes of use, especially ye mineral 
Waters; & Cold water taken gradually 
into ye Stomach, as by sucking thro' a Pipe,
is useful. Exercise is very beneficial. For 
Diet, Solid animal Food wth. no vegitables 
except bread is to be preferred; & it agrees best 
salted– Chocolate may be used for Breakfast;
& for common Drink Water with a little Spirits 
is best -
if any malt Liquor be used it shd. be porter.-




145
Genus 40. Colica
This is a spasmodic affection of ye.
Intestine from any irritating Cause.- 
The Chief Symptoms are [an] acute excruciating
Pain in ye Belly, not fixed attended
wth. Vomiting & Costiveness, & sometimes a 
suppression of Urine; after ys. has continued 
for some time, Patients labour under Anxiety 
& Delirium ye Vomiting is often attended 
wth. hiccup, Convulsions, & Cold Sweats, &
mostly terminates favourably, but often 
recurs – The first thing to be done towards
ye Cure of a fitt is V.S. ys ought 
never to be omitted, except in very weak & 
delicate habits – after ys. A full dose of 
Opium shd. be given, & if ys. is vomited up, repeated-
To remove ye irritating Cause Injections 
must be had recourse to, ye best 
are Emollient or Diluents, or if yse. do not answer,
Glaubers or common Salt, may be 
added & if ys fails Tobacco smoke will often
succeed. Sometimes Purgatives by ye Mouth 
are proper; as Ol. Ricin & Allum has been 
lately much praised by Dr. Perceval, & wn. other 
means fail ys. may be tried.-



146
Externally no Applications are better yn.
warm Fomentations, or Bath & Semicuprium,
wn. yse. means fail recourse is had to Blisters, 
but, unless wre. we dread inflammation, they
are better omitted.- To prevent its return
Bark, Chalybeates & ye Cold Bath are to be 
employed, tho' nothing is perhaps better yn.
ye chewing of Rhubarb: All exciting causes 
such as flatulent & acessent Food are 
to be avoided. Milk diet has often cured it. 
Exercise too ought to be carefully enjoined.
Genus 41. Cephalæa.
This is a pain of ye Head either topical
or general: This is often productive of Fever,
& loss of Appetite, & is sometimes attend'd
wth. great discharge from ye Nose & Eyes: Patients
are very watchful & wn. they sleep, are 
not refreshed by it : the belly is often costive.-
Sometimes Syncope, Deliq. Animi.
& Convulsions take place, but ys. is not 
common: for ye most part ye Pain is the 
only affection. The prevention of ys Disease



147
Disease must be by avoiding occasional Causes,
all corporeal & mental Stimuli as Cold, Heat,
intense Thought, &c.- For ye Cure, V. S. in
plethoric habits is often serviceable: if 
yre. is a sense of Pulsation in ye Head, topical
Blood letting shd. be had recourse to: Cathartics
of ye. Saline kind are very useful
in such habits. Wre. increased sensibility of 
ye Nerves is ye Cause, Blisters, Issues, Ward's
Volatile Ess. Æther, &c. shd. be had recourse
to; & Volatiles applied to ye nose are sometimes 
beneficial. Opium is often applied 
externally in ye form of Patches or Liquid,
but ye best way of using it is internally,
[crossed out] it shd. be taken in a full Dose: in 
ye same Way Camphor & Valeria are 
sometimes usefully employed. Hyosciamus 
has sometimes cured wn. other 
things failed. Sometimes a patient may 
be relieved by pressure applied to ye pained 
part. Errhines will sometimes remove
ye Disease. To remove predisposition
Bark & Cold Bathing may be employed. 
If ye above fail, Cuprium. [Ammon.]
Zinc, or Bark may be used wth. success.






148
Genus 42 Odontalgia. 
For an Acct. of ys. Disease, I shall refer 
you to Mr. John Hunter’s publication.
An Irritation of ye Nerves of ye Jaw, but 
more commonly a disease of ye Tooth is ye.
cause of ye Pain – Sometimes it affects 
ye neighbouring parts as ye Nose, Eyes &c.
The Irritation may be removed by extracting 
ye Tooth, or filling it up wth. Lead, Tinfoil
&c. or ye pain may be alleviated
often by Opium. A Cure is often effected
by destroying ye Nerve, either by ye actual
Cautery or by Caustic, as 1 Pt. of Nitrous Acid
mixed wth. 3 Pts. of dulcified Spt. The best way 
to prevent toothach is by washing ye Teeth
frequently wth. cold Water, or if any thing 
else is required, [crossed out] nothing is better
yn. burnt bread - In Caries Pulv. Cort
& R. Myrrh. may be used.-



149
Order 7th. Morbi Dissimiles, or 
Chronic Affections wch. have [very] little 
Analogy to each other, or to any of ye Associations
already mentioned.-
Genus 43. Symptomata a Venenis.
We shall divide yse. into ye Stimulant. 
& sedative kinds: of ye former are Mercury,
Arsenic, Copper & many other minerals;
some Vegetables, as Euphorb. Helleb. &c
Animals as Cantharides: & to yse. we may add
substances wch. act more mechanically as 
powdered Glass, Hair cut small &c. Of ye. 
Sedatives are Cicuta, Solamins, Camphor,
Opium &c. In ye case of Stimulants, ye first
Symptom is Nausea, wth. Vomiting & Hiccup,
soon after a violent pain in ye Stomach &
intestines occurs: There happens great
heat, & thirst, the Throat is parched, Circulation
increased, & Palpitation of ye heart is produced.
after ys. ye vomiting in some degree ceases,
a Stricture is felt abt. ye. Stomach; ye. Countenance 
looks horrid, Convulsions are produced






150
produced, ye heat is increased, but is sometimes 
attended wth. Cold sweats: ye Urine comes away 
wth. great Violence great prostration of Strength 
succeeds, [crossed out] Delirium is produced. At length he becomes comatose &
[ye patient] dies. [crossed out] Sometimes
Patients recover, but yn. they are troubled
wth. Chronic Affections all ye remainder 
of yr. Lives - As to ye Sedatives, they produce 
first a Sense of dullness & great disposition
to sleep; there attends Nausea, &
sometimes Vomiting, anxiety, difficulty
of Breathing, wth. Fainting, Vertigo & Tinnitus
Aurium; & [after] also much Delirium: A Tremor, 
often wth. Convulsions, is produced, ye pulse is 
quick, small & intermittent, & tho' ye heat 
is sometimes augmented, ye Patient appears
cold; ye superficial Veins particularly
abt. ye Head, are much enlarged; ye Countenance
appears livid; Hemorrhages from
different parts succeed, & a deep sleep follows
from wch. ye Patient seldom recovers.-
To form a diagnostic, ye Vomiting, peculiar 
heat, pain & Thirst must be attended to: the 
peculiar taste too is some assistance. On Dissecting,
ye Inflammation, & sudden putrefaction
will be a great help; wn. Opium was ye.



151
Poison ye Smell of it may discover it, & Arsenic
may be known by ye white Colour wch.
ye Fumes of it give to Copper; & ye smell of 
Garlic.- When yre. is a suspicion of Poison,
ye first thing to be done is to endeavour 
to expell it & ys. may be effected by irritating 
ye Fauces, or by giving an Emetic of ℈i Vitriol.
All.- Camomile Infus – or Infus of Tobacco.
[crossed out] Diluents shd. be drank very plentifully.
After ye vomiting has been carried to a certain
extent, fat Breath, &c. shd. be given,
likewise Oil, warm Milk & mucilaginous 
Injections shd. nt. be omitted. After
yse. we may employ medicines to decompound 
ye Poisons, met. Salts are sometimes,
decompounded by Acids, & yr. activity is 
diminished by Sulphur: A Solution of 
Salt of Tartar is sometimes given wth.
particular advantage agst. Sublimates
Camphor has been [illegible] to counteract Cantharides,
but I wd. put but little trust 
in it: the Juices of Plantain & Horehound 
has been recommended agst. Canthar. & Arsen.
but we have not had sufficient proof of its 
Efficacy. -



152.
Genus 44 Symptom. a Vermibus 
There is no part of ye Body in wch. Worms may
not exist; but they are most common in
ye Alimentary Canal: of yse. yre. are 3 kinds: 
ye Lumbrici are ye chief; yse. are very like 
earthworms only of a paler Colour they are 
abt. ye Size of a Goose quill, but yrn. length is 
precarious, tho' seldom more yn. 12 Inches. The 
next are ye Ascarides. yse. seldom exceed an Inch 
in length, are white & abt. ye thickness of a [crossed out] 
thread: they exist chiefly in ye Rectum, & are 
very numerous. The other kind is ye Tænia 
of yse. yre. is seldom more yn. one at a time. It is 
flat & broad & made up of a number of joints
& is often several Yards in length: it is discharged 
in Fragments, & if any joint [part] remains 
in ye Intestines it has ye power of increasing, 
& forming a new Worm. Worms are most 
commonly met in children, & mostly 
in phlegmatic habits, & chiefly in yse. of an 
idle & sedentary Life. It is a fact yt. yse. Vermin
have decreased, since ye use of Tea has increas'd,
whether Tea has any influence from its 
narcotic Powers is uncertain. -



153
We shall now take notice of some of ye principal
Symptoms. In ye first place, ye Appetite is impaired 
sometimes, but most commonly voracious 
& fanciful, wth. ys. yre. is a temporary vomiting,
wth. sour Eructations; yre. is a great desire 
for Fluids: ye Countenance becomes pale & sallow,
wth. flushings; ye Eyes appear dull; ye Pupil
is sometimes dilated, ye Palpebræ are swelled,
& ye Eyes are surrounded wth. a blueness, ye Lips 
& Nose are tumified & Itch much: The Sleep
is disturbed by frightful dreams; they grind 
yr. teeth, & feverish fitts occur; sometimes wth.
Delirium: during yse. Symptoms yre. is great 
Headach, disagreeable taste in ye Mouth wth. an 
increased flow of Saliva, dry Cough, pain of 
ye. Side, Dyspnea, Hiccup, Borborygmi and
Gripes. – In Case of Ascarides, ye Belly is 
swelled & tense abt. ye Navel, yre. is an Itching 
abt. ye Anus, & sometimes Tenesmus & Prolapsus
Ani- In ye Tænia, ye Belly is mostly 
loose, yre. is a frequent discharge of a glairy
matter, & sometimes joints of worms are ejected
both by Stool & Vomit: Convulsions, Epilepsy
& Paralysis are often produced, & in some 
Cases Idiotism: & unless they are expelled, Death
frequently ensues. -



154
The Cure depends upon killing & [crossed out] expelling 
ye Worms. Agst. ye Lumbrici Vegitable Bitters
have been reckoned very useful. Rhubarb &
Sem [S??ton] have been much used & sometimes 
wth. success– Oil is a good remedy in 
most Cases; Harrowgate Water is often serviceable-
But I think metallic Anthelmintics
wn. properly managed preferable to 
most others, as white & green Vitriol and 
Pulv. Stanni.- We have a more powerful
remedy in Mercury, & ye best Preparations
are Calomel & Sublimate, ye latter may be 
dissolved & made into Pills & given to children
wth. safety. To expell ye. worms wn. killed
I think Jallap preferable to any other Purgative.
Cowitch mix'd wth. Syrup is often given, in ye
West Indies agst. worms. Cabbage Tree Bark 
has been much used of late wth. various Success.-
Indian Pink root has been found to 
be very [useful] efficacious - The greatest 
difficulty occurs in treating ye Tænia, 
but many Medicines have been lately introduced 
agst. it. The first we shall take notice of 
in Gamboge united wth. Sal Absynth, & given

Pro Adulto
Capt. Pulv Stannia ℥fs ad ℥i omni nocte
ad [illegible] vel 4 vicen – ne cnon 
ꝶ Pulv. G. Gambog. gr. v
Sal [illegible] Vegetal. Alk. gn. v ♏︎. ft. 
ejus modi dos iij – Capt. i mane mox post
dosin ultim. Hanni & rept. omn. hor.
nisi prius supervent. Catharsis-
- vel-
ꝶ. Pulv Rad. Filicis maris ʒij
sumt. mane hora octava, & hora 10
Pulv Jalap. Comp ʒi -

155
form ye quantity of from gr x to xv of each
for a Dose, ys. is given in a morning, & if ye-
is not discharged, ye Dose is repeated at ye end
of 2 hours even to ye 3d Time: I have used it in
smaller doses I think wth. Success. The next 
remedy is Mad. Neufort's wch. is ye Pulv Filius
Mar. given in a Morning to ye Extent of ʒij
& after it a strong Purge of Scammony & Gamboge:
I cured a woman wth ys. who was troubled
wth. Tænia for 30 years she discharged 
abt. 50 Inchs. of Tænia & has not been troubled
since. [crossed out] Pulv. Stanni will often 
Cure wn. other things fail. Camphor too will 
sometimes prove serviceable: also Electricity.
Ascarides may be killed by Injections of 
Sem. Santon in Decoct: but I believe Oily
Injections preferable to most others, except 
Lime Water; wch. is a good remedy. Harrowgate
Water, ye Infus of Tobacco, or Smoke of 
it may be thrown up. – Besides yse. we 
may mention ye Dracunculus wch. mostly 
affects ye inferior Extremities of ye Negroes,
& may be drawn out by wrapping round a 
stick; but I think it best to kill it, wch. I once 
did by strong Ol. Camph. Another Worm, confined 
to ye Nose, may be killed by Tobacco.-



156
Genus 45. Symtomata a Calculis 
I shall view Lithiasis as a Genus, comprehending 
yt. called Renalis & Vesicalis. 
The chief symptoms of ye Lithiasis Renalis 
is, a pain in ye Region of ye Kidneys, wch. is 
sometimes gravative, but commonly -
pungent, shooting downwards in ye course 
of ye Ureters, & causing a Stupor of ye -
Thighs; besides ys. ye urine is much diminished
in quantity, & yre. is a quantity of
Sand in it, & it acquires a bloody tinge; & -
sometimes yre. is an appearance of Pus;
Affections also of ye Alimentary Canal
happen, as vomiting & Costiveness: ye Appetite
too is affected. Patients have intervals
of ease. but are readily attacked afresh, &
often, even without any manifest Cause,
sometimes ys Disease lasts for Life, wch. terminates 
in a gradual manner; but ye Patient 
is commonly cut off by Hectic Fever:
Sometimes from a want of Secretion of Urine, ys. 
is deposited on ye Brain &c. & produces Death by 
Coma. -



157
In ye. Lithiasis Vesicalis an acute pain is 
perceived in ye Bladder. no scarcity of Urine 
is observed but a difficulty of passing it, wch.
is sometimes done in drops; sometimes it is 
free, & is suddenly stop'd; & ye Efforts to discharge 
it are frequent & painful: A pain is 
felt in ye Glans Penis, wch. sometimes strikes 
to ye Root of it. The Urine is sometimes bloody, 
& often pure blood is discharged, & a glairy
matter from ye Glans of ye Bladder. Stranguary,
Constipation (sometime Diarhhœa)
attend.- We now come to speak of particular
remedies, & first for ye Renalis. In 
ye Fitt Bloodletting may be of service; but 
it shd. not be carried to great Extent. Cathartics 
also are of service, & Manna given to 
ye quantity of ℥ij for a dose has been much 
recommended, particularly by Sydenham.
Ol. Ricini is a good medicine for ys. purpose. 
Emuls. Arab. Infus, Lini & emollients Glysters 
will often afford relief in great pain.
If Spasm exists Opium & ye Warm Bath 
are indicated. Wre. yre. is a want of Secretion
of Urine, Diuretics as Gin & Water, Spt. Nitr. V.
&c. may be used. As to Lithontriptics, no –
such have as yet been discovered. If an -



158
Abcess forms & points outwardly it may be 
opened & ye Stone removed. To prevent ye. regeneration 
of Calculus Uva Ursi has been much 
recommended. Diluents used freely, may be
of service. [crossed out] Calculus Vesicalis, ye Symptoms 
[?must] be alleviated by ye same means
as in ye former, & ye Urine may be drawn of 
by ye Catheter if necessary: The only Cure 
can be obtained by Operation. A Solution
of ye mild Alkali taken in ye form of Drops 
has been said to have good Effects, as preventing 
ye Irritation of ye Bladder by ye Stone.
Dr. Percival has recommended Water impregnated 
wth. fixed Air; I have tried it several 
Times but without Sucesss. -
G. 46. Symptemata Infantibus propria.
The Rententio Meconic is ye first we shall
speak of: The milk wch. ye. Child receives is 
in general sufficient to Discharge ys Matter:
but sometimes it will be retained, & in ys.
Case several symptoms are induced as Gripes,
swelling of ye Abdomen, restlessness & sometimes
Convulsions causing Death. If the Anus is



159
imperforate, Operation must be had recourse
to: but if ys. is not ye Case; the best Medicine we 
can employ is brown Sugar, or Manna dissolv'd
in Water: if ye Abdomen is considerably swell'd,
irritation of ye Rectum, [crossed out] fm cases of a suppository 
will be best, or if ys. sh. fail Injections 
may be used. - The next Disease is 
ye Ephelis Lutea, wch. by most is tho'. a Species of 
Jaundice, tho' I think wth. Impropriety: Thre. are
two Species called ye red & yellow Gum: It is a 
preternatural Tinge of ye Skin, chiefly confined 
to ye face & in local blotches. It generally 
goes of in a little time & no medicines
are requisite: but if [they] any are given, ye.
mildest purgatives are best. We next 
come to speak of ye. Aphtha: At first white 
specks appear on ye Tongue, & angles of ye Mouth;
yse. gradually increase & cover ye whole internal
surface of ye Mouth, & in some Cases even ye
Stomach & Intestines. These Spots form a -
Crust, wch. falls off [crossed out] but is often 
regenerated in a short time: & ye parts underneath
are ulcerated: wth ys. ye. Child has a reluctance to 
suck, degutition is difficult, heat & Watchfulness
are observed, a diminution of Strength 
gradually takes place: & Infants are sometimes 
tho very rarely, cut off by it. -

+
recommended: but if it can be omitted I 
think it ought: & friction wth. Crust of Bread
or Glyceyrrh. is preferable.- To diminish 
Inflammation. ye general means must be 
used, as V. S. & Purgatives. Antispasmodics
are sometimes useful as Blisters, Pediluvium,
Semicupriums, &c. -


160.
The chief indication towards ye. Cure is ye removal
of ye Crusts; ys may be done by astringents
particularly [crossed out] Borax in powder, mix'd wth. Sugar,
& sprinkled on ye parts; if Ulcerations remn.
nothing is better yn. ye Milk: Mel Rosar; Infus.
Japon &c. I have found serviceable. If ye Nurses
milk bind too much, she shd. be changed.-
Another Disease is Acidity on ye Stomach, wch.
produces many Symptoms as Cardialgia, Gripes,
Vomiting, Acid Eructations, Purging &c. The best 
medicine for ys. is Magnes. Calcin.- To prevent 
ye generation of Acid, Rhubarb, may be used
wth. Exercise & ye Cold Bath: To counteract flatulency,
warm flannels are useful, & a 
little Spt. & Water shd. be given, particularly 
Gin.- The only Affections remaining 
are yse. from Teething. For ye formation of 
ye Teeth &c. I refer ym. to Mr. J. Hunters Publicatn.
Teething generally happens from ye 5 or 6 Month to 
ye 3d or 4th Year. Restlessness & heat are 1st observed,
Children start wn. asleep, & often awake as if affrighted;
they have an uncommon desire for 
drink, ye Gums appear protuberated & red, except 
at ye. Apex, but of all Symptoms ye most threatening 
are yse. of ye nervous kind, as Subrulous
Tendinum, Convulsions, &c. wch. often end in
Death. For ye Cure Incision has been much +




161
Genus 47. Symptomata 
Mulieribus propria.
I mean here to treat of yse. Symptoms wch.
are peculiar to ye Pregnant State; but ys. I shall
do in a very cursory manner, as it more 
particularly belongs to Midwifery. Cardialgia,
Headach &c, generally terminate as soon
when left to ym. selves, as wn. Medicines are used:
Abortion is ye most dangerous Symptom: ys generally 
happen between ye 2d. & 7th. month, &
is induced by a variety of Causes: Symptoms 
threatning Abortion are headach, Shivering &c.
ye Mammæ become flacid, ye Abdomen sinks.
Vomiting, Palpitation, sometimes Deliq. An.
succeed; then follow pains in ye back, Loins, &
Belly, extending to ye Thighs, wth. Tenesmus; afterwards
yre. is a discharge from ye Vagina, first 
watery, afterwards wth. Hemorrhages; & at length 
ye Fœtus &c is expelled; after ys. ye Patient generally 
recovers; but it sometimes terminates
fatally by Hemorrhage, Convulsions or
Syncope, [crossed out] or by Fever wth. Delirium.
These Sequelæ must be [crossed out] treated in ye common
manner, as if they arose from other Causes.-
The Puerperal Fever we shall next Consider-
It has been particularly treated of by Drs. Hulme,
Leak, & White; as to its nature yse. writers differ: 



162
& I hold a peculiar Contagion to be ye Cause of it.
At ye Commencement of ye Fever; ye. only Evacuants 
we shd. use are gentle Cathartics & Injections – 
After ye. Inflammation has in some 
measure subsided; ye same means must be 
used as in fevers of ye Typhoid Kind.-



163
Ordr. 8th. Hæmorrhagiæ
Genus 48. Epistaxis.
Of all Hemorrhagies ys. is ye most frequent, &
often salutary: the first Symptoms are 
a florid face wth. Turgescence & swelling abt. ye
nose: yre. is a gravative pain in ye Head, mostly 
abt. ye frontal Sinuses, wth. Vertigo & disposition
to sleep: ye Vessels of ye Eyes are red, & objects appear
red; yre. is a discharge of Tears, Tinnitus Aurium
frequently, & sometimes febrile heat &
Languor; ye Pulse is quick: a Pulsation is observed
in ye Nose, wch. is hot, dry & itchy. At length
ye discharge takes place, sometimes very copiously, 
& often get into ye stomach, wre. it causes 
Vomiting & Gripes: sometimes ye. discharge is
so great yt. ye strength fails, ye Extremities grow
cold, ye pulse becomes small & feeble & Deliquium
Animi succeeds wch. is sometimes
ends in Death.- While ye Discharge
continues moderate, no measure shd.
be pursued to stop it, especially if ye Patient 
is plethoric, unless it be V.S. wch. may be of 
use: Topical Bleeding, as cuppings & Scarifications
to ye Temples, or between ye Shoulders [will]
may be used.- Cathartics are often of use 



164
especially ye Saline ones, as Crem. Tart. & Nitre.
Astringents are sometimes serviceable ye best 
are El. Vitriol & Allum. External Applications 
may be used as Solut. Alum. or Galls &c.
but perhaps general Astringents are better
as cold Substances applied to ye. Neck &c. or a 
Mouthful of Cold Water often renewed is 
perhaps preferable. Peruvian Bark & Cold 
Bathing are good wre. debility is induced,
but in general they are not admissable.
Ligatures round ye Extremities so as to compress
ye [illegible] have been advised; but yn cannot 
do much good, & if ye Arteries are compressed,
they prove hurtful. In urgent casels,
Dossils of Lint, moistened wth Astringent 
Solutions, may be applied to ye bleeding Vessels.
The body shd. be kept Cool, & ye head erect, but
rather forward to avoid swallowing ye Blood.
To prevent a return, ye Diet shd. be cool, not
stimulating nor highly nutritious: & 
a full meal should be avoided.-



165
Genus 49. Hamoptysis. 
This Disease is very dangerous by it's
Consequences as producing Phthisis.
The most favorable habits in ys. as well
as in Epistaxis are ye Sanguine. It is 
brot. on by Coughing, Singing &c. & often begins
like fever wth. Lassitude, Shivering, Coldness
of extremities, Anxiety, &c. A titillation
in ye Trachea succeed, wth. a sweet or salt taste
in ye Mouth, & at length a discharge of florid
Blood is coughed up wch. has a frothy Appearance: With ys. yre. is Pain in ye.
Breast, & Dyspnea: After ye. Discharge has continued 
sometime, it diminishes, & at length 
ceases; & is seldom attended wth. danger, unless
from its Consequences.- It sometimes 
happens, yt a great discharge comes on at 
once; & many pounds are spit up [crossed out]
& sometimes ye Appearance as of Ramifications 
of Vessels; wch. is ye Gluten coagulated:
In consequence of ye Great loss of Blood debility 
is induced; & ye. Patient, if he is not suffocated,
is cut off by Deliq. Animi. This 
Disease is more subject to Males yn. Females,
& is much connected wth. long neck, narrow 
chest, fair [crossed out] Countenance, & light Hair. 
In ys. Disease, general Evacuants are of 
great benefit, particularly V.S. but ys. shd.

The following has been found often 
serviceable in Hœmoptysis.
ꝶ. Pulv G. Tragac.
_ Amyli
_ Sacc. Alb. p. œ. ♏︎
Sumat Coch. Thean: ter indies.

166
not be repeated, so as to make it become habitual;
instead of wch. refrigerant Cathartics
shd. be had recourse to, as Crem. Tart. &c. Nitre
is often employed wth. advantage. Cold Applications
are very serviceable; but it is unsafe
to apply Cold to ye Surface of ye Body:
drinking Cold Water is preferable; Ice or 
Ice Cream too is both useful & safe. Opiates & 
Pediluvium I think generally improper 
Emetics may act by altering ye mode of Circulation
I have tried ym. but never saw any 
benefit derived from ym: I think their
Concussion may produce bad Consequences.
Sailing may act on ye same principles,	
but I think ought not to be used. Riding on
Horseback gently is serviceable, but it 
shd. not be carried so far as to produce Lassitude,
or accelerate Circulation. Astrigents 
may be employed after evacuating Measures
have been used; but they are never 
good in Plethora: The Vitriolic Acid is beneficial,
either diluted, or in ye form of Allum:
& it may be joined wth. Succ. Japon, or [illegible] Kind
Regimen shd. be neither stimulating or highly 
Nutritious: Bodily fatigue is bad, 
& nothing is of more consequence, yn. avoiding 
great heat or Cold.-

x Morbus Niger of Hippocrates, 
Secessus Cruentus – Hoffman. & 
Melane - Sauvages- }

167
Genus 50. Hæmatemesis.-
This is sometimes Idiopathic, but mostly 
symptomatic, especially of Amenorrhea
There is first Nausea & Anxiety wth. a Sense of 
Stricture at ye. Stomach, & sometimes apparent 
Swelling, Sense of weight & loss of Appetite:
at length ye Hæmorrhage appears, wch:
is generally of a dark & coagulated appearance 
ye quantity is various from ℥i to sevial [illegible]
sometimes ye Blood is mixed wth. Alimentary 
Matter or Bile; & it is sometimes discharged 
by Stool. After ye Blood is discharged ys. Symptoms 
cease: but generally return either 
in a few Hours or in a day or two. When it 
is symptomatic of Amenorrhaa, it appears
only once a month, & is little dangerous. 
In ys. Case ye Cure must be attempted by Emmenagogues.
When it arises from strong
Vomiting, different Antiemetics, particularly 
Opium, are necessary; but Opiates 
shd. be used wth. Caution & thrown in in -
small Doses. In some cases evacuations 
are employed, & wn. yre. is much Plethora
V.S. may be serviceable, but it -
must be cured wth. Caution. Cathartics are 
less admirable here. yn. in any other -







168
Hemorrhages; but Saline Injections should 
seldom be omitted. The lowest Diet & Regimen 
must be used. Emetics have been
employed by some, but yse. are only suited
to particular Cases. When ye Hemorrhage is 
so great as to threaten Life, Astringents shd.
not be omitted, & ye best are, Vitriolic Acid, 
Allum, Vegetable Acid, Infus. Ros &c. Rhubarb
in Infusion has been said to do good.
Cold applications are only admissible in
profuse discharges. After ye Hemorrhage
has stopped, Chalybeates have been advised, 
but perhaps low Diet combined wth. gentle 
Laxatives are ye best medicines. Upon ye 
whole Hæmatemesis often resists ye greatest 
efforts of Art. wh. in some Cases it terminates
naturally without medical Aid. -
Genus 51. Menorhagia. 
This is ye Most frequent, & one of ye most 
Dangerous of ye Hæmorrhages. In ys Disease
ye menses come on at shorter periods yn.
usual, ye Discharge is [more] excessive &
remains longer & is black, grumous, and 
samous & is attended wth. great pains: Patients soon lose yr. Colour & Strength,
ye habit wastes, & ye Disease often terminates 


ꝶ. Spt. Vitriol. Ten. R. Theb. aa ʒi
Ag. Font. ℥iv mucil. G. G. ℥ij
♏︎. Capt. ℥fs ter de die 
ꝶ. Pulv. Alum – Succ. Japon:
Cort. Cassica aa gr. v ♏︎.
Sumat in sing das. Mistura præceds.

169
in Dropsy, sometimes patients are cut off
by Hectic Fever, or Deliq. Animi, & in some 
Cases a Cancer of ye Uterus is induced. -
The remedies employed here are much
ye same as in other Hemorrhages; but 
none perhaps are more to be depended on
yn. a proper Regimen: The patient shd. for ye.
most part be confined to her Bed, & shd. lie 
on her back wth. her Loins raised. All Stimuli
are to be avoided as Light, Noise, & particularly 
heat; ye Chamber shd. be cool; she 
shd. lie on a mattrass, & ye covering shd. be very
thin & light: plenty of Drink shd. be allowed, 
but ys. shd. be cool & weak: Vegetable Diet is best.
No animal shd. be used except milk or weak
broth, & yse. ought to be given very sparingly.-
All depressing & exciting passions, are to be 
avoided. - If yre. is much Plethora, V. S.
may be requisite, or refrigerant Cathartics.
In many Cases Opium has been of Service;
but it shd. never be used wre. V. S. is necessary.
Emetics are very doubtful; Sudorifics are better;
I had a Case communicated to me wre. Pulv.
Dover's was used wth. success. Astringents, ye
same as in other Hemorrhages shd. be employed.
I think Blisters may in some Cases be very 
beneficial. To prevent a return Exercise, 
Cold Bathing, & ye Bark are proper.-







170
Genus 52. Hæmorrhois. 
The Symptoms are Pains abt. ye. Sacrum, Pubes
& Loins, headach of ye gravative kind,
lacerating pains abt. ye Anus wth. Itching 
& Tenesmus: Tumors are perceived abt. ye. 
Anus, either externally or internally,
wch. increase in size: in case of Costiveness,
ye pains are very violent: At length ye Tumors 
break & discharge a quantity of blood wch. relieves
ye Patient. Sometimes internal Piles
continue to bleed a long time, & wn. they 
stop are apt to return once or twice a Year:
sometimes ye discharge is not above ℥i, at
others it amounts to [illegible]. When it becomes 
habitual, a stoppage produces bad Consequences,
as violent pains & Hemorrhages in
other parts of ye Body.- Often ye Parts suppurate,
& produce sinous Ulcers & Gangrene.
In some Cases it produces irrecoverable
Affections, as Apoplexy, Mania, Cachexia, 
Dropsy, Paralysis &c.- If ye pain is excessive,
Topical V. S. may be of service, as 
Leeches applied near ye Anus, or ye Tumors 
maybe opened, wch. is sometimes very beneficial.
An Antiphlogistic regimen shd. be 







171.
enjoined, & ye horizontal posture. Sulphur 
is much used both external & Internally:
The parts may be rubbed wth. Oil or any
soft Ointment, & it is useful to sit over
ye. Steams of hot water: Camphor is sometimes
employed united wth. Oil: wn. ye Inflammation
is high Saturnine Applications
are proper: [crossed out] Anodyns also may be used externally.
To prevent Costiveness, gentle Cathartics are to 
be employed as Manna, Ol. Ricin. or Sulph.
combined wth. El. Lenitiv: or Crem. Tart. Wn.
ye Hemorrhage is so violent as to threaten a fatal
Termination Astringents must be used
both externally & internally 
Genus 53. Hæmaturia.
This Disease generally arises from 
some injury, & yn. ye discharge is ye first
Symptoms: but it is sometimes produced 
by plethora, & yn. is preceeded by general Torpor, 
wth. weight & pain at ye Regio Lumbarum.
In ye. Case ye evacuation is reckoned salutary,
& is generally of great extent, sometimes to 
a ℔ or more, & is voided by ye natural efforts
to make Urine, sometimes without being







172
being mixed wth. Urine. It Sometimes induces 
Tabes, sometimes Dropsy or Ischuria; but 
in most Cases it does not prove fatal; tho' it 
often continues thro' Life. It mostly takes 
place in advanced periods of Life.- It is 
hard to restrain ye. Discharge, but ys. is of little
Consequence, as it is only dangerous 
by repetition. To prevent a return, V.S. may
be of service in some Circumstances, but 
more is to be derived from gentle Cathartics, 
as Cassia, Manna, Gum. Tart. Rhubarb. &c.
Nitre may be good as a refrigerant. Diluents 
as Decoct. Alth. Infus. Lini, Rice Water &c, & 
Demulcents as Milk, Emulsions &c are of 
service. G. Arab. & Nitre is useful. But 
ye greatest benefit may be expected from 
Astringents as Allum &c, & Tonics as Bark & Chalybeates.
Emollient Injections & warm bathing 
are sometimes necessary to obviate Pain.
The Patient shd. be restricted to a proper Regimen;
hard exercise & strong Liquors must 
be avoided; his food must be mild, & his 
Drink diluent & Astringent -







173
Ordr. 9. Epidemicæ.
Genus 54 Variola.
For ye best method of treating ys Disease 
I shall refer you to Baron Dimsdale &
Mr. Sutton’s Publications, & shall yre. fore
pass it over in a very cursory manner.
Inoculation ought not to be neglected as 
ye Advantages arising from it are many 
& great: I think, in great Towns, Children 
might be Inoculated before teething, but 
before it, they shd. be used to drink freely &
to sleep in a Bed, [& it] wch. is greatly preferable 
to a Cradle. If it can be put off till they 
are older, 'twill be better. The months of 
June, July, & August ought to be avoided
if possible ye coldest months. As to preparations 
I do not think any necessary, unless
ye Child be of a full habit, & yn. gentle
purges are proper. The Diet shd. be milk
& Vegetables; Animal food must be avoided,
even butter, & ye Puddings shd. be made 
without Eggs: This diet shd. be used sometime 
before Inoculation, but ys. must be 










174
regulated by ye. state of ye Patient– In ye.
Eruptive Stages, a Purge shd. be given, for Childn. 
ye best is R. Jalap. & Syr. Simp. for Adults Inf.
Sena, Sal. Gl. Gum. Tart. &c. must be used to 
mitigate ye fever: & cold Air shd. be admitted
freely. If Convulsions or Epileptic [?ece?ions]
occur, sedatives must be employed,
especially Opium; & ye Eruption must 
be forwarded by warm Bathing, Semicupium
&c. During ye Suppurative Stage
ye Cold regimen is not so necessary: but ye
Air shd. be rather Cold yn. otherwise: The 
belly shd. be kept open to counteract ye.
phlogistic Diathasis; but ye use of Cathartics
is often pushed too far: Anodynes
are sometimes requsite to procure rest.
If putrid Symptoms occur, Bark, Wine &
Vitriol. Acid must be had recourse to. -
The Symptoms during ye State of desquamation
are often very dangerous. If yre. is 
inflammation V. S. may be used; but in Case 
of putrescent Symptoms Bark & Wine &c.
Blisters may be applied to ye Back or Throat:
& to free ye Throat from Viscid Matter emollient 
Gargles may be useful.-







175
Genus 55th. Rubeola
This Depends on a specific Contagion, & 
attacks a person but once. It is most frequent 
wth. young people & in winter. The 
first Symptoms are like yse. from Cold, as 
shivering fitts succeeded by heat, Sickness
of Stomach, want of Appetite, & sometimes 
vomiting: but frequent Cough & other Catarrhal
Symptoms are ye most troublesome;
The expectoration is but small, but sometimes 
bloody: frequent sneezing is observ'd,
& watery discharge from ye Nose & Eyes; ye. 
Lips & Eyelids swell; yre. is difficulty of 
breathing, wth. pain of ye Breast: & abt. ye
5th Day Red spots appear, first abt. ye face, & 
are extended over ye rest of ye Body; yse. do 
not appear elevated, but may be felt. The 
Eruption commonly mitigates ye vomiting, 
but ye other symptoms remn. & ye Cough and 
Dyspnea are often aggravated. The Spots 
change yr. Colour first on ye face, they become 
brown, & at length yre. is a desquamation
of white Scales, or Powder. The [Sequ???]
are Inflammatory affections of ye.
breast, Pthisis, but chiefly a troublesome 








176
Diarrhœa, to wch. many fall Victims: Affections 
of ye Eyes also very troublesome.
I think much advantage might be derived 
from Inoculating Measles. Little is necessary 
in ye treatment, as it will generally run
its natural course. Patients shd. be kept in 
a moderate temperature, & shd. use mild 
& diluent Liquors as Linseed Tea, Emulsions,
&c. & ripe fruits: If y Belly is bound it shd. be kept 
open by gentle Cathartics if ye inflammatory 
Symptoms are urgent, V.S. is very proper.
Anodynes are good to reliefe ye Cough,
but they shd. not be used in ye beginning:
Demulcents are proper for ye Throat. If Diarrhœa
occurs, Anodynes & Astringents as 
Succ. Japon. must be had recourse to.-
Blisters are often serviceable to relieve 
ye Breasts & ye Steams of warm water may 
be received into ye Lungs. If Putrid symptoms 
appear towards ye End, Bark, Wine
& Ol. Vitriol. must be used; but ys. is 
seldom ye Case, as ye Inflammatory
Symptoms generally continue. At
ye end it is customary to use repeated
Cathartics, but yse. I think are of no use. 







177
Genus 67 Pertussis
This Disease is contagious, & like other 
Epidemics attacks a person but once; hence
is chiefly peculiar to ye early part of 
Life. It begins like Catarrh wth. slight Cough
& horsness, & continues for one, two or more
Weeks: as it advances the Cough increases 
in severity: The fitts of Coughing come 
at Intervals of an hour or two, & continue 
several minutes without intermission
so violent yt ye face becomes turgid, florid,
& sometimes Blue, ye Eyes become prominent,
yre. is a discharge of Tears, &
mucous from ye Nose, & often Hemorrhage:
The Cough is accompanied by a 
peculiar inspiration like ye crowing  
of a Cock, or braying of an Ass. The fitt
ends by expectoration of Mucus, or by 
Vomiting. It sometimes ends fatally 
by Convulsions during ye fitt, or by 
inducing Disease of ye Lungs- At ye early Stage
V. S. in often proper to obviate inflammation, 
but it shd. be used wth. Caution








178
for ye move debilitated Patients are, ye more
tedious ye Disease will prove in Childn.
it is best Done by Leeches, The Belly shd.
be kept gently open by refrigerent Cathartics.
If yre. be pain in ye Breast or much Dyspnœa,
Blisters may be applied after V. S.- The 
Cough arises from ye natural efforts to 
expel Mucus & yre. fore Demulcents Sedatives
&c are of no service, but do harm;
Emetics are ye only medicine from wch.
we can expect relief & they are often 
very serviceable; Squills are frequently 
used, but I think Ipecac. or Tart. Emet.
preferable. Wn. ye Disease continues 
long it is supported by irritability, in 
wch. Case ye Bark may be useful, but 
it shd. be employed to a Considerable extent.
It has been often cured by change
of Air & Situation; ys has been recommended
by every practitioner, & a succession 
of Changes is sometimes necessary.-







179
Genus 57. Scarlatina.
This is most frequent to Infants, & does
not attack yse. who have had it before. It
begins wth. Cold & hot fitts, headach, Sickness
at Stomach & sometimes vomiting; Pain & redness of
ye. Eyes, swelling of ye Eyelids, an increas'd
discharge of Tears & Mucus by ye Nose, Inflammation
of ye fauces & Difficulty
of Swallowing occurs: On ye 3d. or 4th. Day
small red spots appear on ye. Face yse. spread
and appear like a genera & Efflorescence, wch. 
appears like Erisypelas, but without ye.
Swelling the redness extends over ye whole
body, & yn. yre. is a sligh abatement of Fever.
The Disease is at ye height abt ye 5th or 6th Day
wn. ye Skin appears rough at length; & yre. is a desquamation,
wn. ye disease ceases: This is the 
Mildest State, in wch. it appears. In bad 
Cases, all ye Symptoms are augmented, ye.
Pulse is a quick, small & fluttering, face sunk, 
severe Vomiting & Looseness, ye Tonsils, Submaxillary
& Parotid Glands are swelled &
inflamed, so much as to impede respiration, 
Ash coloured spot appear. wch. soon


x Dr. Monro has had patients who have been twice wth.
Cynanche Maligna-


180
slough & leave bad Ulcers, darker Sloughs
succeed, & ye surrounding parts appear livid,
the breath is very foetid, & ye matter spit up
is bloody: The pulse becomes quick & feeble,
& ye Patient is soon cut off either by Suffocation
or ye putrid fœtor. Droply often 
succeeds ys. Disease even wn. it is mild.-
Sometimes ye Eruption happens without 
ye Sore Throat, & ye Sore Throat without ye.
Eruption, & ye has been called Cynanche
maligna: x but I consider ye Scarlatina
Anginosa as being ye properest name.-
Sometimes at ye beginning Inflammation
takes place in ye Throat to a great degree, in
wch. Case topical Y.S. may be proper, but it is mostly
inadmissable, as putrescent Symptoms, generally
prevail. Emetics may be serviceable.
If ye belly is bound in ye beginning
Laxative Injections, or a solution of Manna
may be good. Diaphoretics have been
much recommended, but no stronger
yn. ye Saline Jalap shd. be given. When
ye swelling is great, & yse. is much discharge
of acrid mucus, Blisters shd.
be applied to ye Throat. Gargles shd. be used
as Decoct. of Figgs, Mallows, Lini &c wth. Vegetable




181
Vegetable Acid, honey, Nitr &c. to remove ye
septic tendency, Decoct. Cort wth. ye Vitriolic
Acid, Antiseptic Funnel recd. & into ye mouth
by an inverted funnel, are of Service. 
Wn. ye Putrescency has gone far, Bark wth.
ye Vitriol. Acid, & Wine must be exhibited
plentifully: It may be given to Infants
in fine powder. mixt wth. solution of
Succ. Glycyrrh. or injected for Ammn.
The Drink shd. be acidulated wth. Ol. Vitriol.
After ye Disease, washing ye Body wth. warm
Water, friction, & gentle Exercise are proper.
Wn. ye Parotid & Submaxillary glands swells
Mercury must be used. Either internally
or externally, or Camph. Ol. & Saturnine
Poultices may be tried: but if yse. fail
& ye tumors tend to suppuration warm 
Poultices &c shd. be used, Sometimes
hectic Fever succeeds, in wch. Case ye.
common method as Milk Diet, [crossed out]
Country Air, Exercise, Asses Milk &c.
may be had recourse to. The Asses Milk
shd. be drank to several pounds in a 
Day.-



182
Genus 58. Influenza
This is generally referred either to Catarrh
or Synocha, but I class it here, as it is certainly
& contagious Disease, tho' it is liable
to occur wth. ye. who have had it formerly. It
is sometimes so slight as to confine
ye Patient a Day; a Cough & Fever is observed,
but yse. are very inconsiderable & soon disappear
by avoiding ye Causes supporting
Catarrh sometimes it is more severe, yse.
are Languor, freqnt. Palpitn. Pulse small, & I Unequal, 
Pain of Head, Breast & Back, impaired Appetite,
wth. thin limpid Discharge from ye Nose
& Eyes previous to ye Cough: ys appears abt. ye.
2 or 3 Day, & first without Expectoration, but
afterwards much Mucous is expelled, ye Cough 
becomes incessant, Breathing difficult, Violent
pains in ye Joints, Breast & Belly, wth. Looseness
& often bloody Stools: The fever is mitigated
after ye 3 or 4 Day. But it sometimes
ends fatally by inducing Phthysis.- In
ye Practice, exciting Causes must be avoided 
as Cold, Wet, &c. for Diet all stimulating 
food & Drink must be shunned: In general
all yt. we have to do is to obviate ye.



183
Fever in ye beginning, & ye Pneumonic Symptoms
afterwards. If ye Cold stage of ye Fever
is long Emetics may shorten it, but yse.
are seldom necessary. After ye Cold Fit V.S.
shd. be performed but it is seldom to be repeated;
& after ys. an Epispastic shd. be applied. 
Demulcents are good for ye Cough, & Opiates to
procure Sleep: The Belly must be kept
open by gentle Cathartics; & a discharge by
ye Surface shd. be induced by Saline Draught, 
Diluents, & proper Cloathing but violent
measure not to be used. If ye Cough
continues violent Bark will often stop it
in ys. as well as Measles, & Cicuta has sometimes
ye same effect. When Phthysical
Symptoms supervenes ye Practice must be
ye same as in Phthysis.-
Genus 59. Dysenteria.-
This is a Contagious Disease. All Cases
accompanied wth. Gripes, Tenesmus & Fever, I
wd. refer to Diarrhœa, if they are not produced
by Contagion, or are incapable of being
propaged to others.-



184
It attacks variously but generally ye is Lassitude,
Headach, Vertigo pain of ye Back, Wind, swelled 
Stomach, wth. prickling heat, nausea & vomiting
wth. Fever, & all its Symptoms generally
of ye putrid Kind. Soon ye Disease commences
& it sometimes comes on without yse. symptoms 
preceding it wth. pain, not fixed as
in Enteritis, Borborygmi, & frequent copious
Stools, at first natural: Soon after
ye Pain becomes violent, Tenesmus &
severe Gripes ensue, the Matter evacuated 
is frothy Mucus wth. Bile & sometimes
Blood. Prolapsus Ani is ofen occasioned.
The Urine is often high coloured, 
& sometimes a Sediment like Coffee grounds
is separated & ye is heat of pain in ye Urethra.
A burning heat is observed in ye Intestines,
wch. are swelled wth. flatus, a fœtid
Bloody sanies is discharged, ye fever is augmented,
ye Tongue & Teeth are covered wth. blk.
matter, ye Breath is foetid, blk spots appear
on ye Mouth & fauces, & often Petechiæ are
observed on ye whole Surface. Facies Hippo.
comes on, the body smells fœtid, ye Patient 
becomes insensible & is sometimes carried
off by ye fever, at others by Convulsions
& other nervous Symptoms.-



185
At ye beginning of ye Disease Emetics are
indicated for ye purpose ye Vitr. Antini. has
been much used: but I think either Ipecac
or Tart. Emet. preferable, & perhaps it is 
best to mix yse. ye Infus. Camom. shd. be drank
during ye Operation. The best effects is often 
derived from Cathartics & ye best we can use
are ye Saline ones: they shd. be repeated every
2d. or even every Day, I shd. be dissolved
in a large quantity of Water. Diluents
of ye demulcent kind, as Barley Water, Inf.
Lini &c. are often serviceable, both by ye Mouth,
& Anus Injections are particularly useful. 
If Inflammation is considerable in ye. beginning
V.S. is indispensably necessary, but 
its repetition must be avoided & it must
never be used unless Inflammation exists.
Blisters, Fomentations & ye warm Bath
may be necessary in violent pains: Opiates are also
frequently productive of great advantage, 
but yse. shd. not be used 'till after due Evacuation:
a purge in ye Morning & Anodyne at
Night is very proper. Strong Diaphoretics are
bad, as they increase ye Septic Tendency: This
must be combated by Wine, Bark, Acids &c-



186
Astringents are proper in ye last stage, as
Simarouba, Juce. Japon G. Kino. Alum wth. Aromatics,
&c. but of all Rhubarb & Bark are
best. At ye. time ye. Diet must be nutritious,
& tho' ye whole of ye Disease ye Air shd. be free.
Genus 60. Pestis.
Of ys. Disease I can say nothing from 
Experience, shall therefore refer you for 
a full acct. of it to Sydenham, & Carolus de
Martin Physician at Moscow.



187
Ord. 10 Phlegmasiæ.
Genus 61. Phrenitis. 
This sometimes comes on very suddenly & 
in ye immediate Consequence of particular
accidents as Lightning &c.- It is commonly
proceeded by Heat & pain in ye Head, shivering,
Tinnitus Aurium & other febrile Symptoms: yse. gradually increase
ye Sleep (if any) is disturbed; & a sense 
of fullness is perceived: ye face becomes red & particularly 
ye Eyes. but without yt. heat & pain 
wch. occurs in Opthalmia: Patients are unable
to bear light, or ye. least Noise. At length 
a pulsation is felt in ye Head: Drops of Blood
fall from ye Nose: the patient cannot sleep,
& yt. Watchfulness wch. characterises ye Disease
succeeds: Delirium occurs wth. violent & impetuous
actions. The febrile Symptoms are
now very high: A great heat is observed, except
in ye extremities wch. are cold: The Tongue is
parched & covered wth. Mucus, & ye Pulse is quick
small & hard. the Urine is Limpid, tho' often
white & turbid: ye fœces too are often white



188
wch. is reckoned a fatal Symptom: Convulsions 
supervenes, wch. generally end in Death.
Sometimes however ye Disease is cured by
artificial Means, or by Crisis, wch. is generally
some great Evacuation, as Diaphoresis,
Diarrhœa or Hemorrhage: At ye Change, ye Urine 
deposites & Lateritious Sediment. This Disease 
seldom continues about 5, 6, or 7 Day, very
rarely above ye 15- If it does yre. is generally
a recovery, but seldom in perfect health, as
it [crossed out] often leaves behind it very obstinate
seguelæ.- In ys Disease no remedy is
more to be relied on yn. Blood letting liberally,
it is [crossed out] best to open ye Jugular Veins; Cupping
wth. Scarifications shd. likewise be employed.
Next to V. S. Cathartics are most to be trusted,
ye best are Crem. Tart. Linitive El. Sal. Gl.
Infus. Tamarind &c. After yse. a Blister ought
to be applied to ye Head. Internal Refrigerants 
as Nitre & Vinegar may be used. Campr.
has often good effects in Delirium, but it
shd. not be used till ye Inflamn. is abated.
Opiates I think may be used after Evacuation.
The Diet must be low & cooling, & Diluents
plentifully given; All stimuli must be
avoided: & ye Patient shd. be kept erect.-



189
Genus 62. Opthalmia.
This mostly attacks suddenly, wth. an uneasy
sensation, as if from Dust, & upon inspection
red vessels much enlarged can be seen. Afterwards
an acute pain is felt, & ye Eyeball appears enlarg'd.
ye Eyelashes are also swelled: this is followed by
a discharge of watery fluid, sometimes so
acrid as to excite excoriation of ye Cheeks: &
ye Eyelashes are glued together in ye Night. If ye.
Disease is propagated inwards, yre. is great uneasiness
from Light, wth. Headach, Thirst, Loss 
of Appetite, quick & hard pulse. If great
Watchfullness occurs, it is an alarming
Symptom, & if after ye prelude of Death.
A Resolution is generally produced: but sometimes
yre. is a suppuration on ye Adnata or 
Cornea. It may occur to only one Eye, but
in most Cases both Eyes are affected, & sometimes
alternately, till there is a loss of Vision.
If is often hard to say whether it be Idiopathic
or Symptomatic. When it resists ye
common practice we may apprehend ye. 
latter. As an Idiopathic Disease it occurs
chiefly in plethoric habits. In ye Cure
an Antiphlogistic regimen is of great
Consequence: All Irritations, as dust, light,


Nothing shd. be used wch. is not soluble in Water.
must be used as Bark, Chalybeates &c. But Topical
cold Bathing is particularly serviceable 
as plunging ye Head in Watr. wth. ye Eyes open.

190
heat, Cold &c. must be avoided. The Eye must 
not be bound up, but ye patient shd. be put in
a dark room. Blood letting in different forms
is often necessary, in most Cases Topical V. S.
will be sufficient wth Cupping: It is often found
very effectual to scarify ye Adnata, so as to
discharge a few Drops. The Belly must be kept
open by refrigerant Cathartics. Blisters & 
Issues will be found very useful. [Hermitatories], 
I think, very dubious. Gentle diaphoretics 
may be serviceable, & Diluents shd. be always employed.
Anodynes may be used wre. yre. is Watchfulness,
but they will be found necessary in 
few Cases. Emollient Applications will often
obviate pain, but they are exceptionable
from ye relaxation they produce. Cold Applications
are preferable as Cold Water, Rotten
Apples &c. Saturnine Appns. are ye most powerful; 
ye Solutn. of Sal Plumbs is best: ys Lotion
shd. seldom be omitted. A Laxity often take,
place in ye latter stages, for wch. Astringents must
be used, as Vitr. Alb. To prevent ye Eyelids being
glued together, Hogs Lard wth. a slight Impregnatn. 
of Ol. Vitr: is ye best Appn. x The Ung. Tutia may be
used wre. ye Disease is seated in ye Palpabræ. The 
thickening of ye Cornea may be removed by operatn.
Escarotics are often used, & ye best in Em. Tart. &
sugar combined. To prevent ye return Tonics



191
Genus 63. Cynanche
Under ye. Title, we mean to treat of ye Inflammatory
sore Throat, or Angina. It
commonly begins wth. shivering Fitts, succeeded
by heat & headach, wth. great Thirst: A prickling
Pain is observed upon Swallowing Liquids, wch.
soon becomes constant, acute, & pungent, attended 
wth. Heat, & at length ye Food cannot be
swallowed but wth. great Difficulty; Respiration
becomes difficult, & ye Articulation of Words
is interrupted. On examining ye. Fauces, we
find yn. inflamed & swelled, & also ye Tonsils & 
Uvula: Tumors of ye Glands are also observed
externally. There is a great Discharge ye of Saliva,
& ye Face appears flushed & redder yn. natural.
The symptoms generally terminate in a 
few Days, & ye Disease mostly ends in Resolution, wn. it
suppurates it is more tedious. If it proves fatal
it is not from Gangrene: but generally
want of Deglutition, of from Fever. x Regimen
is often sufficient for ye Cure; & wn. Medicines,
are necessary, ye same may be used as in 
other inflammations. V. S. is in most 
Cases unnecessary, & unless indicated by Plethora
may be omitted. Cathartics are useful,
either by ye Mouth or Injection.
x Antiphlogistic



192
Nitre may be used as an Refrigerant. Emollient
Gargles, & Fomentations are serviceable, 
also Gargles wch. promote ye secretion of Mucus
as Squill Vinegar. Inf. Ros. Vinegar & Mel. &c.
Volatile Liniment / 1pt. spt. & 2pts. Oil / & Blisters.
may be proper- Pediluvium of moderate heat
is sometimes of service. Wn. Respiration
is obstructed Bronchotomy must be performed
Wn. deglutition, Nutritive Clysters of Chicken
Broth &c. may be administered. When Resolution 
cannot be brot. abt. we must promote- 
Suppuration by emollient Poultices &c.
ye Abscess can be reach'd, it may be opened.
but wn [of] it is beyond our reach, it may often
be ruptured by strong Efforts of ye Parts, as
swallowing. Wn. ys. is effected, Garganisms 
of Barley Water &c. are proper.-
Genus 64. Pleuritis.
Many Authors include wth. ys. ye. Peripnuemonia,
but as yse. is much Difference
in ye. Proximate causes & symptoms. I
think they shd. be separated.- 
Pain is ye first Symptom, it is sometimes
preceeded by Fever, but ye Fever mostly 
comes on after it. The pain soon becomes



193
fixed, is pungent & Acute & is very much aggravated by Coughing,
sneezing & Inspiration; The pain is fixed rather
below ye middle of ye Thorax, & generally
on one side, & shoots to ye neighbouring Parts.
The Pulse is very hard; & ye Urine high coloured.
The Disease mostly arrives at ye Height, abt. ye.
3d. 4th. or 5th. Day. seldom goes so far as ye 10th. with
either a Crisis or Death. The Crisis is often brot. abt by 
an Expectoration of a think Mucus or bloody
sanies, sometimes by Diarrhea or copious Diaphoresis. 
In ye Cure V. S. is considered as indispensably
necessary: ye blood shd. be drawn from a large 
orifice, & ye quantity shd. not be less yn, ℥xij
at first: & ye repetition must be regulated
by ye Age & Constitution of ye Patient, & hardness
& frequency of ye Pulse, but we shd.
not take too much away; as ye Disease is
generally in ye End, of a putrescent Tendency. 
Blisters shd. be applied to ye pained part, & 
frequently repeated, before ye former Sore is
heald. Cathartics are tho. to be bad; but perhaps
emollient Injections may be used. Cold
Regimen is found necessary; ye State ye Room
shd. be kept at between 50 & 60° & tepid Diluent
drinks are proper; All hot things shd. 
be avoided. Nitre may help to abate ye Inflamn.
The Pediluvium of a moderate heat may
prove useful; & a natural but not copious



194
Sweat is good: but all stimulating Diaphoretics
are to be avoided. To allay ye pain & Cough
Opuim may be well employed after Bleeding
& Blistering: Fomentations & Anodyne
Balsam may relieve ye Pain. Some recommend
Squills & Emetics to promote expectoration,
but I think ym. too stimulating. 
Wn. Supperation occurs, ye same treatmnt.
must be had recourse to, as in Phthisis-
Genus 65 Peripneumonia.
I shall endeavour to point out ye difference
between ye & Pleuritis but diffused over 
ye whole chest, & is obtuse & gravative,
like ye Pain felt in a finger wn. a Ligature
is tied round its. In pleuritis, Respiration
in augmented in frequency, but in Peripneumony
it is not increased; but in some
Cases is slower yn. natural. In ys too, a deep
inspiration appears to give relief, where as
in yt. nothing is so much dreaded. In Peripneumony,
Consequences of Obstructed
Blood appear in ye tinged & even livid Faces.
in pleuritis ye Face is only a little flush'd.
In Pleuritis ye Pain is aggravated by ye Cough



195
but in peripneumonia it is relieved by it; 
& ye Expectoration is free & copious contrary to
wt. happens in Pleuritis. In Peripneumony
ye Pulse is quick & soft in Pleuritis, quick &
hard.- The proximate Cause of Pleuritis
is an [crossed out] increased Action; & of Peripneumonia
an accumulation of Blood
in ye Lungs.- The Cure is generally ye.
same as in Pleuritis- hence copious 
V. S. & repeated blisters are proper- Emetics
also are useful in ye first stages-
Expectorants & ye streams of warm Vinegar
are of much service.-
Genus 66. Enteritis.
This I wd. consider as an inflammation
of ye whole Intestinal Canal, & in it comprehend 
wt. is called Gasteritis. The first
Symptom is an Acute shooting Pain, generally
abt. ye Umbilious, attended wth. heat &
Fever: ys. is succeeded by Vomiting & a rejection
of every thing, taken into ye. Stomach, &
even Injections are often thrown up by 
ye mouth: In general ye. is great Constipation;
but in some cases frequent small
stools of a watery Mucus: wth. yse yre. is tension



196
of ye Abdomen wth. Soreness: & sometimes Spasm 
so violent yt. a glyster pipe cannot be introduced. 
Strangury too is frequent: Borbouygmi & hiccup
occur: ye Tongue becomes dry: respiration laborious,
Pulse small, freq, & hard sometimes irregular.
Prostration of strength, delirium,
Convulsions & Death ensue. Sometimes
Gangrene is produced wch. is known by sudden
cessation of Pain, fœtid & blk. stools,
weak, small & intermitting Pulse, & Change
of Countenance.- To bring abt. a Cure
by resolution ye same remedies must be
used as in other Inflammations, particularly 
V. S. wch. in ye Disease is observed to render
ye Pulse full & soft Blisters ought not 
to be omitted. Emollient Clysters are of much 
service & may remove ye cause of ye Disease.
If Food cannot be taken by ye Mouth, Nutritive
Injections are proper. Cathartics -
seldom do good; & if ye. is any stricture, they
must do harm; if any are used ye mildest
shd. be preferred. To mitigate Symptoms
as Vomiting & Pain- Mint Water, Saline
Julep., & Conf. Japon. are often employed: but 
nothing is better yn. Opium, & ys. shd.
not be given in a sparing Manner.-



197
Genus 67. Hepatitis.
This comes on by shivering heat & other
Symptoms of Fever; yse. are succeeded by
pain in ye region of ye. Liver, sometimes
acute, & other times dull & gravative; 
& yre. is a degree of tension & sense of weight;
yre. is a manifest elevation of ye integuments,
wch. is painfull to ye Touch: The pain 
strikes to ye Scrobiculus Cordis, shoulder &
scapula, wch wth. a dry Cough gives it ye Appearance 
of Pleuritis: Respiration also 
is painful, Wth yse. bilious Symptoms
as in Jaundice also occur. The Tongue is covered wth. a blk,
or yellow crust. The patient breaths easiest
wn. lying on ye affected side.-
Wn. it ends in Resolution it generally
abates abt. ye 3 Day; if it continues to ye.
7th. Suppuration is generally ye consequence
ye pain yn. is acute & shooting, wth. a sense
of Pulsation & burning heat. There is generally 
a great tumour perceived, & in
some Cases fluctuation is felt. Sometimes
ye matter is discharged by Vomiting, Stool &c.
& it often is discharged by ye abcess bursting
externally or internally: In ye last Case



198
it produces Hectic Fever; & gives rise to Tabes
hepatica. It often ends in Schirrhus, wch. is
known by a hardness & swelling remaining.
ys. often continues during Life, & gives rise
to Dropsical Affections. It sometimes, tho'
very rarely ends in Gangrene.-
The Inflammation must be resolved as
in other inflammatory Diseases. by V. S.
Blisters, Cathartics, &c. Refrigerants as
Nitre, may also be used, ye French combine
Camphor wth. ys. but I have not heard of much
good produced by it. Wn. Supperation
comes on it must be promoted by Fomentations
&c. & wn. ye Abcess if fully formed,
it shd. if possible be opened wth. a Lancet:-
Wn. ye Abcess breaks internally, ye. Matter [crossed out] has sometimes
been taken up by ye absorbents, &
carried off by Urine. The Bark shd. be
given in considerable Quantity to counteract
ye effects of purulent absorption; & 
if ye Abcess continues long open, Myrrh. &
Mezereon may be conjoined to its use. 
The chief remedy agst. Schirrhus is ☿ &
ye best method of applying it is by friction, 
& it shd. be continued some length of times. 
Cicuta, Scamonium, Hyosciamus, & Solanum, 
are also used but above all, I wd. recommend
Electricity-



199
Genus 68. Nephritis.
We may divide ys. into ye Nephritis
Calculosa, & Vera
It begins wth. pain abt ye. Region of ye. Kidney, 
wch. is sometimes acute & pungent, sometimes-
gravative.- ys. is propagated down ye course
of ye Ureters, & causes a torpor of ye Thigh. It
is attended wth. general Fever, & quick, hard, & 
small pulse. The Urine is passed in small 
quantity, & wth. pain & heat, & is generally
pale coloured, tho. often bloody, in ye latter stages.
An Aversion to food wth. Sickness, & Vomiting & 
are often induced- likewise Obstipatio
& severe colic pains attend.- It generally
ends favorably in ye Course of 3 or 4 Days,
sometimes in a few Hours; but wn. the
Symptoms remain violent after ye
4th. Day it often ends in Suppuration. The
Matter is sometimes discharged by ye Urine;
& ye Ulcer may remn. during Life. Sometimes
schirrhus is induced, wch. is known by Ischuria,
& a degree of Paralysis of ye Leg of
ye affected side. & Termination in Gangrene 
is very rare.- In ye Cure we
must have regard to ye Cause of ye. Inflammn.



200.
If Calculi are ye Cause, nothing is better yn.
Diluents, Diuretics, Warm Bath, Opiates &c.
To check ye Inflammation- V. S. Antiphlogistic
Regimen- Cooling Cathartics,
&c. as in other Inflammations are proper,
Blisters perhaps we had better abstain from, 
as Cantharides are apt to stimulate Urinary 
organs: tho I think they only act on
ye neck of ye. Bladder. The Posture of ye Patient,
shd. be erect or to one Side. If yse. means are
found ineffectual for ye. Resolution; we must
promote suppuration: & to induce a free
discharge of ye Matter, Mucilaginous Diluents
shd. be taken, as Infus. Lini- Althæe
To heal ye Ulcer, Bals. Caphiri, Gum. Myrrh,
Bark &c. are used- & lately ye Uva Ursi
has been introduced, wch. appears to be very
powerful.- If ye. Abcess points outwardly,
it may be opened wth. a Lancet.-
Genus 69. Erysipelas-
It generally begins wth. febrile Symptom,
wch. continue for 3 or 4 Days: During ys.
time ye Symptoms of Erysipelas come on,
yre. first a prickling pain, wth. redness &



201
Swelling: tho sometimes ye parts are yellow
or even black: The swelling appears bright 
and polished in ye center: & puts on pressure.
By degrees ye most prominent part becomes unequal 
& Vesications filled wth. a blk & fœtid liquor appear, & ye pain is very 
violent, great prostration of strength, Watchfulness, Stupor & high Delirium
succeed & ye patient is often cut off
by ye fever- It arrives at ye height at a medium
abt. ye. 3d or 4th. Day, tho. it often runs 
on to ye 7th. The decline is manifest, by ye Decrease 
of Fever, swelling & by ye white colour,
& at length a Desquamation comes on. The termination
is sometimes attended wth. sweat,
an increase of Urine wth. much sediment. It
often proves fatal by producing Gangrene:
& sometimes by ye inflammation being [crossed out]
transferred to some of ye vital parts: it has
been known to attack every part of ye Body
by transition. The Disease is sometimes
hereditary: [crossed out] often arise from Contagion: &
Patients who have once had it are most subject
to an Attack. A Cure is not to be brot.
abt. by any artificial means; the Fever
must run its course: all we can do is to
mitigate: It has at first an inflammatory
appearance, but in its progress assumes ye. 
Typhoid Type, so yt at first we must restrain 
increased Action; & at last obviate a sedative




202
tendency.- In ye beginning ye Antiphlogistic
plan must be pursued- Much dispute
has arisen concerning ye propriety of V. S.- I
think wn. yre. is Delirium, good Effects may be
produced from it, but it ought to be sparingly 
used, & think not repeated. Refrigerant Cathartics 
shd. be moderately used. [crossed out] It
is common to dust ye part wth. dry powders
as flour, Starch, Chalk &c. but by yr. forming
crusts they may produce bad Ulcers, the
best application is warm Furrs, dry cotton 
cloths &c. The Application of bruised Cabbage
Leaves has lately been much recommended,
but I think ye. would rather increase ye Inflammation,
however it must be reffered
to future Experience. Wn. ye parts [crossed out] much
ulcerated Ointments are used, particularly
ye saturnine, wch. may defend ye pt & allay ye Inflammation; 
but ye best application here as well
as in common burns, is Ol. Lini & Aq.
Calcis p. æ. (ye Common remedy) upon ye whole- As to
ye Fever, in ye first Stage, we must restrain
ye increased Action by cool regimen & Cathartics-
& afterwards counteract ye.
Septic Tendency by Bark & Port Wine.
Camphor has proved successful.-



203
Genus 70. Rheumatismus
We may divide ys. into acute, & chronic;
tho' ye latter is generally, if not always ye.
consequence of ye. former. In ye. acute
Rheumatism, yse. is an acute & lancinating 
pain, wch. is generally seated in ye larger
Joints, & propagated along ye Course of
ye Muscles. After ye. has continued some
Hours a swelling comes on wch. abates ye
Pain: ye Part is red & painful to ye Touch, wth.
a sense of Heat. The pain is sometimes 
confined to one Joint, sometimes it shifts
from one to another, but it mostly attacks
several at ye same time. The Inflammation
generally ends in Resolution in
2 or 3 Days; but sometimes it continues
violent for 3 or 4 Weeks, & yn. it seldom fails
to end in Suppuration or Gangrene. In Some
obstinate Chronic Cases, ye swelling remains
for Life, & a cretaceous matter is 
deposited in ye Joints. A Fever of the 
Inflammatory kind comes on & continues
wth. ye pain- All ye complaints are 
worst in ye night.- A natural Chysis is
sometimes brt. abt. by profuse Sweat,



204
copious discharge of Urine, [crossed out]
or Hæmorrhage, but more frequently by 
Cutaneous Eruptions. It often degenerates
into Chronic Rheumatism, wch. is known
by ye abatement of ye Fever & Inflammation
& ye swelling continuing, besides in Chronic
Cases ye pain is less, ye Limb stiffer,
& a crakling Noise is perceived on motion.
This Disease is almost peculiar to yse. in
ye prime of Life, & who are robust, & vigorous.
It may be known from Gout because 
generally attacks ye smaller, & ys. ye larger -
Joints; besides in ys. yre. is no Affection of
ye Alimentary Canal: The pain too in 
Gout is always confined to one Joint: It's being
hereditary [crossed out] is also a good mark. If ye habit
is sanguine, it is commonly Rheumatism;
but in a full & corpulent
habit we may suspect Gout.-
In Rheumatism yre. are four Stages, ye.
Inflammatory, ye Irritable, Atonic, &
Paralytic- In ye 1st. Stage, Copious and
repeated V. S. are particularly serviceable,
especially topical V. S.- Antiphlogistic
Regimen must also be used; but external 
Cold ought to be avoided as it aggravates 
ye Symptoms- Cathartics, I

ꝶ. Pulv. Guaiac. Comp. Snmt.
Coch. paw. bis ucl. ter dedie-

205
not admissible, except in case of Costiveness,
from ye pain wch. ye least motion occasions-
The Chief Remedies to be depended
upon are Sudorifics; ye Tart. Em. & Vin.
Antim. are very good; but ye pulv. Dover.
is ye. best Medicine; it is best given in
doses of abt. gr. x. & repeated every 3 or 4
Hours 'till a Sweat is produced, to support
wch. diluents shd. be taken; & ye Patient
must lie in a Cotton or Flannel Shirt, in
a bed without Sheets; yt. ye. Blankets may 
absorb ye. Sweat: It ought to be continued
for 8 or 10 Hours, & all Motion & change of 
Posture shd. be avoided during ye. Time.
G. Guaiac may also be given: it may be
given in powder, wth. an equal quantity of
Crem. Tart. wch. makes it dissolve more readily
in ye Stomach; it may be dissolv'd
in ye Decoct. Lignor wth ye help of Egg. Stimulant
are good in ye 2d. Stage, & yse. may
be joined wth. Guaiac- a proper quantity
of ys. may be dissolved in a bottle of Rum,
& ℥i taken once, twice, or thrice a Day.
Vol. Alk. may be also good especially in ye.
Paralytic State. Mezereon has been used
in ye early Stages, & in some Cases it may
be useful.-

This Lecture unavoidably missed

206
External Stimuli are much used, but they
often only Change ye pain from one place to
another. Blisters are sometimes useful, but
they are inconvenient, & often excite inflammation.
Rubefacientic are better, as ye Vol.
Limmin or Camphor Oil Alk.-The Vitriolic
Acid abt. ʒi to ℥i of Axing. is a good application
in ye 2d Stage- Ward's Ess. & Hoffman's
Lig. Oth. An. often relieve violent pain,
as also ye Ancd. Balsam.- Sedatives shd. not
be freely used, but they are sometimes necessary
to procure Sleep.-For ye 3d. Stage
or Atomic, Bark & Cold Bathing may be had
recourse to- Mercury has often very 
good effects in ye late Stages, both internally
& externally used- Electricity
ought not to be omitted-If a stiffness
shd. remain in ye Joint, Warm Bathing 
& Emollient Ointments may prove serviceable.-
Genus 71. Arthritis-



207
When ye irregular, wandering or anomalous 
Gout attacks ye Stomach, we must endeavour 
to repel it by strong Wines, Aromatics  
&c. & yse. may be used largely wth. Rum,
Brandy, (wch. may be combined wth. Asafœtida) or
even Vol. Alk. Wn. spontaneous Vomiting
comes on we may encourage it by Inf. Camom.
Wn. it attacks ye Lungs, it produces severed Dyspnœa
& Asthma, to remove wch. we must have
recourse to powerful Antispasmodics, as ye.
vapour of Æther, inspired. Blisters may
be used in urgent Cases, especially wn. it
attacks ye Head, & assumes ye Appearance of
Apoplexy- in wch. Case V. S. must also be
freely used- We must also endeavour
to solicit ye Gout to ye Extremities by [crossed out]
warmth & friction applied to ye Feet, also
acrid Cataplasms, & Blisters have in some
Cases been successful, but yse. are only admissable
wn. yre. is no pain in ye Feet. To 
prevent a return, nothing is of more service
yn. a proper Regimen- Constant Exercise,
wth. mental & Corporeal Amusements,
plain & light food & drink, wth. proper Clothing
are very useful. The Duke of Portland powder
& ye. G. Guaiac. have been much celebrated,
& I believe may sometimes be useful.



208.
Genus 72. Phthisis.
We may refer all Cases of Phthysis to one
of three Species viz: ye. Catarrhal, ye.
Purulent, & ye Tuberculous. In ye first,
Matter comes from ye. Surface of ye Lungs
without Ulceration: ye 2d. is wn. purulent
matter is discharged from a Vomica in ye.
Lungs. & ye last is wn. yre. are Tubercles or
indurated Tumors in ye Lungs. The 
Symptoms may be divided into 3 Heads.
ye Pulmonary or Pneumonic, ye Hectic, & 
ye Supervening- The Catarrhal Phthysis
is very frequent from neglected Colds, tho'
it is sometimes caused by Matter formed
in a distant part of ye Body, being taken
up & Carried to ye Lungs. The [crossed out]
Pneumonic Symptoms in ye Species are
as follows: The Patient is troubled wth. a
severe Cough thro' ye. Day, wch. is increased
on going to Bed, wth. Dyspnœa particularly
wn. in an horizontal posture; yre. is no
fixed or constant pain, but a sense of 
Cold & general Soreness in ye Breast; ye Matter of
expectorated is at first white, but afterwards



209
afterwards becomes yellow, & has a disagreeable
smell, & is sometimes streaked wth Blood.
if spit into water, part of it sinks: yre. is also 
a disagreeable salting taste in ye Mouth. After
some continuance of yse. Hectic Symptoms
commence.- From ys. Species many 
have recovered x.- The Purulent kind
is more generally fatal: It is generally occasioned
by Hæmorrhage or Inflammation.
The Pneumonic Symptoms of ys. are these; 
a fixed pain is felt at some part of ye Breast;
wth. a sense of weight, & Dyspnœa wn. horrizontal, 
particularly wn. lying on ye opposite side; 
ys. is so bad before ye breaking of ye Vomica,
yt. ye Patient can breath only wn. on ye affected
side: The Cough is [crossed out] sometimes violent; but yre. 
is seldom much expectoration at first.
The Bursting of ye Vomica is preceeded by
a slight bloody expectoration; & yn. ye-
Matter is coughed up, sometimes to the
amount of several lbs. The Symptoms 
are now mitigated; but ye Discharge soon
acquires a thinner Consistence; & the 
Hectic Fever comes on wth. great severity,
'tho ys sometimes happens before ye bursting 
of ye Abcess.-
x It may be known by its occurring at advanced periods of Life.



210
The Tuberculous Species is most frequent
and most dangerous; it consists in a peculiar
indurated State of ye Glands of ye Lungs,
& is mostly Scrophulous; tho' it sometimes
arises from Small Pox, Measles, Syphilis,
&c. It generally happens between ye 15th. &
25th. year. At ye Commencement it is accompanied 
wth. high spirits; ye Cough is a Typicula,
without expectoration. There is no 
remarkable Pain in ye Breast, & ye Dyspnœa 
takes place only upon motion, &
Patients can lye wth. equal ease on either 
side. If any expectoration takes place, it is
a watery Mucus or Sanies, like ye matter
from a Scrophulous Ulcer.-
The Symptoms of Hectic Fever are ye same
whether they arise from purulent Absorption
from ye Lungs, or from an Abcess in any other
part of ye Body. They consist of repeated
Paroxysms of no long duration, & are ushered
in by a sense of Cold, wth shivering wch. is
sometimes partial: & hot fit succeed, yre.
is a glowing heat with a circumscribed
red Spot on ye upper part of ye. Face, in 
ye palms of ye Hands & Soles of ye Feet. The 
Pulse at every Apyrexia is seldom under
100. & during ye Paroxysm it rises to 120.



211.
& is small & hard: The Tongue is moist & often
without any white covering; yre. is no degree of
febrile Anxiety; but during ye Fitts, Patients
are in [crossed out] good Spirits: The Urine is high coloured,
& yre. is a considerable furfuraceous Sediment,
wch. appears suspended in ye middle. The Paroxysms
recur in an uncertain manner, as from 
eating meals &c. sometimes a Surprise will
induce ym. -The Sequelæ or supervening 
Symptoms we come next to treat of.
Marks of Emaciation soon appear, & many
Circumstances indicate a failure of Circulation,
in ye extreme vessels of ye Body: I ye.
Eye, ye red Vessels of ye Adnata disappear, & ye
whole of it becomes a pearly white; ye hair
falls off, & yre. is an uncommon paleness in
ye face wch. puts on ye Appearance of ye Facies
Hippocratica- After a time Colliquative
Sweats & Diarrhœa come on, wch. hasten ye Patient's
Death. ye Sweats are partial commonly
abt. ye Head & Shoulders- Œdamatous-
Swellings of ye Legs appear; & at length a low
Delirium, & ye patient is out off sometimes
without a struggle.- Phthysis
may be known from Catarrh by ye Pearly
Appearance of ye. Tunica Adnata, & by the 
Expectoration of Pus wth. ye Mucus.- As
Phthysis is ye Consequence of other Diseases, ye.
Prevention maybe referred to them-



212
For ye Cure, we shall first mention V. S.-
This shd. only be employed in ye 1st. Stage.
especially in ye purulent Phthysis, it may
perhaps prevent ye forming of matter, but wn.
ye Abcess is formed, it wd. do harm: if yre.
is violent pain topical V.S. may be useful-
As ye Catarrhal species is owing to
a diffused Inflamn. on ye Surface of ye Lungs,
V. S. may perhaps prove beneficial in ye.
beginning of it- But it may be better
employed in ye Tuberculous, yn. any of
ye other Species; & in ys only, repeated small
Bleedings are recommended.- Dr. Dover
advises 5 Oz. to be drawn every Day, for
6 or 7 Days. but Physicians shd. remember,
"Borrus medicus nunquam sanguininis
"human prodiges."- We shall not find
any great Advantage from ye. practice; however,
in ye Tuberculars, wn. a state of Inflammation
is indicated, small Bleedings
are necessary.- Epispastics are employed
wth. Advantage to all ye Species & they shd.
be applied as near as possible to ye affected Part. 
Issues & Setons are particularly useful in 
ye. Catarrhal; & also in ye purulent before
ye Vomica has burst: but in ye Tuberculous 
they ought never to be advised.-
Repeated Emetics are sometimes useful;



213
in ye Catarrhal they promote expectorations
& they may be useful in ye Ulcerous after
ye Vomica has broke to promote ye evacuation
of ye Contents: In ye Tuberculous they may 
tend to a Cure by bringing on a determination
from ye Lungs: Ipecacuana is ye best Emetics:
it shd. be given to excite full Vomiting-
Refrigerants have been advised, as Acids
& ye Neutral Salts- The Juice of Lemons
has a high Character; & I have reason to
consider it as having effected ye Cure of
a Catarrhal Consumptions wre. pus was
mixed wht. ye. Mucus, & ye Hectic Symptom [crossed out]
had appeared; no other Medicine being
given. Ass Mare's Milk & Goats Whey
may be serviceable. In ye Confirmed Phthysis
Medicines will mostly be of little avail, however
we must try some. The use of ye Cort. Per.
has been productive of much Controversy:
but I have in some Cases seen it produce
ye best effects. In ye Tuberculous it ought
not to be given; & it is seldom useful in ye.
Catarrhal as it produces Dyspnœa, but if 
ys. does not take place, it may be productive
of much benefit:- But it is more 
remarkably useful in ye purulent. It 
shd. not be given before or immediately after
ye Vomica has broke; but wn. ye Discharge is



214
lessened & appears ichorous, it may be given
wth. safety; & it sometimes induces Inflammation
& Adhesion, wch. can be our only object.
The Cold Infusion is ye preparation to be preferred.- 
The Vegetable Balsams & Gums were
once much extolled; but are now fallen
into Disrepute, tho' I think undeservedly;
I have seen good Effects produced by some of
them, particularly Myrrh: & Dr. Symmonds,
& Dr. Griffith have wrote in its favour;
Dr. Saunders & Dr. Fordice have also employed
it wth. great success. It may be given in ye same
Cases as ye Bark, & shd. be joined wth. Crem.
Tart. or Nitre. There has been much Controversy 
wth. regard to ☿: I think it seldom admissable,
unless Phthysis is complicated wth. syphilis;
is wch. Case Mezereon may also be of
service; I think it promises to be useful in ye.
Disease, it may be given in powder to ye quantity
of gr: v, three or 4 times a Day, it's pungency
may be corrected by ye Additn. of Rad. Glyctuir.
Cicuta has been used, I think it promises to 
be of considerable Advantage, in ye Tuberculous.
Tussilags has been used, but the Advantage
derived from it is only temporary, from its
lubricating Nature; but it ought to come under
ye Article Diet. The Inhalation of fixed,
Air &c. has been recommended; & ye Vapour of 



215.
other promise to be serviceable, I think it
deserves a trial.- With regard to Regimen, In
ye incificent stage of ye Ulcerous, a spare Vegetable
Diet is ye most proper, & with Butter Milk,
wch. is preferable to Milk. In ye Catarrhal, a
more nutritious Diet may be used: & in
ye Tuberculous, a generous Diet I think
shd. be recommended, & if ye Patient has a 
craving for anything, I wd. recommend moderate
Indulgence. The Patient's drink shd. be Diluents:
but I wd. not deny them fermented
Liquours, or Spirits, but they shd. be diluted.
A pure Dry Atmosphere is of service, & advantage 
in derived from a warm Climate, &
being near ye Sea. The Patient shd. not be clad
too thick either by Day or Night; & a Cotton Shirt
is useful to absorb ye Sweat, A Regular Discharge
shd. be kept up by ye Belly, wth. Crem. T. El. Len. &c
The Passions shd. be properly regulated.
Exercise is very beneficial, especially Sailing. 
I wd. recommend a daily excursion, over a
ferry or Arm of ye Sea- Urgent Symptoms,
as ye Cough may be obviated by Balsamics,
& Opiates- ye Diarrhœa by Absorbents & Antiseptics; 
& ye Sweats by Bark & Elixir Vitriol.-



216.
Order 11th. Febres strictly so called.
Fever may be said to consist of a sense of Coldness, increased
heat, Thirst, Febrile Debility,
Anxiety, & Confusion of Head: & unless
yse. is a Combination of there Symptoms
Fever does not exist: This I call Ephemera
or simple Fever; it may consist of
one or more Paroxysms.- When ys. is 
combined with an inflammatory Tendency,
I have marked it out, under ye.
Title of Synocha.- When it is jointed wth.
a Putrescent Tendency, I have called it
Typhus:- And wn. yse. are Intermissions,
in wch. ye Patient may be said to be entirely
free from Fever, it may be denominated
Intermittens.
Genus 73. Ephemera
The first Symptom is a Sense of Coldness,
extended over ye Body, sometimes so
great as to occasion Shivering; ys. is attended
wth. Sickness, a distressing Anxiety & sometimes
Vomiting: The Cold Fit does not continue



217.
continue long; increased heat to a great Degree
soon follows; wn. ys begins ye Skin becomes
red, wth. flushings in ye Face & Headach, or a 
sense of Weight & Confusion. Patients have
no inclination for Sleep; or if yt. shd. take
place, they are not refreshed by it. Violent
Thirst ensues, & the Tongue becomes dry
& parched, tho' there is no Change in ye Colour of 
it: Anxiety & Sickness continue: The Pulse
becomes quick but regular & full: Respiration 
is quick & yre. is a small degree of Dyspnœa,
& sense of Weight abt. ye Breast: Pains occur
in different parts of ye Body, wth Lassitude.
These Symptoms continue several Hours. Thro'
ye whole Course ye Skin has it natural Softness;
& by degrees it becomes covered wth a
general Moisture; & for ye most part ye Disease
terminates in a profuse Sweat.
Ephemera generally terminates in 24
Hours, & seldom continues longer yn. 36. It
is mostly concluded wth. one Paroxysm, & ye only
inconvenience left is Debility. But ys.
is not always ye Case, repeated Paroxysms-
sometimes occur; & in yse. ye Coldness is hardly
perceptible, & ye Sweating is often wanting
or at most only a gentle moisture takes
place. In such Cases it sometimes terminates
by Hæmorrhage or a Copious Discharge
of Urine; & ys. is [crossed out] by ye 4 or 5th. Day



218.
if ye fever extends beyond yt. it degenerates
either into ye Synocha or Typhus. Ephemera
is never ye product of Contagion, wch is ye.
most common Cause of Typhus.-
During ye Cold Stage perhaps ye less yt. is done
ye better, ye only things shd. be warmth in
Bed; but too much warmth must be avoided; 
much is to be feared from ye use of Cordials,
& Wine, Diluents shd. be given to quench-
Thirst, & yse. only in a tepid State: if yre. is
great Coldness of ye Legs & Feet, warm Water
in a Bottle may be applied; but ys. & all
additional Bed cloaths shd. be removed
as soon as ye Cold ceases Wre. yre. is Sickness,
Vomiting shd. be encouraged by Inf. Camon.
or tickling ye Fauces; but Emetics are
seldom admissable; except wre. we suspect
a load on ye Stomach. We must endeavour 
to shorten ye duration of ye hot fit by
exciting Sweat; but not be stimulating
Medicines or Regimen, yse. must be avoided.
Cold Drink, as Cold Spring Water, Barley
Water, Milk & Water, Water Gruel &c. shd.
be freely drank: The Air of ye. Chamber
must be kept as a moderate Temperature, 
& a free Circulation of Air shd be
promoted: The Covering on ye Bed shd. be
light, & ye hands & Arms may be exposed.



219 
This gives Relief to ye Patient, promoted
Sleep; & Sweating will more readily occur
yn. if ye heat was supported. If any Medicine
is necessary, ye most gentle Diaphoretics
may be used as Saline Draughts. 
Spt. Minder or Nitrous, Julep, or if yse. are
not sufficiently relaxing, Opium may
be used, but wre. it does not seem necessary
it shd. be avoided, as it increases ye Confusion.
The Sweating shd. be encouraged 'till
ye pulse gets nearly to ye natural Standard,
& ye other Symptoms are abated. It
may be carried on by lying [crossed out] still, & Diluents
taken in a tepid state. For Food, Farina,
ripe Fruits, roast or Boiled Apples &c. may
be taken; but Animal Food, even Broth,
must be shunned. It was formerly the
practice to give repeated purges after every
Fever, but ys. is not necessary: One gentle
Purgative may be given to discharge ye.
fœces yt have been retained.-
Genus 74 Synocha
This is often a forerunner of Typhus, &
it not unfrequently is a Consequence of 
Ephemera from improper treatment: besides
ys it sometimes [often] occurs alone; & in ys. State we



220 
mean to describe. Before ye attack of 
ye febrile Symptoms. Patients are affected,
wth. flying pains in ye Bones & Lassitude, after yse.
have continued 1, 2 or more Days ye common
Symptoms of Fever come on, & wth yse. ye Pains
in ye. Shoulders, Back, Head &c are encreased.
At ye accession of ye Heat, ye Celerity of ye Pulse
is increased, & it becomes strong, full, & 
hard; but uniformly regular, by wch. Synocha
may be known, The Breathing becomes
quick, & ye Breath appears very hot.
The Eyes appear red, & are much affected by
Light; & yse. is a like Affection of ye Sense of
hearing; but sometimes Patients subjected 
to Deafness; Vertigo & Delirium often
occurs & ye Delirium is of ye. Phrenetic
kind, & is marked by an impetuosity
of words & actions. Long continued Watchfulness
is very distressing. The Tongue becomes
very dry & white, & ye whole Surface
of ye Body is dry. If yre. are any Ulcers on ye.
Body, ye Discharges is diminised, & ye Parts
abt. ym. are much inflamed. The Urine is
more scanty yn. usual, & or a very high Colour,
but yre. is no seperation on cooling,
wh. ye Symptoms continue violent. [crossed out]
In 8 or 10 Hours, ye Symptoms are somewhat
[crossed out] lessened. But ye fever seldom terminates
by a single accession, for tho' the



221 
Symptoms are not uniformly violent,
yet ye Disease is protracted for many Days.
often 13. or 14; but its duration is generally
less yn. Typhus. A fresh accession is seldom
ushered in by a sense of Coldness. Wn.
yre. is a salutary termination, it is by an
obvious Crisis, under ye form of Diarrhea,
Vomiting, Hæmorrhage, but most by Sweat:
& ye Crisis is generally preceeded by an
aggravation of ye Symptoms. But wn. ye.
Delirium is particularly much increased,
& is a prelude to Death. It may be known
from Typhus, by ye latter coming on slower,
& ye symptoms being milder: By ye Heat
being greater yn in Typhus: In Synocha
ye Pulse is regular, stronger & hard, in Typhus, small,
weak, & irregular but quick in both.-
In Typhus ye Delirium is of ye Melancholic
kind. Synocha is perhaps never ye Consequence
of Contagion, as Typhus is. Wn.
a Critical Diarrhœa occurs it is preceeded
by ye intermitting Pulse. We shall now 
speak of particular practices used in ys.
Affection. There is no Fever in wch. V. S.
is equally necessary. It is necessary often 
before other medicines, particularly Emetics,
for without previous depletion



222 
yre. is reason to apprehend disagreeable Consequences 
from yse. Wre. ye Pulse is quick,
full & hard V.S. may be considered as proper,
but it must be cautiously employed, &
regulated by ye State of ye Pulse; it is very
seldom yt we can venture on a repetition
After Depletion is obtained, Emetics will
often bring ab. an immediate Cure, &
for ys. purpose I look on Ipecac. as preferable
to Antimonials. Refrigerant Cathartics
I think may be of great use, & I reckon
Crem. Tart. preferable to any other:
ʒi shd. be given every hour till it operates:
wre. it does not agree, its place
may be supplied wth. El Lenitiv. Senna
Tea, Infus. Tamarind, &c. but it is not
adviseable to repeat yse. so often as ye. Evacuation
of ye Canal may seem necessary:
in yse. Cases mild Injections may be 
had recourse to. Besides yse. Refrigerants
are proper, as Nitious Mixtures, & acidulated
Diluents, & ye. Patient shd. drink 
barley Water, Gruel &c. Great Benefit is
sometimes obtained from gentle Diaphoretics
as Saline Julep. &c. Small doses of 
Tartar. Em. sometimes do good in ys.
way, I have often tried ys. I never saw-



223 
any material good effects from it, therefore, 
from ye distressing Nausea wch. it occasions,
have been induced to lay it aside.
The Pediluvum of moderate heat has produced
advantage. Antispasmadics as
Camphor, Valerian, Musk &c have been
used, but yse. are very uncertain. I have
often used Blisters wth Advantage, in
Cases wre. yre. was a fixed pain in any part,
by applying ym. as near as possible to 
ye Part. Opiates are often of great use to
alleviate Pain, but they shd. not be used
'till after Bleeding & Blisters. In long
continued Watchfulness, Opiates often
give considerable relief from ye greatest
distress. The Diet shd. be of ye Refrigerant
kind & taken entirely from ye Vegetable
kingdom: & Diluents shd. be taken somewhat
acidulated, & if yre. is an inclination 
for Cold Water, it shd. be [crossed out] indulged.
In ys. fever Cleanliness is of ye greatest
service & ye Bed & Body Linen shd. be
frequently changed.-



224 
Genus 75. Typhus.
This is one of ye most frequent Diseases
in ys. Country. I mean by ys.
Term to comprehend wt. have been called, ye low or slow
Fever, ye Nervous, & ye Putrid: These Denominations 
only expressing particular
Appearances of ye same Disease. The 
first is wse. wth. ye fever, yre. is great Oppression,
ye 2d. wre. ye Nerves are particularly
affected as may be known by ye Tremor,
Subsultus &c. ye 3d. wre. yre. are Marks of a
putrid State, as Hæmorrhage, Petechiæ, Vibices
&c. It often changes from one State to
another-& is taken by Contagion.-
Wth. ye Common Symptoms of Fever, here
is great Oppression, Sighing wth. often a pale &
dark Countenance, Headach, Vertigo, &
Tinnitus Aurium, wth. Watchfulness, or
disturbed Sleep; ye Pulse is feeble, weak 
& fluttering; ye Tongue & Skin dry; Belly
found, & Urine pale. The Symptoms-
continue for 10, 12, & sometimes 20 Days
or more, yn. gradually diminish: This is
wt. is called ye low Fever.- But in some
Instances, ye Pulse is very irregular as
well as feeble & frequent, yre. is flushing of
ye Face, violent heat in ye Hands & Feet & wth.



225. 
partial Coldness & cold Sweats, great uneasiness
from Sight & Noise, Delirium of ye
low kind, Subsulsus, Tendinum, Tremors 
partial Convulsions; Watchfulness or
constant stupor; redness of ye Eyes & Parched
Skin. Small dark red spots called Petechiæ, or
large livid blotches/Vibices/ appear; Hæmorrhages
from ye Nose & Mouth, fœtid Breath & 
Sweat; blk Tongue, & a blk incrustation over
ye Teeth; Delirium, Convulsions & Death.
Wn. Patients live after ye 15 or 16 Day, yre. is a
great Chance of Recovery; & ye Disease seldom
proves fatal after ye 20th.- Emetics are 
particularly useful in ye beginning of 
ys. Fever, & have often produced an artificial
Termination: Cathartics are also
necessary to empty ye inferior part of ye.
Canal; but we shd. not push ye use of yn
so far as to evacuate from ye System in
general. Much is to be apprehended from
V. S.- some symptoms seem to indicate
is as Pains in ye Breast, affecting 
Respiration; but if any, topical V. S. is 
only admissable; After ys. V. S. if Headach
& difficulty of Breathing is severe Blisters
may have a good effect: they are sometimes
also used in ye late Stages in Case of Torpor. 



226. 
& except in ys. Care are seldom of use [crossed out]
& unless yir. applications is indicated by ye.
above Circumstances, they ought to be avoided,
as they sometimes appear rather to increase
ye. Fever. No Medicines are more generally
applicable yn. [crossed out] Antiseptic, & ye
best is ye Cort. Per. & wre. putrescent Symptoms
appear. it shd. be used as liberally as
possible. The Mineral Acid are also of
use, especially ye Vitrolic, wch. shd. be used to
acidulate Drinks wth. & 20 or 30 Drops taken
twice a Day. Recent Vegetable Acids are very
proper to allay thirst as Oranges, Lemons &c. 
Among ye Antiseptics [cross out] we may mention
Cold wch. is also one of ye best Cordials: the
Doors & windows shd. be set open, & ye Bed
placed in an airy situation; but streams
of Air shd. be avoided. Wine may be given
plentifully, ye best is Claret or Rhenish;
it shd. be frequen wth. in small quantities
& not given so as to increase ye Headach:
it may be increased gradually, & wth.
Adults ye quantity of a Bottle may be 
taken in 24 Hours. Wre. yre. is a natural
Craving Spirits may be allowed. Camphor
in ye form of Emulsion, I think a good
Cordial, I have lately used it much in Typhus



227 
Typhus, & I think wth. good effect: it may also
be combined wth. Wine & Bark. Asafœtida 
has been proposed but is little used. Opium
has been much recommended by D Heysham 
of Carlisle, Dr. Camel of Exeter, & Dr.
Wall of Oxford; but I think it shd. not be
used except wre. it is indicated by long Watchfulness,
Violent Pain or Looseness.- The 
excretions must be kept as regular as possible:
The Chamber clean, & ye Bed & Body
linen frequently changed. All Animal 
food shd. be avoided 'till ye Fever is on
ye Decline, Acessent Foods & Fairnacea
are principally to be used; & ye Patient shd.
have a full Supply of Cold Acidulated
diluents. By these means ye Disease
will be mild & conclude successfully.
Practitioners, I am convinced, frequently
err in ys. Disease, more by doing too much,
than too little.-



228 
Genus 76. Intermittens
In all ye varieties of ye. Genus, ye. leading
Symptoms are ye. same as yse. common
to other Fevers. In almost every
instance, each Paroxysm has 3 Stages,
viz: ye Cold, ye Hot, & ye Sweating. From 
Sweat taking place, ye Symptoms gradually
disappear, & a state of Apyrexia
comes on wch. continues a long time: without
any obvious Cause however, ye same
symptoms recur, [crossed out] after
a [crossed out] certain Time. Where yre. are Intermissions
of 24 Hours it is called Quotidian; 
48 a Tertian; & 72 Quartan. Wn. ye Paroxysms 
begin at uncertain periods [cross out] it 
is called irregular, & Quotidian, Tertian
or 4tan. as it approaches more nearly to the
Type of any of ysn. wn. one Paroxysm is
severe & another slight alternately, it is
called double, from a supposition. yt yre.
are two different intermittents. They 
are called Vernal, & Autumnal, from ye.
seasons in wch. they happen; & ys ought to
be had in view, for in ye. Spring [crossed out]
yre. is a disposition to Inflammation, &
in ye Autumn to ye putrescent State. -



229 
It is generally allowed yt they are caused
by ye Effluvia of Marshes. The Vernal ones
are less dangerous yn. ye. Autumnal, & ye.
Tertian is ye easiest cured.- In every
modification, Emetics are generally
necessary, & they shd. be given at such 
time yt. yis. operation may be just finish'd
wn. ye cold Fit begins: ye. disease has
often been compleatly cured by [crossed out] repeated 
Emetics. It is seldom necessary
to use any medicines to regulate or lessen
[crossed out] the course of a Paroxysm in ys. Climate, it generally
terminates in a complete intermission. 
wn. any are necessary those tending to induce
Sweat are ye best as Spt. C. C. in Sack
Whey. Opium has been much used of late, 
in order to render ye. [crossed out] Cold Fit milder:
in my opinion it is chiefly necessary,
wre. in former Paroxysms, a compleat Apyrexya
did not take place, [crossed out] & I wd. ascribe it's
effects to it's producing a more copious Sweat:
in ye. same way Saline Julep &c. & Ipecac.
combined wth. opium may be useful.-
Sometimes local Inflammation occurs, &
Dyspnœa, in wch. Case V. S. & Blisters may
be necessary, but yse. require caution.-




230 
It is necessary to obviate ye bound State of 
ye Belly, wch. shd. be done by gentle Laxatives 
or Injections. During ye Intermissions, 
ye best medicine is ye Cort. P. It shd. be 
given to ye quantity of ʒss, ʒij, or ʒi every 
2 or 3 Hours during ye Apyrexia. [crossed out] 
Sydenham wary first who ventured to 
use it freely. It shd. be given to ye quantity 
of ʒi or ʒij every Day for some Time 
after ye Disease is stopped.- Sometimes
ye Bark will fail wn. ys. is ye Case intermittents 
are sometimes cured by Alum, 
Blue & White Vitriol, or Sacc. Taturn, but 
yse. are hazardous & require to be used wth. 
caution. Sublimate has been sd. to cure. 
Arsenic has been much used, & it is said 
wth. great Success: Dr. Chalmers dissolved ʒi & 
as much Opium in ℥viij of Water, & gave 
3 or 4 gtt. 1ce or 2ce. a Day; Professor Milman has 
invented a Sal. Arsenic, wch. he recommends. 
The tasteless Ague Drop too has been much 
used; it is found to be Arsenic dissolved 
in Water by means of ye fixed vegetable Alkali. 
Exercise, Cold Bathing, & Change of Situation 
may be had recourse to [crossed out] prevent a return. 
The Diet shd. be much ye same as in other 
Fevers during ye Paroxysm. -




231
Index.-
Page
Introduction-1
{Order 1st. Humoralia (contin.Gen. b.) 21 ad 67.
Genus 1st. Anasarca-21.
-2 Hydrocephalus-45.
-3 Hydrothorax-52.
-4 Ascites-56.
-5 Emphysema-61.
-6 Tympanites-63.
{Ordr. 2. Epischeses (cont. Gen. 5) -68 ad 85.
Gen. 7 Obstipatio-68.
-8 Ischuria-71.
-9 Icterus-76.
-10 Amenorrhœa-80.
-11 Dyslochia-83.
{Ordr. 3. Profluvia (cont. Gen 7)-86 ad 104.
Gen. 12 Catarrhus-86.
-13 Diarrhœa-90.
-14 Cholera-92.
-15 Diabetes-94.
-16 Cystirrhœa-97.
-17 Lencorrhaœa-99.
-18 Gonorrhœa-101.
{Ordr. 4 Cachexia (cont. Gen. 5)-105. ad 117.
Gen. 19 Scorbutus-105.
-20 Scrophula-108.
-21 Rachitis-111.
-22 Syphilis-113.
-23 Cancer-116.


232.
Index.
Page
{Order 5. Impetigines (cont. Gen. 4) 118 ad 123.
gen. 24 Psora-118.
-25 Herpes-119.
-26 Lepra-129.
-27 Tinea-121.
{Order 6. Neuroses (cont. G.15) -123 ad 148.
Genus 28 Apoplexia-123.
-29 Paralysis-126.
-30 Epilepsia-129.
-31 Convulsio-131.
-32 Tetanus-131.
-33 Rabies-133.
-34 Mania-135.
-35 Melancholia-135.
-36 Hypochondriasis-137.
-37 Hysteria-139.
-38 Asthma-141.
-39 Dyspepsia-143.
-40 Colica-145.
-41 Cephalœa-146.
-42 Odontalgia-148.
{Ordr. 7 Morbi Dissimiles (cont. G.5) -149 ad 162.
Gen. 43. Symptomata e Venenis-149.
-44 Symptomata e Vermibus-152.
-45 Symptomata e Calculis-156.
-46 Symp. Infantibus propria-158.
-47 Symp. Mulieribus propria-161.


233.
Index
Page
{Ordr. 8. Hæmorrhagiæ (cont. G.6) -163 ad 172.
Gen. 48 Epistaxis-163.
-49 Hæmoptysis-165.
-50 Hæmaternesis-167.
-51 Mænorrhagia-168.
-52 Hæmorrhosis-170.
-53 Hæmaturia-171.
{Ordr. 9 Epidemicæ (cont. G. 7) -173 ad 186
Genus 54. Variola-173.
-55 Rubeola-175.
-56 Pertussis-177.
-57 Scarlatina-179.
-58 Influenza-182.
-59 Dysenteria-183.
-60 Pestis-186.
{Ordr. 10 Phlegmasiæ (cont. G. 12) -187. ad 215.
Genus 61. Phrenitis-187.
-62 Opthalmia-189.
-63 Cynanche-191.
-64Pleuritis-192.
-65 Peripneumonia-194.
-66 Enteritis-195.
-67 Hepatitis-197.
-68 Nephritis-199.
-69 Erysipelas-200.
-70 Rheumatismus-203.
-71 Arthritis-206.
-72 Phthysis-208.
{Ordr. 11. Febres (cont. Gen. 4) -216 ad 230.
Gen. 73 Ephemera-216.
-74 Synocha-219.
-75 Typhus-224.
-76 Intermittens-228.
-Finis.-