ARMY MEDICAL LIBRARY
FOUNDED 1836
WASHINGTON, D.C. 
 
 
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   ME STIC  MEDICINE:

  R   E   AT    I    S   E
*#«.'        d n-  r  a e- ■'
 l^E VMTION: and  CURE
               O  F
    I   S   E    A    S    E   S
                B Y
MEN*and  Sl-Mf
W  1  1
   hi BRAKY
SURGE W) AWEAAU&CmCE
                       OCT.—S-13D3.
                    K  /  H^'z-'^'O-
.*E N DIX, containing 0 ISgEjJSAXflRYJj^
  fat the. Ufe of Private Pra&itioners.
4
^
       L'ClAk  BJJ CHAN,   M. D.
Fellow Gf the Royal College of Phyficians, Edinburgh.
ifully Corrcaed from the lateft LONDON  EDITION,
  To which is now adde.d, a Complete INDEX.

      P  H  I  L^A  D E L  P  H  I  A:
P.'nted for Joseph Crukss^bekv Robert Bell, and Jame3 MuJe>
   f Philadelphia: Aad for Robert Hodge, of New-York.
M. DCC. I.XXXIV. 
■•:#;
Vatttudofuftentdtur notitiafui corporis; et  obfervathne, qtu
  aut prodeffe foleant, aut obeffe; et continentia in vielu ontn\
  que cultu, corporis tuendt caufa j et pratermittendis vofypi
  tibus, &ci                           ClC. DE OFF'k.j

The body may be kept in health by a proper knowledge £j
  its component  parts, and  an experience of thofe thi'rigS
  Which are known either to affift  or injure its functional
  Temperance in eating,  drinking,  and every kind of exepjl
  cife is alfo to be obferved  ; and the avoiding all thofe reljj
  creations  and pleafures  which may be unfit for the hur^ao^
, conftitution, &c.                                   *
Optimumvero medicament urn efl, opportune cibus datus.
                                        Cels. de  Me

The beft kind of phyfie is meat and drink, taken feafon
  and in proper quantities.
 
T  O
,*•
S:r>JOHN  PR INGLE,  Bart.

\:g (physician  to her^aj&sty.
  S  I  R,

* f* H E character which you  juftly fuftain
     in the literary world,  your laudable and
  ccefsful endeavours to  extend and  improve
  >e art of Medicine,  the confidence repofed in
  )ur ikill by  the  Public,  and the important
  «tion > m hold in the care of  the* Royal Fa-
mily, all confpire to point you out as  the moft
Proper Patron of a Performance which has fo*
  ; object the  Health of the inhabitants of
  vc'ar Britain.

  These, Sir,  were the motives which in-
voiced me to  dedicate to you  the following
•^                                 meets,
tf 
Iv    DEDICATIOI<
meets.   I  wifh they were  more wordy
your acceptance;  but,  fuch as they are,
freely fubmit  them  to  your candour   ;:nU
make no doubt of meeting with that ,  Jul-
gence which is infeparable from  great abi-
lities.

  That you  may  long continue  an oma^
ment to Society, and an honour to  the Me-
dical Profeflion, is the fincere wifh of, f
S  I R,
Your moft obedient
Humble Servant,
 Edinburgh,
June 4, 1772.
WILLIAM BUCHAN.
I 
PREFACE.
      WHEN  I fir ft fignified my intention  of publifhing the
       following lfieets, I was told by my friends  it would
draw on  me the refentment of th« whole Faculty.  As I never
could entertain fuch an unworthy idea of phyficians, I was re-
folved to make the experiment, which indeed came  out pretty
much as  might have been expedited.   Many whofe learning and
liberality of fentiments do honour  to medicine,  received the
Book in  a manner which at once Aewed. their indulgence, and
the falfity of the opinion,  that every phyfician wiftes to conceal
his art;  while the more felfiih and narrow-minded part, which
is always the greateft in any profeflion,  have not failed to pur-
fue both the book and its author with every fpecies  of per/ecu*
tion.
   The reception,  however, which  the book has met with from
the Public merits my moft grateful acknowledgments.,  As the
belt way of expreffing thefe, I have endeavoured to render it
more generally ofeful,  both by  enlarging the prophylaxis, or
that part which treats of preventing difeafes; and likewife. by
(adding many articles which were entirely omitted in  the former
impreffions.   It is needlefs to  enumerate thefe additions.   I
(hall only  fay,  that they have coif me fome  pains,  and I hope
they will be found real improvements.
   The obfervations relative to Nurfing and the Management of
Children, were chiefly  fuggefted  by,anextenfivepra6Mce among
infants,  in a large branch of tne Eoundling Hofpital, where  I
had an opportunity not only of treating the difeafes incident to
Childhood,  but likewife of trying  different plans of hurfing,
tind obferving their effe&s.   Whenever I had it in my power to
place the children under the care of  proper nurfes, to inftruft
 thefe nurfes in their duty,  and to be fatisfied that they perform-
 ed it, very few of them died; but when, from diftance of place,
 and other  unavoidable circumftances, the children were left to
 the fole care of mercenary nurfes,  without any  perfon to in-
 ftrucf or fuperintend them,  fcarce any of them lived.
   This  was fo  apparent, as,  with  me, to amount  to a proof
 of the  following melancholy fa£t: That almoft one half <f the
 human fpecies perift in  infancy, by improper management  or  ne-
glett.   This reflection has made me often with to be-the happy
 inftrument  of alleviating the miferies of thofe fuffering  inno-
 cents, or of  refcuing them from an untimely grave.  No one
 who has not  had an opportunity of obferving them, can ima-
 gine what  abfurd arjd ridiculous practices fiill prevail in the
                                                    nurfing 
 VI            *   R    E   F   A    C    £..

 inurfing and management of infents, and what numbers of man-
 kind perim by thefe Praoees.   Many  of them; howeve'r,  are  j
 owing to ignorance; an-.\ it is to be hoped,  that when nurfes  I
 are better  informed, their conducf will be very different.
 ;  The  application of medicine  to the  various occupations of
 life was likewife chiefly the refult  of obfervation.   An exten-
 five practice for feveral years, in one of the largeft manufac-  I
 turing towns  in England, afforded me fufficient opportunities
 of obferving the injuries  which thofe ufeful people fuftain from  j
 their  particular  employments, and likewife of trying  various
anethods of obviating fuch injuries.  The fuccefs which attend-  II
ecf thefe trials was fufficient  to encourage this attempt, which  II
I hope will be,of ufe to thofe who are  under the neceflity of  II
earning their bread by fuch  employments as  are unfavourable  1
to health.                                                  .11
   1 do  not mean to intimidate men, far lefs  to infinuate that
even thofe  arts,  the practice  of which  is attended with foms"
degree of danger, fhould not be carried on;  but to guard the
lefs cautious and unwary againft  thofe dangers which they have
it in their power to avoid, and which they often, through mere
fool-hardinefs, incur.   As  every occupation in life difpofes
thofe who  follow it to fome  particular difeafes more  than tp
others,  it  is certainly of  importance to know thefe, in order;
that people may  be upon their  guard againft them.   It is al:
ways  better to be warned of the approach of an enemy, than "
to be furprifed by him, efpecially where there is a poffibility
of avoiding the danger.
   The obfervations concerning  Diet,  Air, Exercife, &c.  are  '
of a more  general nature, and have not efcaped the attention
of phyficians  in any age.  They are fubje&s of too  great  in>
portance,  however,  to be palled over in an  attempt  of this
jkind,  and can never  be fufficiently recommended.   The man
who pays  a proper  attention to thefe,  will  feldom need.the
phyfician;  and he who does not,  will feldom  enjoy health,  let  ,
hfm employ as many phyficians as he pleafes.
   Though  we have  endeavoured  to point out the caufes  of
difeafes,  and to put people upon their guard againft them,  yet
it  muft be acknowledged that they are often  of fuch a nature
as to admit  of being removed only by the diligence and  activity
of the public magiftrate.   We are forry, indeed, to obferve,
that the power of the magiftrate is very fcldom exerted in this, i
country for the prefervation of health.   The importance of a
proper medical police is either not underftood, or  very  little
regarded.   Many things highly  injurious to the public health
are daily praclifed with impunity,  while others abfolutely  ne-   i
ceffary for  its prefervation are entirely neglected.
                                                     Some 
PREFACE.             v!t
   Some of the public means of preferving health are mention-
 ed in the  general prophylaxis,  as the inspection  of provifions,
 widening  the ftreets of great towns,  keeping them clean,  flip-
 plying the inhabitants with  wholefome  water,  &c. but  they
 are palfed over in  a very curfory manner.  A proper attention
 to thefe  would have  fwelled  this- volume to too large a  iije;
 I have therefore referved them for the fubject of a future  pub-
 lication.
   In the treatment of  difeafes, I have been peculiarly attentive
 lo regimen.  The generality of people lay too much ftrefs up-
 on Medicine, and truft too little to their own endeavours.  Ic
 is always, however, in the power of the  patient,  or of thofe
 about  him, to do  as  much towards his recovery as can be ef-
 fected by the phyfician.   By not attending to this, the defigns
 of Medicine are often fruftrated; and the patient, by purfuing
 a  wrong plan of regimen, not  only defeats the doctor's  endea-
 vours,  but renders them dangerous.  I have often known pa-
 tients killed by an error in regimen, when they were ufing ve-
 ry proper medicines.  It  will be faid,  the phyfician  always or-
 ders the regimen when he prefcribes a medicine.   I wifiYit were
 fo,  both  for the honour of the Faculty and the  fafety of their
 patients:  But phyficians,  as well as other people, are too lit-
 tle attentive to this matter.
   Though many reckon it doubtful whether medicines are mqre
 beneficial or hurtful to manJcind, yet all allow the  neceflity and
.importance of a proper regimen in difeafes.  Indeed the very
 appetites of the fick prove its propriety.   No man in his fenfes
 ever imagined that a perfon  in a fever, for example, could eat,
 drink,  or conduct himfclf in the fame manner as one in perfect
 health.   This part of medicine,  therefore,  is evidently found-
 ed in Nature, and is every way confiftent with reafon and com-
 mori fenfe.  Had  men been more attentive to it,  and lefs feli-
 citous in  hunting after fecret remedies, medicine had never be-
 come an  object of ridicule.   .
   Indeed this  feems  to have been the firft idea of Medicine,
 The ancient phyficians acted chiefly in the capacity of nurfes.
 They went very little beyond 'aliment in their prefcriptions; and
 »ven this they generally adminiftered themielves,  attending the
 fick, for  that purpofe, through the whole courfe of thedifeafe;
 which gave them an opportunity not only of marking the changes
 of difeafes with great accuracy,  but likewife of obferving the
 effefts of their different applications, and adapting them, to the
 fymptoms.
   The learned Dr. Arburthnot aflerts,  that by a proper  atten-
 tion to thofe things which are almoft within tne reach of every
 body,  more good and lefs niifchief will be d<?oe in acute dif-
                                                       eafes; 
Vili            PREFACE.

eafes, than by medicines improperly and unfeafonably adminif*«
tered;  and that great cures may be effected in chronical diftein- I
pers,  by a proper regimen of the diet only.  So entirely do!
the Doctor's  fentiments  and mine  agree, that I would *dvife  |
every perfon ignorant of phyfic, to confine his practice folely
to diet, and  the other parts  of regimen; by which means he
may often do much good, and can feldom do any hurt:.
  This feems alfo to have been the opinion of the ingenious
Dr. Huxham, who obferves,  that we often feek from Art what
all-bountiful Nature moll readily, and as effectually,  offers us,
had we diligence and fagacity enough to obferve and make ufe
of  them;  that the dietetic part of medicine is  not fo much
ftudied as it ought to be; and that, though lefs pompous, yet
it is the molt natural method of  curing difeafes.
  To render the book more generally ufeful, however,  as well
as more acceptable  to the intelligent part of mankind,  I have,
in moil difeafes,  befides regimen,  recommended fome of the
Bioft fimple and approved forms of medicine,  and added fuch
cautions and directions as feemed neceffary for their  fafe admi-
niftration.  No doubt it would have been more acceptable to
many,  had it abounded  with pompous prefcriptions,  and pro-  !
mifed great cures in confequence of their ufe; but this was not  J
my plan:  I think the adminiftration of medicines always doubt-  I
ful, and often dangerous,  and  would much rather  teach men
how to avoid the neceflity of ufing  them,  than how they fhould
fee ufed.
  There are,  however,  feveral medicines, and thofe of confi-
derable efficacy, which may be adminifteredwith great freedom,
and at the fame time with fafety.   Phyficians generally trifle.a
long time with medicines before they come to know how to ufe  '
them.    Many peafants at prefent know better how to ufe
fome of the  moft important articles in-fche materia medica, than
phyficians did a century ago; and  doubtlefs  the fame obferva-
tion will hold with regard to others  fome time hence.  Wherever
1 was  convinced that medicine might be ufed with  fafety, or
where the cure depended chiefly upon  it, I have taken care to
recommend it; but where it was either highly dangerous, or not
very necefTary, it is omitted.
   1 have not troubled the reader with an ufelefs parade of quo«
 tations from different authors;  but have  neverthelefs made ufe
 of their observations where my own were either defective, 01
 totally wanting.   Thofe to whom I have been moft obliged were,
 Ramazini, Arbuthnot, andTiffot; the laft of whicji,  in  his Avis
 au Peuple, comes the neareft to my views of any author whicl&
 J have feen.  Had the  Doctor's plan been  as complete as thtl
 execution is mafterly, we ihould have had no occafion for an'jra
                                                       new 
PREFACE.            it
teewtreatife of this kind foon; but by confining himfelf to the
acute difeafes, he has,  in my opinion, omitted the moft ufeful
part of his fubject.   People in acute difeafes may fometimes be
their own phyficians, but in the chronic the cure mutt ever de-
pend chiefly upon the patient's own endeavours.  The Doctor
has alfo palled over the Prophylaxis,  or preventive part of Me-
dicine, very flightly, though it is certainly  of the greateft im-
portance in fuch a work.  He had, no doubt, his reafons for fo
doing, and I am fo far  from finding  fault with him,  that I think
his performance does great honour both to  his head and to his
heart.
   Several other foreign phyficians of note have written on near-
ly the fame plan with  Tiffot, as the Baron Van Swicten,  phy*
fician to their Imperial Majefties, M. Rofen, fir ft phyfician of
the kingdom of Sweden, &c. but as  thefe gentlemen's producti-
ons have never come to my hand, I cannot fay any thing con-
cerning them.  I cannot help wifhing, however, that fome of
our diftinguifhed countrymen would follow their example. There
ftill remains  much  to be done  on this fubject, and it does not
appear to me how any man could better employ his time or ta-
lents,  than in eradicating hurtful prejudices,  and diffufing ufe*
ful knowledge among the people.
   I know fome of the Faculty difapprove  of every attempt of
this nature, imagining that it muft totally deftroy their influence.
But this notion appears to me to be as abfurd as it is illiberal.
People in diftrefs will always apply for relief to men of  fupe-
rior abilities, when they have it in  their power; and they will
do this with far greater confidence and readinefs when they be-
lieve that Medicine is  a rational fcience, than when they take
it to be only a matter of mere conjecture.
   Though I have endeavoured to render this Treatife plain and
ufeful,  yet I found  it  impoffible to  avoid  fome terms of art;
but fuch as are made ufe of are, in general,  either explained,
or are fuch as  moft people underftand.  In fhort,  I have en-
deavoured to write down to the capacities  of mankind in  gene-
xal; and, if my Readers do not flatter either  themfelves or me,
with fome degree of fuccefs.  This,  however, on a medical
Subject, is not  fo  eafy a matter as fome  may imagine.   It id
eafier to make a fhow of learning  than to write plain fenfe,
efpecially in a fcience which has been  kept at fuch a difiance
from common obfervation.   It would, however, be no difficult!-
matter to prove that every thing valuable  in  the practical pars
of Medicine  is within the reach of common fenfe,  and that the
Art would lofe nothing by being ftripped of all that any perfou
endued with ordinary abilities cannot comprehend.
                            b              ,           All- 
X             PREFACE.              I

   All I mail fay with regard to this edition is, that I have en-B
deavoured to render it ftill lefs defective than the former.  An  ■
author would, in my opinion, be highly to.blame who fhouI<M»
neglcft to improve his Book,  merely becaufe the purchafers of  f
a former impreffion might complain.  It is a debt which every  I
Writer owes to the Public, to render his .works as complete as  J
poffible; nor can it ever be confidered as injurious to the pur-  I
chafers  of a former impreffion, as  it takes nothing away from  j
them.                                                      I
   It would  be ungenerous not to exprefs my warmeft acknow-
ledgments to thofe Gentlemen who have endeavoured  to extend
the ufefulnefs of  this performance, by tranflating it into the
language of their  refpective countries.  Moft of them have not
only given an elegant tranflation of the Book,  but have alfo en-
riched it with many ufeful obfervations of their own,-  by which
it is rendered more complete,  and is likewife better adapted to
the climate and the conftitutions of their countrymen.   But I
lie under  peculiar obligations to the  learned Dr. Duplanil of  \
Paris, phyfician to the Count de Artois.   This Gentleman has.
enlarged my fmall Book into five volumes,  and, by his elegant  ,
tranflation and ufeful notes,  has rendered it fo popular on the
Continent,  that it is  now tranflated into  all the languages of
modern  Europe.
   I have only to add,  that the Book has not more exceeded my  ,
expectations in its fuccefs, than in the effects it has produced.  1
Some of the moft pernicious practices, with regard to the treat-  1
ment of the fick,  have already given place to a more rational  1
conduct; and many of the moft hurtful prejudices, which feem-  I
ed to be quite infurmountable,  have, in a great meafure,  yield-  I
ed to better information.   Of this a  ftronger inftance cannot  j
be given than the  inoculation of the fmall-pox.  Few mothers,  j
fome years ago, would fubmit to have their children inoculated  '
even by the hand of a phyfician; yet nothing is more certain than
that  of  late many of them have performed this operation with
their own hands;  and as their fuccefs has been equal to that of
the moft dignified Inoculators, there is little reafon to doubt
that the practice will become general.  Whenever this lhall be
the cafe,  more lives  will be faved by inoculation alone, than
are at prefent by  all the endeavours of the Faculty.
INTRO. 
INTRODUCTION.
      TH E improvements in  Medicine, fince  the  revival of
       learning, have by no  means  kept  pace with thofe of
 the other  arts.  The reafon  is obvious.  Medicine has been
 ftudied by few, except thofe  who intended to  live by it as a
 trade.   Such, either from a miftaken zeal  for the  honour of
 Medicine, or to raife their own importance, have endeavour-
 ed to difguife and conceal the ait.  Medical authors have ge-
 nerally written in  a foreign language j and  thofe  who were
 unequal to this talk, have even valued themfelves upon couch-
 ing, at leaft, their prescriptions, in terms and characters un-
 intelligible to the reft of mankind.
   The contentions of the clergy, which happened  foon after
 the reftoration of learning, engaged the attention of mankind,
 and  paved the way for  that freedom  of thought and inquiry
 which has fince prevailed in moft parts of Europe with regard
 to religious  matters.  Every man took a fide in thofe bloodv
 difputes ;  and every gentleman,  that  he  might diftinguifh
 himfelf on one fide or other, was inftructed in divinity. This
 taught  people to think  and reafon for  themfelves in matters
 of religion,  and at laft totally  deftroyed  that complete and ab-
 folute dominion which the clergy had  obtained over  the minds
 of men.
   The ftudy of law  has likewife, in  moft  civilized nations,
 been juftly deemed a neceiTary part of the education of a gen-
 tleman.   EveYy gentleman  ought certainly to know at leaft
 the laws of his own country :  and, if he were alfo acquainted
 with thofe of others, it  might be more than barely an orna-
 ment to him.
   The different branches  of Philofophy  have alfo  of tate
 been very  univerfally ftudied by all who pretended to a  liberal
 education.  The advantages of this are manifeft.  It frees tha
 mind from prejudice and fuperftition ; fits it for the invefti-
 gation of truth ; induces habits of reafoning and judging pro-
 perly ;  opens  an  inexhauftible  fource of entertainment ;
 paves the  way to the improvement of  arts and agriculture ;
 and  qualifies men for acting with propriety in  the  moft  im-
 portant ftations of life.
   Natural Hiftory is likewife  become an object of general at-
tention.   And it well deferves to be fo.  Ic leads to discove-
 ries  of the  greateft  importance.   Indeed, agricukure, the
                                                    1:10ft
• 
lit          INTRODUCTION.

mod ufeful of all arts,  is  only a branch of Natural Hiftory,
andean i.cvct arrive at a high degree of improvement where
the ftudy of that fcience is neglected.
  Medicine however,  has not,  as far as we know, in any
country, been reckoned aneceflary part of the education of a
gentleman.  But, furely,  no  fufficient reafon can be afligned
for ihiscmiflion. No fcience lays open a more extenfive field
of ufeful knowledge, or affords more ample entertainment to
an  inquifuive mind. Anatomy, Botany,  Chemiftry, and the
Materia Medica, are  all branches of  Natural Hiftory,  and
are fraug t with fuch amufement and  utility, that the man
who entirely neglects them has but a forry claimeither to tafte
or learning.  If a gentleman has a turn for obfervation,  fays
an elegant and  fenhble writer*,  furely the natural hiftory of
his own fpecies is a more interefting fubject, and  prefents a
more ample field for the exertion of genius,  than the natural
hiftory of fpiders and cockle-fhells.
   We do not mean that every man fhould  become a phyfi-
cian. This would be  an attempt as ridiculous as it is impof-
fible.  All we  plead for is,  that men of  fenfe and learning
fhould be fo far acquainted with the general principles of Me-
dicine, as to be in a condition to derive from it fome of thofe
advantages with which it is fraught; and at  the fame time to
guard themfelves againft the  deftructive influences of Igno-
rance, Superftition, and Quackery.
   As matters ftand  at prtient, it is  eafier to  cheat  a man out
of his life than  of a  (hilling,  and almoft  impoflible either to
detect or punifii the offender. Notwithstanding this, people
ftill fhut their eyes,  and  take every thing upon trull that is
adminiftered by any pretender to Medicine, without daring to
afk him'a reafon for any part of his  conduct.  Implicit faith,
every where elfe the object of  ridicule, is  ftill facred here.
Many of the Faculty  aie, no doubt, worthy  of all  the confi-
dence that can be repofed in them ;  but. as this can never be
the character of every individual in any profeflion, it would
certainly be for the fafety, as well as the honourof mankind,
to have fome check upon  the conduct of thofe to whom they
intruft fo valuable a treafure as Health.
   The veil of  myftery which ftill hangs over Medicine  ren-
ders it not only a conjectural, but even a fufpicious art. *This
has been long  ago  removed  from the other  fcience?, which
induces  many to believe that  Medicine is a  mere trick   and
that it will not bear a fair and  candid examination.  Medi-

  * Obfervations on  the Duties  and OiT.ces of a  Phyfician.      '
% 
INTRODUCTION.
xiri
cine, however, needs only to be better known, in order to fe-
cure the general efteem of mankind. Its precepts are fuch as
every wife man would chufeto obferve, and it forbids nothing
but what is incompatible with true happinefs.
   Difguifing Medicine not  only retards its improvement as a
fcience,  but expofes the profeflion to ridicule, and is injuri-
ous to the true interefts of fociety.  An art founded on obfer-
vation never can arrive at any high degree of improvement,
as long as it is confined to a few who make a trade of it. The
united obfervations  of all the ingenious and  fenfible part of
mankind, would do more in a few years towards the improve-
ment of Medicine, than thofe of the Faculty alone in a great
many.  Any man can tell when a medicine gives him eafe as;
well as  a  phyfician ;  and if he only knows the name and dofe
of the medicine, and the name of the difeafe, it is fufficient to
perpetuate the fact.   Yet the man who  adds one fingle fact:
to the ftock of medical obfervations, does more real fervice to
 the art,  than he who writes a volume in  fupport of fome fa-
 vourite hypothefis.
   Very  few of the valuable difcoveries  in medicine have
 been made by phyficians.  They  have,  in general, either
 been the  effect of chance or of neceflity,  and have been  ufu-
 ally oppofed by the Faculty till every body elfe was convinced
 of their  importance.  An implicit  faith in the opinions of
 teachers, an attachment to  fyftems and eftablifhed forms, and
 the dread of reflections,  will always operate upon thofe  who
 follow Medicine as a  trade.  Few  improvements  are to be
 expected from a man who might ruin  his character and fami-
 ly by even the fmalleft deviation from an eftablifhed rule.
    If men of letters, fays the author of the performance quot-
 ed above, were to claim their right of inquiry into a matter
 that  fo nearly concerns  them,  the good  effects on Medicine
 would  foon appear.   Such men would have no feparate in-
 ter eft from that of the art.  They would detect and expofe
 afluming Ignorance under the mafk of  Gravity and Impor-
 tance,  and would be the judges and patrons of modeft merit.
 Not having their underftandings  perverted in their youth by
 falfe theories, unawed by authority and unbiafled by  intereft,
 they would canvafs with  freedom  the moft  univerfally re-
 ceived principles in Medicine,  and expofe the uncertainty of
 many  of thofe doctrines,  of which a phyfician dares not fo
 much as fcem to doubt.
    No argument, continues he, can be brought againft laying
 open Medicine,  which  does  not apply with equal, if not
                                                   greater 
Xiv          INTRODUCTION.
 greater  force,  to religion ; yet experience  has fhewn,  that
 iince the laity have aflerted their right of  inquiry into thefe
 fubjects, Theology coniidered as a fcience, has been improv-
 ed, the interefts of real religion have been  promoted, and the
 clergy  have become a more learned,  a more ufeful, and a
 more refpectable body of  men, than they  ever were in the
 days of their greateft power and fplendour.
   Had other medical writers  been  as  honeft as  this gentle-
 man, the art had been upon  a very different footing at this
 day. Moft of them extol the merit of thofe men who brought  '
 Philofophy out of the fchools, and fubjected it to the rules of
 common fenfe. But they never confider that Medicine at pre-
 fent is in nearly the fame fituation as Philofophy was at that
 time, and that it might  be as much improved by being treated
 in the fame manner.   Indeed, no fcience can either be ren-
 dered rational or ufeful, without being fubmitted to the com-
 mon fenfe and reafon of mankind. Thefe alone ftamp a value
 upon fcience; and what will not bear the  teft of thefe ought
to be rejected.
   I know it will be faid,  that diffufing medical knowledge
among the people, might induce them to tamper with Medi-
cine, and to trull to their own fkill inftead  of calling a phyfi-
cian.  The reverfe of this, however,  is true.   Perfons who
have moft knowledge in thefe matters, are commonly moll;
ready both to afk and to follow advice, when it is neceflary.
The ignorant are always moft apt to tamper with Medicine,
and have the leaft confidence in phyficians. Inftances of this
are daily to be met with among the ignorant peafants, who,
while they abfolutely refufe to take  a medicine which has
been prefcribed by a phyfician, will  fwallow, with greedinefs,
any  thing that is recommended to them by their credulous
neighbours.   Where men  will act even without knowledge,
it  is certainly more  rational to afford them  all the light we
can, than to leave them entirely in the dark.
  It will alfo be alledged,  that laying Medicine more open
to mankind would leflen their faith in it. This would indeed
be the cafe with regard  to fome; but it would have  a quite
contrary erFed Upon others.  1 know many people who have
the utmoft dread and horror of every thing prefcribed by  a
phyfician, but who will, neverthelefs, very readily take a me-
dicine  which they know,  and  whofe qualities  they are in
fome meafure acquainted  with. Hence it is evident   that
the dread arifes from the doctor, not from the drug. Nothing
ever can or will infpire  mankind with an abfolute confidence
in 
          INTRODUCTION.          xv

in phyficians, but an open, frank, and undifguifed behaviour.
As  long as the leaft fhadow of myftery  remains  in the con-
duct of the Faculty, doubts, jealoufies,  and fufpicions, will
arife in the minds of men.
  No doubt, cafes will  fometimes occur,  where a prudent
phyfician may find  it expedient to difguife a medicine.   The
whims and humours of men muft be regarded by thofe who
mean to do them fervice ; but this can never affect the gene-
ral  argument in favour of candour and opennefs.  A man
might as well alledge,  becaufe there are knaves  and fools in
the world, that he ought  to take  every one he meets for fuch,
and to treat him accordingly. A fenfible phyfician will always
know where difguife is neceflary ;  but it ought never to ap-
pear on the face of his general conduct.
  The  appearance of myftery in the conduct of phyficians
not only renders their art fufpicious,  but lays the foundati-
ons of quackery, which is  the very difgrace of Medicine.
No two characters  can be more different than that of the ho-
neft phyfician and  the quack ;  yet they have generally been
very much confounded.  The line betwixt them is not  fuffi-
ciently apparent; at leaft it is too fine for  the general eye.
Few  perfons are able to diftinguift. fufficiently between the
conduct of that man who adminifters a fecret medicine, and
him who writes a prefcription in myftical characters and an
unknown  tongue.   Thus the conduct of the  honeft phyfi-
cian,  which needs  no difguife,  gives a fanction to that of the
villain,  whofe foleconfequence depends upon fecrecy.
  No laws will ever be able to prevent quackery, as long as
people believe that  the quack is as honeft a man, and as well
qualified,  as the phyfician.   A very fmall degree of medical
knowledge, however, would be fufficient to break this  fpellj
and nothing elfe can effectually undeceive them.  It is the ig-
norance and credulity of the multitude, with  regard to me-
dicine,  which renders them fuch an eafy prey to every one
who has the hardinefs to attack them on this quarter.  Not
can the evil be remedied  by any other means but making them
wifer.
   The  moft effectual way to deftroy quackery in any art or
fcience, is to diffufe the knowledge of it among  mankind.
Did phyficians write their  prefcriptions in the common lan-
guage of  the country, and explain their intentions to tb.e pa-
tient, as far as  he could underftand them,  it would  enable
him to know when the medicine had the defired effect; would
infpire  him  with  abfolute confidence in the phyfician; and
                                                  would 
Xti
INTRODUCTION.
 would make him dread and deleft every  man who  pretended
 to cram a fecret medicine down his throat.
   Men, in the different ftates of fociety,  have very different
 views of the fame object.   Some time  ago it  was the  prac-
 tice of this country for every perfon to fay  his prayers  in
 Latin, whether he knew any thing of that language or not.
 This  conduct, though  facred  in the eyes of  our anceftors,
 appears ridiculous enough to us ; and doubtlefs fome parts  of
 ours will feem as ftrange to pofterity.  Among thefe we may
 reckon the prefent mode of  medical prefcription,  which we
 may venture to affirm will fome time hence appear to have
 been completely ridiculous, and a very  high burlefque upon
 the common fenfe of mankind.
   But this practice is not only  ridiculous, it is likewfe dan-
 gerous.  However capable  phyficians may be of  writing La-
 tin, I  am certain apothecaries are not always in  a condition
 to read it,  and that dangerous miftakea, in  confequence of
 this, often happen.  But fuppofe the apothecary ever fo able
 to read the phyfician's prefcription,  he is generally otherwife
employed,  and the bufinefs of making up prefcriptions is left
 entirely to the apprentice.  By this means the greater! man in
the kingdom,  even when he employs a  firft-rate phyfician,
in reality trufts his life in the hands of an idle  boy, who has
not only  the chance  of being very ignorant,  but likewife
giddy and carelefs.  Miftakes will fometimes happen in fpite of
the greateft care; but, where human lives are concerned, all
poffible methods ought certainly to be taken to  prevent them.
For this reafon the prefcriptions of phyficians; inftead of be-
ing couched in myftical characters and a foreign language,
ought, in my humble  opinion,  to be conceived in the  moft
plain and obvious terms  imaginable.
  Diffufing medical knowledge among the people would not
only tend  to improve (he art, and to banifh quackery, but
likewife to render Medicine more  univerfally ufeful,  by ex-
tending its  benefits to fociety.  However long Medicine may
have been known as a fcience, we will venture to  fay, that
many of its moft important purpofes to  fociety have either
been overlooked, or very little attended to\   The cure of dif-
eafes is doubtlefs a matter of great importance; but the pre-
fervation of health is of  ftill  greater.  This is the concern of
every man, and furely what relates to it ought to be rendered
as plain and obvious to all as poffible.   It is not  to be  fup-
pofed,  that men can be  fufficiently upon their  guard againft
difeafes, who are totally ignorant of their caufes.   Neither
can 
         INtftODUCTIONi         ivu

the legislature,  in whofe power it is to do  much more  for
preferving the public health than can ever be done by the Fa-
culty, exert that power with propriety, and to the greateft ad-
vantage, without fome degree of medical knowledge.
  Indeed, men of every  occupation and  condition  in  life
might avail themfelves of a degree of medical knowledge ;
as it would teach them to avoid the dangers peculiar to their
refpective ftations ;  which is always eafier  than to remove
their effects.  Medical knowledge, inftead of being a  check
upon the enjoyments of life, only teaches men how to make
the moft of them.   It has indeed been faid, that to live medi*
tally, is to live miferably :  But it might  with equal  propriety
be faid, that to live rationally is to live miferably.  If phyfi-
cians obtrude their own ridiculous whims upon  mankind, or
lay down rules inconliftent with reafon or common fenfe,  no
doubt they will  be defpifed.  But this is not the fault of Me-<
dicine.   It propofes no rules that I know, but fuch as are per-
fectly confident with the true enjoyment of life, and every
way conducive to the real happinefs of mankind.
  We are forry indeed toobferve,  that medicine has hitherto
hardly been confidered as a popular fcience, but as a branch
of knowledge folely confined to a particular fet of men, while
all the reft have been taught, not only to neglect j but even to
dread and defpife it.  It will* however,  appear, upon a more
ftrict examination,  that no fcience better deferves  their  at-
tention, or is more capable  of being rendered generally ufe-
ful.
  People are told, that  if they  dip the leaft into medical
knowledge,  it will  render them fanciful, and make them be-
lieve that they  have got every difeafe of which they read.
This, »I am fatisfied,  will feldom  be  the cafe  with fenfible
people; and, fuppofe it were, they muft foon be undeceived*
A fnort time will fhew them their error,  and a little more
reading will infallibly correct it.   A fingle inftance will fhew
the abfurdity of this notion.  A fenfible lady, rather  than
read a medical performance, which would inftruct her in  the
management of her children, muft leave them entirely to the
care and conduct of the moft ignorant, credulous, and  fuper-
ftitious  part of the human fpecies.
  Indeed, no part  of Medicine is of more general importance
than that which relates to the nurfing  and  management of
children.   Yet  few parents pay a proper  attention  to it.
They leave the fole care of their tender  offsprino;, at the  ve*
ry time when care and attention are molt neceflary, to hire-
                           c                       lings, 
Xviii
INTRODUCTION.
 lings, who are either too carelefs to do. their duty, or  too
 ignorant to know it.   We will venture to affirm, that  more
 human lives are loft by the careleflhefs and inattention of pa-
 rents and nurfes, than arefaved by the Faculty? and that the
 joint and  well-conducted endeavours, both of private per-
 fons and the public, for the prefervation of infant lives, would
 be of more advantage  to fociety,  than the whole art of Me-
 dicine,  upon its prefent footing.
   The benefits of Medicine, as a trade, will ever be confin-
 ed to thofe who are able to pay for them, and  of  courfe  the
 far greater part of mankind will be every where deprived of
 them.  Phyficians, like other people, muft live by their em-
 ployment, and the poo*waa*ttneither want advice  altogether,
 or take up with tbat which is worfe than none.   There  are
 not, however, any where wanting well-difpcfed  people, of
 better fenfe, who are  willing to  fupply the  defect of medi-
 cal advice to the poor, did not  their fear of doing  ill  often
 fupprefs their inclination to do good.   Such people are often
 deterred from the moft noble and  praife-worthy actionsj by
 the foolrfh alarms founded in  their ears by a fet of men,  who,
 toraife their own importance, magnify  the  difficulties of do-
 ing good, find  fault with what is truly  commendable, and
 fleer at every attempt to relieve the fick  which  is  not con-
 dutfed by  the precife rules of Medicine.   Thefe  gentlemen
 muft, however,  excufe  me  for faying, that  I  have  often
 known fuch well-difpofed perfons do much  good; and that
 their praftice,  which is generally the refultof good fenfe and
obfervation, affifted by a  little medical reading,  is frequently
 more rational than that of the ignorant  retainer  to  phytic.
 who  defpifes both  reafon and  obfervation, that  he  may n
 wrong by rule-, and who, while he is dofing his patient with
 medicines, often neglects other things of far greater  irapor*

   Many things  are neceflary for the  fick befides medicine.
 Nor is the perfon who takes care to procure thofe for them,
 of left importance than a  phyfician.   The poor oftener perifh
 in  difeafes  for want  of  proper nurfing  than of medicine.
 They are frequently  ,„ want of even the neceflaries  of life,
 and ftill  more fo of what is proper for  a fick-bed •  No one
 can imagine, who has not been a witnefs of thefe  fituarinn,
 how much  good a well-difpofed perfon may do, by  only
 taking care to have fuch wants fupplied.  there certain J
 cannot be a  more neceflary, a more noble, 0r a more Kod-like .
 adion,  than to adminiiler  to the wants of our fellow  crea
tures 
          INTRODUCTION.          x'ix

tures in diftrefs.   While virtue or religion are known among
mankind, this conduct will be approved ; and while Heaven
is juft, it muft be rewarded !
  Perfons who do not chufe to adminifter  medicine to  the
fick, may neve rthelefs direct  their regimen.   An eminent
medical author has faid, That by diet alone all the  intenti-
ons of Medicine may be anfwered.  No doubt a great  many
of them may ; but there are other things befide diet, which
ought by no means to be neglected.   Many  hurtful and  de-
ftructive prejudices,  with regard to the treatment of the fick,
ftill prevail among the people,  which  perfons of better  fenfe
and learning alone can eradicate.   To guard the poor againft
the influence of thefe prejudices, and  to inftil into their minds
fome juft ideas of the importance of proper food, frefh  air,
cleanlinefs, and other pieces of regimen neceflary in difeafes,
would  be a work of great merit, and productive of many hap-
py confequences.   A proper regimen, in moft difeafes, is at
leaft equal to medicine,  and in many  of them it is greatly fu-
perior.
  To affift the well-meant endeavours of  the humane and  be-
nevolent in  relieving diftrefs ; to eradicate dangerous and
hurtful prejudices;  to guard the ignorant and  credulous
againft the frauds and impofitions of  quacks and impoftors;
and to fhew men  what is in their own power, both with  re-
gard to the prevention and cure of difeafes,  are certainly  ob-
jects worthy of  the phyfician's attention.   Thefe were the
leading views of compofing and publifhing the  following
fheets.  They were fuggefted by an attention to the conduct
of mankind, with regard to Medicine, in the courfe of a pret-
ty long practice in different parts of this ifland, during which
the Author has often had occafion  to wifh  that his patients,
or thofe about them,  had been pofleffed of fome fuch plain di-
rectory for regulating their conduct.   How  far he has fuc-
ceeded  in his endeavours to fupply this deficiency, muft be
left for others to determine ; but if they he  found  to contri-
bute, in any meafure, towards alleviating the  calamities of
mankind, he will think his labour very well beftowed.
CONTENTS. 
 
CONTENTS.
      PART   I.

Of the General Caufes of
         Difeafes.

      CHAP.    I.
    OF Children       Page 25
     Of Difeafed Parents     29
Of Clothing of Children     31
Of Food of ditto            35
Of Exercife of ditto         40
Of Air                   46
Of Nurfes                 48
      CHAP.   II.
Of the Laborious, &c,       53
Of the Sedentary           58
Of the Studious            63
      CHAP.   HI.
Of Aliment                68
      CHAP.   IVf
Of Air                   78
      C  H  A P.   V,
Of Exercife               82
      C  H  A  Pf    VI.
Of fleep                   87
Of Clothing               88
      CHAP.   VII.
Of Intemperance           91
     CHAP,   VIII.
Of Cleanlinefs             95
      CHAP-   IX.
Of infection               100
      CHAP.   X.
Of the Paffione             J04
Of Anger                 ib.
Of Fear                   105
Of Grief                  107
Of Love                  109
Of Religious Melancholy    no
      CHAP.   XI.
Ofthe Neceflary Evacuations in
Of Stool                  ib.
Of Urine                  113
Of Perfpiration            114
Of being affected by Changes in
   the Atmofphere          115
   8f Wet Clothes           ib.
   f Wet Feet              ibr
Of Night Air        Page 116
Of Damp Beds             ib.
Of Damp Houfes          1 if
Of Sudden TranCtions from Heat
  to Cold                118

   PART   II.

       Of  Difeafes.

     chap.  xir.
Of the Knowledge and Cur« of
  Difeafes                 lit
     CHAP.  XIII.
Of Fevers in general        125
     C  HA  P.  XIV.
Of Intermitting Fevers or Agues
                          130
     CHAP.   XV.
Of an Acute Continual Fever 137
     CHAP.  XVI.
Of the Pleurify             141
Of the .Baftard ditto        i&
Of the Paraphrenias        ib.
    CHAP.   XVII.
Inflammation of the Lungs   147
    CHAP.   XVIII.
Of Consumptions          149
     CHAP.  XIX.
Ofthe Slow or Nervous Ferer 159
     CHAP.   XX.
Malignant,  Putrid, or Spotted
  Fever.                  164
     C KH  A  P,  XXI.
Miliary Fever             171 >.
    C  H  A  Pf   XXII.     "^
Remitting Fever           17c
    CHAP.   XXJIL .'
The Small-Po*            178
Inoculation                18*
    CHAP.  XXIV.
The Meafles              jo*5
The Scarlet  Fever          200
The Bilious  Fever          201
    CHAP.   XXV.
St. Anthony's Fire         202
    CHAP.   XXVI.
 Inflammation of the Brain  ^zor>

                   CHAP. 
XXI!
CONTENTS.
    CHAP.   XXVII.
 Inflammation of the Eyes  P. 210
    CHAP.  XXVIII.
 The Quinfey               214
 The Malignant ditto        219
    CHAP.   XXIX.
 Colds and Coughs          222
 A Common Cough         225
 Hooping-Cough            228
     CHAP.   XXX.
 Inflammation ofthe Stomach 231
 Inflammation ofthe Inteftines 233
 Of the Colic               236
 Inflammation of the Kidnies 240
 Inflammation of the Bladder 243
 Inflammation ofthe Liver   ib.
     CHAP.  XXXI.
 Ofthe Cholera Morbus  and o-
  ther excefEve Djfcharges from
  the Stomach and Bowels  246
Of-a Diarrhoea orLoofenefs 248
 Of Vomiting               250
    CHAP.   xxxn.
 Diforders  of the Kidnies and
  Bladder                 253
 Ofthe Diabetes or exceflive Dis-
  charge of Urine          ib.
 Of a Suppreflion of ditto     255
 Of the Gravel and Stone     256
    C  H   A  P.  XXXIII.
 Involuntary Difcharges of Blood
                          260
Bleeding at the Nofe        262
Bleeding and Blind Piles     264
Spitting of  Blood           266
Vomiting of ditto          269
 Bloody Urine             270
 Bloody Flux              271
 Cceliac Paflion            276
   CHAP.   XXXIV.
 Of the Head-ach           277
 Of the Tooth-ach          280
 Of the Ear-acb.            282
 Pain ofthe  Stomach, &c   283
    CHAP.  XXXV.
 Of Worms               285
    CHAP.  XXXVI.
 Of the Jaundice           289
   CHAP.    XXXVIL
 Of the Dropfy            292
   CHAP.    XXXVIII.
 Of the Gout              296
 Of the Rheumatifm        301
   C  H  A  P.
Of the Scurvy
XXXIX.
30s
 Ofthe Scrophula      Page 309
 Of the Itch                3"
      CHAP.   XL.
 Ofthe Afthma             314
      C  HA  P.   XLI.
 Of the Apoplexy           317
     CHAP.   XLII.
 Of Coftivenefs .            319
 Of Want of Appetite       3a!
 Of Heart-burn             322
     CHAP.  XLIII.
 Of Nervous Difeafes        323
 Of Melancholy             328
 Qf the Palfy              .331
 Of theEpilepfy, orFalling Sicfc-
   nefs  '                   332
 Of the Hiccup*             33 J
 Of Cramp of the Stomach    336
 Of the Night-mare          337
 Of Swoonings             338
 Of Flatulencies, or Wind   340
 Of Low Spirits             342
 Of Hyftenc Affections      343
 Of Hypochondriac Affections 346
     CHAP.   XLIV.
 Diforders of the fenfes      349
 Diforders of the Eye         ib.
 A Gutta Serena            350
 A Cataract                 351
 Short Sightednefs           ib.
 Seeing  only at  too great a Dif- '
   tance               -     ib.
 Squinting                  ib.
 Spots or Specks            ib.
 Bloodlhot Eye              ib.
 Watery or Weeping Eye    552
 Of the Ear                 ib.
^Of the TaiTe and Smell      354
 Ofthe Touch           -356"
     CHAP.   XLV.
 Of a Scirrhus and Cancer    ib.
     C H  A  P.    XLVI.
 Of Poifons                 36b
 Of Mineral Poifons          362
 Of Vegetable ditto          363
 Bites of poifonous Animals   364
 Bites of the Mad Dog     '  tb.
 Bites of the Viper        ;"  370
 Bites of poifonous Infects ,   ib.
 Bites ofthe Rattle-Snake    371
    CHAP.   XLVII.
 Of the Venereal  Difeafe     372
 Of the Virulent Gonorrhoea  37?
 Of Gleets                  -gj
 Of Swelled Tefticle         383
                           Of 
CONTENTS.           xxiii
Of Buboes            Page 384
Of Chancres              385
Of a Confirmed Lues or Pox 388
General Ohfervations      391
  CHAP.   XLVIII.
Difeafes of Women        396
Of the Menftrual Difcharge 397
Of Pregnancy             403
Of Child-birth            40?
OfBarrennefs             411
    C  H  A.  P.   XLIX.
Difeafes of Children       412
Of the Meconium         414
Of the Aphthae or Thrufh    ib.
Of Acidities              415
Of Galling and Excoriation 417
Of Stoppage of the Nofe     ib.
Of Vomiting ■             4}%
Of a Loofenefs             ib.
Of Eruptions              419
Ofthe Croup              421
Of Teething               423
Of the Rickets            425
Of Convulfions            427
Of Water in the Head     429
       CHAP.  L.
 Of Surgery               43°
 Of Bleeding                ib.
 Of Inflammations and Abfceffes
                          433
. Of Wounds               434
 Of Burns                 437
 Of Bruifes                439
 Of  Ulcers                44«
     CHAP.   LI.
Of Diflocations        Page 44*
Diflocation of the Jaw       443
Diflocation ofthe Neck     444;
Diflocation of the Ribs      ib.
Diflocation of the Shoulder  445
Diflocation of the Elbow    ib.
Diflocation of the Wrift. and Fin-
  gers                    446
Diflocation of the Thigh     ib.
Diflocation of the Knees    ib.
Diflocation ofthe Ancles   ib,
Diflocation of the Toes      ib.
     CHAP.   LIL
Of Broken Bones, &c.      447
Of Strains                449
Of Ruptures               450
     CHAP.   LIIL
Of Cafualties             45*
Of Subftances ftopt  between the
   Mouth and Stomach      453
Oft)rowned  Perfons       457
Of Noxious Vapours       401
Effects of Extreme Cold    463
.'CHAP.   LIV.
 Of Fainting Fits, and other Cafes
   which require immediate Af-
   fiftance                 4^4
 Of Intoxication           467
 Of Suffocating and Strangling
                          469
 Of Perfons who expire in Con-
   vulsion Fits             471
CONTENTS 
XXIV
CONTENTS  of  the  APPENDIX.
'Ntroducfion
t Lift of Simples
Page 477
     482
    Medicinal Preparations.

Ales                      484
Balfams                   48?
Bolufes                    480
Cataplafms and Sinapifms   487
Clyfters-                   488
Collyria, or Eye-Waters    490
Confecfions               491
Conferves and Preferves     ib.
Decoctions                493
Draughts                  49?
Electuaries                496
Emulfiorta                 49s
Estrada                   499
Fomentations         Page  50a
Gargles                    5°*
Infufion8                   5°2
Juleps                     5°4
Mixtures                   5°^
Ointments, Liniments, &c.  507
Pills                       510
Plafters                    5*3
Powders                   515
Syrups                     5*8
Tincfures, Elixirs, &c      519
Vinegars                   523
Waters by Infufion, &c,     525
Simple diftilled Waters      526
Spirituous diftillcd Waters  527
Wheys                     ib.
Wines                     528
p  a  n  t 
PART         I.
                    OF    THE

GENERAL  CAUSES  of  DISEASES.
        C    H    A   P.      I.

OF     CHILDREN.
          TH E better  to trace  difeafes  from their original
           caufes, we (hall take a view of the common treat-
           ment of mankind in the (late of infancy. In this
           period of our lives, the  foundations of a good or
           bad conftitudon are generally laid; it is there-
fore of importance, that parents be  well acquainted with  the
various caufes which may produce difeafes in their offspring.
  It appears from the annual regittersof the dead,that aimoffc
one half of the children born  in  Great Britain die under
twelve years of age.  To many, indeed, this may appear a
natural evil;  but, on due examination, it will be found to be
one of our own creating.  Were the death of infants a natu-
ral evil, other animals  would be as liable to die young as
man ; but this we find  is by no means the cafe.
  It may feem ftrange that man, notwithstanding bis fuperior
reafon,  fhould fall To far fhort of other animals  in the ma-
nagement of his young : But our furprife will foon ceafe,  if"
weTconfider that brutes, guided  by  initinct, never err in  this
refpect;  while man, trufting folely to  art,  is feldom right.
Were a catalogue of thofe infants who perilb annually by art
alone exhibited to public view, it would aftonifh moft people*
  If parents  are above  taking care of their children, others
muft be employed for that purpofe  : Thefe will always  en-
deavour to recommend themfelves by  the appearance of  ex-
traordinary (kill and addrefs.  By this  means fuch a number
of un neceflary and deftructive articles  have been introduced
into the diet, clothing, &c. of infants,  that it is  no  wonder
fo many of them perilh.
                            A                  Nothing 
 26           OF   CHILDREN.

   Nothing can  be  more  prepofterous  than a  mother who
 thinks it below her to take care of her own  child, or who is
 fo ignorant as not to know what is proper to be done for it. If
 we fearch Nature throughout, we  cannot find  a  parallel to
 this.   Every other creature is the uurfe of  its own offspring,
 and they thrive  accordingly.   Were  the brutes  to bring up
 their young by  proxy, they would (hare the  fame fate with
 thofe ofthe human fpecies.
   We mean not, however, to impofe it as a tafk upon every
 mother to fuckle her own child.  This, whatever fpecula-
 tive writers may alledge,  is in many cafes impracticable, and
 would inevitably prove deftructive both to the  mother  and
 child.  Women of delicate conftitutions, fubject to hyfteric
 fits, or other nervous affections, make very bad nurfes : And
 thefe  complaints are now  fo common, that it is rare to find a
 woman of fafhion free from them ; fuch women, therefore,
 ruppofing them willing, are really unable to  fuckle their own
 children.
   Almoft every  mother would be in a condition  to give fuck,
 did mankind live agreeably to Nature:  But whoever confi-
 ders how far mothers often  deviate from her  dctates,  will
 not befurprifed to find many  of them  uflable to perform that
 receffary office.   Mothers who do not eat a fufficient quan-
 tity of folid  food, nor enjoy the benefit of free air and exer-
 cife, can neither have wholefome humours  themfelves,  nor
 afford proper nourifhment to an infant.  Hence children who
 are fudkled by delicate women, either die young, or are weak
 and fickly all their lives.
   When we fay that mothers are not always in a condition
 to fuckle their own children, we would not be underltood as
 difcouraging that practice.  Every mother  who can, ought
 certainly to perform fo tender and agreeable an office *.  But,.
 fuppofe it to be out of her power, fhe may, neverthelefs, be of
                                                    great

  * Many advantages would arife to fociety,-ais  well  as to indivi-
 duals, from mothers fuckling their own children.  It would pre-
vent the temptation which poor women are laid under, of abandon-
ing their children  to fuckle thofe of the rich for  the fake of gain :
by which means fociety lofes many of its moft ufeful members"  and-
mothers become in fome fenfe the murderers of their own offspring.
I am fure  I fpeak  within the truth, when  I  fay,  that not one in a
hundred of thofe children live who are thus abandoned by their
mothers.  For this reafon, no mother mould be allowed to fuckle
 another's child till her own  is  fit to be weaned.  A regulation of
this kind would faye many lives among the poorer  fort, and could
 do no  hurt to the rich,  as moft  women  who make good nurfes are
able to fockJle two childreu infucceflion upon the fame milk. 
OF    CHILDREN.
27
great fervice to her child.   The  bufinefs of nurfing is by no
means confined to giving fuck.  To a woman who abounds
with milk, this is the eafieft part of it.  Numberlefs other
offices are necelTary for a child,  which the mother ought  at
leaft to fee done.,
   A mother who abandons the fruit of her womb,  as foon  as
it is born, to the fole care of an hireling, hardly deferves that
name.   A child,  by  being  brought up under the mother's
eye, not only fecures her affection,  but may reap all the ad-
vantages of a mother's care^ though it be fuckled by another.
How can a mother be better employed than, in fuperintend-
ing the nurfery I This- is at once the moft delightful  and im-
portant office ; yet the molt trivial bufinefs, or infipid amufe-
ments  are  often preferred to it! A ftrong proof both of the
bad  tafte and wrong education of modern females.
   It is indeed to be regretted, that more care is notbeftowed
in teaching the proper  management of  children, to  thofe
whom Nature  has  defigned for mothers.  This, inftead of
being made the principal, is feldom confidered as any part of
female education.   Is it any wonder, when females, fo edu-
cated, come to be mothers, that they fhould be quite ignorant
ofthe duties belonging to that character ? However ftrange
it may appear,  it is certainly true,  that many mothers, and
thofe of fafhion too, are as ignorant, when they have brought
a child unto the world, what to do for it,, as the infant  itfelf.
Indeed,  the moft ignorant of the fex are generally reckoned
moft knowing in the bufinefs of nurfing.   Hence,  fenfible
people become the dupes of ignorance ^nd fuperdition  ; and
the  nurfing of children,  inftead of being conducted by rea-
fon, is the refult of whim and caprice*.
   Were the time that is generally fpent by females in the ac»
 quifition of trifling  accomplifhments,  employed in learning
 how to bring up their children ;  how to  drefs them fo as not
 to hurt, cramp, or  confine  their motions;  how to feed them
 with wholefome and  nourifJhing food; how  to exercife their
 tender bodies, fo as belt to promote their growth and ftrength:
 Were thefe made the objects of female inftruction,  mankind
                                                   would

   * Tacitus, the celebrated Roman hiftorian, complains greatly of
 the degeneracy of the Roman Ladies in his time, with  regard to
 the  care of their offspring.   He  fays,  that in former times, the
 greateft women in Rome ufed to account it their chief glory to keep
 the houfc and attend their children ; but tha,t now the young infant
 was committed to the fole care of fome poor Grecian wench, or o-
 ther menial fervant.—We are afraid, wherever luxury andeffemi*
 nacy prevail, there will be too much ground for this complaint. 
28           OF   CHILDREN.
 would derive the greateft  advantages  from  it.  But while
 the education of females implies little more than what relates
 to drefs and public (hew, we have nothing to expect from
 them but ignorance, even  in the molt  important concerns.
   Did mothers reflect on their own importance, and  lay it to
 heart, they would embrace every  opportunity of informing
 themfelves of the duties which they owe to their infant ofF-
 fpring.   It is their province, not only  to form the body,  but
 alfo to give the mind its moft early hias.  They have it very
 much in their power to make men healthy or valetudinary,
 ufeful in life, or the pelts of fociety.
   But the mother is  not  the only perfon  concerned in the
 management of children.  The  father has  an  equal  intereft
 jn  their  welfare,  and ought  to affift  in every thing  that re-
 fpects either the improvement ofthe body or mind.
   It is pity that the men fhould be fo inattentive to this mat-
 ter.  Their negligence  is  one reafon why females know  fo
 little of  it.  Women  will ever be defirous to excel  in fuch
 accomplishments as recommend them to the other fex.   But
 men generally keep at fuch a diftance from even the  fmalleft
 acquaintance with the affairs ofthe nurfery, that many would
 efteem it an affront,  were they fuppofed to know any thing
 of them.   Not fo, however,  with the kennel or the ftables:
 A gentleman of the firft  rank is not alhamed to give  directi-
 ons con«erning the management of his dogs or horfes,  yet
 would blufh were  he furprifed in performing the fame office
 for that beinjg who derived  its  exiftence from himfelf,  who  is
 the heir of his fortunes,  and the future hope of his country.
   Nor have phyficians  themfelves been fufficiently attentive
 to  the management  of children :  That has been generally
 eonfidered  as the fole province of old women, while  men of
 the firft charaaer  in phyfic have refufed to  vifit infants even
■when fick.  Such  conduct in  the faculty has not only caufed
 this branch of medicine to be neglected, but has alfo  encou-
 raged the other fe* to aflume an abfolute title to  prefcribe for
 children in the moft  dangerous difeafes.  The confequence
 »s, that a phyfician is feldom called till the good women have
 exhaufted all their fkill ; when his attendance can  only ferve
 to divide the blame and appeafe the difconfolate parents.
  Nurfes fhould do all  in their  power to prevent difeafes;
 but when a child is taken ill,  fome perfon of fkill ought im-
 mediately to be confulted.   The difeafes of children  are Ce-
 fcerally acute,  and the leaft delay is dangerous.
                                                  Were 
             OF    CHILDREN.            29

  Were phyficians rhore attentive to  the difeafes of infants,
they would not only be better qualified to treat them properly
when fick, but likewife to give ufeful  directions for their ma-
nagement when well.  The difeafes  of  children  are  by no,
means fo difficult to be underftood as many imagine.  It i«
true, children cannot tell their  complaints;  but  the  caufes
of them may be pretty certainly discovered by obferving th«
fymptoms,  and putting proper queftions  to  the nurfes.   B««»
fides, the difeafes of infants,  being lefs complicated, are tall-
er cured than thofe ot  adults *.
  It is really aftonifhing, that  fo little  attention  fhould in
general  be paid to the  prefervation of infants.   What labour
and expence are daily beftowed to prop an  old tottering car-
cafe for a  few years, while thoufands  of  thofe who might D6
ufeful in life, perifh without being regarded! Mankind  are
too apt to value things according to  their prefent, not their
future ufefulnefs.  Though this is of all  others the  moft er-
roneous method ofeftimation ;  yet upon no other principle is
it poffible  to account for the general indifference with refpect
to the death of infants.

                   Of Difeafed  Parents.
  One great fource of  the difeafes of children is,  the UN-
Healthiness  of parents.  It would be as reafonable to
expect a rich crop from a barren foil, as that ftrong and heal-
thy children fhould  be born of parents  whofe conftitutions
have been worn out with intemperance or difeafe.
  An ingenious  writer obferves f, that on the conftitution
of mothers: depends originally that of their offspring.  No one
who believes this will  be furprifed,  on a view of tbe female
world, to  find difeafes and death  fo frequent among children.
A delicate female, brought up within doors, an utter ftranger
to exercife and  open  air,  who lives on  tea and other flops,
may bring a child into the world, but it  will hardly be fit to
live.  The firft blaft of difeafe will  nip  tbe tender plant in
the bud : Or, fhould it druggie through a few years exift-
ence, its feeble frame,  fhaken with  convulfions from every
                                                    trivial

  * The common opinion, that the difeafes  of  infants are hard to
difcover and  difficult  to cure,  has deterred many phyficians from
paying that attention to them which they deferve.  I can, however,
from experience, declare, that this opinion is without foundation,
and that the difeafes of infants are neither fo difficult U difetfver*
nor fo ill to cure, as thofe •£ adults.
  f  RoutTeau. 
30            OF    CHILDREN.
 trivia] caufe, will be unable to perform the common function!
 of life, and prove a burden to fociety.
   If, to the delicacy of mothers, we add the irregular lives
 of fathers,  we  fhall fre further caufe to believe  that  chil-
 dren are often hurt by the conftitution of their parents.   A
 fickly  frame may be originally induced by hardfhips or in-
 temperance, but chiefly by the latter.  It is impoffible that a
 courfe of vice fhould not fpoil  the beft  conftitution : And,
 did the evil terminate here, it would  be a juft punifhment for
 the folly of the fufferer;  but, when once a difeafe is contract-
 ed and rivetted in the habit, it is entailed on pofterity. What
 a dreadful  inheritance is the gout,  the fcurvy or the king's
 evil,  to tranfmit to our offspring !  How happy had it been
 for the heir of many a great  eftate, had he been born a beg-,
 gar, rather than to inherit his father's fortunes at the expence
 of inheriting his difeafes  !
   No perfon who labours under any incurable malady ought
 to marry.  He thereby  not only fhortens his own life,  but
tranfmits mifery to others : But,  when both parties are deep-
ly tainted with the fcrophula, the fcurvy, or the like, the ef-
fects muft he  ftill worfe.   If fuch have any iflue,  they muft
be miferable indeed.  Want of attention to thefe  things, in
forming connexions for  life, has rooted  out  more families
than plague,  famine, or the fword  ; and,  as long as thefe
connexions are formed from mercenary views, the  evil  will
be continued.
  In our matrimonial contracts, it is amazing fo little regard
is had to the health and form of the  object.  Our fportfmeri
know, that the generous courfer cannot  be bred out  of the
foundered jade, nor the fagacious fpaniel out of the fnarling
cur.  This is fettled upon immutable laws.   The man who
marries a woman of a  fickly  conftitution, and defcended of
unhealthy  parents,  whatever  his views  may be, cannot be
faid to act a prudent part.  A difeafed woman may prove fer-
 tile; fhould this be the cafe, the family  muft become an in-
firmary : What profpedt of happinefs the father of fuch a fa-
mily has, we fhall  leave any one to judge *.
                                                    Such

  * The Jews, by their laws, were, in certain cafes, forbid to have
any manner of commerce with the difeafed ;  and indeed to this all
wife legiflators ought to have a fpecial regard. In fome countries,
 difeafed perfons have actually been forbid to marry.  This is an e-
 vil of a complicated kind,  a natural deformity, arid political mif-
 «hief •,  and therefore requires a public confideration. 
OF    CHILDREN,
3»
   Such children as have the misfortune to be born of difeaf-
ed parents,  will require to be nurfed with greater care than
others.  This is the only way to make amends for the de-*
fects of conftitution ; and it will often go a great length.  A
healthy nurfe, whohfome air, and fufficient exercife, will do
wonders.  But when thefe  are neglected, little  is to be ex-
pected from  any other quarter.  The defects of  conftitution
cannot be fupplied by medicine.
   Thofe who inherit any family difeafe ought to be very cir-
cumfpect in  their manner  of living.  They fhould confider
well the nature of fuch  difeafe, and guard againft it by a pro-
per regimen.  It is certain, that famrly-difeafes have often,
by proper care, been kept off for one generation ; and there is
reafon to believe, that, by perfifting in the fame  courfe, fuch
difeafes might at length be wholly eradicated.  This is a fub-
ject very  litrle regarded,  though of the greateft importance.
Family conftitutions are as capable of improvement as family
eftates ; and the libertine, who impairs the one, does greater
injury to his pofterity, than the prodigal,  who fquanders a-
way  the other.

               Of the  Clothing of Children.
   The clothing of an  infant is fo fimple a matter, that it is
furprifing how any perfon fhould err in it; yet many chil-
dren  lofe their lives, and otheis are deformed, by inattention
to this article.
   Nature knows no other ufe of clothes  to an infant,  but to
keep it warm.  All that is neceflary for this purpofe, is to
wrap it in a  foft loofe covering.   Were a  mother left to the
dictates of Nature alone, fhe would certainly follow this me-
thod.  But  the bufinefs of dreffing an infant  has  long been
out of the hands of mothers,  and has at laft become a fecret
which none but adepts pretend to underfta-nd.
   From the moft early ages it has been thought neceflary,
that a woman in labour fhould  have fome perfon to attend
her.  This  in time became a bufinefs ; and, as  in all  others,
thofe who were employed in it, ftrove  to outdo  one another
in the different branches of their profeffion.  The dreffing of
a child came of courfe to be confidered as the midwife's pro-
vince, who no doubt imagined,  that the more dexterity fhe
could fhew in this article,  the more her fkill would be ad-
mired.  Her attempts were  fetonded by the vanity of parents*
who, too often defirous of making a fhew of the infant asfoon
as it was born, were ambitious to have as much  finery  heap- 
3?           Q F   CHILDREN.
 •d upon it as poffible.  Thus it came to be thought as necef-
 fary for a midwife to excel in bracing and dreffing an infant,
 as for a furgeon to be expert ii applying bandages to a bro-
 ken limb; and the  poor child, as foon as  it came  into the
 World, had as many rollers and wrappers applied to its body^
 as if every bone had been fractured in the  birth : while thefe
 were often fo tight, as not only to gall  and  wound its tender
 frame, but even  to obftruct the motion  of the  heart,  lungs*
 and  other organs neceflary for life.
   In feveral parts of Britain, the  practice of rolling children
 with fo many bandages is now, in fome rfieafure,  laid afide ;
 but it would ftill he a difficult  talk to perfuade the generality
 of mankind, that thefhape of an infant does not entirely de-
 pend on the care ofthe midwife.  So  far,  however,   are all
 their endeavours to mend the fhape from  being  fuccefsful,
 that they constantly operate the corftrary way,  and mankind
 become deformed juft in proportion to the means ufed to pre-
 vent it.   How little deformity of body  is to be found among
 uncivilized nations ? So little indeed,   that  it is vulgarly be-
 lieved,  they  put all their deformed children to death.  The
 truth is, they hardly know fuch a thing as a deformed child.
 Neither fhould we,  if we followed their example.   Savage
 nations never think  of manacling their children.  They al-
 low them the  full ufe of every organ,  carry them abroad in
 the open air,  wafh their bodies daily in  cold water, cffr.  By
 this  management,  their  children  bgcome fo  ftrong and
 hardy, that,  by  the time our puny  infants  get out  of the
 aurfe's arms, theirs are able to fhift for themfelves.
   Among brute  animals, no art is neceflary to procure a fine
lhape.  Though many of them are extremely delicate when
they come into the  world,  yet we never  find them grow
crooked for want of fwaddling bands.   Is Nature lefs  gene-
rous  to the human kind ? No : But we take the bufinefs out,
of Nature'.? hands.
  Not only the analogy of other animals,  but the very feel-
ings  of infants tell us, they ought to be kepteafy and free from
all preffure.   They cannot indeed  tell their complaints ; but
they  can (hew figns of pain ; and  this  they never  fail to do,
by crying, when pinched by  their  clothes.  No fooner are
they  freed from their bracings, than they feem pleafed and
happy ;  yet, ftrange infatuation ! the moment they hold their
peace, they are again committed to their chains.  '
  Ifweconfider  the body of an infant as a bundle of foft
 pipes, replenifhed with fluids in continual motion,  the dan-

                                                     ger 
OF    CHILDREN.
32
g*rof preffure will appear in the ftrongeit light.  Nature, in
order to make way for the growth of children,  has  formed
their bodies foft and  flexible; and,  left  they  fhould  receive
any injury from preffure in  the womb,  has furrounded the
foetus every where with fluids.   This fhews the care which
Nature takes to prevent all unequal preffure on the bodies of
infants, and to defend them againft every thing that might in
the leaft cramp or Confine their motions.
   Even the bones of an infant are fo foft and cartilaginous,
that they  readily yield to the ftighteft preffure, and eafily af-
fume a bad fliape, which can never after  be remedied. Hence
it is, that fo many people appear with high fhoulders, crook-
ed fpines, and flat breafts, who were as  well proportioned at
their birth as others, but had the  misfortune to be fqueezed
out of fliape by the application of ftays and bandages.
   Preffure, by obftructing the circulation, likewife prevents
the equal distribution of nouxifhment to the different parts of
the body, by which means the growth becomes unequal. One
part grows too large,1 while another remains too fmall; and
thus in time  the whole frame becomes difproportioned and
misfhapen. To this we muft add, that when a child is cramp-
ed in its clothes, it naturally fhrinks from the part that is
hurt; and, by putting its body into unnatural pollutes, it
becomes deformed by habit.
   Deformity of body may indeed proceed from weaknefs or
difeafe ; but, in general, it is the effect of improper clothing.
Nine-tenths, at leaft, of the deformity among mankind, muft:
be imputed to this caufe.  A deformed body is not only difa-
greeable to the eye, but by a bad figure, both the animal and:
vital functions muft be impeded,  and of courfe health im-»
paired.   Hence few people,, remarkably misfhapen, are ftrong
or healthy.
   The new motions which commence  at the birth, as the
circulation of the whole mafs of blood through the lungs, re-
spiration,  the periftaltic motion,  t$c. afford another ftrong
 argument for keeping the body of an infant free from all pref-
 fure.  Thefe organs, hot having been accuftomed to move,
 are eafily flopped;  but, when this happens, death muft enfue.
 Hardly any method  could be devifed more effectually to ftop
 thefe motions, than  bracing the body too tight with rollers *
                            B                        and

   * This is by no means inveighing againft a thing  that does not
 happen. In many parts of Britain at this day, a roller five or fix feet
 in length,  is applied tightly round the child's body as foonas it is
 born. 
34            of   children:
  and bandages.  Were thefe to be applied in the fame manner
  to the body of an adult for an equal length of time, they could!
  hardly fail to hurt the  digeftion and make him fick.   How
  much more hurtful they muft prove to the  tender bodies of
  infants, we fhall leave any one to judge.
   Whoever confiders thefe things will not be furprifed,  that
 fo many children die of convulfians foon after the  birth.
 Thefe fits are generally attributed to fome inward caufe ; but
 in fact,  they oftener proceed  from our own imprudent coni-
 dudt.   I have known a child feized with convulfion fits, foon
 after the midwife had done fwaddling  it, who,  upon taking
 off the rollers and bandages,  was immediately relieved,  and
 never had the difeafe afterwards.  Numerous examples of this
 might be given, were they neceflary.
   It would be fafcr to fix on the clothes of an infant with
 firings than pins,as thefe often gall and irritate their tender
 lkins,  andoccafion diforders.  Pins have been found  flicking
 above half an inch into the body of a child after it had died
 of convulfion fits, which, in all probability, proceeded from
 that caufe.
   Children are not only hurt by the tightnefs of their  clothes,
 but alfo by the quantity.   Every child  has fome degree of fe-
 ver after the birth ; and,if it  be loaded with too many  clothes,
 the fever muft be increafed.   But  that is not all ; the child
 is generally laid in bed with  the mother,  who is often like-
 wife feverifh; to  which  we may  add the heat  of the bed-
 chamber, the wines, and other heating things, too frequently.
 given  to children immediately after  the  birth.   When all
 thefe are combined, which does not feldom happen, they muft
 increafe the fever to fuch a degree as- will  endanger  the  life
 of the  infant.
   The danger of keeping  infants  too  hot,  will further  ap-
 pear, if we confider, that, after they have been for fome time
in the  fituation mentioned above, they are often fent into the
 country to  be nurfed in a cold  houfe..   Is it any wonder,  if a
child,  from fuch a tranfition,. catches a mortal cold,  or con-
traas fome other  fatal difeafe ? When an  infant is kept  too
hot, its lungs, not being fufficiently expanded,  are apt to re-
 main weak and flaccid for life; hence proceed coughs,  con*
fumptions,  and other difeafes ofthe breaft.
   It would  anfwer  little purpofe  to  fpecify the particular
pieces of drefs proper for an infant.  Thefe will always vary
 m different places,  according  to cuftom and the  humour of
Barents.  The gretf rule to be obferved is,  That a child htwf
n& 
OF    CHILDREN
35
■no more clothes than are neceffary to keep it warm, and that they
be quite eafy for its body.
   Stays are the very bane of infants.  A volume would not
ruffice to point out all the bad  effects of this ridiculous piece
of drefs both on children and adults.   Themadnefs in favour
of flays, feems,  however,  to be fomewhat abated;  and it is
to be hoped, The world will, in time, become wife enough to
know,  that the human fhape does  not folely depend  upon
whale-h.ne and bend-leather *.
   We fhall only add, with  refpect to the clothes of children,
.that they ought tobekept thoroughly clean.  Children per-
fpire more than adults ;  and, if their clothes be not frequent-
ly changed,  they  become  very  hurtful.   Dirty clothes not
only gall and fret the tender fkins of infants, but likewife oc-
cafion ill fmells ;  and,  what is worfe,  tend to produce ver-
min and cutaneous difeafes.
   Cleanhnefs is not only  agreeable  to the eye,  but  tends
greatly to preferve the health of children.   It promotes the
perforation, and, by that means,  frees the body from fuper-
fluous humours, which, if retained, could not fail to  occafion
difeafes.  No mother or  nurfe can have any excufe for al-
lowing a child to be dirty.  Poverty may oblige  her to give it
coarfe clothes; but, if fhe does not keep them clean, it muft
be her own fault.

                Of the  Food of Children.
  Nature not only points out the food proper for an infant,
hut  actually prepares it.   This, however,  is not fufficient to
-prevent fome who  think themfelves wifer than Nature, from
•attempting to bring up their children without her provifion.
Nothing can fhew the difpofition which  mankind  have to
depart from nature,  more than their endeavouring to bring
up children without the bread.   The mother's milk, or that
-of a healthy nurfe, is unqueftionably the beft food for an in-
fant.  Neither art nor nature can afford  a proper fubftitute
for it.   Children may feem to thrive for a few months  with-
out the breaft ; but when teething, the fmall-pox, and  other
difeafes incident to childhood, come on, they generally penAi*
   A child, foon after the birth, fhews an inclination to fuck;
and  there is no reafon why it fhould not be gratified.   It is
true, the mother's milk  does not  always come immediately
                                                    after

  *  Stays  made of bend-leather are  worn by all the women o£
iower ftation in many parts of England. 
36           OF    CHILDREN.

after the birth ;  but this is the way to bring it : Befides, the
firft milk that the child can fqueeze out  of the breaft an-
fwers the purpofe of cleanfing,  better than all  the  drugs  in
the apothecary's fhop,  and at the fame time prevents inflam-
mations of the breaft, fevers, and  other difeafes incident  to
mothers.
   It is ftrange how people came to think that  the firft thing
given to a child fhould be drugs.  This is beginning with
medicine by  times, and no wonder  that they generally end
with it.  It  fometimes  happens,  indeed,  that a child  does
not difcharge the meconium fo foon as could be wifhed ;  this.
has induced phyficians,  in fuch cafes, to give fomething  of
an opening nature to cleanfe  the firft paffages.  Midwives
have improved upon this hint,  and never fail to give fyrups,
oils, &c.  whether they  be neceffary or not.  Cramming an
jnfant with fuch indigeftible fluff, as  foon as it  is bom,  cap
hardly fail  to make it fick, and is more likely to occafion dif-
eafes, than to prevent them.  Children are feldom long after
the birth without having paffage  both by ftool and utint;
though thefe evacuations may be wanting for fome time with-
out any danger.   But,  if  children muft have fomething be-
fore they he allowed  the breaft, let it be  a little thin  water-
pap, to which may be added an equal quantity of new milk;
or rather water  alone, with the addition of a little fugar.  If
this be given, without any wines or fpiceries,  it will neither
heat the blood, load the ftomach, nor occafion gripes.
   Upon the firft fight of  an infant,  almoft every perfon  is
ftruck with the idea of its being  weak, feeble, and  wanting
fupport.   This naturally fuggefts the need of cordials.  Ac-
cordingly,  wines are univerfally mixed with the firft food  of
children.   Nothing can be more fallacious than this way  of
reafoning, or more hurtful to infants than the conduct found-
ed upon it.   Children need very little food for fome time af-
ter the birth; and what they receive fhould be  thin,  weak.
light, and of a cooling quality.  Avery  fmall quantity  of
wine is fufficient to heat and inflame the blood of an infant;
but every perfon, converfant  in thefe matters, muft  know,
that moft of  the difeafes of infants proceed from the heat  of
fheir humours.
   If the mother or nurfe has enough of milk, the  child  will
need little or no other food before the third or fourth month.
It will then be proper to give it, once  or twice a day, a little
of fome food  that is eafy of digeftion ;  as  water-pap,  milk-
gottage,  weak  broth with bread in it, and fuch like.  ThiS
                                                     wUJ 
OF    CHILDREN.
37
will eafe the mother, will accuftom the child  by degrees to
|ake food, and will render the weaning both lefs difficult and
lefs dangerous.   All great and fudden tranfitions  are to  be
avoided in nurfing.  For this purpofe  the food of children
ought not only to be fimple,  but to  refemble, as  nearly as
poffible, the properties of milk.  Indeed  milk  itfelf  fhould
make a principal part of their food,  not only before they are
weaned, but for a long time after.
   Next to milk,  we would recommend  good  light bread.
Bread may be given to a child as foon as it fhews an inclina-
tion to chew ;  and  it  may at  all times be allowed as much
plain bread as it will eat,   The very chewing of bread will
promote the cutting of the teeth, and the difcharge offaliva*
while,  by mixing with the nurfe's  milk  in the ftomach, it
will afford an excellent nourifhment.  Children difcover  an
early inclination to chew whatever is put into their hands.
Parents obferve the inclination, but generally miftake the ob-
ject.   Inftead of  giving the child  fomething which  may at
once exercife its gums and afford it nourifhment,  they com-
monly put into its hands a piece of hard metal  or impenetra-
ble coral.   A cruft of bread is the  beft gum-ftick.  It not
only anfwers the purpofe better than any  thing elfe, but has
the additional properties of nourifhing  the child and carrying
the faliva down to  the  ftomach, which  is too valuable a li-
quor to be loft.
   Bread,  befides being ufed dry, may  be many ways  prepare
ed into food for children.  One ofthe beft methods is to boil
it in water, afterwards  pouring the water off,  and mixing
with the bread a proper quantity of new milk unboiled. Milk
is both more wholefome and nourifhing this way than  boil-
ed, and is lefs apt to occafion coftivenefs.  For a child  far-
ther advanced, bread may be mixed  in veal or chicken broth,
made into puddings, or the like,  Bread  is a proper food for
children at all times, provided it be plain, made of wholefome
grain, and well fermented ; but, when enriched  with fruits,
fugars, or fuch things, it becomes very unwholefome.
   It is foon enough to allow children animal food, when they
have got teeth to eat it.  They fhould never tafte it till after
they arc weaned, and even then they ought to  ufe it fparing-
Jy.   Indeed, when children live wholly on vegetable food,  it
is apt to four their ftomachs; but,  on the other hand, too
much flefh  heats  the blood,  and occafions fevers and other
inflammatory difeales.  This plainly points out a due mixture
pf animal and vegetable food as moft proper for children- 
gfi            OF    CHILDREN

  Few things are more hurtful to infants,  than the common
method of  fweetening their food   It entices them to take
more than thev ought to do, which makes them grow fat and
bloated,  k  is pretty certain,  if the  food of children were
quite plain,  that they would never take more than en.ough«
Their  exceffes are entirely owing to nurfes.  If a child be
gorged with food at  all  'hours, and  enticed to take it,  by
making it fweet and agreeable to the palate, is it any wonder
that fuch a child mould in time be induced  to  crave more
food than it ought to have •?
  Children may  be  hurt by too little as  well as too much
food.  After a child  is  weaned, it ought  to  be  fed four ou
five times a day ; but fhould  never  be accuftomed to eat in
the night;  neither fhould it have too much at a time.  Chil-
dren thrive  beft  with  fmall  quantities of food  frequently
given.   This neither overloads the ftomach, nor hurts the
*Jigettion, and is certainly moft agreeable to nature.
   Writers  dn nurfing have  inveighed-with fuch vehemence
againft giving children too much food, that many parents, by
endeavouring to  fhun that error, have run into the oppofite
extreme, and ruined  the conititutions  of their children. But
the error of pinching children  in  their food  is more hurtful
*ban the other extreme.  Nature has many ways of relieving
herfelf when overloaded ; but a child, who is pinched  with
hunger, will never become a ftrong or healthy man.   That
errors  are frequently committed on  both fides,  we are ready
to  acknowledge; but where one child is hurt by the quanti-
ty  of its food, ten fuffer  from the quality.   This is the prin-
cipal evil, and claims our ftricteft attention.
   Many people imagine, that the food which they themfelves
love cannot be bad for their children : But this notion is ve-
jry abfurd.   In the more advanced periods  of life,  we often
acquire an inclination for food, which,  when children, we
could  not endure.   Befides,  there are many things that by
 habit may agree very well with  the ftomach of a grown per-
 fon, which  would be hurtful to a child ; as high-feafoned,
 falted, and  fmoke-dried provifions, &c.   It would alfo b?
 improper to feed children with fat meat,  ftrong broths, rich
ibups, or the like.
    All ftrong liquors are hurtful to children.  Some parents
 teach  their children to  guzzle ale,  and  other fermented li-
 quors, at every meal.  Such a  practice cannot fail to do mif-
 chief. Thofe children feldom efcape the violence ofthe fmall-
 pox, mealies, hooping cough, or fome inflammatory diforder.
                                                    Milk, 
OF    C  H I  L D'R FN.
3*
Milk, water, butter-milk, or whey,  are the moft proper for
children to drink.  If they have any thing ftronger,  it may
be fine fmall beer, or a little wine mixed with water.   The
ftomachs of children can digeft well enough without the af-
iiftance of warm ftimulants  : Befides, being naturally hotjs
they are eafily hurt by  every thing of a heating quality.
   Few things are more hurtful to children than unripe fruits.
They weaken the powers of digeftion, and four and relax the
ftomach,  by which means  it becomes a proper nelt for in-
fects.  Children  indeed  fhew a  great inclination for-fruit,
and lam  apt to believe, that if good ripe fruit were allowed)
them in proper  quantity, it would have no bad effects.   We
never find a natural inclination wrong, if properly regulated.
Fruits are generally of a cooling nature, and correct the heac
and  acrimony of the humours.   This  is what moft children*
want; only care  fhould be taken left they exceed.  Indeed,
the beft way to prevent children from  going to excefs in the
ufe of fruit,, or  eating that which is baJ, is  to allow them »
proper quantity of what is good.
   Roots which contain a crude  vifcid juice fhould be fpa-
ringly given to  children.   They fill the body with grofs hu-
mours, and tend to produce eruptive  difeafes.  This caution
is peculiarly neceflary  for the poor ;  glad to obtain at a fmall
price what  will fill the bellies of  their children, they ftuftT
them two or three times a day with potatoes,.or other  orude
vegetables.   Children had better eat a fmall quantity of food
which yields a- wholefome  nourifhment, than be crammed
with what their digeftive powers are unable properly  to afti-
milate.
   Butter ought likewife to be fparingly given to children. It
both relaxes the  ftomach, and produces grofs humours. In-
deed, moft things that are fat or oily, have this effect.  But-
ter, when falted, becomes ftill more hurtful.  Inftead  of but-
ter, fo liberally given to children in moft parts of Britain, we
would recommend  honey-  Honey  is not only wholefome,,
but cooling, cleanfing,  and tends  to fweeten the humours.
 Children who  eat honey are feldom troubled  with worms:
They are alfo lefs fubject to cutaneous difeafes, as itch, .cab-
bed head, cifc
   Many  people err in  thinking that the diet of children ought
to be altogether moift.  When children live entirely uporx
flops, it relaxes their folids, renders them weak, and difpofea
them to the rickets, the fcrophula, and other glandular dif-
•rders.   Relaxation is. one  oi  the moil general caufes of the.
                                                  difeafes, 
4<?            OF    CHILDREN1.
 difeafes of children.  Every thing therefore which  tends  ftf
 unbrace their folids, ought to be carefully avoided.
    We would not be underftood,  by thefe obfervations,  as
 Confining children  to  any particular kind of food.  Their
 diet may be frequently varied, provided always that  fufficient
 regard be had to fimplicity.

                Of  the Exercife of Children.
   Of  all the caufes which confpire to render the life of man
 fhort and miferable, none has greater influence than the want
 of proper exercise  : Healthy parents, wholefome food, and
 proper clothing, will avail little, where exercife is neglected.
 Sufficient exercife will make up for feveral defects in  nurfing;
 but nothing can fupply the want of it.'  It is  abfolutely ne-
 ceflary to the health, the growth, and the ftrength of children.
   The defire of exercife is coeval  with life itfeff.  Were this
 principle attended to, many difeafes might be prevented. But,
 while  indolence and fedentary employments  prevent  two-
 thirds  of mankind  from  either  taking  fufficient  exercife
 themfelves, or giving it to their children,  what  have  we to
 expect but  difeafes and  deformity among their offspring?
 The rickets,  fo deftructive to children, never appeared  in
 Britain till manufactures began to flourifh, and people, at-
 tracted by the love of gain, left the country to  follow feden-
 tary employments in great towns.   It is amongft thefe peo-
 ple that this difeafe chiefly prevails* and  not only deforms,
 but kills many of their offspring.
   The conduct  of other young animals fhews the propriety
 of giving exercife to children. Every other animal makes*
 life of its organs of motion as foon as it  can,  and many of
 them,  even when under no neceflity of moving in queft of
 food, cannot be  reftrained without  force.   This is evidently
 the cafe with the calf, the lamb,  and moft other young ani-
 mals.   If thefe  creatures  were not  permitted to frifk about,
 and take «erafe, they would foon die  or become difeafed.
 J he fame inclination appears  very early in the human fpe-
 cies ;  but, as they are not able to take exercife themfelves.
 K is the bufinefs  of their parents and nurfes to affift them
 .l,hlld/fn may   beexercifed  various  ways.  The beft me-
thod, whde they are light, is to carry them about in the nurfe's
arms.   Th.s gives the nurfe an opportunity of talking to the
child, and of pointing out every thing that may pleafe  and de-
light its fancy.   Befides   it is much fafer  than fwinging an
nfant in a machine,' or leaving it  to the care of  fuch as are
                                                     not 
             OF   CHllDREN.           ^

*iot fit to take care of themfelves.  Nothing  can be more ri-
diculous than to fet one child to keep another :  this conduct
has proved fatal to many infants, and has rendered others mi-
ferable for life.
  When children begin to walk,  the fafeft and beft method
of leading them about,  is by the hands.  The common way,
of fwinging them in leading  ftrings fixed to their backs,  has
feveral bad confequences.  It makes them throw their bodies
forward, and prefs with their whole weight upon the ftorhach
and breaft: By this means  the breathing  is obftructed, the
breaft flattened, and the bowels compreffed;  which muft
hurt the digeftion,  and occafion confumptions of the lungs,
and other difeafes.
   It is a common notion, that if children be fet upon their
feet too toon* their legs will become crooked.   There is
reafon to believe, that the very reverfe of this is true. Eve-
ry member acquires ftrength in proportion as it is exercifed.
The  limbs of children are weak indeed, but their bodies are
proportionally light; and, had they fkill to direct themfelves,
they would foon be able to fupport their own weight. Who
ever heard of  any other animal that became crooked by ufing
its legs too foon ? Indeed, if a child  be not permitted  to make
 any ufe of its  legs till a confiderable time after the birth, and
 then befet upon them with its whole weight at once, there
 maybe  fome  danger;  but this proceeds entirely from the
 child's not having been accuftomed to ufe its  legs from the
 beginning.
   Mothers of the poorer fort think  they  are  great gainers
 by making theirchildren lie or lit while they themfelves work.
 In this they are greatly miftaken. By neglecting to give then*
 children exercife, they  are obliged  to keep them a long time
 before they can do any thing for themfelves,  and  to fpend
 more on medicine than would have paid for proper care.
   To take care of their children,  is the moft profitable bufi-
 nefs in which even the poor can be employed :  But,  alas !  it
 is not always in their power.  Poverty often obliges them to
 neglect their  offspring, in order to procure the neceftaries of
 life.  When this is the cafe,  it becomes the intereft as well
 as the duty of the Public to affift them.   Ten thoufand times
 more benefit would accrue to the ftate, by enabling  the poor
 to bring up their own children, than from all the *  hofpitals
 that ever can be erected for that purpofe.
                           C                    Whoever

   *  If it were made the intereft of the poor to keep their children
  alive-, we mould  lofg very few of them.  A foall premium giveu
                                                  annually 
 42          OF    CHILDREN.

   Whoever confiders the ftructure ofthe human  body* will
 foon be convinced of the neceflity of  exercife for the health
 of children.  The  body is compofed  of an infinite  number
 ofveffels, whofe fluids cannot be pufhed on without the acti-
 on and preffure of the mufcles.  But,  if the fluids remain in-
 aaive, obftruaions muft happen, and the humours will of
 courfe be vitiated, which cannot fail to occafion difeafes. Na-
 ture has furnifhed both the vefl'els which carry the blood and
 lymph with numerous valves, in order that the actio-, of eve-
 ry mufcle might pufh forward their contents ; but without
 a'aion, this admirable contrivance can have no effea.  This
 part of the animal ceconomy proves toademonftration the ne-
 ceflity  of exercife for the prefervation of health.
   Arguments to fhew the importance of exercife might be
 drawn from every part of the animal  ceconomy  : Without
 exercife, the circulation of the blood cannot be properly car-
 ried  on,  nor the different fecretions duly  performed  ; with-
 out exercife,  the humours cannot be properly prepared,  nor
 the folids rendered ftrong or firm.   The action of the heart,
 the motion ofthe lungs, and all the vital funaions, are great-
 ly affifted  by exercife. But to point out the manner in which
 thefe efreas  are produced,  would lead  us farther into the
 ceconomy ofthe human body, than moft  of thofe for whom
 thistreatife is intended would be able  to follow.   We fhall
 therefore only add, that, where exercife is  negkaed,  none of
 the animal funaions can  be duly performed ;  and, when that
 is the cafe, the  whole conftitution muft go to  wreck.
  A good conftitution ought certainly  to  be  our firft object
 in the  management of children.   It  lays a foundation for
 their being ufeful and happy in life ;  and whoever neglects
 it, not  only fails in his duty to his offspring, but to fociety.
  One very common error of parents, by which they hurt the
conftkutions  of their children, is the fending them too young
 to fchool.   This is often done  folely to prevent trouble.
 When  the child is at fchool, he needs no keeper.  Thus the
fchoolmafter is made the nurfe ; and the poor child is  fixed to
 a feat  feven  or eight hours a-day,. which time ought to be
                                                   fpent

 annually to each poor family, for every child they have alive at the
year's end, would fave more infant lives, than if the whole reve-
nue of the crown were expended upon hofpitals  for this purpofe.
This  would make the poor efteem fertility  a bleflmg ; whereas ma-
ny of them think it the greateft curfe that can  befal them ; and in
place of wifhing their children to live, fo far does poverty eet'the
better of natural affection,, that they are oftf* very happy wh|n they 
OF    CHILDREN.
43
fpent in exercife and diversions.  Sitting  fo long cannot fail
to produce the worft effeas upon the body ;  nor is the mind  .
lefs injured.   Early application weakens  the  faculties, and
often fixes in the mind an averfion  to books,  which conti-
nues for life.
   But, fuppofe this were the way to make children fcholars,
h certainly ought not to be done at the expence of their con-
ftitutions.  Our anceftors, who feldom went  to fchool very
young, were not lefs learned than we.  But we imagine the
boy's  education will be quite marred, unlefs he be carried to
fchool in his nurfe's arms.  No wonder if fuch hot-bed plants
feldom become either fcholars or men \
   Not only the confinement of children  in public fchools,
but their number, often*proves hurtful.  Children are much
injured by being kept in crowds within doors ; their breath-
ing not only renders the place unwholefome, but, if any one
of them happens to be difeafed, the reft catch the infection.
A fingle child  has been  often  known to communicate the
bloody-flux, the hooping-cough, the itch, or other difeafes,
to almoft every  individual in  a numerous  fchool.
   But, if fafhion muft prevail,  and  iofants are to be fent to
fchool,  we would recommend it to teachers, as they value th©
interefts of fociety, not to confine  them  too long at a time,
but allow them to run  about and play at  fuch  active diverfi-
ons as may promote their growth and fkengthen their confti-
tutions.   Were boys,  inftead of being whipped for ftealing
an hour to run, ride,  fwim, or the like, encouraged to em-
ploy a proper part of their time in thefe manly and ufeful ex-
ercifes,  it  would produce many excellent  effeas.
   It would be of great fervice to boys,  if, at a proper age,
they were taught the military exercife.  This would increafe
their ftrength,  infpire them with courage, and when their
country called for their affiftance,  would enable.them to a£b
in her defence, without being obliged to undergo a tedious
and troubleforne courfe of inftruaions, at a time when they
are lefs fit to learn new motions, geftures, &c. *■
   An effeminate education will infallibly  fpoil the beft na-
tural  conftitution ; and, if boys are  brought up in a more de-
licate manner than even girls ought to be, they never will be

men*                                                Nor.
   * I am happy to find that the mafters of academies now begin to
put in practice  this advice.  Each of  them  ought to  keep a  drill
terjeant for teaching th,e  boys the military exercife.  This, befides
contributing to their health and vigour  of body,  would have many
dither happy effects. 
44
OF    CHILDREN.
   Nor is the common education of girls lefs hurtful to the
conftitution than that of boys.   Mifs is  fet down  to her
frame, before fhe can put  on her clothes; and is taught to
believe, that to excel at the needle is the only thing that can
entitle her to general efteem. .It is unneceffary here to infill
upon the dangerous  confequences of  ohliging girls to  fit too
much.  They are pretty well known, and are too often felt
at a certain time of life.   But  fuppofe this critical period to
be got over, greater  dangers ftill await them when they come
to be mothers.  Women who have been early accuftomed to
a fedentary  life,  generally  run great hazard in  childbed;
while thofe who have been ufed to romp about, and take fuf-
ficient exercife, are feldom in any danger.
  One hardly meets with a girl who can,  at the fame time,
boaft of early performances  by the needle, and a good confti-
tution.  Clofe and early confinement generally occafions in-
digeftions, head-achs, pale complexions, pain of the ftomach,
lofs of appetite, coughs, confumptions of the lungs,  and de*
fortuity of body.  The laft of thefe indeed  is not to be won-
dered at,  confidering the aukward poftures in which girls fit
at many kinds of needlework,  and  the delicate flexible ftate
pf their bodies in the early periods of life.
  Would mothers, inftead of having their daughters inftruct*
ed in many trifling accomplifhments, employ them  in plain
work and houfewifery, and  allow them fufficient exercife  in
the open  air, they would both make them more healthy mo-
thers, and more ufeful members of fociety.   I am no enemy
to genteel accomplifhments, but would have them only con*
fidered as fecondary, and always difregarded when they impair
health.
  Many  people imagine it a great  advantage for children to
be  early  taught to  earn their bread.  This opinion is cer-
tainly right,  provided they  were fo employed as not to hurt
their health or growth ;  but, when thefe fuffer,  fociety, in-
ftead of being benefited, is a reaT lofer by their labour. There
are few employments, except fedentary ones,fby which chil-
dren can earn a  livelihood;  and if they be fet to thefe too
foon, it ruins their  conftitutions.   Thus,  by gaining a few
years from childhood, we generally lofe twice as many in the
latter period  of life,  and even render the perfon lefs ufeful
while he  does live.
  In order to be fatisfiedof the truth of this obfervation, one
needs only look into the great manufaauring towns, where
he will find a puny,  degenerate race of people, weak and fick- 
QF    CHILDREN.
45
ly all their lives, feldom exceeding the middle period of life;
or, if they do, being unfit for bufinefs,  they become a bur-
den to fociety.  Thus, arts and manufaaures, though they
may increafe the riches of a  country,  are  by no means fa-
vourable to the health of its inhabitants.  Good policy would
therefore  require,  that fuch people as labour during life,
fhould not be fet too early  to work.  Every perfon conver-
fant in the breed of horfes, or other working animals, knows,
that, if they be fet to hard  labour too foon, they never will
turn out to advantage.  This is  equally true with refpea to
the human fpecies.
  There are neverthelefs various ways of employing young
people,  without hurting their health.   The eauer parts of
gardening,  hufbandry, or  any  bufinefs carried  on without
doors, are moft proper.  Thefe are employments which moft
young people are fond of, and fome parts of them may al-
ways be  adapted to their age, tafte,  and  ftrength *.
  Such parents, however,  as are under the neceflity of em-
ploying their children  within doors, ought to  allow them
fufficient  time  for aaive diverfions.  This would both en-
courage them to do more work, and prevent their conftitu-
tions from being hurt.
  Some imagine,  that exercife within doors is fufficient;
but they are greatly miftaken.   One hour fpent in running,
or any other exercife without  doors,  is worth  ten within.
When children cannot go abroad, they may indeed be exer-
cifed at home.   The beft method of doing  this,  is to make
them runabout in a long room, or dance.   This laft kind of
exercife,  if not carried to  excefs,  is  of excellent fervice to
young  people.   It cheers  the fpirits,  promotes perforation,
ftrengthens  the limbs,  &c.  I  know an eminent  phyfician
who ufed to fay, that he made his children dance,  inftead of
giving them phyfic.  It were well  if more people followed
his example.
  The Cold Bath may be confidered as  an aid  to exercife.
By it the body  is braced and ftrengthened, the circulation
and fecretions promoted,  and, were it conduaed with pru-
dence, many difeafes,  as  the rickets,  fcrophula, &c.  might
thereby be prevented.  The ancients,  who took  every me-
thod to render children hardy  and robuft,  were no ftrangers
                                                      to

  * I have been told that in China, where the police is the beft in
the world, all the children are employed in the eafier parts of gar-
dening and hufbandry ; as weeding, gathering ftoues off the laud,
and l'uch like. 
4,6           OF   CHILDREN.
to the ufe of the  cold  bath  ; and, if we may credit report,
the praaice of immerfing children daily in  cold water, muft
have been very common among our anceftors.
  The greateft objcaion  to the ufe of the  cold  bath,  arifes
from the fuperftitious prejudices of nurfes.   Thefe are often
fo ftrong, that it is impoffible to bring them to make a  pro-
per ufe of it.  I  have  known fome of them who would not
dry a child's fkin after bathing it, left it fhould deftroy the
effea of the water.  Others will even put clothes dipt in the
water upon the child, and either put it to bed, or fuffer it to
go about in that condition.  Some  believe, that the whole
virtue of the water depends upon its being dedicated to a par-
ticular faint.  While others place their confidence  in a cer-
tain number of dips, as three,  feven,  nine, or the like;  and
the world could not perfuade  them,  if thefe do not fucceed,
to try it a  little  longer.  Thus,  by the whims of nurfes,
children lofe the benefit of  the cold bath, and the hopes of5
the phyfician  from that medicine are often fruftrated.
  We  ought not, however, entirely to fet afide the ufe of the-
cold bath, becaufe fome nurfes make a wrong ufe of it. Eve-  .
ry child, when in health, fhould  at leaft have its extremeties
daily warned in cold water.   This is a partial ufe of the cold
bath, and is better than none.  In winter  this may fuffice ;#
but in  the warm feafon,  if a child   be relaxed, or feem to
have a tendency to the rickets or fcrophula, its  whole  body
ought to be frequently immerfed in cold water.  Care,  how-
ever, muft be taken  not to do  this  when the body  is  hot, or
the ftomach full.  The child  fhould  be dipt only once at a
time, fhould be taken out immediately, and have its fkin well-
rubbed with a dry cloth.

     The bad Ejfecls of unwholefome Air upon Children.
  Few things are moredeftruaive to children than confined
or unwholefome air.  This is one reafon why fo few of thofe
infants,  who are put into hofpitals,  or parifh work houfes.,
live.   Thefe places are generally crowded  with old, fickly,
and infirm people ;  by which means the air is rendered fo ex-
tremely pernicious, that it becomes a poifon to infants.
   Want oi wholefome air is likewife  deftruaive to  many of
the children born in great towns.   There  the poorer fort of
inhabitants live in low, dirty, confined houfes,  to which the
frefh air has no accefs. Though grown people, who are har-
dy and robuft may live in fuch fituations,  yet they generally
prove fatal to their offspring,  few of whom arrive a? maturi- 
OF    CHILDREN.
47
ty, and thofe who do are weak and deformed.  As fuch peo-
ple are not able to carry their children abroad into the open
air, we muft lay our account with lofing the greater part of
them.   But the rich have not this excufe.  It is their bufi-
nefs to fee that their children be daily carried abroad, and
that they be kept in the open air for a fufficient time.  This
will always fucceed better if the mother goes along with
them.   Servants are often negligent in thefe matters, and al-
low a child to fit or lie on the damp ground, inftead of lead-
ing or carrying it about.  The  mother furely  needs air as
well as her children ; and how  can fhe be better employed
 than in attending them ?
   A very bad  cuftom prevails,  of making children fleep irt
fmall apartments,  or crowding  two or three beds  into one
chamber.  Inftead of this,  the  nurfery  ought always to be
the largeft and  beft aired room  in the houie.  When chil-
dren are confined in fmall apartments,  the  air  not only  be-
comes unwholefome, but the heatielaxes their fofids, renders
them delicate, and difpofes them to colds and many other dif-
orders.  Nor is the cuftom  of wrapping  them up tooclofe
in cradles lefs pernicious.   One would  think that nurfes were
afraid left children fhculd fuffer by breathing free air, as ma-
ny of them aaually cover the child's face while  afleep, and
others wrap a covering over the whole cradle, by which means
the child is forced to breathe the fame air  over and over all
the time it is in it.
   A child is generally laid to fleep with  all its clothes on  ;
and if a number of others are  heaped  above them,  it muft be
over-heated ; by which means it cannot fail to catch cold on
being  taken out of the cradle,  and- expofed to the open air
with only its ufual clothing,  which is too frequently the cafe.
   Children who are kept within doors all  day,  and fleep all
night in warm clofe apartments,  may,  with great propriety,
be compared toplants nurfed in a hot-houfe,. inftead of  the
open air.  Though  fuch plants  may by this means be kept
alive for fome time, they will never arrive at that degree of
ftrength, vigour, and magnitude,  which they would have  ac-
quired in the open air, nor would they be abie to bear it after-
wards, fhould they be expofed to it.
   Children brought up in the country, who have been ac-
cuftomed to open  air, fhould not be too early  fent to great
towns, where it is confined and unwholefome.  This is fre-
quently done with a view  to forward  their education, but
proves very hurtful to their health,   All fchools and feraina- 
 4*            Of   CHILD  Rfitf.

 ries of learning ought, if poffible,  to  be  fo  fituated  as to
 have frefh,  dry, wholefome air, and  fhould never be tod
 much crowded.
   Without entering into a detail of the particular advanta-
 ges of wholefome air to children, or ofthe bad confequences
 which proceed  from the want of it, I  fhall  only  obferve,
 that, of feveral thoufands of children  which have been un-
 der  my care, I do  not  remember  one inftance of a fingle
 child who continued healthy in a clofe confined fituation;
 but have often  known the moft obftinate difeafes cured by
 removing them from fuch a fituation to a free  open air.

                       Of  Nurfes.
   It is not here intended to lay down fules for the choice of
 nurfes.   This would be wafting  time.   Common fenfe will
 direa every one to eh ufe a  woman who is healthy, and  has
 plenty of milk  *.   If fhe be at the fame time  cleanly, care*
 ful,  and good-natured,  fhe can hardly fail to make a proper
 nurfe.  After all, however,  the only certain proof of a good
 nurfe, is a  healthy child upon her breaft.  But, as the mif-
 conduft of nurfes often proves fatal  to children, it will be of
 importance to point out a few of  their moft capital blunders,
 in osder to  roufe the attention of parents, and to make them
 look more ftriaiy into the conduct  of thofe to whom  they
 commit the care of their infant offspring.
   Though  it admits of fome exceptions, yet  it may be laid
 down as a general rule, that every woman who  nurfes for hire,
 ought to be carefully looked after, otherwife fhe will not do hit
 duty.   For this reafon parents  ought always to have their
children nurfed under their own eye, if poffible ;  and where
 this cannot be done, they fhould be extremely circumfpect
 in the choice of thofe  perfons to whom they intruft  them.
 It is folly to imagine that any woman, who  abandons  her
 own child to fuckle another for the fake of gain,  fhould feel
 all the affeaions of  a parent towards her nurfling; yet fo ne-
ceflary are  thefe affeaions in  a nurfe,  that,  but  for them,
 the human race would foon be extina.
   One of  the  moft common faults of thofe who nurfe f«#
hire, is to dofe children with ftupefaaives,  or  fuch thines as
'uL^S afleep"   An indo,ent nurfe»  who does not give a
 child fufficient exercife in the open air to make it fleep, and
                                                    does

  * I have often known people fo impofec* upon, as  to give an infant
 to a nurfe to  be fuckled who had not one drop of milk in her oreafts. 
OF    CHILDREN.
49
does not chufe to be difturbed by it in the night, will feldom
fail to procure for it a dofe of laudanum, diacodium, faffron^
or, what anfwers the fame purpofe, a  dram  of  fpirits, or
other ftrong liquors.  Thefe, though they be certain poifon
to infants,  are every day adminiftered by many who bear the
charaaer of very good nurfes.
   A nttffe^^ho  has not milk enough is apt  to imagine that
this defea may be fupplied by giving the child wines, cordi-
al waters,  or  other ftrong liquors.   This  is an egregious
miftake.  The only thing that has any  chance to fupply the
 ftlace of the nurfe's milk, muft be fomewhat  nearly of the
 ame  quality,  as cow's milk, afs's milk, or the like, with
good bread.  It never can be done by the help of ftrong li-
quors.  Thefe,  inftead of nourifhing an infant, never fail to
produce the contrary effea.
   Children are often hurt by nurfes fuffering them to cry long
and vehemently.  This ftrains their tender bodies, arid  fre-
quently occafions  ruptures,  inflammations of the  throat,
lungs, &c.  The nurfe who can hear an infant cry till it has
almoft fpent itfelf, without endeavouring to pleafe  it, muft:
be cruel indeed,  and is  unworthy  to be intruded with the
care of an human creature.
   Nurfes who deal  much in medicine are always to be  fuf-
peaed.  They truft to it,  and neglea their duty.   I never
knew a good nurfe  who had her  Godfrey's cordials,  Daffy's
elixirs, &c. at hand.   Such generally imagine, that a dofe
of medicine will make up  for all defeds in  food,  air, exer-
cife and cleanlinefs.
   Allowing children to continue long wet, is another very
pernicious  cuftom of indolent nurfes.   This is not only dis-
agreeable,  but it galls and frets  the infant,  and by relaxing
the folids,  occafions fcrophulas, rickets, and other difeafes.
A dirty nurfe is always to be fufpeaed.
   Nature often attempts to free the bodies of children from
bad  humours,  by  throwing  them  upon the fkin: By  this
means fevers,  and other difeafes are prevented.  Nurfes are
apt  to miftake fuch critical eruptions for an itch, or fome o-
ther infeaious diforder.   Accordingly  they take  every  me-
thod to drive them in.   In this way many children lofe their
lives; and no wonder, as Nature is oppofed in the very  me-
thod fhe takes to relieve them.   It ought to be a rule, which
every nurfe fhould obferve, never to ftoo any eruption with-
out  proper advice, or being well affured that it is not of a cri-
                       D                            tied 
 SO           OF   CHILDREN.

 tical nature.   At any rate, it is never to be done without pre-
 vious evacuations.
   Loofe ftoe-ls is another method by which Nature often pre-
 vents or carries  off the difeafes of  infants.  If thefe proceed-
 too far,  no doubt  they ought to be checked ;  but this is ne-
 ver to be done without the greateft caution.   Nurfes,  upon
 the firft appearance of loofe ftobls, frequently fly to the ufe of
 aftringents, or fuch things as bind  the belly.   Hence inflam- \
 matory fevets, and other fatal difeafes, are occafioned. A dofe
 of rhubarb, a gentle vomit, or fome  other evacuation, fhould
 always precede the ufe of aftringent medicines *.
   One of the  greateft faults of nurfes is, concealing the dif-
 eafes Of children  frOm their parents.  This they are extreme-
 ly ready to do, efpecially when the difeafe is the effea of their
 own negligence.   Many inftances  might be given, of per-
 fons who have been rendered lame  for life by a fall from their
 nurfe's arms, which fhe, through fear, concealed till the mif-
 fortune was pait cure.   Every  parent who  intrufts a nurfe
 with the care of a child, ought to give her the ftriaeft charge
 not to conceal the ifiofli trifling diforder or  misfortune that
 may befal it.
  We can fee no  reafon why a nurfe who conceals any mif-
 fortune which happens to  a child under her care,  till it lofes
 its life,  fhould not be punifhed.  A few examples of this
 would favethe  lives of many infants ;  but, as there is little
reafon to ekpea that it ever will be the  cafe;,  we would ear-
 neftly  recommend  it to all parents to look carefully after their
 children, and not to truft fo valuable a treafure entirely in the
 hands  of an hireling.
  No perfon ought to imagine thefe things unworthy of his
 attention.  On  the proper management of  children depend
 not only their  health and ufefulnefs  in  life, but likewife the
 fafety and profperity ofthe ftate to which they belong.  Ef-
 feminacy ever will prove the ruin of any ftate, where it pre- -
 vails ; and, when its foundations are laid in infancy it ca«
 never afterwards be wholly eradicated. Parents who love their
 offspring,-and wifh well to their country, ought therefore in
 the management of their children, to avoid every trungthat
                                                     may

  * Some nurfes  are fo extremely nice, that rather than take  th*
 trouble of cleanmga child frequently,'they  will attempt to fto£
 up the paffage : and there are not wanting  inftances of faVeami<E
 maids  who have actually been known to make ule of corSfor tnU
 purpofe.  What have not mothers to fear,  who  huruft their chiK
 dm to the, care of giddy girls i                        Vit UM 
OF    CHILDREN.
5*
may have a tendency to make them weak or effeminate,  and
to take every method in their power to render their confuta-
tions ftrong and hardy.
                ———By arts like thefe
  Laconia nurs'd of old her hardy fons ;
  And Rome's uneonquer'd legions urg'd their way,
  Unhurt thro* ev'ry toil in every clime *.

------------------.------------------>

                CHAP.     II.

Of the LABORIOUS,  the  SED ENT AR Y,
              and  the  STUDIOUS.

      THAT men are expofed to particular difeafes from the
      occupations which they follow, is a faa well known 5
but to remedy this evil is  a matter of fome difficulty.  Moll
people are under a neceflity of following the employments to
which they have been bred,  whether they be favourable to
health or not.   For this reafon,  inftead of inveighing, in a
general way, as fome authors have done,  againft thofe occu-
pations which are hurtful to health, we  fhall endeavour to
point out the circumftances in each of them from which the
danger chiefly arifes, and  to propofe  the moft  rational  me-
thods of preventing it.
   Chymifts, founders, glafs-makers, and feveral other  art-
ifts, are hurt by the unwholefome air  which they are obliged
to breathe.  This air is not only loaded with the noxious ex-
halations arifing from metals and minerals, but is fo charged
with pblogifton as to be rendered unfit  for  expanding the
lungs fufficiently, and anfwering the  other important purpo-
ses of refpiration.  Hence proceed afthmas, coughs, and con-
fumptions  of the lungs, fo incident to perfons who  follow
thefe employments.
   To prevent fuch  confequences, as  far as poffible, the pla-
ces where thefe occupations are carried on, ought to be con-
 ftruaed with the utmoft care for difcharging the fmoke and
 other exhalations, and admitting a free current of frefh air.
 Such artifts ought never  to continue too long at work; and
 when they  give over, they  fhould fuffer themfelves to  cool
 gradually, and put on their clothes before they go into the
 open air.   They  ought never to drink large quantities of
 cold, weak, or watery liquors, while their  bodies are hot,
                                                     not
            *  Armftrong. 
1
 5a   Of the LABORIOUS, the SEDENTARY,

 nor to indulge in raw fruits, fallads, or any thing that is cold
 on the ftomach.
    Miners, and  all who work under ground,  are likewife
 hurt by unwholefome air.   The air,  by its  ftagnation in
 deep mines, not only lofes its proper fpring and other quali-
 ties neceflary for refpiration,  but is  often loaded with  fuch
 noxious exhalations as to become a moft deadly poifon.
    The two kinds of air which prove moft deftruaive to mi-
 ners,  are what they «all the fire-damp, and the choke-damp.
 Jn both cafes the air becomes a poifon, by its being loaded
 with phlogifton.   The danger from the former may be obvi-
 ated by making it explode before it accumulates in too great
 quantities; and  the latter  may be generally carried off by
 promoting a free circulation of air in the mine.
   Miners are not only hurt by unwholefome air, but  like-
 wife by the  particles  of metal which adhere  to  their  fkin,
 clothes, &c.   Thefe are abforbed, or taken up into  the bo-
 dy, and occafion palfies,  vertigoes, and other nervous difor-
 ders, which often prove fatal.  Fallopius obferves, that thofe
 who work in mines of mercury feldom live above  three or
 four years.  Lead, and feveral other metals, are Jikewife ve-
 ry pernicious to the health.
   Miners ought never to go to work fafting, nor to continue
 too long at work.  Their food ought to be nourifhing, and
 their liquor generous:  Nothing more certainly  hurts them
 than living too low.  They fhould by all  means avoid  cof-
 tivenefs.  This may either be done by chewing a little rhu-
 barb, or taking a fufficient quantity of fallad oil.  Oil not
 only opens the body, but fheaths and defends the inteftines
 from the ill effeas of the metals.  All who work in mines or
 metals ought to wafh carefully, and to change their clothes
 as  foon as they  give over working.   Nothing would tend
 more to preferve the health of fuch people than a ftria,  and.
 almoft religious regard to cleanlinefs.
  Plumbers, painters, gilders, fmelters,  makers  of white
 lead, and many others who work in metals, are liable to the
 fame difeafes as miners, and ought to obferve the fame direfli-
 ons for avoiding them.
  Tallow-Chandlers, boilers of oil, and all who work  in pu-
 trid  animal fubftances,  are likewife liable to fuffer from the
 unwholefome fmells or effluvia of thefe bodies.  Thev ou^ht
 to pay  the fame regard to cleanlinefs as miners ;  and when
 they are troubled  with naufea, ficknefs, or indigeftion;  we
 would adv.fe them to take a vomit or a gentle purge.  Such
fubftances ought always to be manufaaured as frefh as poffi-
                                                    ble.   H 
AND  THE  STUDIOUS.
S3
ble.   When long kept, they not only become unwholefome
to thofe who manufaaure them, but likewife to people who
live in the neighbourhood.
   It would greatly exceed the limits of this part of our fub-
jea, to fpecify the difeafes peculiar to perfons of every occu-
pation ; we fhall therefore confider mankind under the gene-
ral claffes of Laborious, Sedentary,  and Studious.

          THE   LABORIOUS.
   Though thofe who follow laborious employments are in
general the moft Healthy of  mankind, yet the nature of their
occupations, and the places where they are carried on, ex-
pofe them more particularly to fome difeafes.   Hufbandmen,
for example, are expofed to all the viciffitudes of the weather,
which, in this country, are often very great and fudden, and
occafion colds, coughs, quinfies,  rheumatifms, fevers, and
other accute diforders.   They are likewife forced to work
hard, and often to carry burdens above their ftrength, which,
by overftraining the veffels, occafion  afthmas, ruptures, &c.
   Thofe who labour without doors are often  affliacd with
Intermitting fevers or  agues,  occafioned by the frequent  vi-
ciffitudes of heat and cold, poor  living, bad  water, fitting
or lying on the damp ground, evening dews, night air, &c.
to which  they are frequently expofed.
   Such  as bear  heavy burdens,  as porters, labourers, &c.
are obliged to  draw in the air with much greater force, and
alfo to keep their lungs diftended  with more  violence, than
is neceflary for common refpiration : By this means the ten-
der veffels of the lungs are  over-ftretched, and often burft,
infomuch that a fpitting of blood or fever enfues.  Hippo-
crates mentions an inftance, to this purpofe, of a man, who
upon a wager, carried an afs; but was foon after feized with
» fever, a vomiting of blood, and a rupture.
   Carrying of heavy burdens is generally  the effea of mere
lazinefs, which prompts people to do at once what fhould be
done at twice.  Sometimes  it proceeds from vanity or emula-
tion.  Hence it is,  that the ftrongeft men are moft common-
ly hurt by heavy burdens, hard  labour, or feats of aaivity.
It is rare to  find one who boafts of his ftrength  without a
rupture, a fpitting of blood, or fome other difeafe, which he
reaps as the fruit of his folly.  One would imagine,  the dai-
ly inftances we have  of the  fatal effeas  of carrying great
weights, running, wreftling, and the like, would be fuffici-
ent to prevent fuch praaices,
                                                  There 
54  Of  the LABORIOUS, the SEDENTARY,
    There are indeed fome employments which neceffarily re-
 quire a great exertion of ftrength, as black-fmiths, carpen-
 ters, &c.   None ought to follow thefe but men of a ftrong
 body;  and they fhould never exert their ftrength  to the ut-
 moft, nor work too long.  When the mufcles  are violently
 {trained, frequent reft is neceffary, in order that they  may
 recover their tone ; without this,  the ftrength and  conftitu-
 tion will foon be worn out, and a premature old age brought
 on.
   The erifipelas, or St. Anthony's fire, is a difeafe very in-
 cident to the laborious.  It is occafioned by whatever  gives
 a fudden check to the perfpiration, as  drinking cold water
 when the body is warm,  wet feet, keeping on wet clothes,
 fitting or  lying on the damp ground,  &c.  It  is impoffible
 for thofe who labour without doors always to guard againft
 thefe inconveniences;  but it is known from experience, that
 their ill confequences might often be prevented by proper
 care.
   The iliac paffion,  the colic, and other complaints of  the
 bowels,  are generally occafioned by the  fame caufes as  the
 erifipelas;  but they  may likewife proceed from flatulent and
 indigeftible food.   Labourers eat  unfermented  bread, made
 of peas, beans, rye, and other windy ingredients.  They
 alfo devour great quantities of unripe fruits, baked, ftewed,
 or raw, with various kinds  of roots and herbs,  upon which
 they  often drink four milk,  ftale fmall beer, or tbe  like.
 Such a mixture cannot fail to  fill the bowels with wind,  and
 occafion  difeafes of thofe parts.
   Inflammations, whitloes, and other difeafes of the extre-
 mities, are Jikewife common amongft thofe who labour with-
 out doors   Thefe difeafes are often attributed to venom,  or
 fome kind of poifon; but they generally proceed  either from
iudden heat after cold, or the contrary.   When labourers,

ZtT   ' ^>C°mei fr°m ?e. fidd' Cold °* w<*> they run
tathe hre, and often plunge their hands in warm  water,  bv

Sdt,meanS th1e,b,°0d, \nd °ther humours in thof-rParts are
foddenly expanded, and the veffels not yielding fo quickly  a
^angulation happens, and  an  inflammation  I »ffl
enfues.

at
  a diltance from the fire for fome time, to wafh their hands
in cold water, and to rub them well witha dry doth.It fome
time, happens, that people are fo benumbed with cold  7To
be quite depnved of the ufe 0f their limbs.   In this cafe,  the
                                                   only 
            AND  THE  STUDIOljA            5$

only remedy is to rub the parts affeaed with (now, or, where
it cannot be had, with cold water.  If they be held near the
fire, or plunged into warm  water, a mortification will gene-
rally enfue.
  Labourers in the  hot feafbn are apt to lie down and fleep
in the fun.'  This praaice is fo dangerous,- that they often
wake in  a burning fever.   Thefe ardent fevers which prove
fo fatal about the end of fummer and  beginning of autumn,
are frequently  occafioned  by this means.  When labourers
leave off work, which they ought always to do during the
heat of the day, they fhould go home, or, at leaft, get under
fome cover, where they may repofe themfelves in fafety.
   Many people follow their employments in the fields from
morning till night, without eating any thing.  This cannot
fail  to  hurt  their  health.  However homely their fare be,
they ought to have it at regular times ;  and the harder they
work, the more frequently  they fhould eat.   If the humours
be not frequently  replenifhed with frefh nourifhment, they
foon become putrid,and produce  fevers of the very worit kind.
   Peafants are extremely  carelefs with refpea to what they
eat or drink, and often, through mere  indolence,  ufe  un-
wholefome food, when they might, for  the  fame expence,
have that which is wholefome.  In many parts of Britain,
the peafants are too carelefs even to take the  trouble of dref-
fing their own viauals.  Such people would live  upon one
meal a-day in indolence, rather than labour,- though it were
to procure them the greateft affluence.
   Fevers of a very  bad kind, are often occafioned among la-
bourers by poor living. When the body is  not fufficiently
nourifhed,  the humours become  bad, and  the folids weak ;
from whence the moft fatal confequences enfue.  Poor living
is likewife produaive of many of thofe cutaneous difeafes fo
frequent among the lower  clafs of people.  It is remarkable
that cattle, when pinched in their food, are generally affeaed
with difeafes of the fkin, which feldom fail todifappear when
they are put upon a good pafture.  This fhews how  much a
good ftate of the humours depends upon a fufficient quantity
of proper nourifhment.
   Poverty  not only occafions,  but aggravates,  many of the
difeafes ofthe laborious. Few of them have much forefight;
and, if they had, it is feldom in their power to fave any thing.
They are glad to make a ftiift to live from day to day ; and,
when any difeafe overtakes them, they are miferable indeed.
Here the godlike virtue of charity ought always to exert it- 
$6   Of  the oJfcORIOUS,  tHe  SEDENTARY,
 felf.  To relieve the induftrious poor in diftrefs, is furely the
 moft exalted aa of religion and humanity. They alone, who
 are witneffes of thofe fcenes of calamity,  can form a notion
 of what  numbers perifh in difeafes for want of proper affift-
 ance, and even for want of the neceffaries of life.
   Labourers are  often hurt by a  foolifh emulation,  which
 prompts  them to vie with one another,  till they  over-heat
 themfelves  to fuch a degree as  to occafion a fever, or even to
 drop down  dead.   Such as wantonly throw away their  lives
 in this manner, deferve to be looked upon in  no better light
 than felf-murderers.
   The office of afoldier, in time of war,  may be  ranked a-
 mongft  the laborious  employments.  Soldiers fuffer many
 hardfhips from the inclemency of feafons, long marches, bad
 provifions,  hunger,  watching, unwholefome  climates, bad
water, &c. Thefe occafion fevers, fluxes,  rheumatifms, and
other fatal  difeafes,  which generally  do  greater  execution
than the  fword, efpecially when campaigns are continued too
late in the year.  A  few weeks of cold  rainy  weather,  will
often prove more fatal than an engagement.
  Thofe who have the command of armies, fhould take  care
that their foldiers be well clothed and well fed.   They ought
alfo to finifh their campaigns in due feafon, and to provide
their men with dry  and well  aired winter quarters.   Thefe
rules, taking care, at the fame time, to keep the fick at a  pro-
per diftance from thofe in health,  would  tend greatly to  pre-
ferve the  lives of the  foldiery *.
                                                   Sailors

  * It is indeed to be regretted, that foldiers  fuffer not lefs from in-
 dolence and intemperance in time of peace,  than from hardfhipsiin
fime  of war. If men are idle, they will be vicious.   It would there-
fore be of great importance, could a fcheme be formed for render-
 ing the military, in timet;of peace,  both  more healthy and more
 ufeful.  Thefe defirable objects might, in our opinion, be obtained
by employing them for fome hours everyday, and advancing their
pay accordingly.  By  this means  idlenefs, the mother of  vice,
might be  prevented, the price of labour lowered, public works,  as
harbours  canals, turnpike roads, &c.  might  be made without hurt-
ing manufactures ;  and foldiers might be  enabled  to marry  and
bring up children.  A fcheme of this kind might eafily be condu'ded
fo as not to deprefs the martial fpirit, provided the meV were only to
work four or five hours every day, and always to work without
 doors : no foldier fhould be fuffered to work too long, or to follow
 any fedentary employment.  Sedentary  employments lender  men
 weak and effeminate, quite unfit for the hardfhips of wa - whereas
 working for a few hours every day without doors would enure them
 SSragT     '     * their nervcs'  «* increafe their ftrSngth and 
              And  the  STUDflBBc.            *?

  Sailors may alfo be numbered amongft the laborious. They
hndergo great hardfhips from change of climate, the violence
of weather, hard labour, bad provifions, &c.   Sailors  are of
fo great importance both to the trade and fafety of this king-
dom, that too much pains can never be beftowed  in  pointing
out the means of preferving their lives.
  One great fource of the difeafes of fea-faring people is ex-
eefs.  When they  get on fhore,  after having been long at
fea, without regard to the climate, or their own conftitutions,
they plunge headlong into all  manner of riot, and often per-
fift till a fever puts  an end to their  lives.   Thus  intempe-
rance, and  not the climate, is often  the caufe why fo many
of our brave failof s die ott foreign coafts.  Such people ought
not to live too low ; but they will  find moderation the beft
defence againft fevers, and many other maladies.
   Sailors,  when on  duty,  cannot avoid fometimes getting
wet.   When  this happens, they fllOutd1  change their clothes
as foon as they are relieved, arid take every method to reilore
the perfpiration.  They  fhould not,  in this  Cafe,  have re-
courfe to fpirits, or other ftrong liquors, but mould rather
drink fuch as are weak and diluting, of a proper  warmth, and.
go immediately  to bed,  where a found fleep and a  gentle
fweat would fet all to rights.
   But the  health of failors fuffers moft from unwholefome
food.   The conftant ufe  of  falted  provifions vitiates  their
humours,  and occafions the fcurvy, and Other obftinate ma-
 ladies.   It is  no eafy matter  to prevent this difeafe  in long
 voyages; yet  we cannot help thinking,  that  much might be
 done towards  effeaing fo  defirable an end,,  were  due pains
 beftowed for that purpofe. For example, various foots, greens
 and fruits, might be kept along time at fea,  as onions,  pota-
 toes, cabbages,  lemons,  oranges,  tamarinds,  apples, &c.
 When fruits  cannot be kept, the juices of them, either frefh
 or fermented, may.   With thefe all the drink,  and even the
 food of the fhip's company, ought to be acidulated in long
 voyaojg.
    Stale'bread and beer likewife contribute to vitiate the hu-
 mours.   Meal will  keep for a long time on  board, of which
 frefh bread might frequently be made.  Malt too might  be
 kept, and infufed with boiling water at any time.  This li-
 quor, when drank even in form of wort, is  very wholefome,
 and is found to be an  antidote againft the fcurvy.  Small
 wines and  cyder might likewife be  plentifully laid in  ; and,
 fljiould they turn four, they would ftill be ufeful as vinegar.
                          E                      Vinegar 
 58   Of the lio0RIOUS,  the  SEDENTARY,

 Vinegar is a great antidote  againft difeafes, and fhould be1
 ufed by all  travellers,  efpecially  at fea.  It may either  be
 mixed wifh the water they drink,  or taken in their food.
   Such animals as can be kept alive, ought likewife  to  be
 carried on board,  as hens, ducks,  pigs, &c.  Frefh broths
 made of portable foup, and puddings made of peas, or other
 vegetables, ought  to be ufed plentifully.  Many other things
 will readily  occur  to  people converfant in thefe matters,
 which would tend to preferve the health of that brave and
 ufeful  fet of men.
   We have reafon to believe,  if due attention  were paid to
 the diet, air, clothing, and above all things to the cleanlinels
 of fea-faring people, they would  be the moft healthy fet of
 men in the world ; but when  thefe are  negkaed, the very
 reverfe will happen.
   The beft  Medical Antidote that we can recommend to fai-
 lors or foldiers on  foreign coafts,  efpecially where dampnefs
 prevails, is  the  Peruvian bark.   This will often prevent fe-
 vers, and other fatal difeafes.   About a drachm of it may  be
 chewed every day ; or  ff this mould prove difagreeable,  an
 Ounce of bark, with  half an ounce  of orange-peel,  and two
 drachms offnake-root coarfely powdered, may be rnfufedfor
 two or three days in  an  Englifh quart of brandy, and half a
 wine-glafs  of it  taken  twice or thrice  a-day,  when the fto-
 mach is empty.  This has been found to be an excellent anti-
 dote againft fluxes, putrid, intermitting, and other fevers,  in
 unhealthy climates.  It is not material in  what form this
 medicine be taken.   It may either be infufed in water, wine,
 or fpirits, as recommended above,  or made  into an eleauary
 with fyrup of lemons, oranges, or  the like.

          THE   SEDENTARY.
  Though nothing can be  more contrary  to  the nature of
 man than a fedentary life, yet this clafs comprehends the far
 greater part of the  fpecies.  Almoft the  whole fermle world,
and in  manfaauring countries, the major part  of thjiriales,
may be  reckoned fedentary *.                     ■*•
  Agriculture, the firft and  moft healthful  of all  employ-
ments,  is now followed by few who are able to  cairy on any
                                                    other
  * The appellation of fedentary has generally been given only td
the ftudious;  we can fee no reafon, however, for reftrifting it to
them alone.  Many artificers may, with as much  propriety  be de-
nominated fedentary as the ftudious,  with this particular difadvan-
tage, that they are often obliged  to fit in very awkward poftureff
which the ftudious need not do,unlefc they pkafe.       P0™™s, 
and the  STUDIOUS.             59
other bufinefs.  But thofe who imagine that the culture  of
the earth is not fufficient to employ all its inhabitants, are
greatly miftaken.   An ancient Roman, we are told,  could
maintain his family from the produce of one acre of ground.
So might a  modern Briton,  if he would be contented to live
like a Roman.  This fhews what an immenfe increafe of in-
habitants Britain might admit of, and all of them live by the
eultureof the ground.
  Agriculture is the great fource of domefticriches.  Where
it is negleaed, whatever wealth may be imported from abroad
poverty and mifery will abound at home.  Such is, and ever
will be, the fluauating ftate of trade and roanufaaures, that
thoufands of people may be in full employment to-day, and
in beggary to-morrow.   This can never happen to thofe who
cultivate the ground.  They can eat the fruit of their labour,
and can always by induftry  obtain, at leaft, the neceffaries of
life.
   Though  fedentary employments are neceffary, yet there
feems to be no reafon why any perfon fhould be confined for
life to thefe alone.   Were fuch employments intermixed with
the more active and laborious, they would never do hurt.  It
is conftant confinement that ruins the health.  A  man will
not be hurt by fitting five or fix hours a day ; but if he is,
obliged to fit ten or twelve,  he will foon become delicate.
   But it is not want of exercife alone which hurts fedentary
people;  they likewife fuffer from the confined  air which they
breathe.   It is  very common to fee ten or a dozen taylors, or
 ftay-makers, for example, crowded into one fmall apartment,
 where there is  hardly room for one fingle perfon to breathe
 freely..  In this fituation they generally continue for many
 hours at a  time, often with the addition of fundry candles,
 which tend likewife to wafte the air, and render it lefs fit for
 refpiration.  Air that is breathed repeatedly, lofes its fpring,
 and becomes unfit for  expanding the lungs.    This  is  one
 caufe of the phthifical coughs,  and other complaints of  the
 breaftv fo  incident to fedentary artificers.
    Even the perfpiration from a great number of perfons pent
 up together, renders  the  air unwholefome.   The danger
 from  this  quarter will be greatly increafed,  if  any one of
 them happens to have bad  lungs,  or to be otherwife difeafed.
 Thofe who fit near him, being forced to breathe the fame air,
 can hardly fail to be infeaed.  It  would be  a  rare  thing,
 however,  to find a dozen of fedentary people all found.  The
                                                   danger 
6o-  Of the LABORIOUS, the SEDENTARY,

danger of crowding them together muft  therefore be evident
to every one.
   Many of thofe who follow fedentary employments are con-
ftantly in a bending pofture, as (hoe-makers, taylors, cut-
lers, &c.   Such a fituation is extremely hurtful.  A bend-
ing pofture obftruas all  the  vital  motions, and of courfe
muft deftroy the  health.  Accordingly  we find  fuch artifi-
cers generally complaining of indigeftions, flatulencies, head-
achs,  pains of the breaft, &c.
   The aliment in fedentary people,  inftead of being puttied
forwards by an erea pofture, and the action of the mufcles,
is  in a manner confined in the bowels.  Hence indigeftions,
coftjvenefs, wind, and other hypochondriacal fymptoms, the
conftant companions  of the fedentary.  Indeed none of the
excretions can be duly performed where exercife is wanting;
and when the matter which ought to be difcharged in this
way, is retained too long in the body, it muft have bad ef-
feas,  as it is again taken  up into the mafs of humours.
   A bending pofture is likewife hurtful to the lungs.  When
this organ is compreffed, the air cannot have free accefs into
all its parts, fo as to expand  them  properly.  Hence tuber-
cles, aduefions,  &c.  are  formed, which often end in con-
sumptions.  Befides, the  proper aftion  of the lungs being
abfolutely neceffary for making good blood,  when that organ
fails, the humours foon become univerfally depraved, and the
whole conftitution goes to wreck.
   Sedentary artificers are not only hurt by preffure on, the
bowels, but alfo on the inferior extremities, which obftruaj
the circulation in thefe  parts, and renders them weak and
feeble.  Thus taylors, fhoe-makers, &c. frequently lofe the
life of their legs altogether; befides, the blood and humours
are, by ftagnation, vitiated, and the perfpiration is obftrua-
ed:  from  whence proceed the fcab,  ulcerous  fores, foul
blotches, and other cutaneous  difeafes, fo common among
fedentary artificers.
   A bad figure of body is  a very common confequence of
clofe application to fedentary employments.   The fptrle, for
example, by being continually bent, puts on a crooked fliape,
and generally remains fo ever after.   But a bad figure of bo-
dy has already been obferved to be hurtful to  health, as the
vital funaions are thereby impeded.
   A fedentary life feldom  fails to  occafion an univerfal re-
laxation of the folids.   This is the great fource from whence
moft of the difeafes of fedentary people flow.   The fcrophu-
                                                    la, 
and the  STUDIOUS.            6l
la,  confumption,  hyfterics, with all  the numerous train of
nervous difeafes, which now abound, were very little known
in this country before fedentary artificers became fo nume-
rous : and they are very little known  ftill among fuch of our
people as follow aftive employments  without doors, though
in great  towns  at leaft two-thirds of the inhabitants are af-
fliaed with them.
  It  is very difficult to remedy thofe evils, becaufe many
who have been accuftomed to a fedentary  life,  like ricketty
children, lofe all  inclination for exercife;  we fhall, however,
throw out a few hints with refpea to the  moft  likely means
for preferving the health of this ufeful fet  of people, which
fome of them, we hope, will be wife enough to obferve.
   It has been already obferved, that  fedentary  artificers are
often hurt by their bending pofture.  They ought therefore
to ftand or  fit as erea as the nature of their  employments
will permit.  They fhould likewife change their pofture fre-
quently, and fhould never fit  too long at a time ; but  leave
off work and walk,  ride,  run, or do any thing that will pro-
mote the vital funaions.
   Sedentary artificers are generally allowed too little time for
 exercife; yet, fhort as it is, they feldom  employ it properly.
 A  journeyman  taylor or weaver, for example, inftead of
 walking abroad for exercife and frefh  air, at  his hours of
 leifure,  chufes often  to fpend them in a public-houfe,  or in
 playing at fome fedentary game, by which he generally lofes
 both his time and his money.
   The awkward poftures in which many fedentary artificers
 work, feem rather to be the effea of cuftom than neceflity.
 For example, a table might furely be contrived for ten or a
 dozen taylors to fit round, with liberty for their legs either to
 hang down, or reft upon  a foot-board, as they  fhould chufe.
 A place might likewife be cut out for each perfon, in fuch a
 manner that he might fit as conveniently for  working as in
 the prefent mode of fitting crofs-legged.
    All fedentary  artificers ought to pay the moft religious re-
 gard to cleanlinefs.  Both their fituation and occupations ren-
 der this highly neceffary.  Nothing would contribute more
 to  preferve their health, than a  ftria attention to it; and
  fuch of them as neglea it, not only run the hazard of  lofing
 health, but of becoming a nuifance to fociety.
    Sedentary people  ought to avoid food that is  windy, or
  hard of digeftion, and fhould pay the ftriaeft regard  to fo-
  briety.  A perfon who  works hard without doors will foon
                                                    throw 
62   Of  the LABORIOUS, the SEDENTARY,      1

throw off  a debauch ;  but one who fits has by no  means  an
equal chance.  Hence it often happens, that fedentary  peo-
people  are feized with fevers after hard drinking.   When   I
fuch perfons  feel  their fpirits low, inftead of running to <he   I
tavern  for relief, they  fhould ride,  or  walk in the fields.  A
This would remove  the complaint  more effectually  than  ■
ftrong liquor, and would never hurt the conftitution.
  Inftead of multiplying rules for  preferving  the  health  of  1
the fedentary, we fhall recommend to them the following ge-  I
neral plan, viz. That every  perfon who follows a fedentary  T
employment fhould cultivate a piece of ground with his own
hands.   This he might dig, plant, fow, and weed at leifure
hours,  fo as  to make it  both an exercife and  amufement,
while it produced  many of the neceffaries of life.  After
working an hour in a garden, a  man will return with more
keennefs  to  his  employment within doors, than  if he had-
been all the while idle.
  Labouring the ground is every way conducive  to health. -
It not only gives exercife to  every part of the body, but the
very fmell of the earth and frefh  herbs revives and cheers tho
fpirits, whilft the perpetual profpe^ of fomething coming to
maturity,  delights  and entertains  the  mind.   We are  fo
formed as  to be always pleafed  with fomewhat  in  profpect, "
however diftant or however trivial.   Hence the happinefs that
moft men feel in planting, fowing, building,  &c.  Thefe
feem to have been the chief  employments of the more  early
ages: and, when kings and conquerors cultivated the ground,
there is reafon to believe, that  they  knew as well  wherein
true happinefs confifted as we do.
  It may feem romantic to recommend  gardening to manu-
faaurers in  great towns; but  obfervation proves, that the
plan is very  praaicable.  In the town of Sheffield, in York-
mire, where the great iron  manufaaure is carried on,  there
is hardly a journeyman cutler who does not poffefs a piece of
ground, which he cultivates as a garden.  This praa.ce has
many falutary effeas.   It not only induces thefe people to
take exercife without  doors, but alfo to eat  many  greens*
roots,  &c. of their own growth, which they would never
think of purchafing.  There can be no reafon why manu-
faaurers in any other  town in Great-Britain fhould not fol-
low the fame plan.  It is indeed to be regretted, that in fuch
a place as London, a  plan  of this kind is not praaicable;
yet even there fedentary artificers may find opportunities of
taking air and exercife,  it they  chufe to embrace them.
                                              Mechanics   , 
AND  THE  STUDIOUS.           63
_ Mechanics are too much inclined to crowd into great towns.
This fituation may have ,fome advantages ; but it has like-
wife many difadvantages.  All mechanics who live  in the
country have it in their power to poffefs a piece of ground ;
which  indeed  moil of them do.   This not only gives them
exercife, but enables them to live more comfortably.   So far
at leaft as my obfervation extends, mechanics who live in the
country are far more happy than thofe in great towns.  They
enjoy better health, live in greater affluence, and feldom fail
to rear a healthy and  numerous offspring.
   In a word, exercife without doors, in one fhape or another,
is abfolutely  neceffary  to health.  Thofe who neglea it,
though they may for  a while drag out life,  can hardly be faid
to enjoy it.   Weak and effeminate, they  languiih for a few
years, and foon drop  into an untimely grave. *(

            THE   STUDIOUS.
   Intense thinking  is fo deftruaive to health, that few in-
ftances can  be produced of ftudious perfons  who are  ftrong
and healthy.   Hard ftudy always  implies  a fedentary  life ;
and, when intenfe thinking is joined to the want of exercife,
the confequences muft be bad.   We have frequently known
even a few months of clofe application to  ftudy, ruin an ex-
cellent conftitution, by inducing a train of nervous.complaints
which  could never be removed.   Man is evidently not form-
ed for continual thought more than for perpetual aaion, and
would  be as foon worn out by the one as by the other.
   So great is the power ofthe mind over the body, that,  by
its influence,  the whole  vital motions may be accelerated or
retarded, to  almoft  any degree.  Thus  cheerfulnefs and
mirth quicken the circulation, and promote all the fecreiions;
whereas fadnefs and  profound thought never fail to letard
them. Hence it would appear, that even a degree of thought-
leffnefs is neceffary to health.   Indeed, the perpetual  thinker
feldom enjoys either health or fpirits ;  while the perfon, who
can hardly be faid to think at all,  generally enjoys both.
  Perpetual thinkers, as they are called, feldom  think  long.
In a few years they generally become quite ftupid, and exhi-
bit a melancholy proof how readily the greateft bleflings may
be abufed.  Thinking, like  every thing elfe,  when carried
to extreme,  becomes a  vice :  nor can any thing afford  a
greater proof of wifdom, than for  a man frequently and fea-
fonably to unbend his mind.  This may generally be done
by mixing in cheerful company, aaive diverfions, or the like.
                                                 inftead 
 64   Of the LABORIOUS, the SEDENTARY,

   Inftead of attempting to inveftigate the nature of that con-
 nexion which fubfifts between the mind and body, or to in-
 quire into the manner in which they mutually affea each
 other,- we fhall only  mention thofe difeafes to which the
 learned are more  peculiarly liable,  and  endeavour to point
 out the means of avoiding them.
   Studious perfons are very fubjea to the gout.   This pain-
 ful difeafe in a great meafure  proceeds from indigeftion, and
 an obftruaed perfpiration.  It is impoffible that the man who
 fits from morning  till night fhould either digeft his  food,  or
 have any of the fecretions in due quantity.  But  when that
 matter, which fhould be thrown off by the fkin, is retained
 in the body, and the humours  a/e not duly prepared, difeafes
 muft enfue.
   The ftudious are likewife very liable to the ftone and gra-
 vel.   Exercife greatly promotes both  the  fecretion and dif-
 charge of urine ; tonfequently a fedentary life,  muft have
 the contrary effect.  Any one may be fatisfied of this, by ob-
 ferving, that he  paffes much more urine by day than in the
 night, and alfo when he walks or rides, than when  he fits.
   The circulation in the liver being flow, obftruaions in chat
 organ can hardly  fail to be the confequence of  inaaivity.
Hence fedentary people are frequently affiiaed With fchirrous"
livers.  But the proper fecretion and difcharge of the bile is
 fo neceffary a part of the animal ceconomy, that where thefe
 are not duly  performed, the health muft foon  be  impaired.
Jaundice, indigeftion,  lofs of appetite, and a wafting of the
 whole body,  feldom fail to be the confequences of a vitiated
 ftate ofthe liver, or obftruaions of the bile.
   Few difeafes prove more fatal to the  ftudious than con-
 fumptions of the lungs.   It has already been obferyed, that
 this organ cannot be duly expanded in thofe who do not take
 proper exercife ; and where that is the cafe, obftruaions and
 adhefions will  enfue.  Not only want of exercife,  but the
 pofture in which ftudious perfons generally fit, is very hurt-
 ful to the lungs.   Thofe who  read or write  much are ready
 to contraa a habit of bending forwards, and often prefs with
 their breaft upon a table or bench.   This pofture cannot fail
 rohurt the lungs.
   The funaions of the heart  may likewife by this means  be
injured.  I remember to have  feen a man opened, whofe pe-
 ricardium adhered to the breaft-bone in fuch a manner, as  to
 Obftrua the  motion of the heart,  and occafion  his death.
 The only probable caufe that  could be affigned for this An-
                                                   gular 
AND  THE  STUDIOUS.            6$
gular fymptom was, that the man, whofe bufinefs was writ-
ing,  ufed conftantly to  fit in a  bending pofture, with  his
breaft prefling upon the edge of a flat table.
  No perfon can enjoy  health who does not properly digeft
his food.  But intenfe thinking artd inaaivity never fail to
weaken the powers of digeftion. Herice the humours  become
crude and vitiated,  the folids  weak and relaxed, and  the
whole conftitution goes to ruin.
  Long and intenfe thinking often occafions grievous head-
achs, which bring on vertigoes, apoplexies, palfies, and other
fatal diforders.  The beft way to prevent thefe is, never to
ftudy too long at one time, and to keep the belly regular,  ei-
ther  by proper food, or taking frequently a little of fome o-
pening medicine.
  Thofe who read or write much are often affliaed with fore
eyes.  Studying  by  candle-light is peculiarly hurtful to the
fight.  This ought  to be pradifed  as  feldom as  poffible.
When it  is unavoidable, the eyes fhould be fhaded,  and  the
head fhould  not be held too low.   When the eyes ate weak
or painful, they fhould be bathed every night and morning in
cold water, to which a little brandy may be added.
  It has already been obferved,  that  the excretions are very
defeaive in the ftudious.  The dropfy  is often occafioned by
the retention of thofe humours which  ought  to be carried off
in this way.  Any perfon may obferve, that fitting makes his
legs  fwell, and that this goes off by exercife ; which  clearly
points out the method of prevention.
  Fevers, efpecially of the nervous kind, are  often the effea
of ftudy.  Nothing affeas the  nerves fo much  as  intenfe
thought.  It in a manner unhinges the whole human frame,
and  not only hurts the vital motions,  but diforders the mind
itfelf.  Hence a delirium, melancholy, and even madnefs, are
often the effea of clofe application to ftudy.   In fine, there
is no difeafe which can proceed either from a  bad ftate of the
humours, a defea ofthe ufual fecretions, or a debility of the
nervous fyftem, which may not be induced by intenfe think-
ing.
  But the moft aftliaing  of all  the difeafes which attack the
ftudious is the hypochondriac.  This difeafe  feldom  fails to
be the companion of deep thought.  It may rather be called
a complication of maladies,  than a fingle one.  To  what a
wretched condition arc the beft of men often reduced by it!
Their ftrength and  appetite fail;  a perpetual gloom hangs o-
ver their minds ;  they  live in the conftant dread of death,
                           F                         and 
66   Of the LABORIOUS, the SEDENTARY,

and are continually in fearch of relief from medicine, where,
alas !  it is not to be found.  Thofe who labour under this
diforder, though they be often made the fubjea  of ridicule,
juftly claim our higheft fvmpathy and compalfion.
   Hardiy any thing can be more prepofterous than for a per-
fon to make ftudy his fole bufinefs.  A mere ftudent is fel-
dom an ufeful member of fociety. He often negfeas the moft
important duties of life, in order to purfue ftudies or a  very
trifling nature.   Indeed it rarely happens, that any ufeful in-
vention is the effea of mere ftudy.   The  farther men dive
into  profound  refearches, they generally  deviate the more
from common fenfe, and too often lofe fight of it altogether.
Profound fpeculations,  inftead  of making men wifer or bet-
ter, generally render them abfolute fceptics, and overwhelm
them with doubt and uncertainty.  All that is neceffary for
man to know, in order to be happy, is eafily obtained ; and
the reft, like the forbidden tree, ferves only to increafe his
mifery.
   Studious perfons, in order to relieve their minds, muft not
only difcontinue to read and write,  but engage  in fome em-
ployment or diverfion, that will  fo far occupy the thought at
to make them  forget the bufinefs of  the clofet.   A folitary
ride or walk are fo  far from relaxing the mind, that they ra-
ther encourage thought. Nothing can divert the mind, when
it gets into a train of ferious thinking, but attention to fub-
jeas of a more trivial  nature.   Thefe prove a kind of play
to the mind, and confequently  relieve it.
   Learned men often contraa a contempt for what they call
trifling company.   They  are  afhamed to be feen with any
butphilofophers.  This, however, is no proof of their being
philofophers themfelves.  No man deferves  that name who i9
afhamed  to unbend  his mind, by aflbciating with the cheer-
ful and gay.  Even the fociety  of children  will relieve the
mind,  and expel the gloom which application to  ftudy is too
apt to occafion.
   As ftudious people are neceffarily much within doors,  they
fhould make choice  of a large and well-aired place for ftudy.
This would not only prevent  the bad effeas  which attend
confined  air,  but would cheer the fpirits,  and have a  moft
happy influence both on  the body and mind.   It is faid of
Euripides the Tragedian, that he ufed to retire to a dark cave
tocompofe his tragedies, and of Demofthenes the Grecian o-
rator, that he chofe  a place for ftudy where  nothing could be
either  heard or feen,   With all  deference to fuch venerable
                             .1                   names, 
            AND  THE  STUDIOUS.             67

names, we cannot help condemning their tafte.  A man may
furely think to as good purpofe in an elegant apartment as in
a cave ; and may have as happy  conceptions where the all-
cheering rays ofthe fun render the air wholefome, as in places
where they never enter.
  Thofe who read or write much fhould be very attentive to
their pofture.   They ought to fit and ftand by turns, always
keeping as nearly in an erea pofture as poffible.  Thofe who
diaate may do it walking.  It has an excellent  effea  fre-
quently to read or fpeak aloud.  This not only exercifes  the
lungs,  but almoft the whole body.   Hence ftudious people
are greatly benefited by delivering difcourfes in public.   Pub-
lic  fpeakers indeed fometimes hurt themfelves by  overaaing
their part; but this is their own fault.  The martyr to mere
vociferation merits not our fympathy.
   The morning has by all medical writers been reckoned  the
beft time for ftudy.   It is fo.  But it is alfo the moft proper
feafon  for exercife, while the ftomach is empty, and the fpi-
rits refrefhed with fleep.  Studious people fhould  therefore
fometimes  fpend the morning in walking, riding, or fome
manly diversions without doors.   This would make them re-
turn to ftudy with  greater alacrity, and would be  of  more
fervice  than  twice  the time after their fpirits  are worn  out
with fatigue.  It is not fufficient to take diverfion only when
we can think no longer.   Every ftudious perfon fhould make
it a part of his bufinefs,  and fhould  let nothing interrupt his-
hours of recreation more than thofe of ftudy.
   Mufic has a very happy effea in relieving  the mind  when
fatigued with ftudy.   It would be well if every ftudious per-
fon were fo far acquainted with  that fcience  as to  amufe
himfelf alter fevere thought, by playing fuch airs as have a
tendency to raife the fpirits, and infpire cfteerfulnefs and good-
humour.
   It is the reproach of Learning, that fo many of her vota-
ries, to relieve the mind after ftudy, betake themfelves to the
ofe of ftrong liquors.  This indeed is a remedy ; but  it  is a
defperate one, and always proves deftruaive.  Would fuch
perfons, when their fpirits are low, get on horfeback,  and
ride ten or a dozen miles? they would find it a more effeaual
remedy than any cordial medicine in the apothecary's fhop,
or all the ftrong liquors in the world.
   This is the plan which I always follow myfelf, and I can-
not recommend  a better to others.   When  my mind  is fa-
tigued  with ftudy, or other ferious bufinefs, I  mount my
                                                   horfe4 
£8 Of  the LABORIOUS, the SEDENTARY, &fc.

borfe, and ride ten or twelve miles into the country, where
I fpend a day, and  fometimes two, with a cheerful friend;
after which 1 never fail to  return to  town with new vigour,
and to purfue my ftudies or bufinefs with frefh alacrity.
  It is much to be regretted that learned men, while in health,
pay fo little regard to thefe things !  There is  not any thing
more common than to fee  a miferable objea  over-run with
nervous difeafes, bathing,  walking,  riding, and, in a word,
doing every thing for health after it is gone; yet, if any one
had recommended thefe things to him by way of prevention,
the advice would, in all probability, have been treated with
contempt, or,  at leaft,  with neglea.  Such is the weaknefs
and folly of  mankind, and fuch the  want of forefight, even
in thofe who ought to be wifer than others.
   With regard to the diet of the ftudious,  we fee no reafoa
why they fhould abftain from any kind of food that is whole-
fome, provided they ufe it in  moderation.   They ought,
however, to be fparing in the ufe of every thing  that is four,
windy,  rancid, or hard  of digeftion.  Their  fuppers fhould
always be light, or taken foon in the evening.  Their drink
may be water, fine malt liquor, not too ftrong,  good cider,
wine and water, or,  if troubled with acidities, water mixed
with a little  brandy,  rum,  or any  other good fpirit.
   We fhall  only obferve,  with regard to thofe kinds of exer-
cife which are moft proper for the  ftudious, that they fhould
not be too violent,  nor ever carried to the degree of exceffive
fatigue.  They ought likewife to  be frequently varied, foas
to give aaion to all the  different parts of the  body ; and
ftiould, as often as poffible, be  taken  in the  open air.   In
general, riding on horfeback,  working in a garden, or play-
ing at fome aaive diverfions, are the beft.
   We would likewife recommend  the ufe of the  cold bath to
the ftudious.  It will, in fome meafure,  fupply the place  of
exercife, and fhould  not be negleaed by perfons  of a relaxed
habit,  efpecially in the warm feafon.
   No perfon ought either to take exercife,  or to  ftudy imme-
diately after  a full meal.


               CHAP.     III.

         OF     ALIMENT.

     UN WHOLE SOME  food,  and irregularities in diet,
      occafion many difeafes.   There is  no doubt but the
wnole conftitution of body may be changed  by  diet alone.
                                                    The 
            OF   ALIMENT,             69

The fluids may be thereby attenuated orcondenfed, rendered
mild or acrimonious, coagulated or diluted,  to  almoft  any
degree.   Nor  are its effeas upon the folids lefs confiderable.
They may be braced or relaxed,  have their fenfibility, moti-
ons, &c.  greatly increafed or diminifhed, by different kinds of
aliment.  A very fmall attention to thefe things will be fuf-
ficient to fhew, how much the prefervation of health depends
upon a proper regimen ofthe diet.
  Nor is an attention to diet neceffary for the prefervation of
health only : It is likewife of importance in the  cure of dif-
eafes.  Every intention in the cure of many difeafes,  maybe
anfwered by diet alone.   Its effeas,  indeed,  are not always
fo quick  as thofe of medicine ;  but they are generally more
lafting :  Befides,  it is neither fo difagreeable to  the patient,
por fo dangerous as medicine, and is  always more eafily ob-
tained.
  Our intention here is  not to inquire minutely into the na-
ture and  properties ofthe various kinds of  aliment in ufe a-
mong mankind ; nor to fhew their  effeas  upon the different
conftitutions of the human body ;  but to mark fome of the
moft pernicious errors which people are apt to fall into, with
refpea both to the quantity and qualities  of their food, and
to point out their influence upon health.
  It is not indeed an eafy matter to afcertain the exaa quan-
tity of food proper for every age, fexand conftitution : But a
fcrupulous nicety here is  by no means  neceffary.  The belt
rule is to avoid all extremes.  Mankind were never  intended
to weigh and meafure their food. Nature teaches every crea-
ture when it has enough  ; and the calls of thirft and hunger
are fufficient to inform them when more is  neceffary.
  Though moderation be  the chief rule with regard  to the
quantity, yet  the quality of food merits a farther confidera-
lion.  There  are many ways  by which provifions may be
rendered unwholefome.   Bad feafons may  either prevent the
ripening of grain, or damage it afterwards.  Thefe,  indeed,
are  aas  of Providence,  and we muft fubmit to them ; but
furely no punifhment can be too  fevere for thofe who fuffer
provifions to fpoil by hoarding them, on purpofe to raife the
price.   The foundeft grain, if kept too  long,  becomes unfit
for  ufe *.
                                                 Animal,
  * The poor, indeed, are generally the firft who fuffer by unfound
provifions ; but the lives of  the labouring poor are of great impor-
tance to  the  ftate  : Befides, difeafes  occafioned by  unwholefome
food often prove infectious, by which means they reach people in
every ftation.  It is therefore the intereft  of all to take care that no
fpoilt provifious of any kind be, expofed to fale. 
70            OF   ALIMENT.
   Animal, as well as vegetable food,  may be  rendered un-
 wholefome,  by being kept too long.  All animal fubftances
 have a  conftant tendency to putrefaaion ; and, when that
 has proceeded too far, they not only become offenfive to  the
 fenfes, but hurtful to health.   Difeafed animals, and fuch as
 die of themfelves, ought never to be eat.  It is a common
 praaice, however, in  fome grafing countries, forfervants and
 poor people to eat fuch animals as  die of any difeafe, or are
 killed by accident.  Poverty,  indeed,  may oblige people to
 do this ; but they had better cat a fmaller quantity of what is
 found and wholefome : It would both afford  a better nou-
 rifhment, and be attended with lefs danger.
   The  injunaions given  to the Jews,  not to eat any creature
 which died of itfelf, feem  to have a ftria regard  to  health ;
 and ought to be obferved by Chriftians as well as Jews. Ani-
 mals never die of themfelves without fome previous  difeafe;
 but how a difeafed animal fhould be wholefome food, is in-
 conceivable : Even  thofe which die by accident  muft be
 hurtful, as their blood is mixed with the flefh, and foon turns
 putrid.
   Animals which feed grofsly, as tame ducks, hogs,  &c. are
.neither fo eafily digefted, nor afford fuch  wholefome nourifh-
 ment as others.  No  animal can  be wholefome  which does
 not take fufficient exercife. Moft of  our flailed cattle are
 crammed with grofs food, but  not allowed exercife  or  free
 air;  by which means  they  indeed grow  fat,  but their hu-
 mours not  being properly prepared or  affimilated,  remain
 crude, and occafion indigeftions, grofs  humours, and  oppref-
 Iion of the fpirits, in thofe who feed upon them.
   Animals are often rendered  unwholefome by being over-
 heated.   Exceffive heat caufes a fever, exalts the animal falts,
 and mixes the blood fo intimately with the flefh, that it can-
 not be feparatcd.  For this reafon,  butchers  fhould be fc-
 verely punifhed who over-drive their cattle. No  perfon would
 chufe to eat the flefh  of an animal which had died in a high
 fever; yet that is the cafe with  all over-drove cattle;  and tne
 fever is often  raifed even to the degree of madnefs.
   But this is not the only way  by which butchers render
 meat unwholefome.   The abominable cuftom of filling the
 cellular  membrane of animals with  air, in order to make
 them appear fat, n> every day praaifed. This not  only fpoils
 the meat, and renders it unfit for keeping, but is fuch a dirty
tnck^hat the very idea of it is fufficient & difguft a perfon^f
 udicfecy at every thing which comes from the Lmbles. Who
                                                    can 
OF    ALIMENT.
7*
can bear the thought of eating  meat which has been blown
up with air from the lungs of a dirty fellow, perhaps labour-
ing under the very worft of difeafes ?
  Butchers have likewife a  method of filling the cellular
membranes of animals with blood.  This makes the meat
feem fatter, and likewife weigh more, but is notwithftanding
a very pernicious cuftom, as ft  both  renders the  meat un-
wholefome and  unfit for keeping.  I feldom  fee a piece of
meat from the fhambles, where the blood is not diffufed
through the whole cellular texture.  I fhall not fay that this
is always the effea of defigH ; but I am certain it is not the
cafe with animals that  are killed for domeftic ufe,  and pro-
perly  blooded.  Veal  feems  to  be moft frequently fpoilt in
this way.   Perhaps that may  in fome  meafure be  owing to
the, practice of carrying calves from a great diftance to mar-
ket, by which  means their tender flefh  is bruifed, and many
of their veffels burft afunder.
  No people in the world eat fuch quantities of animal food
as the Englifli, which is one reafon why they are fo general-
ly tainted  with the fcurvy and its numerous train of confe-
quences,  indigeftion,  low  fpirits,  hypochondriacifm,  &c.
Animal food was furely defigned for man, and, with  a pro-
per mixture of vegetables,  it will  be found the moft whole-
fome ;  but,  to gorge  beef,  mutton, pork, fifh, and.  fowl,
twice or thrice a day, is certainly too much.  All who value
health ought to be contented with  making one meal of flefh
meat in the twenty-four hours,  and this ought to confift of
one kind only.
  The moft obftinate fcurvy has often been cured by a veget-
able diet;  nay, milk alone will  frequently do more in that
difeafe than any medicine.   From hence it is evident, that  if
vegetables and milk were more ufed in diet, we fhould have
lefs fcurvy, and likewife fewer putrid and  inflammatory fe-
vers.  Frefh vegetables,  indeed, come to be daily more ufed
in diet;  this laudable praaice we hope will continue to gain
ground.
  Our aliment ought neither to be too moift,  nor too dry.
Moift aliment relaxes the folids, and renders the body feeble.
Thus we fee females,  who live much on tea and other  watry
diet, generally become weak, and unable to di'geftfolid food;
from whence proceed hyfterics,  and all their dreadful confe-
quences.   On the other hand,  food that is too dry, renders
the folids in a manner  rigid, and the humours  vifeid, which
                                                difpofe* 
72
OF    A t I M E N f;.
difpofes the body to  inflammatory fevers, fcurvies,  and the
like.    *
   Much has been faid on the ill effeas of tea in diet.  They
are, no doubt,  numerous;  but they proceed rather from the
imprudent  ufe of it, than from any bad qualities in the tea
itfelf.   Tea is now the univerfal breakfaft in this part of the
world ;  but the morning is  furely the moft improper time of
the day for drinking  it.  Moft delicate perfons, who, by the
by, are the greateft tea-drinkers,  cannot eat any thing in the
morning.   If fuch perfons,  after falling ten or twelve hours,
drink four  or five cups of tea, without  eating almoft any
bread, it muft hurt  them.  Good tea,  taken in moderate
quantity, not  too ftrong, nor too hot,  nor drunk  upon an
empty ftomach,  will  feldom do harm ;  but if it be bad, which
is often the cafe, or fubftituted in the room of folid  food, it
muft have many ill effeas.
  The  arts of  cookery  render many things unwholefome,
which are not fo in their  own  nature.  By jumbling  toge-
ther a number of different ingredients, in order to  make a
poignant fauce, or rich foup, the compofition proves almoft
a poifon.  All high-feafoning,  pickles, &c.  are only incen-
tives to luxury, and never fail to hurt the ftomach.   It were
well for mankind, if cookery,  as an art, were entirely pro-
hibited.  Plain roafting or boiling is all that the ftomach re-
quires;  Thefe alone are fufficient for people in health, and
the fick have ftill lefs need of a cook.
  The liquid part of our aliment likewife claims  our atten-
tion.  Water is not only the bafis of moft liquors, but alfo
compofes a  great part of our folid food.   Good water muft
therefore be of the  greateft importance in diet.   The beft
water  is that which is moft pure, and free from any mixture
of foreign bodies. Water takes up parts of moft bodies with
which it comes into contaa ; by which means it is often im-
pregnated with metals or minerals of a hurtful or poifonous
nature.   Hence the inhabitants of fome hilly countries have
peculiar difeafes, which in all  probability proceed from the
water.  Thus the people who live near the Alps in Switzer-
land,  and the inhabitants of the Peak of Derby in England,
have large tumours or wens  on  their necks.   This difeafe  is
generally imputed to  thefnow-water ; but there is more rea-
fon to believe it is owing to the minerals in  the  mountains
through which the waters pafs.
  When water is impregnated with foreign bodies, it gene-
rally  appears by  its  weight, colour, tafte,  fmell, heat, or
                                                   fome 
OF    ALIMENT.
n
feme other fenfible quality.  Our bufinefs therefore is to chufe
fuch water,  for common ufe, as is lighteft, and without any
particular colour, tafte, or fmell.   In moft places of Britain
the inhabitants have it in their power to make choice of their
water, and  few things would contribute more to health than
a due attention to this article.  But mere indolence often in-
duces people to make ufe of the water that is neareft  them,
without confidering its qualities.
  Before water be brought into great towns, the ftriaeft at-
tention ought to be paid  to its qualities, as many difeafes may
be occafioned or aggravated by bad  water ; and when once it
has been  procured at  a great expence, people are unwilling
to give it up.
  The common methods of rendering water clear by filtrati-
on, or foft,  by cxpofing it  to the fun and air, &c.  are fo
generally known, that it is  unneceffary to fpend time in  ex-
plaining  them.   We fhall only,  in general, advife  all to
avoid waters which ftagnate long  in fmall lakes, ponds, or
the like,  as fuch waters often become putrid,  by the corrup-
tion of animal and vegetable bodies with which they abound.
Even «attle frequently fuffer by drinking, in dry feafons, wa-
ter  which has flood long in fmall  refervoirs,  without being
fupplied by fprings, or frefhened with fhowers.  All wells
ought to  be kept clean,  and to have a free communication
with the  air.
  As fermented liquors, notwithftanding they have been ex-
claimed againft by many writers, ftill continue to be thecoma
mon drink of almoft every  perfon  who can afford them ; we
fhall rather endeavour to affift people in the choice of thefe
liquors, than pretend to  condemn  what cuftom has fo firmly
eftablifhed.   It is not the moderate ufe of found fermented
liquors which hurts mankind ;  it is excefs, and ufing fuch as
are ill-prepared or vitiated.
  Fermented liquors, which are too ftrong, hurt digeftion ;
and the body is lo far from being ftrengthened  by them, that
it is weakened and relaxed.  Many imagine, that hard la-
bour could not be fupported without drinking ftrong liquors:
This is a very erroneous  notion. Men who never tafte ftrong
liquors are  not  only able to endure more fatigue, but  alfo
live much  longer, than thofe  who ufe them daily.  But,
fuppofe ftrong liquors did enable a man to do more  work,
they muft ncvei thelefs wafte the powers of life, and  occafi-
on premature old age. They keep up a conftant fever, which
                          G                     exhaufts 
 74            OF   ALIMENT,

 exhaufts the  fpirits,  heats and inflames the blood, and  din.
 pofes the body to numberlefs difeafes.
   But fermented  liquors may be  too weak as  well  as  too
 ftroncr:  When that  is the cafe,  they muft either be drunk
 new,°or they become four and dead ;  when fuch liquors are
 drunk new, the fermentation not being over, they generate
 air in the bowels, and occafion flatulencies; and, when kept
 till ftale, they four on the ftomach,  and hurt digeftion.   For
 this reafon  all malt-liquors,  cider, &c. ought to be of fuch
 ftrength  as to keep till they be ripe, and then they fhould bo
 ufed.  When fuch liquors are kept too long, though  they
 fhould not become four, yet they generally contraa a hard-
 nefs,  which renders them unwholefome.
   All families, who can, ought to prepare their own liquors.
 Since preparing and vending of liquors became one of  the
 moft general branches of bufinefs, every method has been
 tried to adulterate them.  The great objea both to the ma-
 kers and  venders of liquor is,  to render it intoxicating.  But
it is well known that this may  be done by other ingredients
 than thofe  which ought to be ufed for making it ftrong.  It
 would be imprudent even to name thofe things which are dai-
 ly  made ufe of to render liquors heady.   Suffice it to fay,
 that the  praaice  is very common, and that all the ingredi-
 ents ufed for this purpofe are of a narcotic or- ftupefaaive na-
 ture.   But, as  all opiates  are of  a  poifonous  quality,  it is
 eafy to fee what muft be the confequence of their general  ufe.
 Though  they do not  kill fuddenly, yet they hurt the nerves,
 relax  and weaken  the ftomach, and fpoil the digeftion.
   Were  fermented liquors faithfully prepared, kept to a pro-
 per age,  and ufed in moderation, they would prove real blef-
 ftngs  to  mankind.-  But, while they are ill prepared, vari-
 ous ways adulterated, and taken  to excefs, they muft have
 many pernicious effeas.
   We would recommend it to families, not only to prepare
 their own liquors, but likewife their bread.  Bread is fo ne-
 ceffary a  part of diet, that too much care cannot be beftowed
 in order to  have it found and wholefome.  For this purpofe,
 it is not only neceffary that it be made of  good  grain,  but
likewife properly prepared,  and kept free from all unwhole-
 fome ingredients.  This, however, we have reafon to believe,
 is not always the cafe with  bread prepared by  thofe  who
 make a trade of vending it.  Their objea  is rather to pleafe
 the eye,  than to confult the health.   The  beft bread is  that*
 which .is  neither toocoarfe nor f.oo fine 3 well fermented,  and
                                                   made 
OF    ALIMENT.
75
made of wheat flour,  or rather of wheat and rye mixed to-
gether.
 • To fpecify the different kinds of aliment, to  explain their
nature and  properties, and to point out their effeas in differ-
ent conftitutions, would far  exceed the limits of our defign.
Inftead of a detail of this kind, which would not be generally
underftood,  and,  of courfe,  little attended  to, we fhall only
mention the following eafy rules with refpea to the choice of
aliment.
  Perfons, whofe folids are weak and relaxed, ought to avoid
all vifcid food, or  fuch things as are hard of digeftion. Their
diet, however, ought to  be folid j and they ihould take plen-
ty of exercife in the open air.
  Such as abound with  blood fhould be fparing in  the ufe of
every thing that is highly nourifhiyg, as fat meat, rich wines,
ftrong ale,  and fuch like.  Their  food fhould confift moftly
of bread and other vegetable  fubftances;  and their drink
ought to be water, whey, or fmall  beer.
  Fat people fhould not eat freely of  oily  nourifhing diet.
They ought frequently to ufe raddifh, garlic, fpices, or fuch
things as are heating and  promote perfpiration and  urine.
Their drink fhould be water, coffee,  tea, or the like ; and
they ought to take much exercife and little fleep.
  Thofe who are too Jean muft follow  an oppofite courfe.
  Such as are troubled with acidities, or whofe food is  apt to
four on the ftomach,  fhould live much on flefh-meats ; and
thofe who areaffliaed with hot alkaline eruaations, ought to
ule a diet confiding chiefly of acid  vegetables.
  People who are affeaed with the gou,t, low fpirits,  hypo-
chondriac,  or hyfteric diforders, ought to avoid all flatulent;
food, every thing that is vifcid, or  hard of digeftion, all fak-
ed or fmoke-dried  provifions, and whatever is auftere, acid,
or apt to four on the ftomach.  Their  food fhould be light,
fpare, cool, and of.an opening nature.
  The diet ought not only to be fuited  to the age and confti-
tution, but alfo to the manner of life :  A fedentary or ftudi-
ous perfon  fhould live more fparingly than one  who labours
hard without doors.  Many kinds of food will nourifh a pea-
fant very well,  which would  be almoft indigeftible to a citi-
zen  ; and the latter will live  upon a  diet on which the for-
mer would, ftarve.
  Diet ought not to be too uniform.   The conftant ufe of
one kind of food might have fome bad effeas. Nature teaches
us this,  by the great variety of aliment which  fhe  has pro-
                                                   vided 
76            OF    ALIMENT.

vided for man, and likewife by giving him an appetite for dif-
ferent kinds of food.                                  .
  Thofe who labour under any particular difeafe, ought to
avoid fuch aliments as have a tendency to increafe it :* or ex-
ample, a  gouty perfon fhould not  indulge  in rich w.nes,
ftrong foups, or gravies, and fhould avoid  all  acids.   One
who is troubled with the gravel ought ro fhun all auftere and
aftringent aliments;  and thofe who  are  fcorbutic fhould he
fparing in the ufe of animal food, &c.
  In the firft period of life, our food ought to be light, but
nourifhing, and frequently ufed.  Food  that is folid, with  a
fufficient degree of tenacity, is moft proper for the ftate of
manhood.  The diet fuited to the laft period of life,  when
nature is upon the decline, approaches nearly to that of the
firft.  It fhould be lighter and more diluting than that of vi-
gorous age, and likewife more frequently taken.
*" It is not only neceffary for health, that our diet be whole-
fome, but alfo that it be taken at regular periods.  Some ima-
gine long fading will atone for excefs ; but this,  inftead of
mending the matter,  generally makes it worfe.  When the
ftomach  and inteftines are over-diftended  with food,  they
lofe their proper tone,  and,  by long  fafting,  they  become
weak,  and inflated with wind.  Thus, either gluttony or
fafting deftroys the powers of digefting.
  The frequent repetition  of aliment is not only neceffary for
repairing the continual wafte of our bodies, but likewife to
keep tbe humours found and fweet.   Our humours^ even in
the moft healthy ftate, have a conftant tendency to putrefac-
tion, which  can only be prevented  by  frequent fupplies of
frefh nourifhment : When that is wanting too long, the pu-
trefaaion often proceeds fo far, as to occafion very danger-
ous fevers.   From hence we may learn the neceflity of regu-
lar meals. No perfon can enjoy a good ftate of health, whofe
veffels are either frequently over-chargedj  or  the humours
long deprived of frefh fupplies of chyle.
  Long fafting is extremely hurtful to young people; it not
only vitiates their humours, but prevents their growth.  Nor
is it lefs  injurious to the aged.   Moft perfons, in the decline
of life, are affiiaed with wind :  This complaint  is not  only
increafed, but even rendered dangerous,  and often fatal, by
long fafting.  Old people, when  their ftomachs are empty,
are frequently feized with giddinefs,  head-achs, and faintnefs.
Thefe complaints may generally be removed   by a bit of
                                                   bread 
OF    ALIMENT.
77
bread and a glafs of wine,  or  taking any  other folid food ;
which plainly points out the method of preventing them.
  It is more than probable, that many of the fudden deaths,
which happen in the advanced periods of life, are occafioned
by fafting too long, as  it exhaufts the fpirits, and fills the
bowels with wind ; we would therefore advife people, in the
decline of life, never to allow their ftomachs to be too long
empty.   Many people take nothing  but  a few cups of tea
and a bit of bread,  from nine o'clock at  night  till two or
three next afternoon.  Such may be faid to faft almoft three-
fourths of their time.   This can hardly fail to ruin the  ap-
petite, vitiate the humours,  and fill the bowels with wind ;
all which might be prevented by a folid  breakfaft.
  It is a very common praftice to eat  a light breakfaft and a
heavy fupper.   This  cuftom ought to be  reverfed.  When
people fup late, their fupper fhould be very light; but the
breakfaft ought always to be folid.   If any one eats alight
fupper, goes foon to bed, and  rifes betimes in the morning,
he will be fure  to  find an appetite for his breakfaft, and  he
may freely indulge  it.
  The ftrong and healthy do not indeed fuffer  fomuch from
fafting as the  weak and delicate ; but  they run great hazard
from its oppofite, viz.  repletion.   Many difeafes, efpecially
fevers are the effea of a plethora, or too great  fulnefs of the
veffels.   Strong people, in high health,  have generally a
great quantity of blood and other humours.  When thefe
are  fuddenly increafed, by an over-charge of rich and nourifh-
ing diet, the veffels become  too much diftended, and obftruc-
tions and inflammations enfue.   Hence fo many people are
feized with inflammatory and eruptive  fevers, after a feaft or
debauch.
  All great and fudden changes in diet  are  dangerous. What
the ftomach has been long accuftomed  to digeft, though  lef3
wholefome, will agree better with it than food of a more fa-
lutary nature which it has not been ufed to.  When therefore
a change becomes neceflary, it  ought always to be made gra-
dually ; a  fudden  tranfition from a poor and low,  to a rich
and luxurious diet, or the contrary, might fodifturb the func-
tions of the body as to endanger health, or even to occafion
death itfelf.
  When we recommend regularity in diet, we  would not be
underftood as condemning every  fmall deviation from it.   It
is next to impoffible for people at all times to avoid fome de-
gree of excefs, and  living too much by  rule might make even
                                                     the 
78             OF    ALIMENT.
the fmalleft deviation dangerous.   It may therefore he pru#
dent to vary a little, fometimes talcing more, fometimes lefs,
than the ufual quantity of meat and  drink, provided always
that regard  be had to moderation.
                CHAP.     IV.

                   OF     AIR.

      UNWHOLESOME air is a very common  caufe of
       difeafes.  Few are aware of the danger arifing from it.
People generally pay  fome attention  to what they eat and
drink, but feldom regard what goes  into  the lungs, though
the latter proves often more fuddenly fatal than the former.
   Air, as well as water,  takes up parts  of  moft bodies with
which it comes into contaa, and is often fo replenifhed with
thofe of a noxious quality,  as to occafion  immediate death.
But fuch violent effeas feldom happen, as people are general-
ly on their guard againft them.   The le/s  perceptible influ-
ences of bad air prove  more generally hurtful to  mankind ;
we fhall therefore endeavour to point out fome of  thefe,  and
to fhew from whence the danger chiefly arifes.
   Air may  become  noxious many ways.  Whatever greatly
alters its degree of heat, cold, moifture,  &c. renders it un-
wholefome : For example, that which is too hot diffipates the
watery parts of the blood, exalts the bile,  and renders the
whole humours aduft and thick.   Hence proceed bilious and
inflammatory  fevers,  cholera  morbus, &c.   Very  cold air
obftruas the  perfpiration,  conftringes the  folids, and con-
denfes the fluids.   It occafions  rheumatifms,  coughs  and
catarrhs, with other difeafes of the  throat and breaft.  Air
that is too moift deftroys the elafticity or fpring of the folids,
induces phlegmatic or lax conftitutions,  and difpofes the bo-
dy to agues, or intermitting fevers,  dropfies,  &c.
   Wherever great numbers of people are crowded into  one
place,  if the air has not a free  current,  it foon becomes  un-
wholefome.   Hence  it is that  delicate perfons are fo apt to
turn fick or faint in crowded churches,  affemblies, or  any
place where the air is injured by breathing, fires,  candles,
or the like.                                             '
   In great cities fo many things tend to pollute the air, that
it  is  no wonder it proves fo fatal to the  inhabitants   The
air in cities is  not only breathed repeatedly over, but'is like-
                                                    wife 
OF     AIR.
79
wife loaded with fulphur, fmoke, and other exhalations, be-
fides the vapours continually arifing from innumerable putrid
fubftances, as dung-hills, flaughter-houfes, &c.  All pota-
ble care fhould be taken to keep the  ftreets of large towns
open and wide, that the air may have a free current through
them.  They ought likewife to be kept very clean. Nothing
tends more to pollute and contaminate the air of a city than
dirty ftreets.
  It is very common in this country to have church-yards in
the middle of populous cities.   Whether  this be the effea
of ancient fuperftition, or owing to the  increafe of fuch
towns,  is  a  matter  of  no  confequence.-------What-
ever gave  rife to the  cuftom,  it is a bad  one.  It  is ha-
bit alone which reconciles  us to thefe things;  by means of
which  the moft ridiculous, nay, pernicious cuftoms, often
become facred.   Certain it  is,  that thoufands of  putrid car-
caffes,  fo near the furfaceof the earth, in a place where the
air is confined, cannot  fail  to taint  it; and that fuch  air,
when breathed into the lungs, muft occafion difeafes*.
  Burying within churches is a praaice ftill more deteftable.
The air  in  churches is feldom  good,  and the effluvia from
putrid carcafles muft  render it ftill worfe.  Churches are
commonly old buildings with  arched roofs.  They are fel-
dom opened above once a week,  are never ventilated by fires
nor open windows,  and rarely  kept clean.  This occafions
that damp, mufty, unwholefome fmell which one feels upon
entering a church, and renders it a very unfafe place for the
weak and  valetudinary.  Thefe inconveniences might, in a
great meafure, be obviated, by prohibiting all  perfons from
burying within churches, by keeping  them clean, and per-
mitting a ftream of frefh air to pais frequently through them,
by opening oppofite doors and windows.
  Wherever  air ftagnates  long, it  becomes unwholefome.
Hence  the unhappy perfons confined in jails not only con-
traa malignant fevers  themfelves, but often communicate
them to others.  Nor are many of the holes, for we cannot
call them houfes,  pofftfled by the poor in great towns, much
better than jails.  Thefe low dirty habitations  are the very
lurking-places of bad air and contagious difeafes.  Such as
                                                   live

  * In moft eaftern countries it wascuftomary to bury the  dead at
fome diftauce  from any town. As this practice obtained among
fhe Jews, the  Greeks, and alfo the Romans, it is ftrange  that the
weftern parts of Europe lhouldnot have, followed their exam?le^n-
a cuftom fo truly laudable. 
8o
OF     AIR.
 live in them feldom enjoy good health ; and their children
 commonly die young.  In the choice of a houfe,  thofe who
 have it in their power ought always to pay the greateft atten-
 tion to open free air.
   The various  methods which luxury has invented to make
 houfes clofe and warm, contribute not a little to render them
 unwholefome.  No houfe can be wholefome unlefs  the air
 has a free paffage through it.  For which reafon houfes ought
 daily to be ventilated, by opening oppofite windows, and ad-
 mitting  a current of frefh air into every room.   Beds, in-
 ftead of being made up as foon as people  rife out  of them-
 ought to be turned down, and expofed to the frefh air frortf
 the open windows through the day.   This would  expel any
 noxious vapour, and could not fail to promote the health of
 the inhabitants.
   In hofpitals,  jails, fhips, &c. where that cannot be con-
 veniently done, ventilators fhould be ufed.  The  method of
 expelling foul,  and introducing frefh air, by means of ven-
 tilators, is a moft falutary invention,  and is indeed the moft
 ufeful of all our modern medical improvements.  It is capa-
 ble of univerfal application,  and is fraught with  numerous
 advantages, both to thofe in health and ficknefs.  In  all pla-
 ces,  where numbers of people are crowded together, venti-
 lation becomes abfolutely neceffary.
   Air, which ftagnates in mines, wells, cellars, &c. is ex-
 tremely noxious.   That kind  of air is to be avoided  as the
 moft deadly poifon. It often kills almoft as quickly as light-
 ning.  For this reafon, people fhould be very cautious in o-
 pening cellars that have been long fhut, or going down into
 deep wells,  or  pits, efpecially if they have been clofely  co-
 vered.
   Many  people who have fplendid houfes, chufe to fleep in
 fmall apartments.  This condua is very imprudent.   A bed-
 chamber ought always to be well aired; as it is generally oc-
 cupied in the night only,  when all  doors and windows are
 fhut.   If a fire  be kept m it,  the danger from a fmall room
 becomes ftill greater.   Numbers have been ftifled, when a-
 fleep by a fire in a fmall apartment.
   Thdfe who are obliged,  on account of bufinefs, to fpcnd
 the day in clofe towns, ought, if poffible, to fleep in the coun-
 try.   Breathing free air in the night, will, in fome meafure,
make up for the want of it through  the day.  This praaice
would have a greater effea in preferving the health  of citi-
 zens than is commonly imagined.
                                                Delicate 
OF     AIR.
81
  Delicate perfons ought,  as much as poffible,  to avoid the
air of great towns.  It is peculiarly hurtful to the afthmatic
and consumptive.   Such perfons fhould fly  cities  as they
would  do the plague.   The hypochondriac  are  likewife
much hurt by it.  1 have often feen perfons fomuch affliaed
with this malady while in town, that it feemed impofiible for
them to live,  who, upon being removed to the country, were
immediately relieved.  The fame obfervation holds with re-
gard to nervous and hyfteric women.  Many people,  indeed,
have it not in their power to change their fituation  in queft
of better air.   All we can  fay to fuch  perfons is,  that they
fhould  go as often abroad into the open air as they can, that
they, fhould admit frefh air  frequently into their houfes,  and
take care to keep them very clean.
  It was neceffary in former times* for frfefy,  to  furround
cities,  colleges, arftl even  llngle houfes, with high  walls.
Thefe,  by obftruaing the  free current of air, never fail to
render fuch places damp and  unwholefome.   As fuch walls
are  now, in moft parts of this country, becom; ufelefs, they
ought to be pulled down, and every method taken to admit a
free paffage to the air.   Proper attention to Air apd Clean-
liness would tend more to preferve the health  of mankind,
than all the endeavours of  the faculty.
  Surrounding houfes  too clofely  with planting,  or thick
woods, likewife tends to render the air unwholefome.  Wood
not only obftruas the free current of the air,   but fends forth
great quantities of moift exhalations, which render it con*
ftantly  damp.  Wood is very agreeable at a  proper diftance
from a houfc, but fhould never be planted too near it, efpe-
cially in a flat country.  Many of  the gentlemen's feats in
England are rendered very unwholefome from the great quan-
tity of wood  which furrounds them.
  Houfes fituated in  low  maifhy  countries, or near large
lakes of ftagnating water,  are likewife unwholefome.   Wa-
ters which ftagnate not only render the  air damp, but load it
with putrid exhalations, which produce the moft fatal difea-
fes.  Thofe who are  obliged  to  inhabit marfhy countries,
ought to make choice of the dryeft fituations they can find,
to live generoufly, and to pay the ftriaeft regard  to cleanli-
nefs.
  If frefh air be neceffary for thofe  in health, it is ftill more
fo for the fick, who often lofe their  lives for want of ir.  The
notion that fick people muft be kept very hot, is fo common,
that one can  hardly enter the chamber  where a patient lies,  ^
                            H                   without 
 82               O   F    A  i   R.

 without being ready to faint, by reafon of the hot fuffocating
 fmell.   How this muft affea the fick, any one may judge,
 No medicine is fo beneficial to the fick as frefh air.  It is the
 moft reviving of all cordials, if it be adminiftered with pru-
 dence.   We are not,  however, to throw  open doors and
 windows at random upon the fick.   Frefh air is to be let in-
 to the chamber  gradually, and, if poffible,  by opening  the
 windows of fome other apartment.
   The air of a fick perfon's chamber may be greatly frefh-
 ened, and the patient much  revived,  by fprinkling the floor,
 bed, &c. frequently with vinegar, juice of lemon,  or any
 other ftrong vegetable acid.
   In places where numbers of fick are crowded into the fame
 houfe, or, which is often the cafe, into the fame apartment,
 the frequent admiftjon of frefh air becomes abfolutely necef-
 fary.   Infirmaries, hofpitals, &c. are often rendered fo nox-
 ious,  for want of proper ventilation, that the fick run more
 hazard from them than from  the difeafe.  This is particular-
 ly the cafe when putrid fevers, dyfenteries, and other infecti-
 ous difeafes prevail.
   Phyficians,  furgeons, and others  who attend  hofpitals,
ought, for their own fafety,  to take care that they be proper-
ly ventilated.  Such perfons  as are obliged to fpend moft of
their time amongft the fick,  run great hazard of being them-
felves infeaed when the  air is bad.  All hofpitals, and places
of reception for the fick, ought to  have an open fituation,
at fome diftance from any great town, and fuch patients as la-
bour under any infeaious difeafe ought never to be fuffered
to come near the reft.
                     CHAP.     V.

           OF    EXERCISE.

         MANY people look upon the neceflity man is under of
          earning his bread by labour,  as a Curfe.   Be this as
   it may, it is evident from the ftruaure of the body, that ex-
   ercife is not lefs neceffary than food  for the prefervation of
   health:  Thofe whom poverty obliges  to  labour  for daily
   bread, are not only the moft healthy,  but generally the moft
   happy part of mankind.  Induftry feldom fails to place fuch
   above want, and aaivity ferves them inftead of phyfic. Thw
*  is peculiarly the cafe with thofe who live by the culture of
                                                        the 
              OF    EXERCISE.            83

the ground.   The great increafe of inhabitants in infant co-
lonies, and the common longevity of fuch as follow  agricul-
ture every where, evidently prove it to  be the moft healthful
as well as the mdft ufeful employment.
   The  love of aaivity fhews itfelf very early in  man.   So
ftrong is this principle, that a healthy youth cannot be  re-
ftrained from exercife, even by the fear of punifhment. Our
love of motion is furely a ftrong proof of its utility.  Nature
implants no difpofition in  vain.  It feems to be  a catholic
Jaw throughout the whole animal creation, that no fcreature,
without exercife, fhould enjoy health, or be able to find fub-
fiftence.   Every creature, except man, takes as much of it as
is neceffary.  He alone,  and fuch animals  as are under  his
direaion, deviate from this original law, and they fuffer ac-
cordingly.
   Inaaivity never fails to  induce an univerfal  relaxation of
the folids, which difpofes the body to  innumerable  difeafes.
When the folids are relaxed, neither the digeftion, nor any of
the fecretions, can be duly performed.   In this cafe the worft:
confequences  muft'enfue.  How can perfon  who loll all
day in eafy chairs, and fleep all night on beds of down, fail
to be relaxed ?  Nor do fuch greatly mend  the  matter, who
never ftir abroad but in a coach, fedan,  or fuch like.   Thefe
elegant pieces of luxury are become fo common, that the in-
habitants of great  towns feem to be in  fome danger  of lofing
the ufe  of their limbs altogether.  It  is now below any one
to walk, who can afford to be carried.  How ridiculous would
it feem, to a perfon unacquainted with modern luxury, to  be-
hold the young and healthy fwinging along  on  the fhoulders
of their fellow-creatures ! or to fee a fat carcafe, over-run
with  difeafes occafioned by  inaaivity,  dragged along  the
ftreets by  half a dozen horfes * !
   Glandular obftruaions, now fo common, generally pro-
ceed from inaaivity.   Thefe are the moft obftinate of all ma-
ladies.  So long as the liver, kidnies, and other glands, duly
perform their funaions,  health is feldom  impaired; but,
when they fail,  nothing can preferve it.  Exercife is almoft
                                                      the

  * It is not neceflity, but fafhion, which makes the ufe of machines
Xo common.   There are many people who have not exercife enough
to keep their humours from ftagnation, who yet dare not venture to
make a vifit to their next neighbours, but  in a coach or fedan, left
they fhould be looked down upon.  Strange that men fhould be fuch
fools as to be laughed out of the ufe of their limbs, or to throw away
their health,  in order to gratify a piece of vanity, or to comply with
a ridiculous fafhion ! 
84             OF    EXERCISE.

the only  cure we know for glandular obftruaions ;  indeed,
it does not always fucceed as a remedy ; but there is reafon
to believe, that it  would  feldom fail  to prevent thefe com.
plaints, were it ufed indue time.   One thing is certain, that,
amongft  thofe who  take fufficient exercife, glandular difeafes
are very little  known ;  whereas  the  indoltnt and  inadtive
are feldom free from them.
   Weak nerves are the conftant companions of  inaaivity,
Nothing but exercife and  open air can brace and  ftrengthen
the nerves, or prevent the endlefs train of difeafes which pro-
ceed from a relaxed ftate of thefe  organs.   We feldom hear
the aaive or laborious complain of  nervous difeafes ; thefe
are referyed for the fons of eafe and affluence.   Many have
been  completely cured  of thefe diforders by being  reduced
from a ftate of opulence, to labour for their daily bread. This
plainly points out the fources from whence nervous difeafes
flow, and the means by which they may be prevented.
   It is abfolutely impoflible to enjoy health, where  the per-
fpiration is not duly carried on ;  but that can  never be the
pafe where exercife is negfeaed.   When the  matter which
ought to  be thrown  off by perfpiration is retained in the body,
it vitiates the humours, and occafions  the gout, fevers, rheu-
matifm,  &c. Exercife would prevent  many of thofe difeafes,
which cannot be cured,  and would remove others  where me?
dicine proves ineffe&ual.
   A late author*,  in his  excellent  treatife on health, fays,
that the weak and valetudinary ought to make exercife  a part
of their religion.  We would recommend  this,  not only to
the weak and valetudinary but to all  whofe bufinefs  does not
oblige them to take fufficient exercife, as fedentary artificers f,
jfliop-keepers, ftudious perfons, &c.   Such ought to ufe ex-
ercife as regularly as they take  food.  This might generally
be done without any interruption to bufinefs or  real lofs of
time.
                                                      No
         * Cheyne.
  t Sedentary occupations ought chiefly to be'followed by women.
They bear confinement much better than men, and are fitter for eve-
ry kind of bufinefs which does not require  much ftrength  It is ri-
diculous enough  to fee a nifty fellow making  clothes, pin's, needles,
or watch-wheels, while many ofthe  laborious parts of hufbandry
are carried on by the other fex.  The fact is, we want men for labo-
rious employments, while one half ofthe other fex are rendered ufe-
jefefor want of occupations fuited to their ftrength, &c.  Were girls
bred to mechanical employments, we fhould not fee fuch numbers of
them proftitute themfelves for bread, nor find fuch want of men for
tfie important purpofes of navigation, agriculture, &c. 
           OF    EXERCISE.              85

  No piece of indolence hurts the health more than the mo-
dern cuftom of lolling a-bed too long in  a morning.  This is
the general praaice in  great towns.   The inhabitants of ci-
ties feldom rife before eight or nine o'clock ;  but the morn-
ing is undoubtedly  the beft time for exercife, while the fto-
mach is empty, and the body refiefhed  with  fleep.  Befides
the morning air braces and ftrengthens  the nerves, and, in
fome meafure, anfwers  the purpofe of  a  cold bath.  Let any
one who has been accuftomed to lie a-bed till eight or  nine
o'clock, rife by fix or feven, fpend a couple of hours in walk>
ing, riding, or any active diverfion without doors, and he
will find his fpirits cheerful and ferene  through the day, his
appetite keen, and his  body braced and ftrengthened. Cuftom
foon renders early rifing agreeable,  and nothing contributes
more to the prefervation of health.
   The inaaive are continually complaining of pains of the
ftomach, flatulencies, indigeftions,  &c.   Thefe complaints,
which pave the way to many others, are  not to be rtmoyed by
medicines.  They can only be cured by a vigorous courfe of
exercife, to which indeed they feldom fail to yield.
   Exercife, if poffible, ought always to be taken in the  open
ait.   When that cannot be done,  various  methods may be
contrived for exercifing the body within doors,  as the dumb
bell, dancing,  fencing, &c.  It is not neceffary to adhere
ftrictly to any particular kind of exercife.   The beft way is
to take them by turns, and to ufe that  longeft which is moft
fuitable to the ftrength and conftitution.  Thefe kinds of ex-
ercife  which give aaion to moft ofthe  bodily organs, are al-
ways to be preferred, as  walkirig, running, riding, digging,
fwimming, and fuch like.
   It is much to be regretted, that aaive and manly diverfions
are now fo little praaifed,  Diverfions make  people take
more exercife than they otherwife would do, and are of the
greateft fervice to fuch as are not under the neceflity  of la-
bouring for their bread.   As aaive diverfions lofe ground,
thofe of a fedentary kind feem to prevail.  Sedentary diverfi-
ons are of no other ufe but to confume time.  Inftead of re-
lieving the mind,  they often require more  thought than ei-
ther ftudy or bufinefs.  Every thing that induces people to
fit ftill, unlefs it be fome neceffary employment, ought to be
avoided.
   The diverfions which afford the beft  exercife are, hunting,
(hooting,  playing at cricket, hand-ball, golff*,  &c.  Thefe
                                                exercife
  *  ColfTis a diverfion very  common in North Britain.  It is well.
                                                calculated 
$6             OF    EXERCISE.

 exercife the limbs, promote perfpiration, and the other fecre-
 tions.  They likewife ftrengthen the lungs, and give firm-
 nefs and agility to the whole body.
   Such as can, ought to fpend two or three hours a-day on
 horfe-back ;  thofe who cannot ride fhould  employ the fame
 time in walking.   Exercife fhould never  be continued too
 long.  Over-fatigue prevents  the benefit  of exercife,  and
 weakens inftead of ftrengthening the body.
   Every man fhould lay himfelf under fome fort of neceflity
 to take exercife. Indolence, like other vices, when indulged,
 gains ground, and at length becomes  agreeable.   Hence, ma-
 ny who were fond of exercife in the early part of life, become
 quite averfe from it afterwards.  This is the cafe of moft hy-
 pochondriac and gouty people, which renders their difeafes
 jn a great meafure incurable.
   In fome countries laws have been made, obliging every
 man, of whatever  rank, to learn fome mechanical employ-
 ment.  Whether fuch laws  were defigned for the preferva-
 tion of health, or the encouragement of manofaaure,  is a
 queftion of no importance. Certain it is,  that if gentlemen
 were frequently to amufe and exercife themfelves in  this
 way, it might have many good effeas.   They would at leaft
 derive as much honour from a few mafterly fpecimens of their
 own workmanfhip, as from the charader  of having ruined
 moft of their companions by gaming, or drinking.  Befides,
 men of leifure, by applying themfelves to the mechanical arts,
 might improve them,*-to the great benefit of fociety,
   Indolence not only occafions difeafes, and renders men ufe-
 lefs to fociety,  but promote* all manner of vice.  To fay a
 man  is idle, is little better than calling him vicious.   The
 mind, if not engaged in fome ufeful  purfuit, is  conftantly in
 queft of ideal pleafures, or  impreffed with the apprehenfion of
 fome imaginary evil.  From thefe fources proceed moft ofthe
 miferiesof mankind.  Certainly man was never intended to
 ■be idle.   Inaaivity fruftrates the very defign of his creation ;
 whereas an aaive life is  the beft guardian of virtue, and the
 greateft prefervative of health.


                                             CHAP,
 calculated for exercifing the body, and may always be taken in fuch
 moderation, as neither to over-heat nor fatigue.  It has greatly the
. e3^ssaris> w aay °f ,hofc gam" ™h1d>"»- 
C   87    J
                CHAP.     VI.

    OF  SLEEP   AND  CLOTHING.

    SLEEP, as well as diet, ought to be duly regulated,/
     Too little fleep weakens the nerves,  exhauft the fpirits,
and occafions difeafes ;  and too much renders the mind dull^
the body  grofs, and difpofes to apoplexies, lethargies, and
fuch like.  A medium ought therefore  to be obferved ; but
this is not eafy to fix.   Children require more fleep tharif
grown perfons, the laborious than  the idle, and fuch as eat
and drink freely, than thofe who live abftemioufly.  Befides,
the real quantity of fleep cannot be meafured by time; as one
perfon will be more refrefhed by five or fix hours fleep, than
another by.eight or ten.
   Children may always  be allowed to take as much fleep  as
they pleafe; but, for adults, fix or feven hours is  certainly
fufficient, and  no  one  ought to exceed eight.  Thofe who
lie more than eight hours a-bed may flumber, but they can
hardly be faid to fleep ;  fuch generally tofs and dream  away
the fore-part of the night, fink to reft towards  morning, and
dofe till noon.  The beft way to make fleep found and  re-
frefhing is to rife betimes.   The cuftom of lolling a-bed for
nine or ten  hours,  not only makes  the fleep lefs refrefhing,
but relaxes  the nerves, and  greatly  weakens  the conftitu-
tion.
   Nature points out  night  as the proper feafon for fleep.
Nothing more certainly deftroys the conftitution than night-
watching.   It is great pity that a praaice fo  deftruaive  to
health fhould be fo much infafhion.  How quickly  the wane
of reft in due feafon will blaft the moft blooming complexi-
on, or ruin the beft conftitution, is evident from the ghaftly
countenances of thofe who,  as the phrafe is, turn dayi nto
night, and night into day.
   To make fleep refrefhing, the following things are requi-
fite.   Firft,  to take  fufficient exercife  in  the  open air,
through the day ; next,  to eat a light fupper;  and laftly,  to
lie down with a mind as cheerful and fereneas poffible.
   It is certain that too much exercife will prevent fleep,  as
well as too little.   We feldom however hear the aaive and
laborious complain of  reftlefs nights.  It is the indolent and
flothful  who generally have thefe complaints.  Is it any won-
der that a bed. of down fhould not be refrefhing to  a perfon
                                                   who 
88     OF  SLEEP  AND  CLOTHING.
  who lolls all day in an eafy chair ? A great part of the plea-
  fure of life confitts in alternate reft and motion; but they
  who neglea the latter can  never relifh the former*  The
  labourer  enjoys more true luxury in plain food  and found
  fleep, than is to be found  in  fumptuous  tables and  downy
  pillows,  where exercife is wanting.
    That light fuppers caufe found fleep, is true even to a pro-
  verb.   Many perfons,  if they exceed the leaft at  that meal,
  are fure to have uneafy nights;  and, if they fall sfleep, the
  load and  oppreffion on their ftomach  and  fpirits occafion
  frightful dreams, broken and difturbed repofe, night-marea,
 ice.  Were the fame perfons to go to bed with a light  fup.,
 per, or  fit up  till  what they eat were pretty well digefted,
 they would enjoy (bund fleep/,  and rife refrefhed and  cheer-
 ful.  There are indeed fome people who cannot fleep unlefs
 they ha^e  eat fome folid food at night, but this does not im-
 ply the neceflity of a heavy fupper; befides, thefe are gene-
 rally perfons who have accuftomed themfelves to this method,
 and who do not take a fufficient quantity of folid food through
 the day.  .
   Nothing more certainly  difturbs our repofe than anxiety.
 When the mind is not at eafe, one feldom  enjoys found fleep.
 That greateft of human bleifings flies the wretched, and vi-
 fits the happy,  the cheerful, and the gay.   This is a fuffici-
 ent reafon  why every man fhould  endeavour to be as eafy in
 his mind as poffible when he goes to reft.   Man v, by indulg-
 ing grief and anxious thought,  have  banifhed found fleep fo
 long, that they could never afterwards enjoy it.
   Sleep, when taken in the fore-part of the night, is gene-
 rally reckoned moft  refrefhing.  Whether this be  the effea
 of habit or not, is hard to  fay ; but, as moft people are ae-
 cuftomed to go early to bed when young,  it may be prefum-
 ed that fleep at this feafon will prove moft refrefhin<* to them
 ever after.  Whether  the fore-part of the night be beft for
 fleep or not, furely the fore-part of the day is fitteft both for
 bufinefs and amufement.  I hardly ever knew an early rifef
 who did not enjoy a good ftate of health.

                      Of Clothing.
  The clothing ought to be foiled to the climate.   Cuftom
has no doubt a very great influence in this article ; but no
cuftom can ever change the nature of thines fo far,  as  to
render the clothing fit for an inhabitant of Nova Zembla and
the ifland of Jamaica.   It is not indeed neceffary to obferve
                                                     an 
     OF  SLEEP  AND  CLOTHING.     &$

an eyaa proportion betwixt the quantity of clothes we wear,
and the degree of latitude which we inhabit; but at the fame
time, proper attention ought to be paid to it,  as  well as to
the opennefs ofthe. country,  the  frequency,and violence of
ftorms, &c.
   In youth, while the blood is hot and,the perfpiration free,
it is lefs neceflary  to cover the body with a great quantity of
clothes ;  but,  in the decline of life, when the fkin becprnes
rigid and the humours cool, the. clothing fhould. be increafed.
Many difeafes  in  the latter period of life, proceed from a  de-
f?a of perfpiration;  thefe may, in fome meafure,  be  pre-
vented by a fuitable addition to the clothing,  or by wearing
fuch as are better calculated for promoting the  difcharge from
the fkin,  as clothes made of  cotton, fla.nnel,  &c.
   The clothing ought likewife to be.foiled to the feafon of,
the year.   Clothing may be warm enough for fumrner, which
is by no means fufficient for winter.  The greateft caution,
however, is neceffary in making thefe changes.   We.•ought,
neither to put off our WJBter clothes too foon,, nor wear our
 fummer ones too long.  In this country, the winter often fets.
 in very early with great rigour, and we have  frequently very.
 cold weather,  even  after, the commencement of the fummer
 months.  It  would  likewife be prudent not to make the.
 change all  at.once, but to do it gradually;  and indeed, the
 changes of apparel in this climate ought to be very inconfir
 derable, efpecially among thofe who have paffed the meridian
 of life.
    Clothes often become hurtful by their being made fqbfervi-
 ent to the purpofes of pride or vanity.   Mankind in  all ages
 feem  to have confidered clothes in this view,;  accordingly
 their  fafhion  and figure have been continually varying,  with
 very little regard either to health, the climate, or conveni-
 ency : A farthingale, for example, may be very, neceffary in
 hot fouthern  climates, but furely nothing can be more ridicu-
 lous in the cold regions of the north.
    Even the human fhape is often attempted to be mended by
  drefs, and  thofe who know, no  better  believe that mankind
  would be  monfters  without its affiftance.   All attempts of
  this nature are highly  pernicious.  The moft deftruaive of
  them in this  country is  that of  fqueezing the  ftomach and
  bowels into  as  narrow  a  compafs as poffible, to  procure,
  what isfalfely called, a fine fhape.  By this praaice the  ac-
  tion of the ftomach and bowels,  the motion  of the heart and
  lungs,  and  almoft  all the vital funaions,  are  obftruaed.
                            I                    ■ Hence 
 90     OF  SLEEP  AND  CLOTHING.

 Hence proceed indigeftions, fyncopes, or fainting fits,coughs;
 confumptions of the lungs, &c.
   The feet likewife often  fuffer by preffure.   How  a fmall
 foot came to be reckoned genteel,- 1 will not pretend to fay;
 but certain it is, that this notion has made many  perfons
 lame.   Almoft nine-tenths of mankind are troubled with
 corns  : a difeafe that is  feldom or never occafioned  but by
 ffrait fhoes.  Corns are not only very troublefome, but, by
 rendering people unable to walk,  they  may likewife be con-
 ■fidered as the remote caufe of other difeafes.
   The fize and figure of the fhoe ought certainly to be adapt-
 ed to the foot.   In children the feet are as well  fhaped as the'
 hands, and the motion of the toes fhould be as  free and eafy
 as that of the fingers; yet few perfons in the  advanced peri-
 ods of life are able to make any ufe of their toes.   They are
 generally,  by narrow fhoes, fqueezed all of a heap, and of-
 ten laid over one another in fuch a manner as to be rendered
 altogether  incapable of  motion.  Nor is the high heel lefs
 hurtful than the narrow toe.   A  lady may  feem  taller for
 walking on her tip-toes, but fhe will never walk well in this
 manner.  Itftrains her  joints, diftorts her limbs, makes her
 ftoop, and utterly deftroys all  her eafe  and  gracefulnefs of
 motion: It is  entirely  owing to fhoes with  high  heels and
 narrow toes,  that not one female in ten can be  faid to walk
 well.
   In fixing on the clothes, due care fhould be taken to avoid
 all tight bandages.  Garters, buckles, &c. when drawn too
 tight,  not only prevent the free motion  and ufe of  the parts
 about which they are bound', but likewife obftrua the circu-
 lation  of the blood, which prevents the  equal  nourifhment
 and growth of thefe parts,  and' occafions  vaiious difeafes.'
 Tight bandages about the neck,, as flocks, cravats, neckla-
 ces, &c. are  extremely dangerous.  They obftrua the blood
 in its courfe from the brain, by which means head-achs, ver-
 tigos,  apoplexies, and other fatal difeafes are often  occafi-
 oned.
   The perfection of drefs is to be eafy and clean.  Nothing-
 can be more ridiculous,  than for  any one to  make himfelfa
 flave to fine clothes.  Such a one,  and many  fuch there are,
 would  rather remain as fixt as a ftatue from mornin* to night,
than difcompofe a hair, or alter the pofition of a ptn.  Were
we to  recommend any particular pattern for drefs,  it would
be tnat which is worn by the people called Quakers.   They
are always neat, clean, and often elegant,  without any thing
                                             fuperfluous. 
      OF  SLEEP AND  CLOTHING.    91

fuperfluous.  What others lay out upon tawdry laces, ruffles,
and ribands,  they beftow upon fuperior cleanlinefs.  Finery
is only the afteaation of drefs, and very often covers a great
deal of dirt.
   We fhall only add, with regard to clothing,  that it ought
not only to be fuifeed  to the climate, the feafon of the year,
and the period of life ;  h>it  likewife to the temperature and
conftitution.   Robuft perfons are able to endure either cold
or heat better than the delicate ; confequently may be lefs at-
tentive to their clothing.  But the precife quantity of clothes
neceffary for  any perfon cannot be determined by reafoning.
It is entirely a matter of experience, and every man is the belt
judge  for himfelf what quantity of clothing is neceffary to
keep him warm.


                CHAP.     VII.

       OF   INTEMPERANCE.

      AM O D E R N author * obferves, that temperance and
       exercife are the two beft phyficians. in the world.   He
might have added, that if thefe were duly regarded,  there
would be little occafion  for any other.   Temperance may
juftly  be called the  parent of health ;  yet numbers  of  man-
kind aa as if they  thought   difeafes and death too  flow in
their progrefs, and by intemperance and debauch, feem as it
were, to folicit their approach.
   The danger of intemperance appears from the very con-
ftruaion ofthe human body.   Health  depends on that ftate
ofthe folids and  fluids which fits them for the due perform-
ance of the vital  funaions ; and,  fo long  as thefe go regu-
larly on, we are found and well;  but whatever difturbs them
neceffarily impairs health.  Intemperance, however, never
fails to diforder the  whole animal  ceconomy ;  it hurts  the
digeftion, relaxes the nerves,  renders the different fecretions
irregular, vitiates the humours, and occafions numberlefs dif-
eafes.
   The analogy between the nourifhment of plants and ani-
mals affords a ftriking proof of the danger of intemperance.
Moifture and manure greatly promote vegetation;  yet,  an
over-quantity of either  will entirely deftroy it.  The beft
things become hurtful, nay  deftruaive,  when carried to ex-
                                                   cels*
             * Rouffeau, 
92
OF    IN  T  E M P E R  AN  C X.
 cefs.  Hencewe learn,  that  the  higheft degree  of human
 wifdom confifts in regulating our appetites and paflions fo aa
 to avoidall extremes.  It is that chiefly which entitles us to
 the charaaer of rational  beings.   The flave of appetite will
 ever be the difgrace of "human nature.
   The Author of Nature hath endued us with various paf-
 fions, for the propagation of the fpecies, the prefervation of
 the individual, &c.   Intemperance is the abufe of thefe pat
 fions; and moderation  confifts in the proper regulation  of
 them.  Men,  not contented with Satisfying the fimple calls
 of Nature,  create artificial wants, and  are perpetually  in
 fearch of  fomething that may gratify them ; but imaginary
 wants never dan be gratified.  Nature is content with little;
 but luxury  knows  no  bounds.  Hence  the  epicure, the
 drunkard, and the debauchee, feldom flop in their carreer, till
 their money, or their conftitution, fails :  Then indeed they
 generally fee their efror when too late.
   It is impoffible to lay down fixt rules with regard to diet,
 on account of the different conftitutiorts of mankind.  The
 moft ignorant  perfon, however,  certainly  knows  what  is
 meant by excefs,; and it  is ih the power of every man, if he
 chufes, to avoid it.
   The great rule of diet, is*to  ftudy fimplicity.   Nature de-
 lights in the moft plain  and fimple food, and  every animaj,
-except man, follows her diaates.  Man alone  riots at largf,
 and ranfacks the Whole creation in queft of luxuries, to his
 own deftruaion.   An elegant writer * of the laft  age fpeaks
 thus of intemperance in diet :  " For my part,  when I be-
 *'  hold a faftnonable table fet  out  in all its magnificence, I
 "  fancy that l; feeqgouts  and dtopfies,  fevers and lethargies,
 «'  with other: innumerable diftempers, lying in  ambufcade
 "  among the rhflies."
   Nor is intemperance in: other things lefs  deftruaive than
 in diet.   Howiquickly does the immoderate purfuit of car-
 nal -pleafures, or rhe>abufe of intoxicating liquors,  ruin the
 beft conifticotion I  indeed thefe  vices  generally go  hand in
•hand.  Hence it is:that we fo  often  behold the votaries  of
 Bacchus  and Venus, even before they  have arrived at the
 prime of life, 'worn out with difeafes,  and hafting with fwift
•pace to an untimely grave.  Did  men reflea en the painful
 difeafes, and premature deaths,'which are  daily occafioned by
 intemperance, it would  be fiifficient to make  them  fhrink
 back with horror from the indulgence even Of  their darlin*
 pleafures.                                              °
                 :  .„.,.                    Intemperance
                * Addifon. 
O F   T/NTr^M'.P-E-R.A-N C E.
m
   Intemperance does not hurt its  votaries  alone ;  the inno-
 cent too often feel theTdbirtful effeas of it. How many wretch-
 ed orphans are to be feen embracing 'dunghills,  whofe pa-
 rents,  regard lefs of the future, fpent in  riot and debauch,
 what might -have  ferved to bring up theinoffspring  in a de-
 cent manner ? How often do we  behold the'miferable:mo-
 ther, with'her he) plefsf infants,  pining in want, whilethe
 cruel father  is indulging hi*infatiateoappetites ?
   Families are not only reduced tomifery, but even extirpat-
 ed by intemperance.  Nothing tends-fo much to prevencpro-
 pagation, and to  fliorten the lives of children,: as the intem-
 perance of parents.  The poor man who labours all day,  arid
 at night lies down contented with his humble fare, can boaft
 a numerous offspring,'while his pampered  lord, funk in eafe
 and luxury,  often  languishes without' an: heir to his ample
 fortunes.  Even ftatfcs andempires feelthe influence of in-
 temperance, arid life or-fall as it prevails.
   Inftead of mentioning'the different kinds of intemperance,
 and pointing out their influence on health,  we fhall only, by
 way of example, make a few Obfervations on one particular
 fpecies of that vice, viz.  the ufe of intoxicating liquors.
   Everyaa of intoxication puts  Nature to the expence of a
 fever, in order to difcharge the poifonous draught.  When
'this is repeated almoft every day, it is eafy to forefee the  con-
 fequences.  That conftitution muft be ftrong indeed, -which
 is able long to hold out under a daily fever ! But fevers oc-
 cafioned by  drinking do not alway*go off in a day; they fre-r
 qaently end in an inflammation of the breaft, liver, -or brain,
-and produee fatal effeas.
   Though the drunkard feould not fall by an  acute difeafe,
 he feldom efcapes thofe of a Chronic kind.  ' Intoxicating li-
 quors,' when ufed to excefs, ^weaken the bowels and fpoil the
 digeftion ; they deftroy thecpower of the nerves, and occafion
 paralytic and  cottviilfive diforders ; they  likewife heat and
 inflame the  blood, deftrOy its  balfamic quality, render it  unfit
 for  circulation, arid  the1 nourifhment Of the body. 'Hence
 obftruaions, -atrophies,' dropfies,  and ednfumptions of the
 lungs.   Thefe are the common ways in  which drunkards
 make their exit.  Difeafes of this-kind, when brought on.by
 hard drinking, feldom admit of a  cure.
   Many people injure their health by drinking,  who feldom
• get drunk.   The continual habit  of foaking,  as it- is called,
 though its effeas bcflOtfo violent, is  not lefs pernicious.
 When the veffels are kept conftantly full and upon the ftretch,
                                                     the 
94      OF    INTEM P E RANCE,
  the different digeftions can neither be duly  performed,  nor
  the humours properly  prepared.   Hence moft people of this
  charader are affliaed  wkh the  gout,  the  gravel,  ulcerous
  fores in the legs, Uc. If thefe diforders do not appear,  they
  are feized with  low  fpirits,  hypochondriacal diforders,  and
  other f) mptoms of indigeftion.
    Confurpptions are  now fo common, that it is thought one-
  tenth of  the inhabitants of great towns die of that difeafe.
  Hard drinking is no doubt one  of the  caufes to which we
  muft impute the increafe of confumptions.   The great quan-
  tities of vifcid malt-liquor drank by the common people of
  England,  cannot..faii to render the blood fizy and unfit for
 circulation ; from whence  proceed obftruaions, and inflam-
 mations ofthe lungs.   There are few great ale-drinkers who
 are not phthifical: nor is that to be wondered at, confidering
 the glutinous and almoft indigeftible nature of ftrong ale.
   Thofe  who drink ardent fpirits or  ftrong wines  run ftill
 greater hazard; thefe  liquors heat and inflame the blood, and
 tear the tender veffels of the lungs in  pieces ; yet fo great is
 the confu mption of them in this country, that one would al-
 moft be induced to think the inhabitants lived upon them.
   The habit of  drinking  proceeds frequently from  misfor-
 tunes in life.  The miferable fly  to it for relief.   It affords
 them indeed a temporary  eafe.   But,  alas ! this folace js
 fhort-lived ;  and when it is over, the fpirits fink as much be-
 low their ufual tone, as  they had before been raifed above it.
 Hence a repetition of the dofe becomes neceffary,  and every
 frefh dofe makes  way for another, till the unhappy  wretch
 becomes a flave to the bottle, and at length falls a facrifice to
 what at firft perhaps was taken only as a medicine.  No man
 is fo dejeaed as the drunkard when his debauch is gone off.
 Hence it is,  that thofe who have the greateft flow of fpirits
 while  the glafs circulates freely,  are of all  others the moft
 melancholy when fober   and often put an end to  their own
 miferable exiftence in  a fit offpleen or ill humour.
   Drunkennefs not only proves deftruaive  to  health,  but
 hkewife to the  faculties of the  mind.  Ic is ftrange  that
 creatures who value themfelves on account of aZ
 gree of reafon to that of brutes,  fhould take pleafurein f nk-
 ngfofar  below  them.   Were  fuch  as  voluntarily  demive
themfelves of the  ufe of reafon, to continue ever after in that
condition   it would feem but a juft ,nmifl»^t. ^JoSS
tins  be not the confequence of one aft  of intoxication, it fel-
                                                    dom 
       OF    INTEMPERANCE.      95:*

dom fails fo Aicceed a courfe of it.   By a habit of drinking,
the greateft  genius is often reduced to a mere idiot *.
  Intoxication is peculiarly hurtful to young perfons.   It
heats their blood, impairs their ftrength,  and obftruas their
growth ; befides,  the frequent ufe of ftrong liquors,  in  the
early part of  life, deftroys any benefit that might arife from
them afterwards.   Thorfe who  make a praaice of drinking
generous liquors when young, cannot expea to reap any  be-
nefit from' them as a cordial in the decline of life.
  Drunkennefs is not only in itfeJf a moft abominable vice,
but is an inducement to many others.   There is  hardly any
crime fo  horrid that  the drunkard will not perpetrate for  the
love of liquor.   We have known mothers fell their children's
clothes,  the food that they fhould have eat,  and  afterwards
even the children themfelves,,  in order to purchafe the  ac-
curfed  draught.


               C    HA   P.     VIII.

           OF   CLEANLINESS.

      TH  E  want of creanlinefs is a fault which admits of no
       excufe.  Where water  can be had for nothing,  it is
furely in the power  of every perfon to be clean.  The con-
tinual difcharge from our bodies by perfpiration, renders fre-
quent change of  apparel neceffary.   Changing apparel great-
ly promotes the  fecretion  from the  fkin, fo  neceffary  for
health.   When that matter which ought  to be carried off by
perfpiration, is eitheir retained in the body, or reforbed from
dirty clothes, it muft occafion  difeafes.
  The itch, and feveral other difeafes of  the fkin, are chief-
ly  owing  to want  of clean!inefs.   They  may indeed be
                                                   caught
  •*  It is amazing, that our improvements in arts, learning, and  po-
litenefs have not put the b'arbarous  cuftom of drinking to excefs  out
of falhion.  It is indeed lefs common in South Britain than it was
formerly ; but it ftill prevails very much in the: North, where  this
relic of barbarity is miftaken for hofpitality.  There no man is fup-
eofed to entertainhis guefts well,  who does not make them drunk.
Forcing people to drink, is certainly the greateft piece of rudenefs
that any man can be guilty of.  Manlinefs, complaifance, or mere
good nature, may induce a man to take his glafs, if urged to it at a
time when he might as well take poifon.  The cuftom of drinking to
excefs has long been out of fafhion in France; and, as itbeginsto
lofe ground among the politer part ofthe Engfifli, we  hope ft wiU
foon bebaniihedfrom every part. 
tf        O  F   CLE  A  N  L I N E S S.
taught by infeaion, or brought on by-poor living, unwhole-
fome food, &c. but they will feldom continue  long.where
cleanlinefs prevails.  To the fame caufe muft we impute the
various kinds of vermin which infeft the human body, boufes,
&C.   Thefe may always be  bauifhed by-cleanlinefs -alone*
and wherever they abound, we have reafon to believe it is'
negleaed.
  One common caufe of putrid and  malignant fevers is the
want of cleanlinefs.  Thefe fevers commonly begin among
the inhabitants of clofe dirty houfes, who breathe  unwhole-
fome air, take little exercife, and wear dirty clothes.   There
the infection is generally hatched, which  often  fpreads far
and wide, to the  deftruaion of many.  Hence cleanlinefs
may  be confidered  as an  objea of public attention.   It is
not fufficient that I be clean myfelf, while the want of it in
my neighbour aff'eas my health as well  as his own.  If dirty
people cannot be removed as a common  nuifance, they ought
at leaft to be avoided as infeaious.  All  who regard  their
health fhould keep at a diftance even from their  habitations.
  In places  where great  numbers  of people are colleaed,
cleanlinefs becomes of the utmoft-importance.   It is  well
known, that infeaious difeafes are communicated by tainted
ajr.  Every thing* therefore, which tends to pollute the air*
or fpread  the infeaion, ought with the utmoft  care to be
guarded againft.   For this reafon* in great towns, no filth,
of any  kind, fhould be  permitted  to  lie upon  the ftreets.
Nothing is more apt to convey infeaion than the excrements
of the difeafed.
  In  many  great  towns  the ftreets  are  little  better than
dung-hills, being frequently covered with aflies,  dung, and
naftinefs of every kind.  Even flaughter-houfes,  or killing
fbambles, are often to  be feen  in  the  very  center of great
towns.   The putrid blood, excrements, &c. with  which
thefe places are generally covered, cannot fail to taint the air
and render it unwholefome.   How eafily  might this be pre-
vented by aaive  magistrates, who  have it  always in  their
power to  make proper laws relative to things of this nature,
aad to enforce the obfervance of them !
 ■  We are forry to fay, that the importance of general cleaff-
Knefs does not feem to be fufficiently underftood by the ma-
gi ftrates ofmoft great towns in Britain; though health, plea.
t^5;  an^d"l,cacy' a»  confPir« to recommend an attention
Slki,       */*! ^rre aSreeable to the fenfes,  more
to the.honour  of the inhabitants, or more conducive to the;
                                                  health* 
OF  CLEANLINESS.
97
health,  than a clean town ; nor can any thing  imprefs a
ftranger with a more difrefpeaful idea of any people than its
oppofite.  Whatever pretentions people may make to learn-
ing, politenefs, or  civilization,  we  will  venture to affirm,
that fo long as they neglea cleanlinefs,  they are in a ftate of
barbarity *.
  The peafants in moft countries feem to hold cleanlinefs in
a fort of contempt.  Were it not for the open fituation of
their houfes", they  would  often feel the bad effeas of this"
difpofition.  One feldom fees a farm-houfe without a  dung-
hill before the door, and frequently the  cattle and their maf-
ters lodge under the fame roof.   Peafants are likewife ex-
tremely carelefs  with refpea to change of apparel, keeping
their houfes,  &c. clean.   This  is merely the effea of indo-
lence and  a dirty difpofition.  Habit may indeed render it lefs'
difagreeable to  them, but no habit can ever make it falutary
to wear dirty clothes, or breathe unwholefome air:
  As many articles of  diet come through the hands of pea-
fants, every method fhould be taken to  encourage and pro-
mote habits of cleanlinefs among them.   This, fbregamplej
might be done by giving a fmall premium to the perfon who
brings  the cleaneft and  beft articles to market, as butter,
cheefe, &c. and by punifhing feverely thofe who bring them
dirty.  The fame method fhould be taken with butchers, ba-
kers, brewers, and all who are employed in  preparing the
neceffaries of life.
  In camps the ftriaeft regard fhould be paid to cleanlinefs.
By  negligence in this  matter,  infeaious difeafes are often
fpread amongft  a  whole army; and frequently more die of
thefe than by the fword.   The Jews, during their  encamp-
ments in the wildernefs, received particular rnftro&ions with
refpea  to cleanlinefs f.   The ruies enjoined them ought to>
be  obferved by all in the like fituation.   Indeed  the  whole
                            K                     fyftent

  # In ancient Rome the  greateft men' did not thinx cleahlinefs an
object unworthy of their attention.   Pliny fays, the Cloacae, or com-
mon fewers for the conveyance of filth and  naftinefs from the city,
were the greateft of all the public Works ; and beftows higher enco-
miums upon Tarquinius, Agrippa, and others Who made and im-
proved them, than on thofe who atchieved the greater! conquefts.
  + Thou flialt have a place alfo without  the camp, whither thou
ftialt go forth abroad : and thou ihalt have a paddle upon thy wea-
pon : and  it fhall be when thou ftialt eafe thyfelf abroad, thou (halt
dig therewith, and fhalt turn back, and cover that which cometh
from thee, frc.                         Deuter. xxiii. «, 13. 
98       OF  CLEANLINESS.

fyftem of laws delivered to that people has a manifeft tenden-
cy to promote  cleanlinefs.  Whoever confiders the nature
of their  climate, and the difeafes to which they were liable,
will fee the propriety of fuch laws.
   It is remarkable, that, in moft eaftern countries,  clean-
linefs makes a great part of their religion.   The Mahomet-
an,  as well as the Jewifh religion, enjoins various bathings,
wafhings, and purifications.  No doubt thefe might be de-
figned to reprefent inward purity ; but they were at the fame
time calculated for the  prefervation  of health.  However
whimfical thefe  wafhings may  appear to fome, few things
would tend more to prevent difeafes  than a proper attention
to many of them.  Were every perfon, for  example, after
vifiting the  fick, handling  a dead body, or touching  any
thing that might convey infeaion, to wafh  before he  went
into company, or fat down to meat,  he would  run lefe ha-
zard either of catching the infeaion himfelf,  or of  commu-
nicating it to others.
   Frequent  wafhing not only removes  the filth  and fordes
which adhere to the fkin,  but likewife promotes the perfpira-
tion, braces the body,  and enlivens the  fpirits.    How re-
frefhed, how cheerful, and agreeable does one feel on being
waved, wafhed, and lhifted ; efpecially  when thefe offices
have been negleaed longer than ufual!
  The eaftern cuftom of wafhing the  feet,  though  lefs ne-
ceffary in this country, is neverthelefs a very agreeable piece
of cleanlinefs,  and contributes greatly to the prefervation of
health.   The fweat and dirt with which thefe parts are  fre-
quently covered, cannot  fail  to obftrua the perfpiration.
This piece of cleanlinefs would often prevent colds  and fe-
vers.  Were  people careful  to bathe their feet  and legs in
lukewarm water at night,  after bein^expofed to cold or wet
through the day, they would feldom experience the ill effeas
which often proceed from thefe caufes.
   A proper attention to cleanlinefs is no where more necef-
fary  than on fhipboard.   If epidemical diftempers break out
there,  no one can be fafe.   The beft way to prevent them is
to take care  that the whole company  be  cleanly  in  their
clothes,  bedding, &c.   When infeaious difeafes  do break
out,  cleanlinefs  is  the moft likely means   to prevent their
fpreading: it is likewife neceflary to prevent their returning
afterwards, or being conveyed to other places.   For  this
purpofe,  the clothes, bedding, &c. of the fick ought to be
carefully wafhed, and fumigated with brimftone.   Infeaion
                                                     will 
OF   CLEANLINESS.
99
will lodge a long time in dirty clothes,  and afterwards break
out in the moft terrible manner.
  In places where great numbers of fick people are colleaed
together, cleanlinefs ought to be moft religioufly obferved.
The very fmell in fuch places is often  fufficient to make one
fick.  It is eafy to imagine what effea that is likely to  have
upon  the difeafed.   In an hofpitat or infirmary, where clean-
linefs is neglected, a  perfon  in  perfea health has a greater
chance to become fick,  than a fick perfon has to get well.
  Few things are more unaccountable than that neglea, or
rather dread  of cleanlinefs which appears among  thofe who
have  the care of the fick ; they think it almoft criminal to
fuffer any thing that is clean to  come near a perfon  in  a fe-
ver, for example,  and would rather allow him to wallow in
all manner of filth than change the leaft bit of his  linen.  If
cleanlinefs be neceffary for perfons in health, it is certainly
more fo for the fick.  Many difeafes may be cured  by clean-
linefs alone;  moft of them  might be mitigated by it;  and,
where it is negleaed, the flighteft diforders are often chang-
ed into the moft malignant.   The fame miftaken care which
prompted people to prevent the leaft admiffion of frefh air to
the fick, feems likewife to have induced them to keep  them.
dirty.  Both  thefe deftruaive prejudices will, we hope, be
foon  entirely exploded.
  Cleanlinefs is certainly agreeable to our nature.   We can- .
not help approving it in others,  even though we fhould not
praaife it ourfelves.  It fooner attraas our regard than even
finery itfelf, and often gains efteem where that fails.  It is an
ornament to  the higheft as  well as the loweft ftation,  and
cannot be difpenfed with in  either.   Few virtues are of  more
importance to fociety than real  cleanlinefs.   It ought  to be
carefully cultivated  efcry where; but, in populous cities,  it
fhould be almoft revered *.

                                              C  H  A P.


  * As it is impofllble  to be thoroughly clean without a fufficient
  Juantity of water, we would earneftly recommend it to the  magi-
  rates of great towns  to be particularly attentive to this article.
Moft great towns in Britain are fo fituated as to be. eafily fupplied
with water; and thofe perfons who will not make a proper ufe of it,
after it is brought to their hand, certainly deferve to be feverely gu-
nilhed.  The ftreets of great towns, where water can be had, ought
to be wafhed every day.  This is the only effectual method for keep-
ing them thoroughly clean; and, upon trial, we are perfuaded, it
will be found the cheapeft. 
[   ioo   ]
                CHAP.    IX.

            OF   INFECTION,

      MOST difeafes  are  infeaious.  Every  perfon  ought
       therefore, as far as he can,  to avoid all communicati-
on with the difeafed.  The common praaice of vifiting the
fick,  though often well meant, has many ill confequences.
Fat be it from us to difcourage any aa of charity or benevo-
lence,  efpecially towards  thofe in diftrefs ;  but we cannot
help blaming fuch as endanger  their own-or their neighbours
lives by a miftaken friendfhip,  or an impertinent curiofity.
  The houfes of the fick,  efpecially in the country,  are ge-
nerally crowded from morning till  night with idle vifitors. It
is cuftomary, in fuch places, for fervants and young people to
wait upon the fick by turns, and even to fit up with them all
night.   It would be a miraple,  indeed,  fhould  fuch always
fefcape.  Experience teaches us the danger of this conduct,
people often catch fevers in this way, and communicate them
to others, till at length they become epidemic.
  It would be thought highly  improper, for one who had not
had the fmall-pox,  to wait upon a patient in  that  difeafe ;
yet many other fevers are almoft as infeaious as the fmall-pox,
and not lefs fatal.  Some imagine, that fevers prove more fa-
tal in villages than  in  great towns, for want of proper medi-
cal affiftance.  This may  fometimes be the cafe; but we are
inclined to think it oftener proceeds from  the  caufe above
mentioned.
   Were a plan to be laid down for communicating infeaion,
it could not be done more effeaually than by the common
method of vifiting the fick.  Such vigors not only endan-
ger themfelves and  their connexions,  but likewife hurt the
fick.   By crowding the houfe, they render the air unwhole-
fome, and by their private whifpers and difmal countenances,
difturb the imagination ofthe patient, and deprefs his fpirits,
Perfons who are ill, efpecially in fevers,  ought to be kept as
quiet as poffible.  The fight of ftrange faces, and every thk.g
that difturbs the mind, hurts them.
   The common pradice in country places,  of inviting great
numbers of people  to  funerals,  and crowding them into the
fame apartment where the corpfe lies,  is another  way of
fpreading infection.   The  infeaion does not always die with
the patient.   In many cafes it rather grows ftronger as the
                                                   body 
OF    INFECTION.
101
body becomes putrid.  This is peculiarly the cafe of thofe
who die of malignant fevers,  or other putrid difeafes.  Such
ought not to lie long unburied ; and people fhould keep, as
much as  poffible, at a diftance from them.
   It would tend greatly  to prevent the fpreading of infeai-
ous difeafes, if thofe in health were kept at a proper diftances
from the fick.   The Jewifh Legiflator,  among  many other
wife inftitutions for preserving health,  has been peculiarly
attentive to the means of preventing infeaion,  or defilement
as it is called, either from a  difeafed perfon or a dead body.
In many cafes the difeafed were to be feparated from thofe in
health; and it was deemed a crime even toappioach their ha-
bitations.  If a perfon only  touched a difeafed or dead body,
he was appointed to  wafh himfelf  in  water, and to keep for
fome time at a diftance from fociety.
   Infeaious difeafes are often communicated by clothes.  It
is extremely dangerous to wear apparel  which has been worn
by the difeafed, unlefs it has been well wafhed and fumigat-
ed, as infeaion may lodge a  long time in it, and afterwards
produce  very tragical  effeas.  This  fhews the danger of
buying at random the clothes which have been ufed  by other
people.
   Infeaious diforders are frequently imported.   Commerce,
together with the riches of foreign  climes,  brings us all their
difeafes.  Thefe do often more  than counterbalance  all the
advantages of that trade by  means of which they are intro-
duced.   It is  to be regretted, that fo little care is commonly
beftowed,  either to  prevent  the introduaion or fpreading of
infeaious difeafes.   Some attention indeed is generally  paid
to the plague ; but other difeafes pafs unregarded *.
   Infeaion is often fpread in  cities by jails, hofpitals, &c.
Thefe are frequently flluated in the very middle  of populous
                                                   towns;

   * Were the tenth part of the care taken to prevent the importation
?f difeafes, that there is to  prevent fmuggling, it would be attended
with many happy confequences.  This might eafily be done, by ap-
pointing a phyfician at every  confiderable fea-port,  toinfpectthe
lhip's company, paflengers, ice. before they came aftiore,  and, if
any fever or other infectious diforder  prevailed, to order the (hip to
perform a Ihort quarantine, and to fend the fick to fome hofpital or
  roper place to be cured.  He might likewife order all the clothes,
  edding, ice. which had been ufed by the lick during the voyage, to
be either deftroyed, or thoroughly cleanfed by fumigation, &c. be-
fore any of it were fent aihore.  A fcheme of this kind, if properly
conducted, would prevent many fevers, and  other infectious difeafes,
from being brought by failors into fea-port to wus, and by this means
diffufed all over the country.
 
(02
OF    INFECTION.
 towns ; and when infeaious difeafes break out in them, it is
 impoffible for the inhabitants to efcape.   Did magift rates pay
 any regard to the health of the people, this evil might be ea-
 fily remedied.
   Many are the caufes which tend to diffufe infeaion through
 populous cities.  The whole atmofphere of a large town is
 one contaminated mafs, abounding with various kinds of in-
 feaion,  and muft  be  pernicious to health.   The beft ad-
 vice that we can give to fuch as  are obliged to live in large
 cities, is,  to chufe an open fituation; to avoid  narrow, dirty,
 crowded ftreets; to keep their own houfes and offices clean ;
 and to be as much  abroad in the  open  air  as their time will
 permit.
   It would tend greatly to prevent the  fpreading of infeai-
 ous difeafes,  were  proper nurfes every  where employed  to
 take care of the fick.   This might often  lave a family, or e-
 ven a whole town, from being infeaed by one perfon.   We
 do not mean that people fhould abandon their friends and re-
 lations in diftrefs,but only to put them on their guard againft
 being too  much in company with thofe who are affliaed with
 difeafes of an infeaious nature.
   Such as wait upon the fick in infeaious difeafes, run very
 great hazard.   They  ought to ftuff their nofes with tobac-
 co, or fome other ftrong fmelling herb,  as rue, tanfy, or the
 like.   They ought likewife  to keep the  patient very clean,
 to fprinkle the room where he lies with vinegar,  or other
 ftrong  acids, frequently to admit a ftream of frefh air into it,
 and to avoid the fmell of his breath as much  as  they  can.
 They ought never to go into company without having chan-
 ged their clothes and wathed their hands; otherwife, if the
 difeafe be infeaious, they will in all probability  carry  the
 contagion along with them*.        •

                                                However

  * There is reafon to believe that infection  is often conveyed from
 ZXSianTiSct I £* C1are,effne%°f the faculty themfelveS
£.3?j P   j £ ?j-  ^-  fan"har way of fitting upon the Datient'a
bedfide and holding his arm for a confiderable time. If tbSpaSnt
 has the fmall-pox, or any other infpfti«„„ rr r  I il.t,lc Patlcpc



mould carry the difeafe along w thh'm> Phvf ™Y W°nde,r th*i ^
 ger others, but alfo themfelves byth\?L^f3    "Z V™}7 eJndan"
t' .metimes fuffer for their Salt of care  P     °'  A"d' mdecd>they 
OF    INFECTION.
103
   However trifling it may appear to inconfiderate  perfons,
we will venture to affirm, that a due attention to thofe things
which tend to diffufe infeaion would be of great importance
in preventing difeafes.   As  moft difeafes are  in fome degree
infeaious, no one fhould continue long with the fick, except
the neceffary attendants.   I  mean not, however, by this cau-
tion,  to deter  thofe whofe  duty  or office leads them to wait
upon the fick,  from fuch a laudable and neceffary  employ-
ment.
   Many things are  in  the  power of the magiftrate which
would tend to prevent the fpreading of infeaion; as  the pro-
moting of public cleanlinefs ; removing jails, hofpitals,church-
yards, and other places where infeaion may be generated, at
a  proper diftance from great towns *  ; widening the ftreets;
pulling down ufelefs  walls, and  taking all methods to'pro-
mote a free circulation of air through  every part ofthe town,
&c. Public hofpitals, or proper places of reception for the
fick,  provided  they were kept  clean,  well  ventilated, and
placed  in an open fituation,  would likewife tend to prevent
the fpreading of infeaion.  Such places of reception would
prevent the poor, when fick,  from being vifited by their idle
or officious neighbours.   They would likewife render it un-
neceffary for fick  fervants to be  kept  in their matters houfes.
Matters had better pay for having their fervants taken care of
in an nofpital,than run the hazard of having an infeaious dif-
eafe diffufed among a numerous family.   Sick fervants and
poor people, when placed in hofpitals, are not only lefs apt  to
diffufe infeaion among their neighbours, but have likewife
the advantage of being well  attended.
   We are not, however, to  learn that  hofpitals, inftead  of
preventing  infeaion, may become the means of diffufing it.
When they are placedjn the middle of great  towns ; when
numbers of patients are  crowded together in fmall appart-
ments; when  there is a conftant communication kept up be-
tween the  citizens  and  the patients; and when  cleanlinefs
and ventilation are negleaed, they become nefts  for  hatch-
ing difeafes, and  every one  who goes into them not only runs
a rifk  of receiving infeaion himfelf,  but likewife of com-
municating it  to others.   This,  however,  is not  the fault of
the hofpitals, but of thofe who have the management  of
them.   It were to be wifhed, that they were both more nu-
merous, and upon a more refpeaable footing, as that would
                                                  induce

   * The ancients  would not fuffer even the Temples of their gods,
where the lick rtforted, to be built within the walls of a city. 
*04
OF   INFECTION.
induce people to go into them with lefs reluaance.   This
is  the more to be defired, becaufe moft of the putrid feveri
and other infeaious diforders break out among the poor, and
are by them communicated to the better fort.   Were proper
attention paid to the firft appearances of fuch diforders., and
the patients early conveyed to an hofpital, we fhould feldom
fee a putrid fever, which is almoft as  infeaious as the plague,
become epidemic.
                  CHAP.    X.

          OF   THE   PASSIONS.

      TH E paffions have great influence  both  in the caufe
       and cure of difeafes.  How mind aas  upon matter,
 will, in all probability,  ever remain a fecret.   It is fufficient
 for us to know,  that there is eftablifhed a reciprocal influ-
 ence betwixt the mental and corporeal parts, and that what-
 ever diforders the one, likewife affeas theother.

                       Of Angtt.
   The paffion of anger ruffles the mind,  diftorts the  counw
 tenance, hurries on the  circulation ofthe blood, and difor-
 ders the whole vital and animal  funaions. It often occafion*
 fevers, and other accute difeafes; and fometimes even fudden
 death.  This paffion is peculiarly hurtful to the delicate, and
 thofe of weak nerves.   I have known fuch perfons frequent-
 ly lofe their lives by a violent fit of anger, and  would  advife
 them to guard againft  the excefs of this pamon with the ut-
 moit care.
   It is not indeed always in our power to prevent bein* an-
 gry ;  but we may furely avoid harbouring refentment in our
 mrt nhttRcf;mment.Pr1e)'s »P0»  the mind, and  occafions the
 ronftita?innn C CNhr°,n.,cald'forde^>  which gradually wafte the
 conUtution    Nothing fhews true greatnefs of mind  more
 than to forglve        . Itpromotef  h               ™«

   s!^YTdrS/^rOWne^ hea1^, andfehchy7'
   Such as value health fhould avoid violent  eufts of anJer
 « they would the moft deadly Foifon.  Neither oueht  thev

 heh m fdstirrV^1 toJ?d?VOUf at '» <~ **
health of the K^r     " a Norh1nS tends  fo  m"ch to the
Health of the body as a conftant tranquillity of  mind.
Of 
       OF  THE   PASSIONS.         105

                       Of Fear.
   The influence of fear, both in occafioning and aggravat-
ing difeafes, is very great.   No man ought to be blamed for
a decent concern about life; but too great a defire to pre-
ferve  it, is often the caufe of lofing it-   Fear and  anxiety,
by deprefling the fpirits, not only difpofe us to difeafes, but
often  render  thofe difeafes fatal which an undaunted mind
would overcome.
   Sudden fear  has generally violent effeas.  Epileptic fits,
and other convulfive diforders, are often  occafioned  by  it.
Hence the danger of that praaice, fo common among young
people, of  frightening one another.   Many have loft  their
lives,  and others have been rendered miferable, by frolics of
this kind.  It is dangerous to tamper with the human  paffi-
ons.  They may be eafily thrown into fuch diforder as never
again to aa with regularity.
   But the gradual effeas of fear prove more generally hurt-
ful.  The  conftant dread of fome future evil, by dwelling
upon the mind, often occafions the very evil  itfelf.   Hence
it  comes to  pafs, that fo  many die of thefe very difeafes of
which they long had a dread, or which had been impreffed on
their minds by fome accident, or foolifh prediaion.   This,
for example,  is often  the  cafe with women in child-bed.
Many of thofe who die in that fituation  are impreffed with
the notion of their death a long time before it happens ; and
there is reafon to believe, that this  impreffion is  often the
caufe of it.
  The methods taken to imprefs the minds of women with
apprehenfions of the great  pain and peril of child-birth, are
very hurtful.  Few women die in labour,  though many lofe
their lives  after it; which may be thus accounted  for.  A
woman after delivery,  finding herfelf weak and exhaufted,
immediately apprehends fhe is in danger j but this fear feldom
fails to obftrua the neceflary evacuations upon which her re-
covery depends.  Thus the fex often fall  a facrifice to their
own imaginations, when there would be no danger, did they
apprehend none.
 It feldom happens that two or three women,in a great town,
die in child-bed, but their  death is followed by many others.
Every  woman  of their  acquaintance, who  is with  child,
dreads the fame fate, and the difeafe becomes epidemical  by
the mere force of  imagination.  This fhould induce preg-
nant women to defpife fear, and by all means to avoid  thofe
tattling goffops who are continually buzzing in their ears the
                          L                  misfortunes 
*o6
OF   THE   PASSIONS.
  misfortunes of others.   Every thing that may in  the leaft
  alarm  a pregnant,  or child-bed  woman, ought with  the
  greateft care to be guarded againft.
    Many women have loft their lives in child-bed by the old
  fuperftitious cuftom, ftill kept up in moft parts of Britain, of
  tolling the parifh bell for every perfon who dies.  People who
  think themfelves in danger are very inquifitive; and if they
  come to know that the bell tolls for one who died in the fame
  fituation with  themfelves, what muft  be the confequence ?
  At any rate, they are apt tofuppofe that this is the cafe, and
  k will often be found a very difficult matter to perfuade them
  of the contrary.
    But this cuftom is not pernicious to child-bed women only.
  It is hurtful in many other cafes.   When low fevers, in
  which  it  is difficult to  fupport the patient's fpirits,  prevail,
  what muft be the effea of a funeral peat founding five  or fix
  times a day in his cars ?  No doubt his imagination will fug-
  geft, that others  died of the fame difeafe under which he la-
  bours.   This apprehenfion will have a greater tendency to de-
  prefs his fpirits, than all the cordials of which medicine can
  boaft will have to raife them.
    If this ufelefs piece of ceremony cannot  be abolifhed, we
 ought to keep the fick as much  from hearing it as  poffible,
 and from every other thing that may tend to alarm them.  So
 far however is this from being generally attended to, that ma-
 ny make it their bufinefs tovifit the fick, on purpofe to whif-
 per difmal ftories  in their ears.  Such  may pafs for fympa-
 th.zing  friends,  but  they ought rather to be  confidered as
 enemies.   All who wifh well to the fick,  ought to keep fuch
 perfons at the greateft diftance from them.
   A cuftom has long prevailed among phyficians, of proz-
 nofticating, as  they call it, the patient's  fate, or foretelling
 the iffue  of the  difeafe.  Vanity no doubt introduced this
 practice   and ft.l  lupports it,  in fpite of common fenfe and

 Inn5h?°K mi  u\ 1 haVe known a Phyflcian barbarous
 hi&V°ft ?   ',that he P/°n0Unced more fentences  than all
 h.s Majefty s judges,  Would to God that  fuch fentences

 ITLV*? eqUaHy, ^ '  h maV indeed b« Pledge"
 the doctor does not declare  his opinion before thegpa  ient.
 fh°e7? t W°r[e*  ,A fenfible P"™  had ^tter hea wha
 wS^e.'^d^hT ^uT the ^""folate looks, the
 feSnm Z  '     thue broken whifpers of thofe about him.  It

£^t£?!TSn "h   thC l0^ giVCS a" u^ourab.e op"
iHon, that it can  be concealed  from the patient.   The very
                                          embarraffrnent 
       OF   THE   PASSIONS.        107

embarraffrnent which the friends and attendants fhew in dif-
guifing  what he  has faid, is generally fufficient to difcovef
the truth.
  Kind Heaven has for the wifeft ends concealed from mor-
tals their fate,  and we do not fee what right any man has to
announce the death of another, efpecially if fuch a declara-
tion has a chance to kill him.  Mankind are indeed  very fond
of prying into future events, and feldom fail to folicit the
phyfician for his opinion.   A doubtful anfwer, however, or
one that may tend rather to encourage the hopes of the fick,
is furely the moft fafe.  This cond«a could neither hurt the
patient nor the phyfician.  Nothing tends more  to deftroy
the credit of phyfic, than thofe bold prognofticators, who, by
the bye, are generally the moft ignorant of the faculty.  The
miftakes  which daily  happen in this way, are  fo  many
ftanding proofs of human vanity, and the weaknefs of fcience.
   We readily admit, that there are cafes where the phyfician
ought to give intimation  of the patient's danger to fome of
his near  connexions; though even this ought always to be
done with  the greateft caution : but it never can be neceffa-
ry in any cafe, that the whole town and country fhould know,
immediately after the doaor  has made his firft vifit, that he
has no hopes of his patient's  recovery.  Perfons whofe imperti-
nent curiofity leads  them  to  queftion the phyfician with re*
gard to the fate of his patient, certainly deferve no better than
an evafive anfwer.
   The vanity of foretelling the fate of the fick is not peculiar
to the faculty.  Others follow their example, and  thofe who
think themfelves wifer than their neighbours often do  much
hurt in this way.   Humanity furely calls upon every  one to
comfort the fick, and not to  add to their affliaion by  alarm-
ing  their fears.   A  friend, or even a phyfician, may often do
more good by a mild and fympathizing behaviour, than by
medicine, and fhould never neglea to adminifter that greats
eft of all cordials, Hope.

                       Of Grief.
   Grief is the moft deftruaive of all  the  paffions.  Its ef-
feas are permanent, and when it finks deep into the mind, it
generally proves fatal.   Anger and fear being of a more vi-
olent nature, feldom laft long ; but grief often changes into a
fixed melancholy, which  preys upon the fpirits, and waftes
the conftitution.   This paffion ought not to be indulged.  It
                                                    may 
r h
108       OF   THE   PASSIONS.

may generally  be conquered at the beginning ;  but when it
has gained ftrength, all attempts to remove it are vain.
  No perfon can  prevent misfortunes in life ; but  it fhews
true greatnefsof mind to bear  them with ferenity. Many per-
fons make a merit of indulging grief, and, when misfortunes
happen, they obftinately refufeall confolation, till the mind,
overwhelmed  with melancholy, finks under the  load.  Such
condua is nof^ only deftruaive to health,  but  inconfiftent
with reafon, religion, and common fenfe.
  Change of ideas is as neceflary for health as change of pof-
ture.   When  f!>fc mind dwells long upon one fubjea,  efpe-
cially of a difagreeable nature,  it hurts  the whole funaions
of the body.   Hence grief indulged deftroys  the appetite
a>id fpoils  the digeftion ; by which means the  fpirits are de-
preffed, the nerves relaxed, the  bowels inflated  with wind,
and the humours, for want of frefh fupplies of chyle, vitiat-
ed.  Thus many an excellent conftitution has  been ruined
by a  family-misfortune, or any thing that occafioned excef-
five grief.
  It is utterly impoflible^that any perfon of a dejeaed mind
fhould enjoy health.  Life may indeed be dragged  out for a
few years : But whoever would live to a good old age, muft
be good-humoured and cheerful.  This indeed is not altoge-
ther in our own power;  yet our temper of mind,  as well as
pur aaions, depends greatly upon ourfelves.   We can either
affociate with cheerful or melancholy companions, mingle in
the amufements and offices of  life, or fit ftill and brood over
our calamities, as we chufe.   Thefe, and many  fuch things-,
are certainly in our power, and from thefe the mind generally
takes its caft.
  The variety of fcenes  which  prefent themfelves to the
fenfes, were certainly defigned to prevent our attention frorp
being toe  long fixed upon  any one objea.   Nature abounds
with variety,  and the mind, unlefs fixed down by habit,  de*
lights in contemplating  new  objcas.   This at once points
out the method of relieving the mind  in  diftrefs.  Turn the
attention frequently to new objeas;  Examine them  for fome
time.   When  thejnind  begins to recoil, fhift the fcene.   By
this means a conftant fucceffion of new ideas may be kept up,
till the difagreeable ones entirely difappear.   Thus travelling,
the ftudy of any art or fcience,  reading or writing on fuch
fubjects as deeply engage  the  attention,  will fooner expel
grief than  the moft fprightly amufements.
                                                     It 
       OF   THE   PASSIONS.       109

  It has already been obferved, that the body cannot be heal-
thy unlefs it be exercifed ; neither can the mind.  Indolence
pourifhes grief.   When the mind has nothing elfe to think
of but calamities, no wonder that it dwells there.  Few peo-
ple  who purfue bufinefs with attention are hurt by grief.  In-
ftead therefore of abftraaing ourfelves from the world or bu-
finefs, when misfortunes happen,  we ought  to engage in it
with more than ufual attention, to difcharge with double dili-
gence the funaions of our ftation, and to mix with friends of
a cheerful and focial temper.
  Innocent amufements are by no  means to be negfeaed.
Thefe,  by leading the mind infenfibly to the contemplation
pf agreeable objeas,  help  to difpel the gloom which misfor-
tunes caft over it.  They  make time feem  lefs tedious,  and
have many other happy effeas.
   Some perfons, when overwhelmed  with grief, betake them-
felves to drinking.  This  is making the cure worfe than the
difeafe.   It feldom fails to end in the ruin  of fortune, cha-
raaer, and conftitution.

                        Of Love.
   Love is perhaps the ftrongeft of all the paifions ;  at leaft,
when it  becomes violent, it is lefs fubjea to the controul ei-
ther ofthe underftanding or will, than any  of the reft. Fear,
anger, and feveral other paffions are neceflary, for the prefer-
vation of the individual, but love is neceffary for the continu-
ation of the fpecies itfelf: It  was therefore proper that this
paffion fhould be deeply rooted in the human breaft.  -
   Though love  be a ftrong paffion, it is feldom fo rapid 'in
its progrefs as feveral of the others.   Few  perfons fall defpe-
rately in love all at once.  We would therefore advife every
one, before he tampers with this paffion, to confider well the
probability of his being able to obtain the objea of his love.
When  that is not likely,  he  fhould avoid every occafion of
increafing  it.  He ought immediately to fly the company all
the beloved objea ; to apply  his mind attentively to bufinefs
or ftudy ;  to take  every kind of amufement; and above all,
to  endeavour, if poffible, to find another objea which may
engage his affeaions, and which it may be in his power to ob-
tain.
    There is no paffion with which people are fo ready to  tam-
per as love,  although none is more dangerous.  Some men
make love for amufement, others from mere  vanity, or on
pfrpofe  to fhew their  confequence with the fair.   This  is
                                                 perhap» 
no*       OF  THE  PASSIONS.
perhaps the greateft  piece  of cruelty  which any one can be
guilty of.   What  we  eagerly  wifh for,  we eafily  credit.
Hence the  too credulous fair are often betrayed into a fitua-
tion which is truly deplorable,  before they are able to difco-
ver that the pretended lover  was only in jeft.  But there is
no jefting with this paffion.  When love has  got  to a cer-
tain height,  it admits of no other cure but the poffeffion of
its objea,  which, in this cafe, ought always, if poffible, to
be obtained *.

                 Of religious  Melancholy.
  Many perfons of a religious  turn  of mind,  behave as if
they thought it  a crime to be cheerful.   They imagine the
whole of religion confifts in certain  mortifications, or deny-
ing themfelves  the  fmalleft indulgence, even of the moft in-
nocent amufements.  A perpetual gloom hangs upon their
countenances, while the deepeft melancholy preys upon their
minds.   At length  the faireft profpeas vanifh, every thing
puts on a difmal appearance, and thofe very objeas which
ought to give delight, afford nothing but difguft.   Life itfelf
becomes a  burden,   and the unhappy wretch, perfuaded that
no  evil can equal what he feels, often puts  an  end to his own
miferable exiftence.
  It is great  pity that ever religion fhould be fo far perverted,
as to  become the caufe  of thofe very evils which it was  de-
figned to cure.  Nothing  can be better calculated  than True
Religion, to raife and fupport the mind of its votaries under
every affliaion that can  befal them.   It teaches them,  that
even the fufferings of this life are preparatory to the happinefs
of the next ; and  that all who perfift in a courfe of  virtue,
fhall at  length arrive at complete felicity.
  Thofe whofe bufinefs it is to recommend religion to others,
fhould beware of dwelling  too much upon gloomy fubjeas.
That peace and tranquillity of mind,  which  true  religion is
calculated  to infpire, is a more  powerful argument in "its fa-
                                                    vour,

  * The conduft of parents with regard to the difpofal of their chil-
dren in marriage is often very blameable.  An advantageous match
is the  conftant aim of parents; while their children often fuffer a
real martyrrlom betwixt their inclinations and duty.  The firft thing
which parents ought to confult, in difpofing their children in marri-
age, is certainly their inclinations.  Were due  regard always  paid
to thefe, there would-be fewer unhappy couples, and parents would
not have fo often canfe to repent the feverity of their conduct aftex a
ruined conftitution, a foft character, or a diftracted mind, has mevvn
them their imitate. 
       OF   THE   PASSIONS.       ji*

vour, than all the terrors that can be uttered.  Terror may
indeed deter men from outward aas of wickednefs;  but it
will never infpire them with that love of God and real good-
nef3, in which alone true religion confifts.
  To conclude ; the beft way to counteraa the violence of
any paffion, is to keep the mind clofely engaged in fome ufe-
ful purfuit.
                                     •-  * ■ ■——...      • i  ■

                 CHAP.    XI.

      OF  THE COMMON  EVACUATIONS,   ,

      TH  E principle evacuations from the human body are
       thofe of /tool, urine, and infenfeble perfpiration.   None
of thefe can be long  obftruaed without imparing the health.
When that which ought to be thrown  out  of the body is too
long retained,  it not only  occafions a plethora, or too great
fulnefs ofthe veffels, but acquires qualities which are  hurt-
ful  to the health, as acrimony,  putrefcence, &c.

                Of the Evacuation by  Stool.
  Few things conduce more to health than keeping the bo-
dy regular.  When  the faces lie  too long in  the bowels,
they  vitiate the humours  ; and  when they are too foon dif-
charged,. the-body is not fufficiently nourifhed.   A medium
is therefore to be defired ;  which can only be obtained by re-
gularity in diet,  fleep, and exercife.   Whenever the body is>
not regular, there is 'reafon to fufpea  a fault in one or other
of  thefe.
  Perfons who eat and drink at irregular hours, and who eat
various kinds of food, and drink of feveral different liquors ac
every meal, have no reafon to expea either that their digefti-
on  will be good,  or their difcharges regular.  Irregularity in
eating and drinking  difturbs every part of the animal cecono-
my, and  never  fails to occafion difeafes.   Either too much
or  too little food will have this effea.  The former indeed
generally occafions  loofenefs, and the latter coftivenefs; but
both have a tendency to hurt the health.
  It would be difficult to  afcertain the exaa number of ftools
which may be  confident  with health, as thefe differ in the
different periods  of  life,  in different conftitutions, and even
in the fame conftitution under a different regimen of diet, ex-
ercife, &c.   It is however generally allowed,  that one ftool
                                                   a-day 
 112    OF THE COMMON feVACUATIONS.

 a-day is fufficient for an adult, and that lefs is hurtful.  But
 this, like moft general rules,  admits of many exceptions.   I
 have known perfons in perfect health who did not go to ftool
 above once  a-week.  Such a degree of coftivenefs however is
 not fafe ; though the  perfon who labours under it may for
 fome time enjoy tolerable health, yet at length it will occafi-
 on difeafes.
   One method of  procuring  a ftool  every day is to rife be-
 times, and go abroad in the open air.   Not only the pofture
 in bed is unfavourable to regular ftools, but alfo the warmth.
 This by promoting the perfpiration leffens all the  other dif-
 charges.
   The method recommended for this purpofe by Mr. Locke,
 is likewife very proper,  viz. to folicit  nature,  by going  regu-
 larly to fool every morning whether one has  a call or not.   Ha-
 bits of this kind may be acquired, which will in time become
 natural.
   Perfons who have frequent recourfe to medicines for pre-
 venting coftivenefs, feldom fail to ruin their  conftitution.
 Purging medicines  frequently  repeated weaken  the bowels,
 hurt the digeftion, and every dofe makes way for another,
 till at length they  become as neceflary  as daily bread. Thofe
 who are troubled  with coftivenefs,  ought rather, if poffible^
 to remove it by diet than  drugs.  They fhould likewife go
 thinly clothed,  and avoid every thing of anaftringent, or of
 an heating nature.  The diet  and other regimen neceflary  in
 this  cafe  will be found under the article Cojlivenefs, where
 this ftate of  the bowels is treated as a difeafe.
  Such perfons as  are troubled with  a  habitual  loofenefs,
ought likewife  to fuit their diet to the nature of their  com-
plaint.  They fhould ufe food which  braces and ftrengthens
 the bowels,  and which is rather of an aftringent quality,  as
wheat-bread made of the fineft flour, cheefe, eggs, rice boil-
ed in milk,  &c.   Their drink fhould  be red porty-wine, cla-
ret,  brandy and water in which toafted  bread has been boiled,
and fuch like.
  As a habitual loofenefs is  often owing to an obftruaed per-
fpiration,  perfons affeaed  with it ought to keep their feet
 warm, to wear flannel  next their  fkin, and to take  every
other method to promote the perfpiration.  Further directi-
 ons with regard to  the treatment of this  cony>laint will  be
 found under the article Loofenefs*
Of 
     OF THE COMMON EVACUATIONS.     113

                       Of Urine.
  So many things tend to change both  the quantity and ap-
pearances  of the  urine, that it is very difficult to lay down
any determined rules for judging of either*.  Dr. Cheyne
fays, the urine ought to be equal to three-fourths of the li-
quid part of our aliment.   But fuppofe any one were to take
the  trouble of meafuring both, he  would  find  that every
thing which altered the degree of perfpiration Would alter
this proportion, and likewife that different kinds of aliment
would afford very different quantities of urine.   Though for
thefe, and other reafons, no  rule can be given for judging of
the precife quantity of urine which ought to be  difcharged,
yet a perfon of common fenfe will feldom be at a lofs to know
when it is in either extreme.
  As a free difcharge of urine not only prevents but aaually
cures many difeafes, it ought by all means  to  be promoted %
and every thing that may obftrudt it fhould be carefully avoid-
ed.  Both the fecretion and difcharge of  urine are leffenecf
by  a fedentary life, fleeping on  beds that are too foft and
warm, food of a  dry and heating quality,  liquors which  are
aftringcnt  and heating, as red port-wine,  claret,  and fuch
like.  Thofe who have reafon to fufpea that their urine is in
too fmall  quantity, or who have any fymptoms of the gravel,
ought not only to avoid thefe things,  but whatever elfe they
find has a tendency to leffert the quantity of their urine.
   When  the urine is too long retained, it is not only reform-
ed, or taken up" again  into thfe mafs of fluids, but by ftag-
nating in  the  bladder  it becomes thicker,  the more watery
parts flying off firft, and the more grofs and earthy remaining-
behind.   By the  conftant tendency which thefe have to con-
crete; the formation of ftones and gravel  in the  bladder is
promoted.  Hence it comes  to pafs, that indolent artd feden-
                            M                       tary

  *  It has long been an obfervation among phyficians, that the ap-
pearances of the urine are very uncertain,  and very little to'be de-
pended on. No one will be furprifed at this, who confider&'how ro*ny
ways it may be affected, and confequently have its appearance aj-~
tered.  The paflions, the ftate of the atmofphere, the quantity and'
quality of the food, the exercife, the clothing, the ftate of the other
evacuations, and numberlefs other caufes,  are fufficient to induce a
change either in the quantity or appearance of the urine.  Aily one
who attends to tfiis, will be aftonilhed at the impudence of thofe
daring quacks, who pretend to find out difeafes  and prefcribe to pa-
tients from the bare inflection of their urine.  Thefe impoftors how-
ever, arc very common all over Britain, and by the amazing credu-
lity of the populace, many of thtraamafs  confiderable fortunes. 
 iH    OF  THE COMMON EVACUATIONS.

 tary people are  much more liable to thefe difeafes, than per-
 fons of a more  aaive live.
   Many perfons  have loft their lives,  and others have
 brought on very tedious, and even incurable diforders, by re-
 taining their urine too long, from a  falfe  delicacy.   When
 the bladder has  been over-diftended, it often lofes its power
 of aaion altogether, or becomes paralytic, by which means
it is rendered unable either to retain the urine or expel it pro-
 perly.   The calls  of Nature ought  never  to  be  poftponed.
 Dqjicacy is doubtlefs a virtue ;  but that can never be reckon-
 ed true delicacy, which  induces any one to rifle his health or
 hazard his life.
   But the urine may be in  too great as well as too  fmall a
 quantity.   This may be occafioned  by  drinking large quan-
 tities of weak  watery liquors, by the exceffive ufe of alka-
 line falts,  or  any thing that ftimulates  the kidnies, diffolves
 the blood,  &c.  This diforder very foon weakens the body,
and induces a confumption.  It is difficult to cure, but may
be mitigated by ftrengthening diet and  aftringent medicines,
 fuch ss are recommended  under the article Diabetes, or ex-
 ceffive difcharge of urine.

                   Of the Perfpiration.
   Insensible perfpiration is by fome reckoned the greatefl
 of all the difcharges from  the human body.  It is of fo great
importance to health,  that few  difeafes attack us while it goes
 properly on ;  but when  it  is obftruaed, the whole frame is
 generally difordered.  This  difcharge being lefs  preceptibk
than any of the  reft, is confequently lefs attended to.   Hence
it is, that accute fevers, rheumatifms, agues, &c. often pro-
ceed from obftruaed perfpiration, before we are aware of its
having taken place.
  It is a true faying, that  colds kill more than plagues.   On
examining patients we find moft of them  impute their difeafes
either to violent colds,  which they had  caught, or to flight
ones which had been negfeaed.   For this reafon, inflead of
a critical enquiry into the  nature of the  perfpiration,  its dif-
ference in different feafons, climates, conftitutions,  &c. we
fhall endeavour  to point  out the caufes which moft common-
ly obftrua it, and  to fhew how far they  may be either avoid-
ed, or have their influence counteraaed by timely care.   The
want of a due attention to thefe, cofts Britain annually fome
thjDufands of ufeful lives.
Change* 
     OF THE  COMMON EVACUATIONS.     nS

                Changes in the Atmofphere.
  One of the moft common caufes of obftruaed perfpirati-
on, or catching cold, in this country,  is the changeablenefs
of the weather,  or ftate of the atmofphere.  There is no
place where fuch changes happen more frequently  than  in
Great-Britain.   With  us the degrees of heat and cold are
not only very different in the different feafons of the year,
but often change almoft from one extreme to  another in  a
few days,  and fometimes even in the courfe of one day.
That fuch changes muft affea the ftate of the perfpiration is
obvious to every  one.
  The beft method of fortifying the body againft the changes
of the weather is to be abroad every day.  Thofe who keep
moft within doors are moft liable to catch cold.  Such pet-
Ions generally render themfelves fo  delicate as to  feel even
the flighteft changes in the atmofphere,  and by their pains,
coughs,  and  oppreffions of the breaft, &c. they become  a
kind of living barometers,

                      Wet Clothes,
  Wet clothes  not  only,  by their coldnefs, obftrua the
perfpiration, but their moifture, by  being abforbed,  or taken
up into the body, greatly  increafe* the danger.  The molt
robuft conftitution  is  not proof  againft the danger arifing
from  wet clothes ; they daily occafion fevers, rheurnatiftns,
and other fatal diforders, even in the young and healthy.
  It is impoffible for people  who go  frequently abroad toa-
void fometimes being wet.  But the danger might generally
be leffened, if not wholly prevented, by changing their clothes
foon ; when this cannot be done, they fhould keep in motion
till they be dry.  So far are many from taking this precau-
tion,  that they often fit or lie down  in the  fields with their
clothes wet,  and frequently even fleep whole nights in  this
condition.  The frequent inftances which we have of the fa-
tal effeas of this condua,  ought certainly to deter others
from being guilty of it..

                       Wet Feet.
  Even  wet feet often occafion fatal  difeafes.  The colic,
inflammations of the breaft and of the bowels, the iliac paf-
fion, cholera morbus, he. are often  occafioned by wet feet.
Habit will,  no  doubt, render this  lefs dangerous ; but it
ought, as far as poffible, to be avoided.  The delicate,  and
                                                  thofe 
 Il6    OF  THE  COMMON EVACUATIONS.

 thofe who are not accuftomed to have  their clothes or feet
 wet, fhould be peculiarly careful in this  refpea.

                       Night  Air.
   The perfpiration is often obftruaed by night AIR ; even
 in fummer, this ought to be avoided.  The dews, which fall
 plentifully after the  hotteft day, make the night more dange-
 rous than when the  weather is cool.   Hence, in warm coun-
 tries, the evening dews  are more hurtful than  where the cli«
 mate is more  temperate.
   It is very agreeable after a warm day, to be abroad in the
 pool evening; but this  is a pleafure to be avoided  by all who
 value their health.  The effeas of evening dews are gradu-.
 al indeed, and almoft imperceptible; but they are  not the lefs
 to be dreaded :  We would therefore advife travellers, labour-
 ers,  and all  who are muth  heated by day, carefully to  avoid
 them.   When the perfpiration has been great,  thefe become
 dangerous jn proportion.  By not attending to this,  in flat
 marfhy countries, where the exhalations and dews are copi-
 ous, labourers are often feized with  intermitting fevers, quin-
 fe)S, and other dangerous difeafes.

                      L>amp  Beds.
   Beds  become  damp, either from  their not being  ufed,
ftandingin damp houfes, or in rooms without fire.   Npthing
is mote to he dreaded by travellers than damp beds, which are
very common in all places where fuel is fearce.   When a
traveller, cold and wet,  arrives at an inn, he may by  means of
a good fire, warm diluting liquor, and a dry bed, have the,
peifpiration reftored ; but if he be put into a cold  room, and
laid on a damp bed, if will be more obftruaed, and the  worft
confequences will enfoe. Travellers fhould avoid  inns which
are noted for  damp beds, as  they would  a houfe infeaed with
 the plague, as no man,  however robuft, is proof againft the
danger arifing from them.
   But inns are not  the only places where damp beds are to
 met with.  Beds kept in private families for the reception of
ftrangers, are often equally dangerous.   All kinds of  linen
and bedding, when not  frequently ufed,  become damp.  How
then  is it poffible,  that beds,  which are not flept  in above
two or three times a-year,  (hould be fafe ? Nothing is more
 common than to hear people complain of having caught cold
 by changing their bed.  The reafon is obvious: Were they
                                                 careful 
     OF THE COMMON EVACUATIONS.     ny

careful never to fleep in a bed but what was frequently ufed,
they would feldom find any ill confequences from a change.
   Nothing is more to be dreaded by a delicate perfon  when
on a vifit, than being laid in  a bed which is kept on purpofe
for ftrangers.  That  ill-judged piece of complaifance becomes
a real injury.   All the bad confequences from  this quarter
might be eafily prevented in private families, by caufing their
fervants to fleep in the fpare beds, and refign them to ftrangers
when they come.  In  inns where the beds are ufed almoft e-
very night, nothing elfe is neceflary than  to keep the  rooms
well feafoned  by frequent fires, and  the linen dry.
   That baneful cuftom faid to be praaifed in many inns, of
damping fheets, and preffing them  in order to fave wafhing,
and afterwards laying them on the beds, ought, when  difco*
vered,  to be punifhed with the utmoft feverity.   It is really
a fpecies of murder, and will  often prove as fatal  as poifon or
gun-fhot.   Indeed no linen,  efpecially if it has been wafhed
in winter, ought to be ufed till it has been expofed for fome
time to the fire; nor is this operation lefs neceffary for linen
wafhed in fummer, provided it has lain by for any length of
time.  This caution is the more needful,  as gentlemen are
often exceedingly  attentive to what they  eat or drink at an
inn, yet pay no regard to a circumftance of much more im-
portance.
                     Damp Houfes.
   Damp houfes frequently produce the like ill confequences J
for this reafon thofe who build fhould be careful to chufe a
dry fituation.   A  houfe which Hands on  a damp marihy foil
or deep clay, will  never be thoroughly dry.  All houfes, un-
lefs where the ground  is exceeding dry,  fhould have the firft;
floor a little raifed.   Servants and others, who are obliged to
live  in cellars  and  funk ftories, feldom  continue long in
health : Matters ought furely  to pay  fome regard to the  health
of their fervants, as  well as to their  own.
   Nothing is more common  than for people, merely to avoid
fome trifling inconveniency, to hazard their lives, by inhabit-
ing a houfe almoft as foon as  the mafons, plafterers, &c. have
done with it: Such houfes are not only dangerous from their
dampnefs,  but likewife from the fmell of lime,  paints, &c.
The afthmas, confumptions,  and other difeafes of the lungs,
fo incident to people who work in thefe articles, are fufficient
proofs of their being unwholefome.
   Rooms  are often rendered  damp by an unfeafonable  piece
of cleanlinefs ; I mean the pernicious cuftom of wafhing them
                                            immediately 
 518     OF THE COMMON EVACUATIONS,

immediately  before  company  is  put into  them.   Moft
people catch cold, if they fit but a very fhort time in a room
that has  been lately wafhed ; the delicate ought carefully to
avoid fuch a fituation,  and even the robuft are not proof a-
gainft its influence.

          Sudden  Tranjkions from Heat  to Cold.
   But nothing  fo frequently obftruas  the perfpiration as
sudden transitions from heat to cold.   Colds are feldom
caught,  unlefs when people have  been too much heated.
Heat rarifles the blood,quickens the circulation, and increafes
the perfpiration ;  but when thefe are  fuddenly checked,  the
conlequences muft be bad.  It is  indeed  impoffible for la-
bourers not to be too hot upon fome occafions ;  but it is ge-
nerally  in their power  to let themfelves cool gradually, to
put on their clothes when they leave off work, to make choice
of a dry place to reft themfelves in,  and to avoid fleeping in
the open fields.  Thefe eafy rules, if obferved, would often
prevent fevers and other fatal diforders.
   Nothing is more common than for people when hot, to
drink freely of cold water,  or fmall liquors.  This conduct
is extremely dangerous.   Thirft indeed is hard to bear,  and
the inclination to gratify that appetite frequently  gets  the
better of reafon, and makes us do what our judgment difap-
proves.   tvery peafant, however, knows, if his horfe be per-
mitted  to drink his bellyful  of cold water after  violent exer-
cife, and be immediately put into the ftable, or fuffered to
remain at reft, that it will kill him.   This they  take the ut-
inoft care to prevent,  ft were well if they were equally at-
tentive to their own fafety.
   Thirft  may be quenched many ways without fwallowing
large quantities of cold Jiquor.  The fields afford variety of
acid  fruits and plants,  the very chewing  of which would a-
bate thirft.   Water kept in the mouth for fome time, and  fpit
out again, if frequently lepeated,  will have the fame effea. If
a bit of bread be eat along with a few mouthfuls of water, it
will both quench thirft more effeaually, and make the danger
lefs.   When a perfon is extremely hot, a  mouthful  of bran-
dy, or other fpirits, ought to be  preferred to any thing elfe, if
ir can be obtained. But if any one has been  fo foolifh, when
hot,  as to  drink freely of cold liquor, he ought to continue
his exercife at leaft, till  what he drank be thoroughly warm-
ed upon his ftomach,
                                                      It 
     OF THE COMMON EVACUATIONS.     119

  •It would be tedious to enumerate all the bad effeas which
flow from drinking cold liquors when the body is hot. Some-
times this has occafioned immediate death. Hoarfenefs, quin-
feys, and  fevers of various kinds, are its common  confe-
quences.  Neither  is  it fafe when warm to eat freely of raw
fruits, fallads, or the like.  Thefe indeed have not fo  fudden
an effea on the body as cold liquors, but they are notwith-
ftanding dangerous, and ought to be avoided.
  Sitting in a warm room, and  drinking hot  liquors  till the
pores are quite open, and immediately going into the cold air,
is extremely dangerous.   Colds, coughs, and inflammations
ofthe breaft,  are the ufual effeas  of this conduit: Yet no-
thing is  more common than for people, after they have drunk
warm liquors for feveral hours, to walk or ride a number of
miles in thecoldeft night, or to ramble about the ftreets.
  People are very apt, when a room is hot, to throw open a
window, and to fit near it.  This is a moft dangerous prac-
tice.  Any perfon had better fit without doors than in fuch a
fituation, as the current of air is direaed againft one particu-
lar  part of  the body.  Inflammatory fevers and confumptions
have often  been occafioned by fitting or (landing thinly cloth-
ed  near an open window.  Nor is fleeping with open  win-
dows lefs to be dreaded.  That ought never to be done even
in  the hotteft feafon.  I  have  known  mechanics frequently
contraa fatal difeafes,  by working ftript at an open window,
and would advife all of them to beware of fuch a praaice.
  Nothing expofes people more to  catch cold than keeping
their own houfes too warm ; fuch perfons may be faid to live
in  a fort of hot-houfes;  they can hardly ftir  abroad to vifit a
neighbour, but at the hazard of their lives.   Were there no
other reafon for keeping houfes moderately cool, that alone is
fufficient:  But no houfe that is too hot can  be wholefome ;
heat deftroys the fpring and elafticity of the air, and renders it
lefs fit for expanding the lungs, and the other purpofes of re-
fpiration.  Hence  it is, that confumptions and other difeafes
of  the lungs prove fo fatal to people who work in forges, glafs-
 houfes, and the like.
    Some are even fo fool-hardy, as to plunge themfelves  when
hot in  cold water.  Not only fevers, but madnefs itfelf has
frequently been the effea of this condua.   Indeed it  looks
too like the adtion of a madman to deferve a  ferious confede-
ration.
    The refult  of  all  thefe obfervations is,  that every one
ought to avoid, with the u-tmoft attention, all fudden tranfi-
                                                   tions 
 120    OF  THE COMMON EVACUATIONS.

tions from heat to cold,  and to keep the body in as uniform
a temperature as poffible ; or, where that cannot be done, to
take care to let it cool gradually.
  People may  imagine that too ftria an  attention to thefe:
things would tend to render them  delicate.  So far however
is this from being our defign, that the very firft rule  propo-
fed for preventing colds, is to harden the body, by inuring
it daily to the open air.
  I fhall put an end to what relates to this part of my fub-
jea by giving an abftraa of the juftly celebrated  advice  of
Celfus, with  refpea  to  the  prefervation of health.  ««  A
" man," fays he, «« who is bleffed with good health, fhould
** confine himfelf to  no particular  rules,  either with  refpett*
ct to regimen or medicine.  He ought frequently to diverfi*
" fy his manner of living; to be fometimes in town,« fome-
" times  in the country ;  to hunt, fail, indulge himfelf in
** reft,  but more frequently  to ufe exercife.   He ought tov
*' refufe no kind of food that  is commonly ufed, but fome*-
" times to eat more and fometimes lefs; fometimes to makei
•' one at an entertainment, and fometimes to forbear it;  to'
«* to make rather two meals a-day than one,  and always to-
" eat heartily,  provided he can digeft it.   He ought neither
•' too eagerly to purfue, nor too fcrupuloufly to avoid inter-
•* courfe with the  Fair fex: Pleafures of this kind, rarely
•* indulged, render the body alert and aaive, but when too'
•' frequently  repeated, weak and  languid.  He fhould  be
** careful in  time  of health  not  to deftroy, by exeeffes  of
44 any kind, that vigour of conftitution which fhould foppofti
*• him under ficknefs."
PA R T, 
£   121    J
PART        II.
OF     DISEASES,
                CHAP.     XII.

  OF  THE KNOWLEDGE AND  CURE  OF  DISEASES.

      TH E knowledge  of difeafes  does not depend fo much
       upon  fcientific  principles  as  many  imagine.   It is
chiefly the refult of experience and obfervation.  By attend-
ing the fick, and carefully obferving the various occurrences
in difeafes,  a great degree of accuracy may be acquired,  both
in diltinguifhing their fymptoms, and  in the application of
medicines.  Hence fenfible nurfes  and other perfons  who
wait upon the fick often difcover a difeafe fooner than thofe
who have been bred to phyfic.  We do not however mean to
infinuate that a medical education is of  no ufe : It is doubt-
lefs of the greateft importance,  but it never can fupply the
place of obfervation and experience.
  Every difeafe may be confidered as an aflemblage of fymp-
toms,  and muft be diftinguifhed by thofe which are moft ob-
vious and permanent.   Inftead therefore of giving a  claffical
arrangement of difeafes, according to the fyftematic method,
it will  be more foitable, in a performance of this nature, to
give a full  and accurate defcription oTeach particular difeafe
as it occurs ; and, where any of the fymptoms of one difeafe
have a near refemblance to thofe of another,  to take notice
of that circumftance, and at the fame time to point out the
peculiar or charaaeriftic fymptoms by which it may be diftin-
guifhed.   By a due attention to thefe, the inveftigafion of
difeafes will be found to  be a lefs difficult matter than  moft
people would at firft be ready to imagine.
  A proper attention to  the patient's  age, fex, temper of
mind,  conftitution, and manner of life, will likewife great-
ly affift, both in the inveftigation and treatment of difeafes.
  In childhood the fibres are lax and foft, the nerves extreme-
ly irritable, and the fluids thin ; whereas in old age the fibres
                         N                         are 
.22    OF   THE   KNOWLEDGE
 are rigid,  the nerves become almoft infenfible,  and many of
 the veffels imperviable.   Thefe and other peculiarities render
 the difeafes of the young  and aged very different,  and of
 courfe they muft require a different method of treatment.
   Females are liable to many difeafes which do not afflia the
 other fex;  befides, the nervous fyftem being more irritable
 in them than in men, their difeafes require to be treated with
 greater caution.   They  are lefs able to bear large evacuati-
 ons ;  and  all ftimulating medicines ought to be adminiftered
 to them with a fparing hand.
   Particular conftitutions not only difpofe perfons to peculi-
 ar difeafes,  but likewife render  it neceffary to treat thefe
 difeafes in a peculiar manner.   A delicate perfon, for exam-
 ple, with weak nerves, who lives moftly within doors,, muft
 not be treated, under any difeafe, precifely in the fame man-
 ner,  as one who is hardy and robuft, and who is much expo-
 fed to the open air.
   The temper  of mind  ought to be carefully attended to in
 difeafes.  Fear, anxiety, and a fretful temper,  both occafi-
 on and aggravate difeafes.  In vain do we apply  medicines to
 the body to remove  maladies which proceed from the mind.
 When it is affeaed, the beft method is to foothe the paffions,
 to divert the mind from anxious thought,  and to keep the pa-
 tient as eafy and cheerful  as poffible.
   Attention ought likewife to  be paid to the climate, or place
 where the patient  lives, the  air  he breathes, his diet,  &c.
 Such as live in low rriarfhy fituations are fubjea  to many dif-
 eafes which  are unknown to the inhabitants of high coun-
 tries.  Thofe whobrea-the theimpure air of cities have many
 maladies to which the more'Hiappy ruftics are entire ftrangers.
 Perfons who feed grofsly, and indulge in ftrong liquors,  are
 liable to difeafes which do not affea the tempeiate and abfte-
 mious, &c.
   It has already  been obferved, that the different occupati-
 ons and fituations in life difpofe men to  peculiar  difeafes.   It
 is  therefore neceffary to inquire into the patient's occupati-
 on, manner of life,  &c.  This will not only affift us in find-
 ing out the difeafe,  but will  likewife direa us in the treat-
 ment of, it.   It would be very  imprudent to treat the labori-
ous and the fedentary exaaiy in the fame manner, even fup-
 poiing them to labour under the fame difeafe
  It will likewife be proper to enquire whether the difeafe be
conftitutional or accidental;  whether it has been of lone or
ftort duration;  whether it proceeds from any great and fud-
                                                    den 
    AND  CURE  OF   DISEASES.     123

den alteration in the diet,  manner of- life, &c.  The ftate of
the patient's body and of the other evacuations, ought alfo
to be enquired into;  and likewife whether he can with eafe
perform all the vital and animal funaions, as breathing, di-
geftion, he.
   Lallly,  it will be proper to inquire what  difeafes the  pa-
tient has formerly been liable  to, and  what medicines were
moft beneficial to him; if he ha& a ftrong averfion  to  any
particular  drug,  &c.
   As  many of the indications of cure may be anfwered by.
diet alone,  it is always the firft thing to be attended to in the
treatment pf difeafes.   Thofe who know no better, imagine
that every thing which goes by. the name of a medicine pof-
feffes fome wonderful power  or fecret charm, and think, if
the patient fwallows enough of drugs,  that he muft do well.
This miftake has many ill confequences.   It makes  people
truftto drugs, and neglea their own endeavours ; befides, it
difcourages all attempts to relieve the fick, where medicines
cannot be obtained.
   Medicines are no doubt ufeful in their place,  and,  when
adminiftered with prudence,  they may do much good ;  but
when they are put in the  place of every thing elfe, or. admi-
niftered at random, which is not feldom the  cafe, they muft
domifchief.  We would  therefore wifh to call the attention,
of mankind  from the purfuit of fecret medicines to fuch
things  as they are acquainted with.   The proper regulation,
of thefe may often do much good, and there is little danger of.
their ever doing hurt.
   Every difeafe  weakens the digeftive powers.  The  diet
ought therefore, in all difeafes, to be light and of eafy digef-
tion.   It would be as prudent for a perfon with a broken leg
to attempt  to walk, as for one in a fever to eat the fame-kind
of food, and in the fame quantity, as when he was in perfeft,
health.  Even abftinence  alone will often cure a  fever, efpe-
cially  when  it has been occafioned by excefs  in eating or
drinking.
   In all fevers attended with inflammation, as pleurifies, pe-
ripneumonies, &c. thin gruels, wheys,  watery infufions of
mucilaginous  plants,  roots, &c. are not only proper for the
patient's food, but they are likewife the beft medicines which
can be adminiftered.
   In fevers of a  flow,  nervous,  or putrid kind, where there
are no fymptoms of inflammation, and where the patient muft:
be fupported with cordials, that intention can always be more
                                              effeaually 
 114    OF   THE   KNOWLEDGE

 effeaually anfwered by nourifhing diet  and generous wines,
 than by any medicines yet known.
   Nor is a proper attention to diet of lefs importance in chro-
 nic than  in  acute difeafes.  Perfons affliaed with  low fpi-
 rits, wind, weak nerves, and other hypochondriacal affeaions,
 generally find more benefit from the ufe  of folid food and ge-
 nerous liquors, than from all the cordial and carminative me-
 dicines which can be adminiftered to them.
   The fcurvy,  that moft obftinate malady, will  fooner yield
 to a proper vegetable diet, than to all the boafted antifcorbu-
 tic remedies of the fhops.
   In confumptions, when the humours  are vitiated, and the
 ftomach fo much weakened as to be unable to digeft the fo-
 lid fibres of animals, or even to affimilate the juices of vege-
 tables, a diet confifting chiefly of milk will not only fupport
 the patient, but will often cure the difeafe after every other
 medicine has failed.
   Nor is an attention to other things of lefs importance than
 to diet.  The  ftrange  infatuation which has long  induced
 people to fhut up the fick from all communication  with the
 external air, has done great mifchief. Not only in fever6, but
 in many other difeafes,  the patient will  receive more benefit
 from having  the frefh air prudently  admitted into his cham-
 ber, than  from  all the medicines which can be given him.
   Exercife may likewife,  in many cafes, be confidered  as a
 medicine.   Sailing,  or riding on horfeback, for example,
 will be of more fervice in the cure of confumptions,  glandu-
 lar obftrudions, &c. than any medicine yet known.   In dif-
 eafes which proceed from a relaxed ftate of  the folids, the
 cold bath, and other parts of the gymnaftic regimen, will be
 found equally beneficial.
   Few things are of greater importance,  in the cure of dif-
 eafes, than  cleanlinefs.   When a patient Is  fuffered to lie in
 dirty clothes, whatever  perfpires from his body,  is again re-
 forbed, or taken up into it, which ferves to nourifh  the dif-
 eafe, and increafe the danger.  Many difeafes may be cured
 by cleanlinefs alone; moft of them may  be  mitigated  by it,
 and in all of them it is highly neceflary  both for the patient
 and thofe who attend him.
  Many other obfervations, were it  neceffary, might be ad -
duced to prove  the importance of a proper regimen in difeafes.
Regimen will often cure difeafes without medicine,  but me-
dicine will feldom fucceed where a proper regimen is negfea-
ed.  For this reafon, in the treatment of difeafes,  we have al-
                                                   ways 
     AND   CURE  OF   DISEASES.    115

ways given the firft place to regimen.   Thofe who are afraid
to ufe medicines may confine themfelves to it only.  For o-
thers, who  have more  knowledge,  we have recommended
fome of the moft fimple, but approved, forms of medicine in
every difeafe.  Thefe, however, are never to be adminiftered
but by people of better underftanding; nor even by  them
without the greateft precaution.


                CHAP.     XIII.

      OF  FEVERS  IN  GENERAL.

     4S more than half of mankind is faid to perifh by fevers,
      it is of importance to be acquainted wirn  their caufes.
     moft general caufes of fevers ate, infeclion,  errors in diet,
unwholefome air, violent emotions of mind, fupprejjien of ufuale-
vacuations, external or internal injuries,  and extreme degrees of
beat or cold.   As moft of thefe have already been treated of at
confiderable length, and their effeas (hewn, we fhall not now
refume the consideration of them, but fhall only recommend
it to all, as they would wifh to avoid fevers,  and other fatal
difeafes, to pay the moft punaual attention to thefe articles.
   Fevers  are not only  the moft frequent of all difeafes, but
they are likewife the moft complex :  In the moft fimple fpe-
cies of fever there is always a combination of feveral different
fymptoms.  The diftinguifhing fymptoms of fever are,  in-
creafed beat, frequency of pulfe,  lofs of appetite, general debility,
and a difficulty inperf$rmhi]> fome of the vital or animal funftions*
The other fymptoms  ufualfy attendant on fevers are, naufea,
thirft, anxiety, wearinefs, wafting of the flefh, want of fleep,
or the fleep difturbed and not refrefhing.
   When the fever comes on gradually,  the patient generally
complains firft of languor or liftleffne/s, forenefs of the flefh
or of the bones,  as the country people  exprefs  it, heaviness
ofthe head, lofs of appetite* ficknefs, with clamminefs ofthe
mouth ; after fome time come on exceffive heat, violent thirft,
reftleffnefs, &c.
   When the fever attacks fuddenly, it always begins with an
uneafy fenfation of exceffive cold, accompanied  with  debility
and lofs of appetite ; frequently the cold is attended with fhi^-
vering, oppreffion about the heart, and ficknefs  at ftomach
or vomiting.
                                                   Fevers 
126     OF  FEVERS  IN  GENERAL.
     Fevers are divided into continual, remitting, intermitting,
   and fuch  as  are attended with cutaneous eruption or topical
   inflammation, as the fmall-pox, eryfipelas, &c.   By a conti-
   nual fever is meant that which  never  leaves the patient dur-
   ing the whole courfe of the difeafe, or  which fhews no re-
   markable increafe or abatement in the fymptoms.  This kind
   of fever is likewife divided into acute,  flow, and  malignant.
   The fever is called acute when its progrefs is quick,  and the
   fymptoms violent; but when thefe are more gentle,  it is ge-
*   rlerally denominated flow. When livid or petechial fpots fhew
  a putrid ftate of the humours, the  fever .is  called malignant,
  putrid, or petechial.
    A remitting fever differs from a continual only in degree.
  It has frequent increafes and decreafes, or exacerbations and
  remiffion3,,but never wholly leaves the patient in the courfe of
  the difeafe.   Intermitting fevers, or agues,  are thofe which,
  during the time that the patient may be faid to be ill, have
  evident intervals or remiflions of the fymptoms.
    As a fever is  only an effort of Nature to free herfelf from
  an offending caufe, it is the bufinefs of thofe  who have the
  care of the lick, to obferve with diligence which way Nature
  points, and to endeavour to affift her operations.  Our bo-
  dies are fo framed, as to have a conftant tendency to expel or
  throw off whatever is injurious to health.   This is generally
  done by urine, fweat, ftool, expeaoration, vomit-, or fome o-
  ther evacuation.
    There is reafon to believe,  if the efforts o&Nature, at the
  beginning of a  fever, were duly attended to and  promoted, it
  would feldom continue long; but when her  attempts are ei-
  ther negleaed  or counteraaed, it is no wonder  if the difeafe
  proves fatal.  There are daily inftances of perfons  who, after
  catching cold,  have all  the fymptoms of a beginning fever •
  but by keeping warm, drinking diluting  liquors, bathing their
 feet in warm water, &q, the fymptoms in a few  hours disap-
 pear,  and the danger is prevented.   When fevers of a putrid
 kind threaten,  the beft method of  obviating their effects is
 by repeated vomits.
   Our defign is not to enter into a critical enquiry into  the
 nature and  immed.ate  caufes of fevers; but to mark their
 moft obvious fymptoms, and  to  point out the  proper treat-
 ment of the patient with refpea to his diet, drink, air, &c. in
 the different ftages of the difeafe.   In  thefe  articles  t£  in-
 clinations ofthe patient will, in a great meafure, direa our
Almoft 
     OF  FEVERS   IN- GENERAL.     js;

  Almoft every perfon  in a  fever complains of great thirft^
and calls out for drink, efpecially of a cooling nature.  This
at once points out the ufe of water, and other cooling anddi-
luting liquors.  What is fo likely to abate the  heat, attenu-
ate the humours,  remove fpafms and obftruaions, promote
perfpiration, increafe the quantity of urine, and in fhort, pro-
duce every falutary effea in an ardent or inflammatory fever,
as drinking plentifully of  water, thin  gruel,  or  any other
weak diluting  liquor,  of which water is the bafis? The ne-
ceflity of diluting liquors is  pointed out by the dry tongue,,
the parched fkin, and the'burning heat, as well  as by the un-
quenchable thirft of the patient.
  Many cooling liquors, which are extremely grateful to pa-
tients in a fever, maybe prepared from fruits,  as decoaions
of tamarinds,  apple-tree, orange-whey, and the like.  Mu-
cilaginous liquors might alfo be prepared from marfhmallow
roots,  linfeed, lime-tree  buds,  and  other  mild vegetables.
Thefe  liquors, efpecially when acidulated, are  highly agree-
able to the patient,  and fhould never be denied him.
  At the beginning of  a fever the  patient generally  com-
plains of great laffitude or wearinefs, and has no inclination
to move.  This evidently fhews the propriety of keeping him
eafy, and, if poffible, in bed; lying in bed relaxes the fpafms,
abates  the violence of the circulation,  and  gives Nature  an
opportunity of exerting all her force to overcome the difeafe.
The bed alone would often remove a fever at the beginning;
but when the patient ftruggles  with  the  difeafe, inftead of
driving it off,  he only fixes it the deeper, and renders it more
dangerous.  This obfervation is too often  verified in travel-
lers, who happen, when on a journey, to be  feized  with a
fever.   Their anxiety to get home  induces them to travel
with the fever upon them, which condua feldom fails to ren-
der it fatal.
   In fevers the mind as  well as the body fhould be kept ea-
fy.  Company is feldom agreeable to the fick.   Indeed every
thing that difturbs the imagination increafes the difeafe ;  for
which reafon  every perfon in a fever ought to  kept perfeaiy
quiet,  and neither allowed to fee nor hear any thing that may
in the  leaft affea or difcompofe his mind. .
   Though the patient in a fever has the greateft inclination
for drink, yet  he feldom has any appetite for folid food; hence
the impropriety of urging him  to take viauals is  evident.
Much  fmlid food in a fever is every way hurtful.  It opprefles
Nature, and inftead of nourifhing the patient,  ferves only to 
 128     OF  FEVERS  IN  GENERAL.

feed the difeafe.  What food the patient takes fhould be  in
fmall quantity, light, and of eafy digeftion.   It ought to be
chiefly of the vegetable kind, as panado, roalled apples, gru-
els, and fuch like.
  Poor people, when any of their family  are taken  ill, run
direaiy to their rich neighbours for cordials, and pour wine,
fpirits, &c.  into  the  patient,  who perhaps never had been
accuftomed  to  tafte  fuch liquors when in health.  If there
be any degree of fever, this  condua muft increafe it, and if
there be none,  this is  the ready way to  raife one.  Stuffing
the patient with fweetmeats and  other delicacies, is likewife
very pernicious.   Thefe are always harder to digeft than
common food,  and cannot fail to hurt the ftomach.
  Nothing is more defired by a patient in a fever than frefh
air.   It  not only removes his anxiety, but  cools the blood,
revives the fpirits, and proves every way beneficial.   Many
patients  are in a manner ftifled to death in fevers, for want
of frefh air;  yet fuch  is the unaccountable infatuation  of
moft people, that the  moment they think a perfon in a fever,
they imagine he fhould be kept in a clofe chamber, into which
not one particle of frefh air  muft be admitted.   Inftead  of
this there ought to be a conftant ftream of frefh air into a fick
perfon's chamber, fo as to keep it moderately cool.  Indeed
its degree of warmth ought  never to be greater than is agree-
able to one in perfea health.
  Nothing  fpoils the air  of a  fick perfon's  Chamber,  or
hurts the patient more, than a number of people  breathing
in it.  When the blood is inflamed,  or the humours in a pu-
trid ftate, air  that has been breathed repeatedly will greatly
increafe the difeafe.  Such air not only lofes its fpring, and
becomes unfit for the purpofe of refpiratlon, but acquires a
noxious quality, which renders it in a manner poifonous to
the fick.
  In fevers,  when the patient's fpirits are low and depreffed,
he is not only to be fupported with cordials, but every me-
thod fhould be taken to cheer and comfort his  mind. Many,
from a  miftaken zeal, when they think a perfon in  danger,
inftead of folacing his mind  with  the hopes and confolation3
of religion,  fright him with the views of hell and damnation.
It would be unfuitable  here to dwell  upon the impropriety
and  dangerous confequences of this conduct j  it often hurts
the body, and there is reafon to believe fcldom benefits the
foul.
                                                Amongtt 
OF  FEVERS  IN  GENERAL.
129
  Amongft common people, the very name of a fever gene-
rally fuggefts the neceflity of bleeding.  This notion Teems
to have taken its rife from moft fevers in this country having
been formerly of an inflammatory nature ;  but true inflam-
matory fevers are now feldom to be met with.  Sedentary oc-
cupations, and a different manner of living,  have fo chang-
ed the ftate of difeafes in  Britain, that there  is now hardly
one fever in ten where the lancet is neceflary.  In moft low,
nervous, and putrid fevers, which are now fo common, bleed-
ing  is really hurtful, as it weakens the patient, finks his fpi-
rits, &c.   We would recommend this general rule, never to
bleed at the beginning of a fever, unlefs  there be evident
figns of inflammation. Bleeding is  an excellent medicine
when neceffary,  but fhould never be wantonly performed.
  It is likewife a common notion, that it is always neceffary
to raife a fweat in the beginning of a fever.   As fevers often
proceed from an obftruaed perfpiration,  this notion is not
ill founded.   If  the patient only lies in bed, bathes  his  feet
and legs in warm water, and drinks freely of water-gruel, or
any other weak, diluting liquor, he will feldom fail to per-
fpire freely.  The warmth of the bed,- and the diluting drink,
will relax the  univerfal  fpafm, which generally afreas the
folids at the beginning of a fever; it will open the pores, and
promote the perfpiration,  by  means of which the fever may
ofttn be carried off.  But inftead of this, the common prac-
tice is to heap clothes  upon the patient, and to  give  him
things of  a hot nature, as fpirits, fpiceries, &c. whichfire
his  blood, increafe the fpafms, and render the difeafe more
dangerous.
  In all fevers a  proper attention fhould be paid to the pati-
ent's  longings.  Thefe  are the calls of Nature, and  often
point out what may be of real ufe.  Patients are not indeed
to  be indulged  in every thing that the fickly appetite may
crave; but it is generally right to let them have a little of
what they eagerly defire,  though it may not feem altogether
proper.   What the patient longs for, his ftomach will gene-
rally digeft ; and fuch things have fometimes a very happy ef-
fea.
  When a patient is recovering from  a fever, great care  is
neceffary to prevent a relapfe.   Many perfons,  by  too foon
imagining themfelves well,  have loft their lives, or contraa-
ed another difeafe, of  an obftinate nature. As the body after a
fever  is weak and  delicate, it is neceflary to guard  againft
catchiagcold.   Moderate exercife in the open air will be  of
                            O                       ufe, 
*30
OF  FEVERS  IN GENERAL
ufe,  but greit fatigue is by all means to  be avoided ;  agree-
able company will alfo have a good effea.  The diet muft.
be light,  but nourifhing.  It fhould be taken frequently,
but in fmall quantities.  It is dangerous  at fuch  a time to
eat as much as the ftomach may crave.
                CHAP.    XIV.

OF  INTERMITTING  FEVERS  OR
                     AGUES.

   INTERMITTING fevers afford the beft opportu-
    nity both of obferving the nature of a fever, and alfo
the effeas of medicine.  No perfon can be at  a  lofs to dif-
tinguifh an intermitting fever from any other,  and the proper
medicine for it is now almoft univerfally known.
  The feveral kinds of intermitting fevers take their names
from the period  in which the fit  returns, as quotidian,  terti-
an, quartan, &c.
  CAUSE S.——— Agues are occafioned by effluvia from
putrid ftagnating water.   This is evident from their abound-
ing in rainy feafons, and being moft  frequent in countries
where the foil is marfhy,  as in  Holland, the  Fens of Cam-
bridgefhire, the Hundreds of Effex, &c.   This difeafgapay
alfo be occafioned by eating too  much ftone fruit, by a^oor
watery diet, damp houfes, evening dews, lying upon the damp
ground,  watching,  fatigue,  depreffing paffions, and the like.
When the inhabitants of a high country  remove to a low
one, they are generally feized with intermitting fevers, and
to  fuch the difeafe is moft apt to prove fatal.  In  a word,
whatever relaxes the  folids,  diminiihes the perfpiration, or
obftruas the circulation in the capillary or  fmall veffels,. dif-
pofes the body to agues.
   SYMPTOM- S.----An intermitting fever generally be-
gins with a pain of the head and loins, wearinefs of the limbs,
coldnefs of the  extremities, ftretching, yawning, with fome-
times great ficknefs  and vomiting ;  to which fucceed fhiver-
ing and  violent  making. Afterwards the fkin becomes moift,
and a profufe fweat breaks out,  which generally terminates
the fit or paroxyfm.   Sometimes indeed the difeafe comes on
fuddenly, when the perfon thinks himfelf in  perfea health;
but it is more commonly preceded by liftleffnefs, lofs of appe-
tite, and the fymptoms mentioned above.
                                           REGIMEN. 
     OF  INTERMITTING  FEVERS.     131

  REGIME N.------While the fit continues,  the pati-
ent ought to drink freely of water-gruel, orange-whey, weak
camomile-tea; or, if his fpirits be  low,  fmall  wine-whey,
fharpened with the juice of  lemon.  All his drink fhould  be
warm, as that will affift in bringing on the fweat, and confe-
quently fhorten the paroxyfm *.
  Between the paroxyfms the patient muft be fupported with
food that is nourifhing, but light and  eafy of digeftion, as
veal or chicken broths, fago gruel with  a little  wine, light
puddings, and fuch like.  His drink  may be fmall negus, aci-
dulated with the juice of lemons or oranges, and fometimes a
little weak  punch.  He ought likewife to drink infufions of
bitter herbs, as camomile,  wormwood, or watertrefoil, and
may now and then take a glafs of fmall wine,  in which gen-
tian root, centaury, or fome other bitter, has been infufed.
  As the chief intentions ef cure in an ague are to brace the
folids, and  promote perfpiration,  the patient ought to take as
much exercife between the fits as he  can bear.   If he be able
to go abroad, riding on horfeback, or in a machine,  will be
of great fervice..   B.ut if he cannot bear that kind of exercife,
he ought to take  fuch as his ftrength will permit.   Nothing
tends more to prolong an intermitting fever,  than indulging
a lazy indolent difpofition.
  Intermitting fevers, under a proper regimen, will  often  go
off .without medicine ; and when the difeafe  is mild, in an
ope^pry country, there is feldom any danger from allowing it
to take its courfe; but when the patient's ftrength  feems to
decline,  or the paroxyfms are fo violent, that  his life is in
danger,  medicine ought  immediately to be adminiftered.
This however fhould  never be  done  till the difeafe be pro-
perly formed,  that is to  fay,, till the patient,  has had feveral
fits of fhaking and fweating.
  M E D IC i N E.—----.Thefirit thing to be done in the
cure of an intermitting fever,  is to cieanfe the ftomach and
bowels.  This not only renders the application  of other me-
dicines mOre fafe, but likewife more efficacious.   In this dif-
eafe the ftomach is generally loaded  with cold vifcid phlegm,
and frequently great quantities of bile are difcharged by vo-r
mit;  Which plainly points  out the neceflity of fuch evacua-
                                                   tions.


  * Dr. Lind fays,  that  twenty or twenty-five drops of laudanum
put into a cup of the patient's drink, and given about half an hour af-
ter the commencement of the hot fit, promotes the fweat, fhortens
the  fit, relieves the head, and tends greatly to remove the  difeafe. 
i3?
OF  INTERMITTING FEVERS.
 tions.  Vomits are therefore to be adminiftered before the pa-
 tient takes any other medicine.   A  dofe of ipecacoanha will
 generally anfwer this purpofe very well.  A fcruple or half a
 dram of the powder will be fufficient for an adult, and for a
 younger perfon the dofe muft be lefs in proportion.  After the
 vomit begins to operate, the patient ought to drink plentiful-
 ly of weak camomile-tea.  The vomit fhould be taken two
 or three hours before the return of the fit, and may be repeat-
 ed at the diftance of two or three days.   Vomits not only
 cieanfe the ftomach, but increafe the perfpiration, and all the
 other fecretions, which render them of fuch importance, that
 they often cure intermitting fevers without the.affiftance of
 any other medicine.
   Purging medicines are likewife ufeful, and often neceffary,
 in intermitting fevers.  A fmart purge has been known  to
 cure an obftinate ague,  after the Peruvian Bark and other
 medicines  had been  ufed  in vain.   Vomits, however^ are
 more fuitable in this difeafe,  and render purging lefs neceO-
 fary ; but if the patient be afraid to take a vomit,  he ought in
 this cafe to cieanfe the  bowels by a  dofe or two of glauber
 falts, jalap, or rhubarb.
   Bleeding may fometimes be proper at the beginning of an
 intermitting fever, when exceffive heat, a delirium, &c. give
 reafon to fufpea an  inflammation ; but as the blood is feldom
 in an inflammatory ftate in intermitting fevers, this operation
 is rarely neceffary.   When frequently repeated,  it tends  to
 prolong the difeafe.
   After proper evacuations, the patient  may fafely  ufe the
 Peruvian bark, which may be taken  in any way that  is  moft
 agreeable to  him.   No preparation of the bark feems to an-
 fwer better than the moft fimple form  in which it  can be giv-
 en, viz. in powder.
  Two ounces ofthe beft Jefuits bark, finely powdered, may
 be  divided  into twenty-four dofes.   Thefe may either be
 made intoboluffes, as  they are ufed,  with a little fyrup of le-
 mon, or mixed in aglafsof red wine,  a cup of camomile-tea,
 water-gruel, or any other drink  that is more agreeable to the
patient.
  In an ague which returns every day, one of the  above dofes
 may be taken every two hours during the interval of the fits.
 By this  method the patient will be able to take  five  or fix
 dofes between each paroxyfm.  In a tertian,  or third-day a-
gue, it will be fufficient to take a dofe every third  hour,  dur-
ing the interval, and in a quartan every fourth.   If the pa-
                                                   tient 
   OF  INTERMITTING  FEVERS.     133

tient cannot take fo  large a dofe of the batk, he may divide
each of  the  powders  into two  parts, and take one every
hour, &c.  For a young perfon,  a fmaller quantity of this
medicine will be fufficient, and the dofe muft be adapted to
the age,  conftitution, and violence of the fymptoms.
  The above quantity  of bark will frequently flop an ague;
the patient however ought not to leave off taking the medi-
cine as foon as the paroxyfms are ftopped,  but fhould conti-
nue to ufe it till there is reafon to believe the difeafe is entire-
ly overcome.   Moft ofthe failures in the cure of this difeafe
are owing to patients not continuing to  ufe the medicine long
enough.   They are generally  directed  to take it till the fits
are ftopped, then to leave it off, and begin again at fome dif-
tance of time ; by which means  the difeafe gathers ftrength,
and often returns with  as much violence as before.  A relapfe
may always be prevented by the  patient's continuing to take
fmall dofes ofthe medicine for fome time after the fymptoms
difappear.  This is both  the moft fafe and effeaual  method
of cure.
  An ounce of gentian root, calamus arorrfaticus, and orange-
peel, of each half an ounce,  with three or four handfuls of
camomile flowers,  and an handful  of  coriander-feed,  all
bruifed together in a mortar, may be ufed in form of infufion
or tea.   About half an handful  of thefe ingredients may be
put into  a tea-pot, and  an Englifh pint  of boiling water pour-
ed on them.  A cup of this infufion drank three or four times
a-day will greatly promote the cure.  Such patients as cannot
drink the watery infufion, may put two handfuls of the fame
ingredients into a bottle of white wine, and take a glafs of it
twice or  thrice a-day.  If patients drink freely of  the above,
or any other proper infufion of bitters,  a fmaller quantity of
bark than  is generally  ufed,  will be fufficient to cure an a-
gue*.
  Thofe who cannot fwallow the bark in fubftance, may
take it in deeodtfon or infufion. An ounce of bark in powder
                                                    may

  * There is reafon to believe, that fundry of our own plants  or
barks, which are very bitter and aftringent, would fucceed in the
cure of intermitting fevers, efpecially when affifted by aromatics.
But as the Peruvian Bark, has  been long approved in the cure of this
difeafe, and is now to be  obtained at a very reafonable rate, it is of
lefs importance to fearch after new medicines.  We cannot how-
ever omit taking notice, that the  Peruvian Bark  is very often adul-
terated, and that it requires confiderable fkill to diftinguiih  between
the genuine and  the falfe.  This ought to  make people very cauti-
ous of whom they purchafe it. 
*34    OF  INTERMITTING  FEVERS.
 may be infufed in a bottle of white wine for four or five days,
 frequently fhaking the bottle,  afterwards let the powder fob-
 fide,  and pour off the clear liquor.  A wine glafs  maybe
 drank three or four times a-day,  or oftener, as there  is occa-
 fion.   If a decoaion be more agreeable, an ounce of the bark,
 and two drams of fnake-root bruifed, with an equal quantity
 of fait of wormwood, may be boiled in a quart of water, into
 an Englifh pint.   To the  ftrained liquor  may be added an
 equal quantity of red wine, and a glafs of it taken frequently.
   In obftinate agues, the bark will be found much more ef-
 ficacious when affi-fted by brandy or other warm cordials, than
 taken alone.  This I  have had frequently occafion to obferve
 in a country where intermitting fevers were endemical. The
 bark feldom fucceeded unlefs affifted by fnake-root,  ginger,
 canella alba, or fome  other warm aromatic.   When  the fits
 are very frequent and violent, in which cafe the fever often
 approaches towards an inflammatory nature,  it  will be fafer
 to leave out the aromatics, and to add fait of tartar in their
 ftead.  But in an obftinate tertian or quartan,  in the end of
 autumn or beginning of winter, warm and cordial medicines
 are abfolutely neceflary *.
   As autumnal and winter agues generally prove much more
 obftinate than thofe which  attack  the patient  in fpring or
 fummer, it will be neceffary to continue the ufe of medicines
 longer in the former than in  the latter.   A  perfon  who is
 feized with an intermitting fever in  the beginning of winter,
 ought frequently,'  if the feafon proves rainy,  to take a little
 medicine, although the difeafe may  feem to be cured,  to pre-
 vent a relapfe, till the return of the warm feafon.  He ought
 likewife to take care not to be much abroad in wet weather,
 efpecially in cold eafterly winds.
   When agues are not properly cured, they often degenerate
 into obftinate chronical difeafes, as the dropfy, jaundice, &c,
 For this reafon all  poffible care fhould be taken to have them
 radically cured, before the humours be vitiated, and the con-
 ftitution fpoiled.
  Though nothing is more rational than the method of treat-
ing intermitting fevers, yet, by  fome  ftrange  infatuation,
                                                    more

  * I" obftinate agues when the patient is old, the  habit phlegma-
 tic  the feafon rainy, the fituation damp, or the like, it will be ne-
 ceifary to mix with two ounces of the bark half an ounce of Virgi-
 nian fnake-root, and a quarter of an ounce of ginger, or fome other
warm aromatic ; but  when the fymptoms  are of an inflammatory
nature, half an ounce of fait of wormwood or fait of tartar may  be
 aided to the above quantity of bark.                      7 
    OF INTERMITTING  FEVERS.    135

more charms and whimfical remedies are daily ufed  for  re-
moving this than any other difeafe.  There is hardly an old
woman who  is  not poffeffed of a noftrum for  flopping an
ague;  and it is amazing with what readinefs their pretenfi-
ons are believed.   Thofe in diftrefs eagerly grafp  at any thing
that promifes fudden relief; but the fhorteft way is not al-
ways the beft in the treatment of difeafes,  The only method
to obtain a fafe and lafting cure,  is gradually to affift Nature
in removing the caufe of the diforder.
   Some indeed try bold, or rather fool-hardy experiments to
cure agues,  as  drinking great quantities of ftrong liquor,
tumping into a river, &c.   Thefe  may fometimes have the
defired  effea, but  muft always be  attended with  danger.
When there is any degree of inflammation, or the leaft ten-
dency  to it,  fuch experiments may prove fatal.    The only
patient whom I remember to have loft in an intermitting fe-
ver, evidently killed himfelf by drinking ftrong liquor, which
fome perfon had  perfuaded him would prove an infallible re-
medy.
   Many dirty things are extolled for the cure of intermitting
fevers, as cobwebs, fnuffings of  candles,  &c.  Though
thefe may fometimes fucceed, yet their very naftinefs is fuffi-
cient to fet them afide, efpecially  when cleanly  medicines
will anfwer the purpofe better.   The only medicine that can
be depended upon,  for thoroughly curing an intermitting  fe-
ver, is the Peruvian bark.  It may always be ufed with fafe-
ty : And I can honeftly declare,  that in all my praaice I ne-
ver knew  it fail, when combined with the medicines men-
tioned above, and duly perfifted in.
   Where agues are endemical, even children  are often  af-
fliaed  with that difeafe.  Such patients are very difficult to
cure, as they can feldom be prevailed upon to take the bark,
or any other difagreeable medicine.  One method of render-
ing this medicine more palatable, is to make it into a mix-
ture with diftilled waters and fyrup, and afterwards to give it
an agreeable fharpnefs  with the  elixir or fpirit of vitriol.
This both improves the medicine,  and takes off the naufe-
ous tafte.  In cafes where the baik cannot be adminiftered,
the faline  mixture  may  be  given with advantage to chil-
dren *.
   Wine-whey is a very proper drink for a child in an ague;
to half an Englifh pint of which may be put a  tea-fpoonful
of the fpirit of hartfhorn.  Exercife is likewife of confide-
                                                    rable
              * See Appendix, Saline mixture. 
136 •  OF  INTERMITTING  FEVERS.

rable fervice; and when the difeafe proves obftinate, the child
ought, if poffible,  to be removed to a  dry  warm air.  The
food ought to be nourifhing, and fometimes a little generous
wine fhould be allowed.
  To children and fuch as cannot fwallow the.fcark, or when
the ftomach  will not bear it, it may  be given  by clyfter.
Half an ounceof the extraa of bark diffolved in four ounces
of warm water, with the addition of half an ounce of fweet
oil, and fix or eight drops of laudanum, is the form recom-
mended by  Dr. Lind for an adult, and this to  be repeated
every fourth hour, or oftner, as the occafion fhall require.
For children the quantity of extraa and laudanum muft be
proportionally leflened.  Children  have been Cured of  agues
by making them wear a waiftcoat with powdered bark quilt-
ed between  the folds of it;  by bathing them frequently in a
ftrong decoaion of the bark,  and  by rubbing the fpine with
ftrong fpirits, or with a mixture of equal parts of laudanum
and the faponaceous liniment.
  We  have been the more full upon this difeafe, becaufe  it
h very common, and  becaufe few patients  in an ague  apply
to  phyficians unlefs  in  extremities.   There  are however
many cafes  in which the difeafe is very  irregular,  being dim-
plicated with other  difeafes,  or  attended  with  fymptoms
which  are both  very dangerous, and very difficult to under-
ftand.  All  thefe  we  have purpofely  paffed over, as they
would only bewilder  the  generality  of readers.   When the
difeafe is very irregular, or the fymptoms dangerousy the pa-*
tient ought immediately to apply to  a phyfician, and ftriaiy
to follow his advice.
  To  prevent agues,  people muft endeavour to  avoid  their
caufes.  Thefe  have been  already pointed out in the begin-
ning of this feaion ; we fhall therefore only add one preven-
tive medicine, which  may be of ufe to  fuch  as are obliged to
live in  low marfhy countries, or who are liable to frequent
attacks of this difeafe.
  Take an ounce ofthe  beft Jefuits bark, Virginian fnake-
root, and orange-peel, of each half an ounce ° bruife them
all together, and infuie for five or fix days in a bottle of bran-
dy, Holland gin, or any good fpirit; afterwards pour off the
clear liquor, and take a wine-glafs of it twice or thrice a-day.
This indeed is recommending a dram ; but the  bitter ingre-
dients in a great meafure take off the ill effeas of the  fpirit.
Thofe who do not chufe it in brandy, may infufe it in wine;
and fuch as can bring themfelves to chew the bark, will find
                                                    that 
    OF INTERMITTING  FEVERS.  ,137

that method fucceed very well.  Gentian root, or calamus
aromaticus,  may alfo  be chewed by turns for the fame pur-
pofe.   All bitters  feem to be  antidotes to agues,  efpecially
thofe that are warm and aflringent.


                 CHAP.   XV.

  OF  AN  ACUTE  CONTINUAL  FEVER.   •

     THIS  fever is denominated acute, ardent-; or  inflam-
       matory.  It moft commonly attacks the young, or
thofe about the prime or vigour of life, efpecially fuch as live
well,  abound  with blood,  and whofe fibres are ftrong and
elaftic.   It  feizes  people at all feafons of the year; but is
moft frequent in the fpring and  beginning of fummer.
  CAUSE S.-------An ardent fever may be occafioned
by any thing that overheats the body, or produces plethora,
as violent exercife, fteeping in the fun, drinking ftrong li-
quors,  eating fpiceries,  a full diet, with little exercife,  &c.
It may likewife be occafioned by whatever obftruas the per-
fpiration, as lying on the damp ground, drinking cold liquor
whfwthe body is  hot,  night-watching, or the like.
 'W MPTOM S.------Arigourorchillnefs general*
ly ufhers in this fever, which is foon fucceeded by great heat,
a frequent and full pulfe, a pain of the head, dry fkin, red-
nefs of the eyes, a florid countenance, pains  in  the backy
loins, &c.   To thefe fucceed  difficulty  of breathing, fick-
nefs, with an inclination to vomit.  The patient complains
of a great thirft, has  no appetite for folid food, is reftlefs,
and his tongue generally appears black and rough.
  A delirium, exceffive reftlefsnefs,  great oppreffion of the
breaft,  with laborious  refpiration, ftarting  of  the tendons,
hiccup, cold, clammy fweats,  and an involuntary  difcharge
of urine, are very dangerous fymptoms.
  As this difeafe is always attended with danger, the  beft
medical affiftance ought to be procured  as  foon as poffible.
A phyfician may  be of ufe at the beginning,  but his fkill is
often  of no avail afterwards.   Nothing can be more unac-
countable than the condua of thofe who have it in their pow-
er,  at the beginning of a fever, to procure the beft medical
affiftance, yet  put it  off till things come to an extremity.
When  the difeafe,  by delay or wrong treatment, has  become
incurable, and has exhaufted the ftrength of the patient,  it
                            P                         is 
  138   OF  AN ACUTE CONTINUAL FEVER.

  is in vain-to hope for relief from medicine.   Phyficians may
  indeed affift  Nature;  but  their attempts muft ever prove
  fruitlefs, when fhe is no longer able toco-operate with their
  endeavours.
    REGIME N.—From the fymptoms  of this difeafe
  ft is evident, that the humours muft be too vifcid and acrimo-
  nious ; that the perfpiration, urine, faliva, and all the other
  fecretions, are in too  fmall  quantity;  that the veffels  are
• rigid,, and- the heat of  the whole body too great: All thefe
  clearly point out the neceflity of a regimen, calculated to di-
  lute the blood, correa  the  acrimony  of the humours, allay
  the exceffive heat, remove the fpafmodic ftriaure ofthe vef-
 fels, and promote the feGretions.
    Thefe important purpofes may be greatly promoted by
 drinking plentifully of  diluting liquors, as water-gruel, or
 oatmeal-tea, clear whey, barley-water, balm-tea, apple-tea,
 &c. Thefe maybe fharpened with juice of orange,jelly of cur-
 rants, rafpberries* and  fuch like: Orange-whey is likewife
 an  excellent cooling  drink.  I& is made by boiling  among
 milk and water a bkter orange fliced  till the curd feparates.
 If no orange can be had,  a lemon, a little creatn of Jarr%
 or a few fpoonfuls of  vinegar, will  have the fame effect.
 Two or three fpoonfuls of white-wine may occafionaMhbLat
 added  to the liquor when boiling.                   *$P^
   If the patient be eoftive,  an ounce of tamarinds, with two
 ounces of ftoned raifins of the fun, and  a couple  of figs,
 may be boiled  in three  Englifh pints  of water to a  quart.
 This makes a<very pleafant drink, and may be  ufed at dis-
 cretion.   The common peaoral decoaion is  likewife a very
 proper drink in this difeafe.  A tea-cupful of  it may be ta-
 ken every two  hours,  or oftener,  if the patient's heat and
 thirft be very great*.
   The above liquors  muft all be drank a little warm. They
 may. be ufed in fmaller quantities  at  the beginning of a
 fever,  but more freely afterwards,  in  order  to affift  in
 carrying off- the mor-bid matter by the different excretions.
 We have mentioned a variety of liquors,that the patient may
 have it in his power toehufe thofe which are moft agreeable;
 and that, when tired of one, he  may haverecourfe to another.
   The patient's diet muft be very fpare and light.  All forts
 of flefh-meats, and even chicken-broths, are to  be avoided.
 He may be allowed groat-gruel, panado, or light bread boil-
 ed in water ; to which may be  added a few grains  of com-
                                                    mon'
           * See Appendix,  Pectoral Decoction. 
    OF AN ACUTE CONTINUAL FEVER.    r39

mon fait, and a little fugar, which will render it more palat-
able.  He may eat roafted apples with a little fugar, toafted
bread with jelly of currants, boiled prunes, &c.
  It will greatly relieve the patient, efpecially  in an hot fea-
fon, to have frefh  air frequently let into his chamber.   This
however muft always be done in fuch a manner as not to en-
danger his catching  cold.
  Ir is too common in fevers to load the patient with bed-
clothes, under the pretence of making him fweat, or defend-
ing him from the cold.   This cuftom has many ill effeas. It
increafes the heat of the body, fatigues the patient, and re-
tards, inftead of promoting, the perfpiration.
  Sitting upright in bed, if the patient be able to bear it, will
often have  a good effea.  It relieves.the head, by retarding
the motion ofthe  blood to the brain.  But this pofture ought
never to be continued too long : And if the patient be inclin-
ed  to fweat, it will be more fafe to let him lie,  only railing
his head a little with pillows.
  Sprinkling the  chamber with vinegar,  juice of lemon, or
vinegar and rofe-water, with a little nitre diffolved in it,  will
greatly refrefh the patient.  This ought to be done frequent*
ly, efpecially  if the weather be hot.
   The patient's  mouth fhould be often walhed with a mix-
ture of water  and  honey, to which a little  vinegar may be
edded; or with a decoaion of figs in barley-water.  His feet
and hands ought  likewife frequently to be bathed  in  luke-
 warm water ;  efpecially if the head be affeaed.
   The patient fhould be kept as quiet and eafy as poffible.
 Company,  noife, and every thing that difturbs the mind, is
 hurtful.  Even too much light, or any thing  that affeas the
 fenfes, ought  to be  avoided.  His attendants fhould be as few
 as poffible, and they ought not to be too often changed.  His
 inclinations ought  rather to be foothed  than contradiaed;
 even the promife of what he craves will often fatisfy him as
 much as its  reality.
    M E D IC I N E.-      In this and all other  fevers, at-
 tended with a hard,full, quick pulfe, bleeding is ofthe great-
 eft importance.  This operation ought always to be perform-
 ed as foon as  the fymptoms of an inflammatory fever appear.
 The quantity of blood to be let, however, muft be in propor-
 tion to the ftrength of the patient and the violence of the dif-
 eafe.  If after the firft bleeding, the fever fhould rife, and the
 pulfe become  more frequent and hard, there  will be a nee f-
 iity for repeating it a feconJ, and perhaps a  third,  or ever, a
                                                    four ^ 
 140    OF AN ACUTE CONTINUAL  FEVER.

 fourth time,  which may be done at the  diftance of  twelve,
 eighteen, or twenty-four hours from each other, as the fymp-
 toms require.   If the pulfe continues foft, and the patient is
 tolerably eafy after the  firft bleeding, it ought not to be re-
 peated.
   If the heat and fever  be  very great, forty or  fifty drops of
 the  dulcified, or fweet  fpirit of vitriol may  be made into a
 draught, with an ounce of rofe-water,  two ounces of com-
 mon water, and half an ounce of fimple fyrup,  or a bit of loaf
 fus;ar. This draught may be given to the patient every three
 orYour hours while the fever is violent; afterwards,  once in
 five  or fix hours will  be fufficient.
   If the patient be affliaed with reaching, or an inclination
 to vomit, it will be right to affift Nature's attempts, by giv-
 ing him weak camomile-tea or lukewarm water to drink.
   If the body is bound,  a clyfter of milk and water  with a
 little fait,  and a fpoonful of fweet oil  or  frefh butter in it,
 ought daily to be adminiftered.  Should  this not have the de-
 fired effea, a tea-fpoonful of magnefia alba, or cream of tar-
 tar,  may be frequently put into his drink.   He may likewife
 eat tamarinds, boiled prunes, roafted apples, and the like-.
   Ifabout the 10th, nth, or  12th day,  the pulfe becomes
 more foft, the tongue moifter, and the urine begins to let fall
 a reddifh fediment, there is reafon to expea a favourable if-
 fue to the difeafe.  But if,  inftead of thefe  fymptoms,  the
 patient's fpirits grow languid, his pulfe finks, and his  breath-
 ing becomes difficult ; with  a ftupor, trembling ofthe  nerves,
 ftarting of the tendons, &c. there is reafon to fear, that the
 confequences will be fatal.   In this cafe  bliftering  platters
 muft be applied to the head,  ancles, infide  of the  legs or
 thighs,  as there may  be occafion ;  poultices of wheat-bread,
 muftard, and vinegar may  likewife be applied to the foles of
 the feet, and the patient muft be fupported  with cordials, as
 ftrong wine-whey, negus,  fago-grucl with wine in it, and
 fuch like.
   A  proper regimen is not only  neceffary during the fever,
 but likewife after the patient begins to recover.  By negleft-
 ing this, many relapfe, or  fall into other difeafes, and conti-
 nue valetudinary for life.   Though the body be weak after a
 fever, yet the food for fome  time ought to be rather cleanfing
 than of too nourifhing  a nature.   The perfon fhould take
great care not to exceed  in any thin?.  Too  much food,
drink,  exercife,  company,  &c. are carefully to be avoided.
1 he  mind ought likewife to be kept eafy, and the  perfon
                                                  Should 
    OF AN ACUTE CONTINUAL  FEVER.    141

fhould not attempt to purfue ftudy,  or any bufinefs that re-
quires intenfe thinking.
   If the digeftion be bad,  or the perfon be troubled at times
with feverifh heats, an infufion of Peruvian bark in cold wa-
ter will be of ufe.  It will ftrengthen the ftomach, and help
to fubduethe remains of the fever.
   When the patient's ftrength is pretty well recovered, he
ought to take fome gentle laxative.   An ounce of tamarinds
and a dram of fena may be  boiled  for a few minutes in an Eng-
lifh pint of water, and an ounce of manna diffolved in the de-
coaion ; afterwards  it  may  be  ftrained,  and a tea-cupful
drank every hour till it operates.  This dofe may  be repeated
twice or thrice, five or fix days intervening betwixt each dofe.
   Thofe who follow laborious employments ought not tore-
turn too foon to  their labour after a fever, but fhould keep
eafy till their ftrength and fpirits be recruited.
r       '

                CHAP.     XVI.

        OF    THE    PLEURISY.

      TH E true pleurify is an inflammation of that membrane
       called the pleura,  which lines the infide of the  breaft.
It is  diftinguifhed  into the  moift and dry.   In  the former,
the patient fpits freely ;  but in the latter, little or  none at all.
There is likewife a fpecies of this difeafe, which is called the
fpurious or bajlardpleurify, in which the pain is more exter-
nal,  and  chiefly affeas  themufcles between the  ribs.  The
pleurify prevails among labouring people,  efpecially fuch as
work without doors, and  are of a fanguine conftitution.   It
is moft frequent in the fpring feafon.
   CAUSE S.    «r  The  pleurify may be occafioned by
whatever obftruas the perfpiration  ; as cold northerly winds;
drinking cold liquors when the body  is hot;  fteeping with-
out doors on the damp ground;  wet clothes;  plunging the
body into cold water, or expofing it to the cold air, when co-
vered  with fweat,  &c.   It may likewife  be occafioned by
drinking ftrong liquors; by the  ftoppage of ufual evacuati-
ons ;  as old ulcers, iffues,  fweating  of the feet or hands, &c.
the fudden ftriking  in  of any  eruption, as the itch,  the
meafles, or the fmall-pox.   Thofe  who have been accuftom-
ed to bleed at a certain feafon of the year, are apt, if they ne-
glea it, to be feized with a pleurify,  Keeping the body too
                                                   warm 
142
OF   THE   PLEURISY.
 warm by means of fire, clothes, Sec. renders it more liable to
 this difeafe.  A pleurify  may  likewife be occafioned by vio-
 lent exercife, as running, wreftling, leaping, or by fupporting
 great weight, blows on the breaft, &c.  A bad conformation
 of the body fometimes renders perfons more liable to this dif-
 eafe,  as a narrow cheft, a ftraitnefs of the arteries of the pleu-
 ra, &c.
   SYMPTOM S.------This, like  moft other fevers,
 generally begins with chillncfs  and fhivering,  which are fol-
 lowed by heat, thirft,  and reftleffnefs.   To  thefe fucceed a
 violent pricking  pain  in  one  of the fides among  the  ribs.
 Sometimes the pain  extends  towards the  back-bone, fome-
 times  towards the forepart of tfhe breaft, and at other times
 towards the fhoulder-blades.  The pain is generally moft vi-
 clent  when the patient draws in his breath.
   The pulfe in this difeafe is commonly quick and hard, the
 urine high-coloured ; and if  blood be let, it is covered  with
 a tough cruft, or buffy coat.  The patient's fpittle  is at firft
 thin, but  afterwards it becomes grofler, and is often ftreaked
 with blood.
   REGIMEN.—-----Nature  generally  endeavours to
carry  off this difeafe by a critical difcharge  of  blood from
 fome part of the body,  by expeaoration, fweat, loofe ftools,
 thick urine, or the like.  We ought therefore to fecond her
 intentions, by leffening the force of the circulation,  relaxing
 the veffels, diluting the humours, and promoting expeaora-
 tion.
   For thefe purpofes the diet, as in the former difeafe,ought
 to be cool, flender,  and  diluting.  The patient muft avoid
 all food that is vifcid, hard of digeftion, or that affords much
 nourifhment ; as flefh, butter,  cheefe, eggs,  milk,  and  alfo
every  thing that is  of a heating nature.  His drink may be
 fweet whey, or an infufion of peaoral andjbalfamic vegetables*.
   Barley-water,  with  a  little  honey, or jelly of  currants
mixed with it, is likewife a very proper drink in this difeafe.
It is made by boilang an ounce  of  pearl-barley in three En-
glifh pints of water to two, which muft afterwards be ftrain-
ed.  The decoaion of  figs,  raifins, and barley, &c. recom-
mended in the preceding difeafe,  is here likewife very pro-
per.   Thefe and other diluting liquors are not to be drank in
large  quantities at a time, but the patient ought, in a man-
ner, to keep continually fipping them, fo as to render his
mouth and throat always  moift.  All  his  food  and drink
inould be taken a little warm.

         * c   a                                    The
         * See Appendix, Peroral Infufion. 
       OF    THE   PLEURISY.      143

   The patient fhould be kept quiet, cool,  and every  way
 eafy, as direaed under the foregoing difeafe.  His feet and
 hands ought daily to be bathed in warm water;  and he  may
 fometimes fit up in bed for a fhort fpace,. in  order to relieve
 his head.
   M E D I C I N E.———Almoft  every  perfon   knows
 when a fever is attended with a violent pain of  the fide, and
 a quick, hard pulfe, that bleeding is neceffary.   When thefe
 fymptoms come on, the fooner  this  operation  is performed
 the better ; and the quantity at firft muft be pretty large, pro-
 vided the patient be able to bear it. A large quantity of blood
 let at once,  in the beginning of a pleurify, has a much bet-
 ter effea than feveral fmall bleedings.   An  adult may lofe
 twelve or fourteen  ounces of blood  as foon as it is certainly
 known that he is  feized with a pleurify.  For a younger per-
 fon, or one of a delicate conftitution, the quantity muft be
 lefs.
  If, after the firft bleeding, the flitch, with the other vio-
 lent  fymptoms, fhould continue, it will be neceffary, at the
 diftance of twelve or eighteen  hours, to  let eight  or nine
 ©unces more.   If the fymptoms do  not then abate, and the
 blood fhews a ftrong buffy coat, a third,  or  even a  fourth
 bleeding may be requifite.  If  the pain of the fide  abates,
 the pulfe becomes fofter, or the patient begins  to fpit freely,
 bleeding ought not to be repeated.   This  operation is feldom
 neceffary after the third or fourth day of the fever, and ought
 not then to be performed, unlqfs in the moft  urgent circum-
 ftances.
  The blood may  be  many ways attenuated  without letting
 it off.   There are likewife many things that may be done to
 eafe the pain of the fide befides bleeding, as fomenting, blif-
 tering, &c.   Fomentations may be made  by  boiling a hand-
 ful of the flowers of elder, camomiie, and common mallows,
 or any other  foft vegetables,  in a proper  quantity of  water.
 The herbs may be either put into a flannel bag, and applied
 warm to the fide,  or flannels may be dipped in the decoction,
 afterwards wrung  out,  and applied to the  part affeaed, with
 as much warmth as the patient can eafily bear.   As the cloths
 grow cool,  they muft  be changed, and great  care taken thai
 the patient do not  catch cold.   A bladder  may be filled with
warm milk and water, and applied to the fide, if the above
method of fomenting be found inconvenient.   Fomentations
 not only eafe  the pain,  but relax the  veffels, and prevent the
ftagnation of the blood and other humours.   The fide may
                                                likewife? 
OF    THE    PLEURISY.
likewife be frequently rubbed with a little of the volatile li-
niment*.
   Topical bleeding has often a very good effea in  this dif-
eafe.   It may either be performed by applying a number of
leeches to the part affeaed, or by cupping,  which is  both
a more certain and expeditious method than the other.
   Leaves of various plants might likewife be applied to the
patient's fide with advantage.  I  have often feen great bene-
fit from young cabbage-leaves applied warm to the fide in a
pleurify.  Thefe not only relax the parts, but likewife draw
off a little moifture, and may prevent the neceflity of Witter-
ing plafters;  which, however, when other  things fail, muft
be applied.
   If the ftitch continues after repeated  bleedings,  fomenta-
tions, &c. a bliftering-platter muft be laid upon the part af-
feaed, and fuffered  to  remain for two days.  This not  only
procures a difcharge from the fide,  but takes off the  fpafm^
and by that means affiftsin removing the caufe of the difeafe.
To prevent a ftranguary when the  bliftering-plafter is on,
the patient may drink freely of the arabic emulfion f.
   If the patient be coftive,  a clyfter of thin water-gruel, or
of barley-water,  in  which  a handful of  mallows, or any
other emollient vegetable, has been boiled, may be  daily ad-
miniftered.  This will not only empty the bowels,  but have
the effea of a warm fomentation applied to the inferior vifce-
ra, which will help to make a derivation from the breaft.
  The expeaoration, or fpitting, may be promoted by (harp,
oily, and mucilaginous medicines.   For  this purpofe, an
ounce of the oxymel,  or the vinegar of fquills, may be ad-
ded to fix ounces  of the peaoral  decoaion, and two table-
fpoonfuls of it taken every two hours.
   Should thefquill difagree with  the ftomach, the oily emul-
fion may be adminiftered % >  or,  in pleee  of it, two  ounces
of the oil of fweet almonds,  or oil of olives, and two ounces
of the fyrup of violets, may be  mixed with as much fugar-
candy powdered,  as will make  an eleauary of the confift-
ence of honey.  The patient may take a tea-fpoonful of this
frequently, when  the  cough is  troublefome.   Should oily
medicines prove naufeous, which is fometimes the cafe, two
tabie-fpoonfuls of the folution of gum ammoniac in barlev-
water may be given  three or four  times a-day §.

           * See  Appendix, Volatile Liniment.
            t See Appendix, Arabic Emulfion.
            % See Appendix, Oily Emulfion.
            S See  Appendix,  Solution of Gum Ammoniac. 
OF   THE  PLEURISY.
MS
  If the  patient does not perfpire,  but has a burning heat
upon his fkin, and paffes very little water, fome fmall dofes
of purified nitre and camphire will  be of ufe.  Two drams
of the former may be rubbed with five  or fix grains of the
latter in a mortar, and the whole divided into fix dofes,  one
of which may be taken every five or fix hours, in  a  little of
the patient's ordinary drink.
  We  fhall only mention one medicine more, which fome
reckon almoft a fpecific in the pleurify, viz.  the decoaion of
the feneka  rattle-fnake root *.  After bleeding, and other
evacuations, have been prertufed, the patient may take two,
three, or four tab le-fpoon full of this decoaion, according as
his  ftomach will bear  it, three  or four times a-day.  If  it
fhould  occafion  vomiting, two or three  ounces of  fimple
cinnamon-water may be mixed with the quantity of decoai-
on  here direaed, or it may be taken in fmaller dofes.  As
this medicine promotes perfpiration and urine, and likewife
keeps the body eafy, it may be of fome fervice in a pleurify,
or any other inflammation of the breaft.
  No one will  imagine,  that thefe medicines are all to be
nfed at the fame time.  We have mentioned different things,
on purpofe  that people may  have it in their power  to chufe ;
and likewifo, that  when  one cannot be obtained,  they  may
make ufe of another.   Different medicines are no  doubt ne-
ceflary in the different periods of a diforder;  and where one
fails of fuccefs,  or difagrees with  the patient, it will  be pro-
per to try another.
   What is called the crifis,  or height ofthe fever, is fome-
times attended with very alarming fymptoms, as difficulty of
breathing,  an  irregular  pulfe,  convulsive  motions,  he.
Thefe fright the attendants, and induce them to do improper
things,  as bleeding the patient, giving him ftrong ftimulating
medicines,  or. the like, JBut they are only the  ftruggles  of
Nature to overcome the difeafe, in  which fhe ought to be af-
fifted by plenty of diluting drink, which is then  neceffary.
If the patient's ftrength however be much exhaufted by the
difeafe, it will be neceffary at this time to fupport him with
frequent fmall draughts of wine-whey, negus, or  the like.
   When the pain and fever  are gone, it  will be proper, af-
ter the patient has recovered fufficient ftrength,  to give "him
fome gentle purges,  as thofe direaed towards the  end of the
acute continual fever.  He ought likewife to ufe a light diet
                            Q.                        of

       * Sec Appendix, Decoction of Seneka Rout, 
 14*       OF   THE   PLEURISY.

 of eafy digeftion, and his drink fhould be butter-milk, whey,
 and other things  of a cleanfing nature.

        Ofthe BASTARD  PLEURISY.
   That fpecies of pleurify which is called  the bajlard or
 fpurious, generally goes off by keeping warm for a few days,
 drinking plenty of diluting liquors,  and obferving a proper
 regimen.
   It is known by a dry cough,  a quick pulfe, and a difficul-
 ty of lying on the affeaed fide* which laft does not always
 happen in the true pleurify.  Sometimes indeed this difeafe
 proves obftinate,  and requires oleeding,  with cupping,  and
 fcarifications of the part affeaed.   Thefe, together with the
 ufe of nitrous and other cooling medicines, feldom fail to ef-
 fea a cure.

          Ofthe PARAPHRENITIS.
  The paraphrenias, or inflammation of the diaphragm, is
 fo  nearly conneaed with the pleurify, and refembles  it fo
 much in the manner of treatment, that it is fcarce neceflary
 to confider it as afeparate difeafe.
  It is attended with a very acute fever, and an extreme pain
of the part affeaed, which is generally augmented by cough-
ing, fneezing, drawing in the breath, taking food, going to
ftool, making water, &c.   Hence the patient breathes quick,
and draws in his  bowels to prevent the motion  of the dia-
phragm ; is  reftlefs, anxious, has a dry cough, a  hiccup,
and often a delirium.   A convulfive laugh, or rather a kind
of involuntary grin, is no uncommon  fymptom of this dif-
eafe.
  Every method muft be taken to prevent a fuppuration, as
it is impoffible to  fave the patient's life when  this happens.
The regimen and medicine are in all refpeas the fame  as in
the  pleurify.    We fhall only add,  that in this difeafe emolli-
ent  clyfters are peculiarly ufeful, as they relax  the bowels,
and by that means make a derivation from the part affeaed.
CHAT. 
C   H7   3
v.***.
              CHAP.    XVII.

OF A  PERIPNEUMONY,   OR  INFLAMMATI-
              ON  OF  THE  LUNGS.

  A S this difeafe affbas an organ which is abfolutely necef-
 /*\. fary to life, it muft always be attended  with danger.
Perfons who abound with^hick blood, whofe fibres are tenfe
and rigid, who feed  updHkrofs aliment,  and drink ftrong
vifcid liquors, are moft liS^Hfo a peripneumony.  It is ge-
nerally fatal  to thofe who n^Ra Hat breaft, or  narrow cheft,
and to fuch  as are affliaed wan an afthma, efpecially in the
decline of life.   Sometimes the inflammation reaches to one
lobe of the lungs only,  at other times the whole of that or-
gan is  affeaed; in which cafe the difeafe can  hardly fail to
prove fatal.
   When the difeafe proceeds from a vifcid pituitous matter,
obftruaing the veffels of the lungs, it is called a fpurious or
bajlardperipneumony.  When  it arifes from a thin  acrid de-
ffoaion on the lungs, it is denominated a catarrhal  peripneu*
mony, he.
   CAUSE S.  <    An inflammation of the lungs is fome-
times a primary difeafe,  and fometimes it is the confequence
of other difeafes, as a  quinfey, a pleurify, he.  It proceeds
from the fame caufes as  the pleurify,  viz. an obftruaed per-
fpiration from cold  wet  clothes, &c. or from an increafed cir-
culation of the blood  by violent exercife, the ufe of fpiceries,
ardent fpirits, and fuch like.   The pleurify and peripneumo-
ny are  often complicated ; in which  cafe the difeafe is called
a pleuro peripneumony.
   SYMPTOM S.------Moft of thefymptoms of a pleu-
rify likewife attend an  inflammation of the lungs; only in
the latter, the pulfe  is  more  foft, and the pain lefs acute;
but the difficulty of breathing, and oppreffion of the breaft,
are generally greater.
   REGIME N.-----As  the regimen  and  medicine are
in all refpeas the fame  in the true peripneumony as in the
pleurify,  we lhall not here repeat them, but refer the reader
to the treatment of that difeafe.   It may not however be im-
proper to add, that the aliment ought  to be more flender and
thin in this  than in any other inflammatory  difeafe.   The
learned Dr.  Arbuthnot afferts, that  even common whey is
fufficient  to fupport the patient, and that decoaions of bar*
                                                   ley, 
148       OF  A   PERIPNEUMONY.
ley, and infufions of fennel-roots in warm water with milk,
are the moft proper both for diink and  nourifhment.   He
likewife recommends the fteam of warm water taken in by
the-breath, whieh ferves.as a kind  of internal fomentation,
and helps to attenuate the impaaed humours.   If the patient
has loofe ftools,  but is not weakened by them, they are not
to be ftopped,  but rather promoted by the ufe of emolieat
clyfters.
   It has already  been obferved,  that the fpurious or baflari
peripneumony is occafioned byJ^'\^fcid pituitous matter ob-
ftruaing the veffels ofthe luntig  It commonly attacks the
old, infirm and phlegmatic, ij^Kiter or wet feafons.
   The patient at the beginniri^^cold and hot by turns, has
a fmall quick pulfe,  feels a  fenfe of weight upon bis breaft,
breathes with difficulty, and fometimes complains of a pain
and giddinefs of  his head.   His urine is commonly pale, and
his colour very little changed.
   The diet in this, as well as in the true peripneumony, muft
be very flender, as weak broths, fharpened with the juice of
orange or lemon, he.  His drink may be thin water-gruel
fweetened with honey, or a decoaion of the roots of fennel,
liquorice, and quick grafs.   An  ounce of each of thefe may
be boiled in three Englifh pints of water  to  a quart,  and
fharpened  with a little currant-jelly, oif the like.
   Bleeding and purging are generally proper at the beginning
of this difeafe ; but if the patient's fpittlc be pretty thick, or
well concoaed,  neither of  them are neceflary.   It will be
fufficient to affift  the expeaoration by fome of the (harp me-
dicines, recommended for that purpofe in the pleurify, as the
folution of gum  ammoniac with  oxymel of fquills,  &c.
Bhfters have generally a good effea, and ought to be applied
pretty early.                              &         rr
   If the patient does not fpit,  he muft  be  bled according as
his ftrength will  permit, and have a gentje purge adminifter-
ed.  Afterwards  his body may be kept open by clyfters, and
the expeaoration promoted, hy taking every four hours two
taple-fpoonfuls of the folution mentioned above.
   When an inflammation of  the  breaft does not  yield to
bleeding, bliftenng, and other evacuations, it commonly ends
in a fuppuration, which is more or lefs dangerous, according
to the part where it is fituated.  When this happens in the
ff.rrV5 fometim^eaks °"<wardly,  and the matter is dif-
pharged by the wound.
                                                  When 
OF  A  PERIPNEUMONY.
149
  When the fuppuration happens  within the fobftance or
body of the lungs, the matter may be difcharged by expeao-
ration ; but if  the matter floats in the cavity of the breaft,
between the pleura and the lungs, it can only be difcharged
by an incifion made betwixt the ribs.
  If the patient's ftrength does not return after the inflamma-
tion is to all  appearance removed; if his  pulfe continues
quick though foft, his breathing difficult,  and oppreffed ;  if
he has cold fhiverings at times, his cheeks flufhed,  his  lips
dry; and if he complain^H, thirft,  and want of appetite,
there is reafon to fear a figuration,  and that a phthifis or
confumption  of the  lungs^yll enfue.  We (hall therefore
next proceed to confider the proper treatment of that difeafe.


                C„JH  A  P.    XVIII.

       OF    CONSUMPTIONS.

A CONSUMPTION is a wafting or decay of the
      whole body from an ulcer, tubercles, or concretions of
the  ungs, an empyema, a nervous atrophy, or a cachexy.
   Dr. Arbuthnot obferves, that in his time confumptions
made up above one-tenth part of the bills of mortality in and
about London.  There is reafon to believe they have rather
increafed fince;  and we know  for certain, that they are not
lefs fatal in fome other towns in England than in London.
   Young perfons betwixt the age of fifteen  and thirty,  of a
flender make, long neck, high fhoulders, and  flat breafts, are
moft liable to this difeafe.
   Confumptions  prevail more in England than in any other
part of  the world, owing perhaps to the great ufe of animal
food and ftrong  liquors,  the general application to fedentary
employments,  and the  great quantity of pit-coal which is
there burnt;  to which we may add, the perpetual changes in
the atmofphere, or variablenefs ofthe weather.
   CAUSE S.-------It has already been obferved, that an
inflammation  of the  breaft often ends in an impofthume:
Confequently  whatever difpofes people to this difeafe muft
likewife "be confidered as a caufe of confumptions.
   Other difeafes, by vitiating the humours, may likewife oc-
cafion confumptions ;  as the fcurvy,  the fcrophula, or king's
evil, the venereal difeafe, the afthma, fmall-pox, meafles, he.
                                                    As 
OF   CONSUMPTIONS.
   As this difeafe is feldom cured, we fhall endeavour to point
out its caufes the more particularly,  in order that people may
be enabled to avoid it.  Thefe are :
         Confined or unwholefome air.   Air which ftag-
nates,  or is impregnated  with the fumes  of metals or mine-
rals, is extremely hurtful to the lungs, and often corrodes the
tender veffels of that neceflary organ.
   -------Violent paffions, exertions,  or  affeaions of the
mind ; as grief, disappointment, anxiety, or clofe application
to the ftudy of abftrufe arts or fcM^Ks.
         Great  evacuations ; as^weating, diarrhoeas, dia-
betes, exceffive venery, the flncir albus, an over-difcharge of
the menftrual flux, giving fuck too long, he.
         The fudden ftoppages of cuftomary evacuations;
as the bleeding piles,  fweating of the  feet, bleeding at the
nofe, the menfes, iffues, ulcers, or eruptions of any kind.
   ————External injuries, calculi, &c.  1  lately faw an in-
ftance  of a confirmed phthifis  occafioned  by a fmall bone
flicking in the bronchus.  It was  afterwards vomited along
with a confiderable quantity of purulent matter, and the pa-
tient, by a proper regimen and the ufe of the Peruvian bark,
recovered.
       ■ -Making a fudden tranfition  from a hot to  a very
cold climate, change of apparel, or whatever greatly leffens
the perfpiration.
        * Frequent and exceffive debaucheries.   Laie watch-
ing, and drinking ftrong  liquors, which generally go toge*
ther,  can hardly fail  to deftroy  the lungs.  Hen<»e  the ban
companion often falls a facrifice to this difeafe.
   ----.—Infeaion. Confumptions are often caught by fleep-
ing with the difeafed; for which reafon this fhould be care-
fully avoided.  It cannot be of great benefit to the fick, and
muft hurt thofe in health.
   -------Occupations in life.  Thofe artificers who fit much,
and are conftantly leaning forward, or preffing upon the fto-
mach and breaft,as cutlers, taylors, fhoe-makers, feamftreffes,
&c. often die of confumptions.  They prove likewife often
fatal to fingers,  and all who have occafion to make frequent
and violent exertions of the lungs.
   -------Cold.  More confumptive patients date the begin-
ning of their diforders from wet feet, damp beds,  night°air,
wet clothes, and fuch like, than from all other  caufes.
   Sharp, fahne, and aromatic aliments, which heat  and in-
flame the blood, are likewife frequently the caufe of confump-
tions,
We 
    •OF   CONSUMPTIONS.     ir*,

  We fhall only add,  that this difeafe is often owing to art
hereditary taint; in which cafe it is generally incurable.
  SYMPTOM S.-----This difeafe  generally  begins
with a dry cough, which often continues for fome months.
If a difpofition to vomit after eating be excited by it, there is
ftill greater reafon to fear an approaching confumption. The
patient complains of a more than ufual degree of heat, a pain
and oppreffion of the breaft,  efpecially after motion;  his
fpittle is of a faltifh tafte* £iid  fometimes mixed with blood.
He is apt to be fad; his appetite is bad, and his thirft great.
There is generally a quick, foft, fmall pulfe ; though  fome-
times the pulfe is pretty full, and rather hard.   Thefe are the
common fymptoms of a beginning confumption.
  Afterwards the patient  begins to fpit a greenifh, white, or
bloody matter.   His body is extenuated  by the heaic fever,
and colliquative  fweats, which mutually fucceed one another,
viz. the one towards night, and the other in the morning. A
loofenefs, and  an exceffive difcharge of urine, are often trou-
blefome fymptoms at this  time, and  greatly weaken the pati-
ent.   There is a burning heat in the palms of the  hands, and
the face generally flufhes  after eating ; the fingers become re-
markably fmall,  the nails are bent inwards, and the hairs fall
off.
  At laft the fwelling of  the feet and legs, the total lofs of
ftrength, the finking of the eyes,  the difficulty of fwallow-
ing,  and the coldnefs of the extremities, fhew the immedi-
ate approach of death,  which however the patient feldom be-
lieves to be fo near.  Such is the ufual progrefs of this fatal
difeafe, which, if not early checked, commonly fets all me-
dicine at defiance.
  REGIME N.       On  the firft  appearance of  a
confumption,  if the patient lives in a large town, or any
place where the air is confined, he ought immediately to quit
it, and to make choice of a fituation in the country,  where
the air is pure and free.  Here  he muft not remain inaaive,
but take every day as much exercife  as he can bear.
  The beft method of taking exercife is to ride on horfeback,
as this gives the  body a great deal of motion without  much
fatigue.   Such  as cannot  bear this kind of exercife, muft
make ufe of a machine.  A long journey, as it amufes  the
mind by a continual change of objeas, is  greatly preferable
to riding the fame ground over and  over.  Care however
muft be taken to avoid catching cold from wet clothes, damp
beds, or the like.  The patient ought always  to  finilh his 
152
OF    CONSUMPTIONS.
 ride in the morning, or at leaft before dinner;  otherwife if
 wiH oftnerdo harm than good.
    It is pity thofe who  attend  the  fick feldom  recommend
 riding in this difeafe, till the patient is either unable to bear
 it, or the malady is become incurable.  Patients are likewife
 apt  to  trifle with every thing that is in their own power.
 They cannot  fee  how one  of the common aaions of life
 fhould prove a  remedy in an obftinate difeafe,  and therefore
 they rejea it, while they greedily hunt after relief from me-
 dicine,  merely becaufe they do not tinderftand it.
   Thofe who have ftrength and courage to undertake a pret-
 ty  long voyage, may expea great advantage from it.  This,
 to  my knowledge,  has frequently cured a confumption after
 the patient  was, to all appearance,  in  the laft ftage of  that
 difeafe,  and where  medicine had proved inefteaual.   Hence
 it is reafonable to conclude, that if a voyage were undertak-
 en  in due time,  it would feldom fail to  perform a cure '*.
   Such  as  try  this method of cure ought to carry as much
 frefh provifions along with them as will ferve for the  whole
 time they are at fea.  As  milk is not to be obtained in  this
 fituation, they ought to live upon fruits, and the broth of
 chickens, or other young animals which can be kept alive on
 board.   It is fcarce  neceffary  to  add, that  fuch voyages
 fhould be undertaken, if poffible,  in the mildeft feafon,  and
 that they ought to be towards a warmer  climate.
  Thofe who have  not courage for a long voyage may travel
 into a more fouthern climate, as thefouthof France, Spain,
 or Portugal ; and if they find the air of  thefe countries agree
 with them, they fhould continue there, at leaft till their health
 be confirmed.
  Next to proper air and exercife,  we would recommend a
 c >e attention to diet.   The patient fhould eat  nothing that
 is either heating  or  hard of digeftion, and his drink muft be
 of a foft and cooling nature.  All the diet ought to be  cal-
 culated to leffen  the acrimony of the  humours, and to nou-
 nfh and fupport the patient.   For this purpofe he muft keet
 chiefly to the ufe of vegetables  and milk.  Milk alone  is of
 more value in this difeafe than the whole materia medico.
                                                   A lies
  * Two things chiefly operate to prevent the benefits which would
S^£°?   /ng'f   /  °'ie]S' *" Phyficians fcldom order it tiLl
the difeafe is too far advanced ; and the other is, that they fcldom
order a voyage of a fufficient length.  A patient may recei/e no be-
^.ht^rnfnlf/f6 ^T'V  ?ho>  Aould he crofs the Atlantic,
TI  ll  T$el*lyA C}1Jed:  Indeed we ha ve rcafon to Relieve, that
Tconfempt onS    '        1D dUC timCj WOuid feldom fail t0  curc 
OF   CONSUMPTIONS.
*S3
  Affes milk is commonly reckoned preferable to any other;
but it cannot always be obtained; befides, it is generally
taken  in a very fmall quantity ; whereas, to produce any ef-
fects,  it ought to make a confiderable part of the patient's
diet.  It is hardly to be expeaed, that a gill or two of Affes
milk,  drank in the fpace of twenty-four hours,  fhould be
able to  produce any confiderable change in the humours of
an  adult; and when people do not perceive its effeas foon,
they lofe hope,- and fo leave it off.  Hence it happens that
this medicine^ however valuable, very feldom performs  a
cure.  The reafon is obvious;  it is commonly ufed too late,
is taken  in too fmall quantities, and is not duly perfifted in.
  I have known very extraordinary effeas from Affes milk
in obftinate coughs, which threatened  a confumption of the
lungs;   and  do  verily believe, if ufed at this period, that
it would feldom fail;  but if it be delayed till an ulcer is form-
ed,  which is  generally the cafe,  how can it be expeaed  to
fucceed ?
  Affes   milk ought to be drank, if poffible,  in its  natural
warmth, and, by a grown perfon, in the quantity of half an
Englifh pint at a time.   Inftead of taking this quantity night
and morning only, the  patient ought to take it four  times,
or at leaft thrice a-day, and to eat a little light bread along
with it,  fo as to make it a kind of meal.
  If the milk fhould happen to purge,  it may be mixed with
old conferve of rofes.   When that cannot be obtained, the
powder of crabs  claws may be ufed in its ftead.   Affes milk
is ufually ordered to be drank warm in bed;  but as it gene-
rally throws the patient into  a fweat when taken in this way*
it would  perhaps  be better to give it after he rifes.
  Some  extraordinary cures  in confumptive cafes have been
performed by women's milk.   Could this be  obtained in fuf-
ficient quantity,  we would recommend it  in preference  to
any other.   It is better if the patient can fuck it  from the
breaft, than to drink it afterwards.   I knew a man who was
reduced to fuch a degree of  weaknefs in a confumption,  as
not to be able to turn himfelf in bed.   His wife was at that
time giving fuck, and the child happening to die,  he fucked
her breafts,  not with a view  to reap any advantage from the
milk, but to make her eafy.  Finding himfelf however great-
ly benefited  by it,  he continued to fuck  her till  he  became
perfeaiy well and is at prefenta ftrong and  healthy man.
  Some prefer butter-milk to any other, and it is indeed  a
very valuable medicine,  if the  ftomach be able to bear it.  It
                           R                       does 
*54
OF   CONSUMPTIONS.
 does not agree with every perfon at firft ;  and is therefore of-
 ten laid afide without a  fufficient trial.   It fhould at firft be
 taken fparingly, and the quantity gradually increafed, until
 it comes  to be almoft the fole food.   I  never  knew it fucceed
 unlefs where the patient almoft  lived upon it.
   Cows  milk is moft readily obtained of  any,  and though it
 be not fo eafily digeftcd as  that of affes or mares, it may be
 rendered lighter by adding to it  an equal  quantity of barley-
 water,  or allowing it to ftand for fome hours, and afterwards
 taking off the cream.  If  it fhould notwithftanding prove
 heavy on the ftomach, a fmall  quantity  of  brandy or rum,
 with a little  fugar, may  be added, which  will render it both
 more light and nourifhing.
   It is  not to be wondered, that milk fhould, for fome time,
 difagree with a ftomach that has not been accuftomed to digeft
 any thing but flefh and ftrong liquors, which is the cafe with
 many of  thofe who fall into confumptions.  We do not how-
 ever advife thofe who have been accuftomed  to animal food
 and ftrong liquors, to leave them ofFall at  once. This might
 be dangerous.   It will be neceffary "for fuch  to eat a little
 once a-day of the flefh of fome  young animal,  or rather to
 ufe the broth made of chickens, veal,  lamb, or fuch like.
 They ought  likewife to drink a  little wine made into neguj,
 or diluted with twice or thrice its quantity of water, and to
 make it gradually weaker till they can leave it off altogether.
   Thefe  muft be ufed only as preparatives to a diet confift-
 ing chiefly of milk and vegetables,  which the fooner the pa-
 tient can  be brought to bear, the better.   Rice and milk, or
 barley and milk boiled,  with a little fugar, is  very proper
 food.  Ripe  fruits roafted, baked,  or boiled,  are likewife
 proper,  as goofe or currant berry tarts,  apples roafted, or
 boiled in  milk, &c.   The  jellies,  conferves, and  preferves,
 &c.  of  ripe fubaced fruits,  ought  to be eat plentifully, as
 the  jelly of currants, conferve  of  rofes,  preferved plums,
 cherries, &c.                                     r
   Wholefome air, proper exercife, and  a diet  confifting
 chiefly of thefe and other vegetables,  with  milk, is the  only
 courfe that can be depended on in a beginning confumption.
If the patient has ftrength and fufficient relolution to nerfift
in this courfe, he will feldom be difappointed of a cure
   In a populous  town in  England *,  where confumptions are
very common, I  have frequently  feen confumptive patients,
                                                    who
* Sheffield. 
      OF   CONSUMPTIONS.      155

who had been fent to the country with orders to ride,  and
live upon milk and vegetables,  return in a few months quite
plump, and free from any complaint.  This indeed was not
always the cafe, efpecially when the difeafe was hereditary,
or far advanced ; but it was the only method in which fuc-
cefs was to be expeaed:  Where it failed,  I never knew  me-
dicine fucceed.
   If the patient's ftrength  and fpirits  flag, he muft be fup-
ported by ftrong broths, jellies, and fuch like.  Some recom-
mend fhcll fifh in this  diforder,  and  with fome reafon, as
as they are nourifhing and reftorative *.   All the food  and
drink ought however to be taken in fmall quantities, left an
overcharge of frefh chyle fhould opprefs  the lungs, and too
much accelerate the circulation of the  blood.
   The patient's mind ought to be kept as eafy and cheerful as
poffible.   Confumptions  are  often occafioned,  and always.
aggravated^ by a melancholy caft of mind; for which reafon,
mufic, cheerful company, and every thing that infpires mirth,
are highly beneficial.  The patient ought feldom  to be left
alone, as brooding over his calamities  is fure to render them
worfe.
   M E D IC IN E.------Though the cure of this difeafe
depends chiefly upon regimen and the  patient's own endea-
vours, yet we fhall mention a few things which  may be of
fervice in relieving fome of the more violent fymptoms.
   In the firft ftage of a confumption,  the cough may fome-
times be appeafed by bleeding; and the expeaoration maybe
promoted by the following medicines.  Take frefh fquills,
gum-ammoniac,  and powdered cardamum feeds, of each  a
quarter of an ounce ; beat them together in a mortar, and if
themafs proves too hard for pills, a little of any  kind of fy-
rup may be added to it,   This may be formed into pills of a
moderate fize, and four or five of them taken twice or thrice
a-day,  according as the patient's ftomach will bear them.
   The lac ammoniacum, or milk of gum ammoniac, as it  is
called,  is likewife a proper medicine in this ftage ofthe dif-
eafe.  It may be ufed as direaed in the pleurify.
   A mixture made of equal parts of lemon-juice, fine honey,
 and fyrup of poppies, may  likewife be ufed.   Four ounces of
each of thefe may be fimmered together in a fauce-pan, over a
                                                  gentle

   * I have often known perfons of a  confumptivc habit, where the
 fymptoms Were not violent, reap great  benefit from.the ufe of oyf-
 tcrs. They generally eat them raw, and drank the juice along with
 them. 
IS&      OF   CONSUMPTIONS.
 gentle fire, and a table-fpoonful of it taken at any time when
 the cough is troublefome.
   It is common in this ftage of the difeafe, to load the pati-
 ent's ftomach with oily and balfamic medicines.   Thefe, in-
 ftead of removing the caufe of  the difeafe, tend rather to in-
 creafe  it, by heating the blood, while they pall the appetite,
 relax the folids, and prove every way  hurtful to the patient.
 Whatever is ufed for removing the  cough, befides riding and
 other  proper regimen,  ought to be medicines of a fharp and
 cleanfing nature ; asoxymel, fyrup of lemon, he.
   Acids feem to have peculiarly good  effeas in this difeafe;
 they both tend to quench the  patient's thirft and to cool the
 blood. The vegetable acids, as apples, oranges, lemons, he,
 appear to be the moft proper.  1 have known patients fuck
 the juice of feveral lemons everyday with manifeft advantage,
 and would, for this reafon, recommend acid  vegetables to be
 taken in as great quantity as the ftomach will bear them.
   For the  patient's drink, we  would recommend infufions of
 the bitter plants, as ground-ivy, the leffer centaury, camomile
 flowers, or  water trefoil.   Thefe infufions may be drank at
 Pleafore.   They ftrengthen the ftomach, promote digeftion,
 reaify the blood, and at the fame time anfwer all the purpofes
 of dilution, and quench thirft much better than things that
 are lufcious or fweet. But if the patient fpits  blood, he ought
 to ufe, for his  ordinary drink,  infufions or decoaionsof the
 vulnerary roots, plants, &c. *
   There are many other mucilaginous plants and feeds, of a
 healing and agglutinating nature, from which decoaions or
 infufions may be prepared with the fame intention; as the
 orches, the quince-feed,  coltsfoot, linfecd,  farfaparilla, &c.
 It is not neceffary to mention the different ways in which thefe
 may be prepared.  Simple infufion or boiling is all  that is
neceffary, and the dofe may be  at difcretion.
  The conferve of rofes  is here peculiarly proper.   It may
either  be put into the decoaion above prefcribed,  or eat by
itfelf.  No benefit is to be expeaed from trifling dofes of this
medicine.  I never knew it of any fervice,  unlefs where three
or four ounces at leaft were ufed daily for a confiderable time.
In this way  I have feen it produce very happy  effeas, and
would  recommend  it wherever there is a  difcharge of blood
from the lungs.                               °
  When the fpitting up  of grofs matter, oppreffion  of the
breaft,  and  the heaic fymptoms fhew that an impofthume is

         #  See Appendix, Vulnerary Decoction. 
O F   C ON SUMPTIONS.
«57
 formed in the lungs, we would  recommend  the  Peruvian
 bark, that  being the only drug  which  has  any chance to
 counteraa  the general  tendency  which  the  humours  then
 have to putrefaction.
    An ounce of the  bark in powder, may be divided into
 eighteen  or twenty dofes, of which one may be taken every
 three hours through  the day, in a little fyrup, or  a cup of
 the patient's ordinary drink.
    If the bark fhould happen to purge, it may be made into
 an eleauary,  with  the conferve  of  rofes,  thus :  Take old
 conferve  of rofes a  quarter of a pound,  Peruvian bark in
 powder an ounce, fyrup of orange or lemon,  as much as will
 make it  of the confiftence of honey.   This quantity will
 ferve the patient four or  five days, and  may  be repeated as
 there is occafion.
    Such as cannot take the bark in  fubftance, may infufe it
 in cold water.   This  feems to be the  beft  menftruum for
 extraaing the  virtues of that drug.  Half an  ounce of bark
 fo powder may be infufed for  twenty-four hours in half an
 Englifh pint of water.   Afterwards let it be paffed through
 a fine ftrainer,  and  an ordinary tea-cupful of it taken three
 or four times a-day.
    We would  not recommend the bark while there are any
 fymptoms of an inflammation of the breaft ;  but when it is
 certainly known, that matter is colfeaed  there, it  is one of
 the beft medicines which can be ufed.  Few  patients indeed
 have resolution enough to give the bark a fair trial at this pe-
 riod of the difeafe, otherwife we have reafon  to believe that
 great benefit might be reaped from it.
    When it is evident  that there is an impofthume in the
 breaft, and the matter can neither be fpit up nor carried off
 by abforption,  the patient muft endeavour to make it break
 inwardly, by drawing in the fleams of warm water or vine-
 gar with his breath, coughing, laughing, or bawling aloud,
 &c. When it happens to burft  within the lungs, the matter
 may  be  difcharged  by  the  mouth.  Sometimes  indeed the
 burfting of the vomica occafions immediate death,  by fuffo-
 cating the patient.   When the quantity of matter is great,
* and  the patient's ftrength exhaufted,  this is  apt to happen.
 At any rate, the patient is ready to  fall into a fwoon, and
 lhould have volatile  fairs or fpirits held to his  nofe.
    If  the matter  difcharged be thick, and  the cough and
 breathing become eafier,  there may be fome hopes.of a cure.
 The diet at this time ought to be light, but reftorative,  as
                                                chicken* 
1$*      OF    CONSUMPTIONS.
chicken-broths, fago-gruel, rice-milk, &c. the drink, butter-
milk,  or  whey  fweetened with honey.  This is likewife a
proper time for ufing the Peruvian bark, which may be taken
as direaed above.
   If the vomica or impofthume fhould difcharge itfelf into the
cavity of the breaft, betwixt the pleura and the lungs, there
is no way of getting the matter out but by an incifion, as has
already been obferved.   As this  operation  muft always  be
performed by a furgeon, it is not neceffary here to defcribeit.
We fhall only add, that it is not fo dreadful as people are apt
to imagine, and that it is the only chance the patient, in this
cafe, has for his life.

   A NERVOUS CONSUMPTION, isawaft-
ing or decay of the whole body, without any confiderable de-
gree of fever, cough, or difficulty of breathing.  It is attend.
ed with indigeftion, weaknefs, and want of appetite, he.
   Thofe who are of a fretful temper,  who indulge in fpiri-*
tous liquors,  or who breathe an unwholefome air,  are mod
liable to this difeafe.
   We would chiefly recommend, for the cure of a nervoul
confumption,  a  light and nourifhing diet,  plenty of exercife
in a free open air, and the ufe of fuch bitters as brace and
ftrengthen the ftomach ; as the Peruvian bark, gentian root,
camomile,  &c. Thefe may be infufed in water or wine, and
a glafs of it drank  frequently.
   It will greatly affift the digeftion, and promote the cure of
this difeafe, to take twice a-day twenty or thirty drops ofthe
elixir of vitriol in a glafs of wine or water.   The chalybeate
wine  is likewife an  excellent medicine  in  this  cafe.  It
ftrengthens the folids,  and powerfully affifts  Nature in the
preparation of good blood*.
   Agreeable amufements,  cheerful company, and riding a-
bout, are, however, preferable to all medicines in this difeafe.
tor which reafon, when the patient can afford it,  we would

^ZZ  J  l^TTJ °f pleafufe> as the *°ft Wkdy
means to reftore  his health.                             J
i?;^ ifymptimatic confumption  cannot  be cured
Thtr wrl     7g thC d'feafe ^ Which k is occafioned.
WnSeTaffrnVS7^°° V™*"* U™ the fcrophula or
K'aS      n-T'thC afthtt,a' th* venereal difeafe,
Tt arifel  anl *?" ""* ** fld f° the ™^v '">* "hence
itanfes, and the regimen and medicine direaed accordingly.

        • See Appendix, Chalybeate Wine.            ^^ 
OF   CONSUMP- TIONS.
*5*
  When exceffive evacuations of any kind occafion a  con-
fumption, they muft not only be reftrained,  but the patient's
ftrength muft be reftored  by gentle exercife, nourifhing diet,
and generous cordials. Young and delicate  mothers often
fall into confumptions, by giving fuck too long.  As foon as
they perceive their ftrength and appetite begin to fail,  they
ought  immediately to wean the child, or provide another
nurfe, otherwife they cannot expea a cure.
  Before we quit this  fubjea,  we would earneftly recom-
mend it to  all, as they wifh  to avoid confumptions, to take as
much exercife  without doors as they can, to avoid unwhole-
fome air,  and to ftudy fobriety.   Confumptions owe  their
prefent increafe not a little  to the  fafhion of fitting up late,
eating hot fuppers,  and fpending every evening over a  bowl
of het punch or  other ftrong liquors.  Thefe liquors,  when
too freely ufed, ndt only  hurt the digeftion, and fpoil the ap-
petite, but heat and inflame  the blood, and fet the whole con-
ftitution on fire.
                CHAP.    XIX.

   OF  THE  SLOW  OR NERVOUS  FEVER.

     NERVOUS fevers have increafed greatly of late years
      in this ifland, owing doubtlefs to our different manner
of living,  and the increafe  of fedentary employments; as
they commonly attack perfons of a weak relaxed habit, who
neglea exercife, eat little folid food, ftudy hard, or indulge
in fpirituous liquors.
  C A U S E S.---—Nervous fevers may be occafioned by
whatever deprefles the fpirits, or impoverifhes the  blood ; as
grief, fear, anxiety, want of fleep, intenfe thought, living on
poor watery diet, unripe fruits,  cucumbers,  melons,  mufh-
rooms, &c.  They may likewife be occafioned by damp, con-
fined, or unwholefome air.  Hence they  are very common
in rainy feafons,  and prove  moft  fatal to thofe  who  live in
dirty,  low houfes, crowded  ftreets, hofpitals, jails, or fuch
like places.
  Perfons whofe conftitutions have been broken by exceffive
venery, frequent falivations, too free an ufe of purgative me-
dicines, or any other exceffive evacuations, are very liable to
this difeafe.
                                                Keeping 
  i6o     OF   THE  lSfERVoUS  F£V£&.

    Keeping on wet clothes,  lying on the damp ground, ex-
  ceffive fatigue,  and  whatever obftruas the perfpiration, or"
  caufes a  fpafmodic ftriaure ofthe folids,  may likewife occa-
  fion nervous fevers.  We fhall only add, frequent and great
  irregularities in diet.   Too great abftinence, as well  as ex-
  cefs, is hurtful.  Nothing tends fo much to preferve the bo-
  dy in a found ftate as a regular diet; nor can any thing con-'
  tribute more to occafion fevers of the worft kind than its op-
  pofite.
    SYMPTOM S.------Low fpirits,  want of appetite,
  weaknefs, wearinefs after motion, watchfulnefs, deep figh-
  ing, and dejeaion of mind,  are generally the forerunners of
  this difeafe.   Thefe are fucceeded  by a quick low  pulfe, a
 dry tongue without any confiderable thirft, chillnefs and flufh-
 ing in turns, he.
   After fometime the patient complains of  a giddinefs and
 pain of his head, has a naufea, with Teachings and vomiting;
 his pulfe is quick, and fometimes intermitting; his urine pale,
 refembling dead fmall beer, and his breathing is difficult, with
 oppreffion of the breaft,  and  flight alienations of mind.
   If towards the ninth, tenth, or twelfth day, the tongue
 becomes more moift, with a plentiful fpitting,* a gentle  purg-
 ing, or a moifture upon  the  fkin ; or if a fuppiiration  hap-
 pens in one or both ears, or large puftules break out about the
 lips and nofe, there is reafon to hope for  a favourable crifis. *
   But, if there be an exceffive loofenefs,  or wafting fweatff,
 with frequent  fainting fits;  if the  tongue, when°put out,
 trembles  exceffively,  and the extremities feel cold, with a
 fluttering  or low creeping pulfe ; if there be  a ftarting ofthe
 tendons, an  almoft total lofs of fight and hearing, and an in-
 voluntary difcharge by ftool  and urine,  there is great reafon
 to fear that death is approaching.
   REGIME N.---—It is very neceflary in this difeafe
 to keep the patient cool and eafy.   The leaft motion will fa-
 tigue him,  and will be apt to occafion wearinefs,  and even
 famtings.   His mind ought not only to be  kept eafy, but
 foothed and comforted with the hopes of a fpeedy recovery.
 Nothing is more hurtful in low fevers of this kind, than pre-
 ThP?,S ?  JC PJtrnl,8ima6inati?n S,oomy or frightful ideas.

 not to be doubted but they will likewife  aggravate them.
   1 he patient muft not be kept too low.  His ftreneth and

£rX,rS F t0 bK- fUPPOrtr"d by n°Uri{hinS ^ and gfnerous
cordials.   For this purpofe his gruel, panado, or whatever
                                                    food 
     OF  THE   NERVOUS  FEVER.     i6i

food  he  takes, muft be mixed with  wine according as the
fymptoms may require.  Pretty ftrong wine-whey, or fmall
negus fharpened with the juice of orange or lemon, will be
proper for his ordinary drink.  Muftard-whey  is likewife a
very  proper drink in this fever, and  may be rendered an ex-
cellent cordial medicine by the addition of a proper quantity
of white-wine*.
  Wine in  this difeafe, if it could be obtained genuine,
would be almoft the only medicine that would be neceffary.
Good wine poffeffes all the virtues of the cordial medicines,
while it is free from many of their bad qualities.  I fay good
wine; for however common this article of luxury is now be-
come, it is rarely to be obtained  genuine,  efpecially by the
poor, who are obliged to purchafe it in fmall quantities.
  I have often feen patients in low  nervous fevers where the
pulfe could  hardly  be felt,  with  a  conftant delirium, cold-
nefs  of the extremities, and almoft  every other mortal fymp-
tom, recover by ufing in whey,  gruel, and  negus, a  bottle
or two of ftrong wine every day.   Good old found claret is*
the beft, and may be made  into negus, or given by itfelf, as
circumftances may  require.
  In a  word, the great aim in this difeafe is to fupport the
patient's ftrength,  by giving him frequently fmall quantities
of the above, or other drinks of  a  warm and cordial  nature.
He  is not however fo be overheated either with liquor or
clothes; and  his food ought to be  light, and given in fmall
 quantities.
  M E D I C I N E.-----Where a naufea,  load,  and
ficknefs at the ftomach prevail at the beginning  of the fever,
it will be neceffary to give the patient a gentle  vomit.   Fif-
teen  or twenty grains of ipecacoanha in fine powder,  or a
fewfpoonfuls of the vomiting julepf, will generally anfwer
this  purpofe very well.  This may be repeated  any time be-
fore  the third or fourth day, if  the above fymptoms conti-
nue.  Vomits not  only clean the ftomach, but, by the ge-
neral fhock  which  they give, promote the  perfpiration, and
have many other excellent effeas in flow fevers, where there
 are no figns of inflammation, and nature wants roufing.
   Such as dare not venture  upon a vomit, may  clean  the
 bowels  by a fmall.dofe of Turkey rhubarb, or  an infufion of
 fenna and manna.
                            §                        In
* See Appendix, Muftard Whey.
f See Appendix, Vomiting Julep. 
*f>2     OF   THE  NERVOUS  FEVER.
     In all fevers,  the great point is to regulate the fymptoms,
   fo as to prevent  them from going to either extreme.   Thus,
   in fevers of the inflammatory kind, where the force of the
   circulation  is too great, or the blood denfe,  and the fibres
   too rigid, bleeding and other evacuations- are neceflary.   But
   in nervous fevers where nature flags,  where the blood is va-
   pid  and poor, and the folids relaxed, there the lancet muft
   be fpared, and  wine with  other cordials plentifully admi-
   niftered.
     It is the more neceffary to caution people againft bleeding
   in this difeafe, as there is generally at the beginning an uni-
   verfal ftriaure upon the veffels, and fometimes an oppreffion
   and difficulty of  breathing, which fuggeft the idea of a ple-
   thora, or too great a quantity of blood.  I have known even
   fome of the faculty deceived by their own feelings in this re-
  fpea, fo far  as to infift upon being bled,  when  k was  evi-
  dent that the operation was improper.
    Though bleeding  is generally improper in this difeafe, yet
  bliftering is  highly  neceffary.   Bliftering-plafters may be
  applied at all times of  the fever  with  great advantage.  If
  the patient is delirious, he ought to be bliftered on the neck
  or head, and it will be the fafeft courfe, while theinfenfibili-
  ty continues, as foon as the difcharge occafioned by one bli-
  ftering-plafter abates, to apply another fomewhere elfe, and
  by that means keep up a continual fucceffion of them till he
  be out of danger.
   I have been more fenfible of the advantage of blifterinzin
  this than any other difeafe  Blifters not oily ftimulate §t
 folids to aa.on  but likewife occafion a eominual  difcharge,
 which  may m fome meafure fupply the want of critical eva-
 cuations  which feldom happen  in this* kind rf fever  T^J
 are  moft  proper  however either towards the beeinnin*  or
 after fome degree  of ftupor has  come on, in SS
 will always be proper to blifter the head
   If the patient is  coftive through the courfe of the difeafe
 it will be neceflary  to procure  a ftool,  by glTng him everv'
 other day a clyfter  of milk and water  with f \\?JL r     J



J^l^f„nf' vfrcftrs °„n; *ma? \° ^ p
ki. ordinary drink the ,bte decnaionA   S "* "*■" «*
   A miliary eruption fometimes  hrPaW ~. *  u
«w.hd.y.  APst„is  ^^"*£££?£

            *S«  Appendix, Whi«D«oai         !hoM
tion. 
     OF  THE   NERVOUS   FEVER.     163

fhould be taken not to retard Nature's operation in this par-
ticular.  The eruption ought neither to be checked by bleed-
ing nor other evacuations, nor pufhed out by a hot regimen ;
but  the  patient fhould fee  fupported by gentle cordials, as
wine-whey,  fmall negus, fago-gruel with a little wine in it,
and  fuch like.   He ought not to  be  kept too warm ; yet a
kindly breathing fweat fhould by no means be checked.
   Though bliftering and the ufe of cordial liquors are the
chief things  to be depended on in this kind of fever ; yet,
for thofe who chufe to ufe them, we fhall mention one or two
ofthe forms of medicine which arecommonly prefcribed in it *.
   In defperate cafes, where the  hiccup and ftarting of the
tendons have already come on, we have fometimes feen ex-
traordinary effeas from large dofes  of mufk frequently re-
peated.  Mufk  is doubtlefs an antifpafmodic, and may be
given to the quantity of  a  feruple three or four times a-day,
or oftener if neceflary.  Sometimes it maybe proper to add
to the mufk a few grains of camphire,  and fait of hartfhorn,
as thefe tend  to promote perfpiration and the difcharge of u-
rine.   Thus fifteen grains of mufk, with three grains of cam-
phire, and  fix grains of fait of hartfhorn, may be made into a
bolus with a little fyrup, and given as above.
   If the fever fhould happen to intermit, which it  frequent-
ly does towards the decline, or if the patient's ftrength fhould
be wafted with colliquative fweats, &c. it will be neceflary
to give  him the Peruvian bark.  Haifa  dram,  or a whole
dram, if the ftomach will bear it, ofthe bark in fine powder,
may be given four or five times a-day,  in a glafs  of red pore
or claret.  Should  the bark  in fubftance not fit eafy on the
ftomach, an ounce of it in powder  may  be infufed in a bottle
of Lifbon or Rhenifh wine, for two or three days, afterwards
it may be ftrained, and a glafs of it taken frequently f-
                                                    Some
  * When the patient is low, ten grains of Virginian fnake-root^
and the fame quantity of contrayerva root, with five grains of Ruf-
iian caftor, all in fine powder, may be made into a bolus with a lit-
tle of the cordial confection, or fyrup of faffron.  One  of thefe may
be taken every four or five hours.
  The following powder may be ufed for the fame intention.  Take
wild Valerian root in powder one fcniple,  faffron and caftor each
four grains.  Mix thefe by rubbing them together in a  mortar, and
give one in a cup of wine-whey three  or four times a-day.
  f The bark may likewife be very properly adminiftered, along
with other Cordials, in the following manner : Take  an ounce of
Peruvian  Bark, orange-peel half an  ounce, Virginian fnake-root
two drams, faffron one dram.  Let all of them be powdered, and
infufed in an Englilh pint of the beft brandy for three or four days.
Afterwards the liquor may be ftrained, and two tea fpoonfuls of it
given three or four times a-day in a glafs of fmall wine or negus. 
164,     OF  THE  NERVOUS  FEVER.

  Some give the bark in  this and other fevers,  where there
are no fymptoms of inflammation, without any regard to the
remiffion or intermiffion ofthe fever.  How far future obfer-
vations may tend to eftablifh this praaice, we cannot  pretend
to fay;  but we have reafon to believe, that the bark is a very
univerfal febrifuge, and that it may be adminiftered with ad-
vantage in moft fevers  where bleeding is not neceffary,  or
where there are no fymptoms of topical inflammation.
                CHAP.     XX.

OF   THE  MALIQNANT,   PUTRID,
         OR  SPOTTED  FEVER.

      THIS  may be called (he pejlilentialfever of Europe, as,
      in many of its fymptoms it bears a great refemblance
to that dreadful difeafe the plague.  Perfons of a lax habit,
a melancholy  difpofition,  and thofe whofe vigour has been
wafted by long fafting,  watching, hard labour, exceffive ve-
nery, frequent falivations, &c. are moft liable to it.
   CAUSE S.------This fever  is  occafioned  by foul air,
from  a number of  people being confined in a narrow place
not properly ventilated, from putrid animal and vegetable ef-
fluvia, &c. Hence it prevails in camps, jails, hofpitals,  and
infirmaries, efpecially where fuch places are too much crowd-
ed, and cleanlinefs is negfeaed.
   A clofe conftitution of  the air,   with long rainy or foggy
weather, likewife occafions putrid fevers.   They often fuc-
ceed great inundations in low and  marfhy countries, efpeciaK
ly when thefe are preceded or followed  by a hot and fultry
feafon.
   Living too much upon animal food, without a proper mix-
ture of vegetables, or eating fifh or flefh that has been kept too
long, are likewife apt to occafion this kind of fever.  Hence
failors on long voyages, and the inhabitants of befieged cities.
are very often  vifited with putrid fevers.
   Corn that has been greatly damaged by rainy  feafons,  or
Jong keeping, and water which has become putrid by ftagna-
tion, &c. may likewife occafion putrid fevers.
   Dead carcafes  tainting  the air, efpecially in hot feafons,
are very apt to occafion putrid difeafes.  Hence this kind of
fever often prevails in countries which  are the fcenes of war
and bloodfbed. This fhews the propriety of removing church*
                                                   yards, 
   PUTRID  OR  SPOTTED  FEVER.    165

yards, flaughter-houfe*, &c.  at a proper diftance from great
towns.
  Want of cleanlinefs is a very general caufe of putrid fevers.
Hence they prevail amongft the poor  inhabitants of  large
towns, who breathe a confined unwholefome air, and negka
cleanlinefs.  Such mechanics as carry on dirty employments,
and are conftantly confined within doors, aie likewife very
liable to this difeafe.
  We fhall only add, that putrid, malignant, or fpotted fe-
vers are  highly infeaious ; and are therefore often commu-
nicated by contagion.   For which  reafon all perfons ought
to keep at a diftance from thofe affeaed with fuch  difeafes,
unlefs their attendance is abfolutely  neceffary.
  SYMPTOM S.-----The malignant fever  is gene-
rally preceded  by a remarkable weaknefs, or lofs of ftrength,
without any apparent caufe.   This  is  fometimes  fo  great,
that  the patient can fcarce walk, or  even fit upright, without
being in danger of fainting away.   His mind too is greatly
dejeaed ;  he fighs, and is full of dreadful apprehenfions.
   there is a naufea, and  fometimes a vomiting of bile; a
violent pain ofthe head, with a ftrong pulfation or throbbing
of the  temporal arteries; the eyes  often appear red and in-
flamed,  with  a  pain at  the bottom of the orbit;  there is a
noife in the ears, the breathing is laborious, and often inter-
rupted with a  figh ;  the patient complains of pain about the
region ofthe ftomach, and in his back and loins; his tongue
is at firft white, but afterwards it appears black  and chap'd ;
and his teeth are covered with a black cruft.  He fometimes
paffes worms both upwards and  downwards,  is affeaed with
tremors, or fluking, and often becomes  delirious.
  If blood be  let,  it  appears diflblved, or with a very fmall
degree of cohefion,  and  foon  becomes  putrid ; the  ftools
fmell extremely foetid, and are fometimes of a greenifh, black,
or reddifb caft.  Spots of a pale purple, dun, or black  colour
often appear upon  the fkin,  and fometimes there are violent
haemorrhages, or difcharges of blood  from the mouth,  eyes,
nofe, he.
  Putrid fevers may be diftinguifhed from the inflammatory,
by the fmallnefs of the pulfe, the great dejeaion ofthe mind,
the diflblved ftate of the blood, the  petechia, or  purple fpots,
and the putrid fmell of the excrements.  They may likewife
be diftinguifhed  from the low or nervous fever, by the heat
and thirft being greater, the urine of a higher colour, and the
proftration of  ftrength, dej?aion-of mind, and all the other
fymptoms more violent.
                                                      It 
t&6   PUTRID  OR  SPOTTED  FEVER.

  It fometimes happens, however, that the inflammatory,
nervous, and putrid fymptoms are fo blended together, as to
render it very difficult to determine to which clafs the fever
belongs.  In this  cafe  the greateft caution and fkill are re-
quifite.   Attention muft be paid to thofe  fymptoms which
are moft prevalent, and both the regimen and medicines a-
dapted to them.
  Inflammatory and nervous fevers may be converted into
malignant and putrid8 by too hot a regimen, or improper me-
dicines.
  The  duration of  putrid fevers is  extremely uncertain;
fometimes they terminate betwixt the  feventh and fourteenth
day,  and at other  times they  are  prolonged  for five or fix
weeks.  Their duration depends greatly upon the conftituti-
on of the patient, and the manner of treating the difeafe.
  The moft favourable fymptoms are a gentle loofenefs after
the fourth or fifth day,  with a warm  mild fweat.   Thefe,
when continued for a confiderable time, often  carry off the
fever, and fhould never be imprudently ftopped.  Small mi-
liary  puftules  appearing between  the  petechiae,  or purple
fpots, are likewife favourable, as alfo hot fcabby eruptions a-
bout the mouth and  nofe.  It is a good fign when the pulfe
rifes upon the ufe of wine, or other cordials, and the nervous
fymptoms abate ; deafnefs coming  on towards the decline of
the fever,  is likewife often a favourable fymptom *, and fo
are abfceffes in the groin, or parotid glands.
  Amongft the unfavourable fymptoms may be  reckoned an
exceffive loofenefs,  with a hard fwelled  belly ; large black or
livid blotches  breaking  out upon the fkin; aphthae in the
mouth ;  cold  clammy fweats ;  blindnefs ;  change of the
voice; a wild flaring ofthe eyes;  difficulty of  fwaliowing;
an inability to put  out  the tongue ; and  a conftant inclina-
tion  to  uncover the breaft.   When the fweat and faliva are
tinged with blood,  and the urine is black, or depofits a black
footy fediment, the  patient is in  great danger.   Starting of
the tendons, and foetid, ichorous, involuntary ftools,  attend-
ed with  coldnefs of the  extremities,  are generally the fore-
runners of death.
  REGIME N.------In the treatment of this difeafe we
ought to endeavour,   as far as poffible, to counteraa the pu-
trid  tendency of  the humours;  to fupport  the  patient's
                                                ftrength

  * Deafnefs is not always a favourable fymptom in this difeafe.
Perhaps  it is only fo when occafioned by ablcelfes formed withia
t'uears. 
    PUTRID  OR SPOTTED  FEVER.    167 .

 ftrength and fpirits ; and  to  affift Nature in  expelling the
 caufe of the difeafe,. by gently  promoting perfpiration and the
 other evacuations.
   It has been obferved, that putrid fevers are often occafion-
 ed  by unwholefome air,  and of courfe they muft be aggra-
 vated by  it.  Care  fhould therefore be taken to prevent  the
 air from ftagnating in the patient's chamber, to keep it cool,
 and renew it frequently, by opening the doors or windows of
 fome  adjacent  appartment.  The breath and perfpiration of
 perfons in perfedt health foon  render the air of a  fmall  ap-
 partment noxious; but this will fooner happen  from the per-
 fpiration  and  breath  of a perfon whofe  whole mafs of hu-
 mours are in a putrid ftate.
   Befides the  frequent admiffion of frefh  air, we would re-
 commend  the ufe of vinegar,  verjuice, juice of lemon,  Se-
 ville orange, or any kind of vegetable acid that can be moft
 readily obtained.  Thefe ought  frequently to  be  fprinkled
 upon  the floor, the bed, and every part of the room.  They
 may alfo be evaporated with an hot iron,  or by boiling, he.
 The frefh fkins of lemons or  oranges  ought likewife to  be
 laid in different parts  of the room,  and they fhould be fre-
 quently held to the patient's nofe.   The ufe of acids in this
 manner would not only prove very refrefhing to the patient,
 but would likewife tend to prevent the infeaion from fpread-
 ing among thofe who attend him*   Strong fcented herbs, as
 rue, tanfy, rofemary, wormwood, &c. may likewife be laid
 in different parts of the houfe, and fmelled to by  thofe who
 go  near the patient.
   The patient muft not only be kept cool,  but likewife qui-
 et and eafy. The leaft noife will  affea  his head, and  the
 fmalleft fatigue will be apt to  make him faint.
  Few things  are of greater importance in this difeafe than
 acids,  which ought to be mixed with all the patient's food as
 well as drink.   Orange,  lemon, or vinegar whey, are all
 very proper, and may be drank by  turns,  according to  the
 patient's inclination.   They may be rendered cordial by  the
 addition  of wine in fuch  quantity as  the patient's ftrength
 feems to require.  When he is very low,  he may drink ne-
 gus, with only one half water, and fharpened with the  juice
of orange  or lemon.   In fome cafes-a glafs of clear  wine
may now and  then  be allowed.  The moft proper wine  is
 Rhenifh ; but if the body be open,, red port or claret is to be
 preferred.
  When  tbe body is bound,  a tea-fpoonful of  the  cream of
tartar  may be put into a cup of the patient's drink, as there
                                                      is 
 168   PUTRID  OR  SPOTTED  FEVER.

 is occafion ; or he may drink a decoaion of tamarinds, which
 will both  quench  his thirft and promote a  difcharge b^
 ftopl.                            ,   .     .   .  .
   If camomile-tea will fit upon the  ftomach, it is  a  very
 proper drink in this difeafe.   It may be fharpened  by adding
 to every cup of the tea ten or fifteen drops of the elixir of
 vitriol.
   The  food muft be light, as panado, groat gruel, and  fuch
 like;  to thefe a little wine may be added, if the  patient be
 weak and low ; and they ought all to be fharpened with the
juice of orange, the jelly of currants, or the like.  The pa-
 tient ought likewife to eat freely of ripe fruits,, as roafted ap-
 ples,  currant or goofeberry tarts,  preferved cherries, plums,'
 and fuch like.
   Taking  a little food or drink frequently not only ftpports
 the fpirits, but counteraas the putrid  tendency of the hu-
 mours ; for which reafon the patient ought frequently to be
 fipping  fmall quantities of fome of the acid liquors mention-
 ed above, or any that may be more agreeable  to his palate/
 or more readily obtained.
   If he be  delirious, his feet and hands  ought to be frequent*
 ly fomented with a ftrong infufion of camomile flowers. This,
 or an infufion of the bark,  to fuch as  can afford  it,  cannot
 fail to have a  good effea.   Fomentations of this kind not
 only relieve the head, by relaxing the veffels  in the extremi-
 ties, but as their contents are abforbed, and taken into the
 blood, they may by their antifeptic qualities affift in prevent-
 ing the putrefcency of the humours.
   M E D I  C I N E.-------If a vomit be given  at fhe be-
 ginning of this fever, it will hardly fail to have a good effea;
 but if the fever has gone on for fome days, and the fymptoms
 are violent, vomits are not quite fo fafe.  The body however
 is always to be kept gently open by clyfters, or mild  laxative
 medicines.
   Bleeding is feldom neceffary in putrid fevers.  If there be
 fignsof an inflammation, it may fometimes be permitted at
 the firft on fet; but the repetition  of it  generally proves hurt-
 ful.
   Bliftering-plafters are never to be ufed unlefs in  the great-
 eft extremities.  If the petechia:  or fpots fhould fuddenly
 difappear,  the patient's  pulfe fink remarkably, and  a deliri-
 um, with  other bad fymptoms, come on, bliftering  may be
 permitted.   In this cafe the bliftering-plafters are to be ap-
 plied to the head,  and infide  of the legs or thighs.   But as
                                                     they 
   ri/TRID  OR  SPOTTED  FEVER.   169

♦hey are fometimes apt to occafion a gangrene,' we would ra-
ther recommend warm cataplafms or poultices  of muftard
and vinegar, to be applied to the feet, having recourfe  to
blifters only in the utmoft extremities.
  It is  common in the beginning of this fever to give the
emetic  tartar in fmall dofes, repeated every fecond Or  third
hour, till  it fhall either Vomit, purge, ot throw the patient
into a fweat.  This praaice is very proper,  provided rt  be
not puftied fo far as to weaken the patient.
  A very ridiculous notion has long  prevailed, of expelling
the poifonous matter  of malignant difeafes  by trifling  dofes
of cordial or alexipharmic  medicines.  In  confequence  of
this notion the contrayerva root,  the cordial confeaiqn, the
mithradate,  &c. have been  extolled as infallible  remedies.
There  is reafon however  to believe, that  thefe feldom  do
much good.   Where cordials are neceffary, we know  none
that is fi/perior to good wine;  and therefore again recom-
mend it both as the fafeft and beft.   Wine, with acids and
antifeptics, are the only things to be relied on in the cure of
malignant fevers.
  In the moft dangerous fpecies 6f this difeafe, when it is
attended with  purple, livid, of black fpots, the Peruvian
bark  muft be  adminiftered.  I  have feen it, when joined
with acids, prove fuccefsful, even in cafes where the petechial'
had the moft threatening afpea.  But, to  anfwer  this pur-
pofe, it muft not only be given in large dofes, but duly per-
fifted in.
  The beft method of adminiftering the bark is certainly in
fubftance.  An ounce of it in powder may be mixt with half
an Englifh pint of water, and the fame quantity of red wine,
and fharpened with the elixir, or fpirit of vitriol, which will
both make it fit eafier on the ftomach, and render it more  be-
neficial.   Two QAfchree ounces of the fyrup of lemon may be
added, and two Sole-fpoonfuls of the mixture taken  every
two hours, or oftener, if the ftomach will  bear it.
   Thofe who cannot take the bark in fubftance may infufe
it in wine, as recommended in the preceding difeafe.
  If there boa violent loofenefs, the  bark muft be boiled in
red wine with a little cinnamon, and fharpened with the elix-
ir of vitriol,  as  above.  Nothing can be more beneficial in
this kind of loofenefs than plenty of acids, and fuch things as
promote a gentle perfpiration.
   If thefjffent be  troubled with vomiting, a dram  of  the
fait of wormwood  diflblved in an ounce and half of frefh
                          T                 lemon-juice, 
I7o  PUTRID  OR  SPOTTED  FEVEff.

lemon-juice, and made into a draught with an ounce of fim.
pie cinnamon water, and a bit of fugar, may be given,  and
repeated as often as it is neceflary.
   If fwelling of the glands appear, their fuppuration is to be
promoted by the application of poultices, ripening cataplafms,,
&c.  And  as foon as there is any appearance of matter in
them, they ought  to be laid open, and the poultices conti-
nued.
   I have known  large ulcerous  fores break out  in  various
parts of the body, in the decline of this fever, of a livid gan-
grenous appearance,  and z moft  putrid  cadaverous  fmell.
Thefe gradually healed, and the  patient recovered, by  the
plentiful ufe of Peruvian bark and wine, fharpened  with the
fpirits of vitriol.
   For preventing putrid fevers we would recommend a ftri6t
regard  to cleanlinefs ; a dry fituation ;  fufficient  exercife in
the open air;  wholefome food, and a moderate ufe of gene-
rous liquors.  Infeaion ought above all things  to be avoid-
ed.  No conftitution is proof againft it.   I have known per-
fons feized  with  a putrid fever,  by only making one fingle'
vifit to a patient in it; others  have caught it by lodging for
one night in a town where it prevailed; and fome  by attend-
ing the  funerals of fuch as died of it.
   When  a putrid fever  feizes any perfon  in  a family,  the
greateft) attention  is neceflary to  prevent the  difeafe from-
fpreading.   The  fick ought to be placed in a large apart-
ment, as remote  from the reft of the  family as poffible; he
ought likewife to be kept extremely clean, and fhould have
frefh air frequently let into  his  chamber; whatever comes
from him fhould  be immediately removed, his linen fhould
be frequently changed, and thofe in health ought to avoid all
unneceffary communication with him.
   Anyone who is apprehenfive of havinagaught the infeai-
on, ought immediately to take a vomit, and to work it off
by drinking plentifully of camomile tea.  This may be re-
peated  in a day or two,  if the apprehenfions ftill continue,
or any unfavourable fymptoms appear.
   The perfon ought likewife to take an infuficflf of  the bark
and camomile  flowers for his ordinary drink ; and before he
goes to  bed, he may drink an  Englifh pint of pretty ftrong-
negus, or a few glaffes of generous wine.   I have been  fre-
quently obliged to follow this courfe, when malignant fevers
prevailed,  and have likewife recommended it tj^thers with
conftant fuccefs.
                                                  People 
   1PUTRID  OR  SPOTTED  FEVER.   t7i

  People generally fly to bleeding and purging as  antidotes
againft infeaion ; but thefe are fo far from fecuring them,
that they often, by debilitating the body, increafe the danger.
  Thofe who wait upon the fick in putrid fevers, ought al-
ways to have a piece of fpunge or a handkerchief dipt in vi-
negar, or juice of lemon,  to fmell to  while  near  the pati-
ent.  They  ought likewife to wafh  their hands, and, if
poffible, to change  their clothes, before they go into  com-
pany.
                CHAP.    XXI.

     OF  THE  MILIARY  FEVER.

      THIS fever takes it name from  the fmall puftules or
       bladders which  appear on  the fkin, refembling, in
fhape and fize, tbe feeds of millet.   The  puftules are either
red or white,  and fometimes both are mixed together.
  The whole body is fometimes  covered with puftules ;  but
they are generally more numerous where  the fweat is moft
abundant, as on the breaft, the back,  &c.  A gentle fweat,
or moifture on the fkin, greatly promotes the eruption ; but,
when the fkin is dry, the eruption is both more painful  and
dangerous.
   Sometimes this is a primary difeafe; but it is much often-
eronly a fymptom of fome other malady,  as the fmall-pox,   *
meafles, ardent, putrid,  or nervous fever, &c.  In all thefe
cafes it is generally the effea of too hot a regimen or medi-
cines.
   The miliary fever chiefly attacks the idle and the phleg-
matic, or perfons of a relaxed habit.  The young and the
aged are more liable to  it  than thofe in the vigour and prime
of life.  It is likewife more incident to women than to men9
efpecially tbe delicate and the indolent, who, negfeaing ex-
ercife, keep  continually within  doors,  and live upon weak
watery diet.  Such females are extremely liable to be feized
with this dtfeafe in childbed,  and often lofe their lives by it.
   C A U S E S.-------The miliary fever  is fometimes occa-
fioned by violent paffions or affeaions of  the  mind;  as ex-
ceffive grief,  anxiety, thoughtfulnefs, &c. It may likewife
be occafioned by  exceffive watching, great evacuations, a
weak watery diet, rainy feafons, eating too freely of cold,
crude, unripe fruits,  as plums, cherries, cucumbers, melons,
                                                    &c. 
 in      OF  THE  MILIARY  FEVER.

 &c. Impure waters, or provifions which have been fpoiled by
 rainy feafons, long-keeping, &c. may  likewife caufe miliary
 fevers.  They may alfo be occafioned by  the ftoppage of any
 cuftomary evacuation, as iffues, fetons, ulcers, the bleeding
 piles in men, or the menftrual flux in women, &c.
   This difeafe  in childbed-women is fometimes the effea of
 great coftivenefs  during pregnancy ;  it may likewife be oc-
 cafioned by their exceffive  ufe of green trafh,  and  other un-
 wholefome things, in which pregnant women are too apt to
 indulge.  But its  moft  general caufe  is indolence.  Such
 women as lead a fedentary life,  efpecially during pregnancy,
 and at the fame time live grofsly, can hardly efcape this  dif-
 eafe in childbed.   Hence it proves extremely fatal to women
 of fathion, and likewife to  thofe women in manufaauring
 towns, who, in order to affift their hufbands, fit clofe within
 doors  for almoft  the whole of  their time.  But among wo-
 men who are aaive and laborious, who live in the country,
 and take fufficient exercife without doois, this  difeafe is very
 little known.
   SYMPTOM S.-----When this is a primary difeafe,
 it makes its attack,  like moft other eruptive fever?,  with a
 flight fhivering, which is fucceeded  by heat, lofs of ftrength,
 faintifhnefs,  fighing, a low  quick pulfe, difficulty of breath-
 ing* w>th great anxiety and oppreffion of the  breaft.   The
 patient is reftlefs,  and fometimes delirious ; the tongue ap-
 pears white, and  the hands (hake, with often a burning heat
 in  the  palms ; and  in  childbed-women tbe milk  generally
 goes away, and the other difcharges flop.
   The patient  feels an itching  or pricking pain  under the
 fkin, after which innumerable fmall puftules of a red or white
 colour begin to appear.   Upon  this  the  fymptoms generally
 abate, the pulfe becomes more full and.  foft, the fkin grows
 moifter, and the  fweat,  as the difeafe advances,  begins to
 have a peculiar fpstid fmell;  the  great load on  the breaft,
 and oppreffion of the fpirits, generally go off, and the cuf-
 tomary evacuations gradually return.   About the fixth or fe-
 venth day from the eruption, the puftules  begin to dry and
 fall off, which opcafiops a yery difagreeable itching in the fkir\.
   It is  impoffible to  afcertain the exaa time when the puf-
 tules will either appear or go off.  They generally come  out
 on the third or fourth day, when the eruption is critical;  but
 when fymptomatical,tHey may appear at any time of the difeafe.
  Sometimes the puftules appear and vanifh by turns. When
fhat »s  the cafe,  there  is  always danger; btit  %hen they 
OF THE  MILIARY  FEVER.
173
go in all of a fudden, and do not appear again,  the danger is
very great.
  In childbed-women the puftules are commonly at firft fill-
ed with  clear water, afterwards they grow yellowifh.   Some-
times they  are  interfperfed with puftules of  a red colour.
When thefe only appear, the difeafe goes by the name of a rajh.
  REGIME N.—<---r-In all eruptive fevers, of whatever
kind, the chief point is to prevent the fudden difappearing of
the  puftules, and  to promote their  maturation.  For this
purpofe the patient muft be kept in fuch a temperature, as
neither to pufh out the eruption too faft, nor to  caufe it to re*
treat prematurely.   The diet and drink ought therefore to be
in a moderate degree  nourifhing and cordial;  but  neither
ftrong nor heating.  The patient's chamber ought neither to
be kept too hot nor cold ;  and  he fhould  not  be too much
covered with clothes.   Above  all, the mind is to be kept ea-
fy and cheerful.   Nothing fo certainly makes an eruption go
in as fear, or the apprehenfion of danger.
  The food muft be weak chicken-broth with bread, panado,
fago, or groat-gruel, &c.  to a gill of which may be  added a
fpoonful or two  of wine, as the patient's ftrength requires,,
with a few grains  of fait and a little fugar.   Good apples
loafted or boiled, with  other ripe fruits of an opening cool-
ing nature, may be eat.
  The  drink may be  fuited  to the ftate of the patient's
ftrength and fpirits. If thefe be pretty high, the drink ought
to be weak; as water-gruel, balm-tea, or the decoaion men-
tioned below *.
  When the patient's fpirits are low,  and the  eruption does
not rife fufficiently, his drink muft be a little more generous ;
as wine-whey,  or fmall negus, fharpened with the  juice of
orange or lemon,  and made ftronger or weaker as circum-
ltances may require.
  Sometimes the miliary fever  approaches  towards a putrid
nature,  in which cafe the patient's ftrength muft be fupported
with generous cordials, joined  with  acids ; and, if  the de-
gree of  putrefcence  be great, the Peruvian bark muft be ad-
miniftered.  If the head be much affeaed, the  body  muft be
kept open by emollient clyfters \.
                                       MEDICINE.
  *  Take two ounces of the ftiavings of hartfhorn, and the fame
quantity of farfaparilla, boil them in two Englifh quarts of water.
To the ftrained decoction add a little white fugar, and let the pati-
ent take it for his ordinary drink.
  f In the Commercuim Literanum for the year 1735, we have  the
                                                  hiftory 
 17*      OF  THE  MILIARY  FEVER.

   M E D ICI N E.------If the food and drink be properly
 regulated, there will be little occafion for medicine in this dif-
 eafe.   Should the eruption  however not rife,  or the fpirits
ilag, it will  not only be neceffary to fupport the patient with
 cordials, but likewife  to apply blifters.  The moft proper
cordial in this cafe is good wine, which  may be either taken
in the patient's food or drink ; and if there be figns of pu-
trefcence, the bark and acids may be mixed with wine, as di-
reaed in the putrid fever.
   Some  recommend blifters through the whole courfe of this
difeafe; and where Nature flags, and the eruption comes and
goes,  it may be neceffary to keep up a ftimulus, by a conti-
nual  fucceffion of fmall blifters; but we would not recom-
 mend above one at a time.  If however the pulfe fhould fink
 remarkably, the puftules fall in, and the head  be affeaed, it
 will  be  neceflary to  apply feveral  bliftering  pi afters to the
 moft fenfible parts, as the infide ofthe legs and thighs, &c.
   Bleeding is feldom neceffary in this difeafe,  and fometimes
 it does much hurt, as it weakens the patient, and depreffeshis
 fpirits.  It is therefore never to be attempted  unlefs by the
 advice  of a phyfician.  We mention  this,   becaufe it has
 been cuftomary to treat this  difeafe in childbed-women by
 plentiful bleeding, and other evacuations, as if it were high-
 ly inflammatory.   But this praaice is generally very unfafe,
 Patients in this fituation bear evacuations very ill.  And in-
 deed the difeafe feems  often to be more of a  putrid than of
 an inflammatory nature.
                                                   Though

 hiftory of an epidemical miliary fever, which raged at Strafburgh iq
 the months of November, December, and January; from which we
 learn the neceflity of a temperate regimen in this malady, and like-
 wife that phyficians are not always  the firft who difcover the proper
 treatment of difeafes.  " This fever  made terrible havoc even among
 men of robuft conftitutions, and all medicine proved in vain.  They
 were feized in an inftant with fhivering, yawning,  ftretching, and
 pains in the back, fucceeded by a moft intenfe heat;  at the fame time
 there was great lofs of  ftrength and  appetite.  On the  feventh or
 ninth day the miliary eruptions appeared,  or fpots like  rka bites,
 with great anxiety, a delirium, reftlefihefs, and tolling in bed. Bleed-
 ing was fatal. While matters were in this unhappy fituation, a
 midwife, of her own accord, gave  to a patient,  in the height ofthe
 difeafe, a clyfter of rain-water and  butter  without fait, and for his
 ordinary drink a quart of fpring water, half a pint of generous wine,
 the juice of a lemon, and fix ounces of the whiteft fugar, gently boil-
 ed till a fcum arofe, and this with great fuccefs ; for the belly was
 foon loofened, the grievous fymptoms vaniflied, and the patient was
 reftored to his fenfes, and fnatched  from the jaws of death." This
 practice was imitated by others with the like happy effects. 
      OF  THE  MILIARY  FEVER.       jf$

  Though  this fever is often occafioned in childbed-women
by too hot a regimen, yet it would be dangerous to leave that
off all of a fudden, and have recourfe to a very cool regimen,
and large evacuations.  We have reafon to believe, that fup-
porting the  patient's fpirits, and promoting the natural eva-
cuations, is here much fafer than to have recourfe to artifici-
al ones, as thefe, by  finking the fpirits, feldom fail to increafe
the danger.
  If the difeafe proves tedious, or the recoveryfiW, we would
recommend the Peruvian bark, which may either be taken
in fubftance, or infufed  in wine or water,  as the patient in-
clines.
  The  miliary fever,  like other eruptive difeafes,  requires
gentle purging, which fhould not be negfeaed as foon as the
fever is gone off,  and the patient's ftrength will permit.
  To avoid this difeafe, a pure dry air, fufficient exercife, and
wholefome  food,  are neceffary.   Pregnant women  fhould
guard againft coftivenefs, and take daily as much exercife as
they can bear,  avoiding all green trathy fruits,  and other un-
wholefome  things;  and when in childbed, they  ought ftriaiy
to obferve a cool regimen.
               CHAP.     XXII.

   OF  THE   REMITTING  FEVER.

     THIS fever takes its name from a remiffion of the fymp-
      toms, which happens fometimes fooner, and fometimes
later, but  generally before  the eighth day.   The remiffion
is commonly preceded by a gentle fweat, after which the pa-
tient feems greatly relieved,  but in a few hours the fever re-
turns.   Thefe remiffions return at very irregular periods, and
are fometimes of longer,  fometimes of fhorter duration ; the
nearer however that the fever approaches to a regular inter-
mittent, the danger is the lefs.
   CAUSE S.----Remitting fevers prevail in low marfhy
countries abounding with  wood and  ftagnating water; but
they prove  moft fatal in places where great heat and moifture
are combined, as in fome parts  of Africa,  the  province of
Bengal in the Eaft Indies, &c. where remitting fevers are ge-
nerally of  a putrid  kind,  and prove very fatal.   They are
moft- frequent in  clofe calm weather,  efpecially after rainy
                                                feafons, 
  j?6   Of THt  RElvIlTTlfcG  FEVlM?.

 feafons, great inundations, or the like.   No age, fex, or con-
 ftitution, is exempted  from the attack of this fever ; but it
 Chiefly feizes perfons of a relaxed habit, who live in low dirt/
 habitations, breathe an  impure ftagnating air,  take little ex-
 ercife, and ufe unwholefome diet.
   SYMPTOM S.------The  firft fymptoms of this
 fever are generally yawning, ftretching, pain, and giddinefs
 in the head, with alternate fits of heat and cold.   Sometimes
 the patient is affeaed With a deliriurri at the very firft attack.\
 There is a pain* attd fometimes a fwellingj, about the region
 of the  ftomach, the  tongue is white,  the eyes and fkin fre-
 quently appear yellow, and the  patient is often affliaed with
 bilious vomitings.  The pulfe is fometimes a little hard, but
 feldom full, and tbe blood when let, rarely fhews any figru
 of inflammation. Some patients are exceedingly coftiVe, and
 others are affliaed with a very troublefome loofenefs.
   It is impoffible to defcribe all the fymptoms of this difeafe,
 as they vary according to the fituation,  the feafon of the
 year, and the conftitution  of  the patient.  They may like-
 wife be greatly changed by the method  of treatment, and by
 many other circumftances  too tedious to mention.  Some-
 times the bilious fymptoms predominate, fometimes the ner-
 vous, and at othertimes the putrid.   Nor is it at all uncom-
 mon to find a fucceffion of each of thefe, or even a compli-
 cation of them at the fame time, in the fame perfon.
  REGIME N.-   '  '  The regimen muft be adapted to
 the prevailing fymptoms.   When there are any  figns of in-
 flammation, the diet muft be flender, and the drink wezk
 and diluting.  But  when nervous or putrid fymptoms occur,
 it will be neceffary to fupport  the patient with food and li-
 quors of a more generous  nature,  fuch as are recommended
 in the immediately preceding fevers.   We muft:  however be
 very cautious in the ufe of things  of a heating quality, as
this fever is frequently changed into a continual by an hot re-
gimen,  and improper medicines.
  Whatever the fymptoms are, the patient ought to be kept
cool,  quiet, and clean.  His appartment, if poffible, fhould
be large, and frequently ventilated  by letting in  frefh air at
the doors or  windows.  It ought  likewife to be fprinkled with
vinegar, juice of lemon, or the like.  His linen,-bed-clothes,
 &c. ought to be frequently changed,  and all his  excrements
 immediately removed.   Though thefe things  hav'e been re-
 commended before^  we think  it neceffary  to repeat them
                                                   here,- 
    OF  THE  REMITTING  FEVER.    177

here, as they are of more importance to the fick than prac-
titioners are apt to imagine*.
   M E D IC I N E.------In  order to cure this fever, we
muft endeavour  to bring it to a regular intermiffion.   This
intention may be promoted by bleeding*  if there be any figns
of inflammation  ;  but when that is not the cafe,  bleeding
ought by no means to be attempted, as it will weaken the pa-
tient, and prolong the  difeafe.   A vomit  however will fel-
dom be improper,  and is generally of great fervice.   Twenty
or thirty grains of ipecacoanha will anfwer this purpofe very
well; blit, where it Can be obtained, we  Would rather re-*
commend a grain  or two of tartar emetic, with  five or fix
grains of ipecacoanha, to be made  into a draught,  and giv-
en for a vomit;   This may be repeated once or twice at pro-
per intervals,  if  the ficknefs or naufea continues.
   The body ought to be kept open either by clyfters or  gen-
tle laxatives,  as  weak infufions of fenna and manna,  fmall
dofes of the lenitive eleauary,  cream of tartar,  tamarinds*
ftewed prunes, or the like;  but all ftrong  or draftic purga-
tives are to be carefully avoided;
   By this courfe the fever in  a  few days  may generally be
brought to a pretty regular or diftina intermiffion, in which
cafe, the Peruvian bark may be adminiftered, and it will fel-
dom fail to perfea the cure.   It is needlefs here to repeat the
methods of giving the bark* as we have already had occafion
frequently to mention them.
   The moft likely way to avoid this fever is to ufe a whole-
fome and nourifhing diet* to pay the moft  fcrupulous regard
to cleanlinefs, to keep the body  warm, to take fufficient ex-
ercife, and in hot countries to avoid damp fituations,  night
air,  evening  dews, and  the like.   In countries  where it  is
endemical,  the beft preventative medicine which we can re-
commend, is the Peruvian bark, which  may either be chew-
ed  or infufed  in brandy or wine, &c.   Some  recommend
fmokihg tobacco as very beneficial  in marfhy countries*  both
for the prevention of this and intermitting fevers.
                           U                  CHAP.

  * The ingenious Dr. Lind,  of  Edinburgh, in bis inaugural dif-
fertation  concerning the putrid remitting fever of Bengal, has the
following  obfervation:  " Indufia, lodices,  ac  ftragula, fspius
funt mntanda,  ac  aeri exponenda; fceces fordefque qnam primum
removendae; oportet etiani ut loca quibus ?egri decumbunt fint
falubria, ct aceto  confperfa; denique  ut asgris cura  quanta maxi-
ma profpiciatur.  Compertum ego habeo,  medicum hasc  fedulo
obfeivantem,  quique ea exequi  poteft, multo magis segris  profu-
turum, quain medicum peritiorem hires commodis deftitutmn." 
[   i7»   3
                CHAP.    XXIII.

     OF   THE   SMALL-POX.

      THIS difeafe is fo general, that very few efcape it at
       one time of life or another.   It is a moft contagious
 malady; and has, for many years,  proved the fcourge of
 Europe.
   The fmall-pox generally appear towards the fpring.  They
 are very frequent in fummer, lefs fo in autumn, and leaft
 of all in winter.   Children are moft liable to this difeafe;
 and thofe whofe food is unwholefome, who want proper ex-
 ercife, and  abound  with grofs  humours,  run  the greateft
 hazard from it.
   The difeafe is diftinguifhed into the diftina and confluent
 kind ; the latter of which  is always attended with danger*
 There are  likewife other diftinaions of the fmall-pox; as
 the cryftalline,  the bloody, &c.
   CAUSE S.-----The fmall-pox are commonly caught
 by infeaion. Since, the difeafe was firft brought into Europe,
 the infeaion has  never been  wholly extinguifhed ; nor have
 any proper methods, as far as I know, been taken  for that
 purpofe •> fo that  now it has become in a manner conftituti-
 onal.  Children-who  have over-heated themfelves by run-
 ning, wreftling,  &c. or adults after a debauch, are moft apt
 to be feized with  the fmall-pox.
   SYMPTOM S.------This  difeafe is fo  generally
 known, that a minute defcription of it is unneceffary.  Chil-
 dren commonly look a little  dull, feem liftlefs  and  drowfy
 for a few days before the more violent fymptoms of the fmall-
 pox appear.  They are likewife  more inclined to drink than
 ufual,  have little  appetite for  folid food,  complain of wearir
 nefs, and, upon  taking exercife, are apt to fweat.  Thefe
 are fucceeded by flight fits of  cold and heat  in turns,  which,
 as the time of  the eruption approaches,, become more vior
lent, and are accompanied with pains of the head and^loins,
vomiting, &c.  The pulfe is  quick, with a great heat of the
fkin, and reftleffnefs.  When the patient  drops  afleep, he
wakes in a kind of horror, with a fudden ftart, which i& a
very common fymptom of the approaching eruption: as are
alfo convulfion fits in very young children.
  About the third or fourth day from the time of fickening,
the fmall-pox generally begin to appear  3 fometimes indeed
                                                   tbey 
OF   THE  SMALL-POX.
179
they appear fooner, but that is no favourable fymptom.  At
firft they very nearly refemble flea-bites, and are  fooneft
difcovered on the face, arms, and breaft.
  The moft favourable fymptoms are a flow eruption, and
an abatement of the fever as foon as the puftules appear.   In
a mild diftina kind of fmall-pox the puftules feldom appear
before the fourth day from the time of fickening, and  they
generally-keep coming out gradually  for feveral days after.
Puftules which are diftina, with a florid red bafis,  and which
fill with thick purulent matter, firft of a whitifh,  and after-
wards of a yellowifh  colour,  are the  beft.
  A livid brown colour  of the puftules is an  unfavourable
fymptom; as alfo when  they are fmall  and flat, with black
fpecks in the middle.  Puftules which contain a thin watery
ichor are very bad. A great number  of pox on the face is al-
ways attended with danger.  It is likewife a very bad fign
when they run into one another.
  It is a moft unfavourable fymptom when petechiae,  or pur-
ple, brown, or black fpots are interfperfed among the puf-
tules.   Thefe are figns 'of a putrid diflolution of  the blood,
and fhew the danger to be very great.  Bloody ftools or urine,
with a fwelled belly, are bad fymptoms;  as is alfo a conti-
nual ftranguary.   Pale urine and a violent throbbing of the
arteries of the neck are figns of an approaching delirium, or
of convulfion fits.   When the face  does not  fwell,  or falls
before the pox come to maturity, it is very unfavourable.  If
the face begins to fall about the eleventh or twelfth day, and
at the fame  time the  hands and feet begin to fwell, the pati-
ent generally does well j but when thefe do not fucceed each
other, there is  reafon  to apprehend danger.   When  the
tongue is covered with a brown cruft,  it is an unfavourable
fymptom.  Cold  fhiverrng fits coming on  at the height of
the difeafe are likewife unfavourable. Grinding of the teeth,
when it proceeds from an  affeaion  of  the nervous  fyftem,
is a bad fign ; but fometimes it is occafioned by worms, or a
difordered ftomach.
   REGIME N.-----When the firft fymptoms of the
fmall-pox appear, people are ready to be alarmed, and often
fly to the ufe of medicine, to the great danger of the patient's
life.  I have known  children, to appeafe the anxiety of their
parents, bled, bliftered,  and purged, during the fever which
preceded the eruption of the fmall-pox, to fuch a  degree,
that Nature was not  only difturbed in her operation, but ren-
dered unable to fupport the puftules  after they were out; fo 
 t8o      OF   THE   S M  A  L L - P O X,

 that the  patient,  exhaufted by mere evacuations, fink  under
 the difeafe.
    When  convulfions  appear,  they give  a  dreadful alarm,
 Immediately fome noftrum is applied,  as if this were a pri,
 mary difeafe :  whereas it is only a  fymptom, and far from be-
 ing an unfavourable one, of  the  approaching eruption. As
 the fits generally  go off before the actual appearance of the
 fmall-pox, it  is attributed  to  the medicine, which by this
 means acquires a reputation without any merit *.
    All that is,  generally fpeaking,  neceflary during the erup-
 tive fever, is to  keep the patient  cool and  eafy,  allowing
 him to drink freely of fome  weak diluting liquors; as balm,.
 tea, barley-water, clear whey,  gruels,  &c.   He fhould not
 be confined to bed ; but fhould fit  up as much as he is able,
 and fhould have his feet and legs frequently  bathed in luke-
 warm water.  His  food  ought to be  very  light ;  and he
 (hould be as little difturbed with company as  poffible.
    Much  mifchief is done at  this period by  confining the pa-
 tient  too  foon to bis bed,  and plying him with warm cordials
 or fudorific medicines.   Every thing that heats and inflames
 the blood increafes  the  fever,  and  pufbes out the puftules
 prematurely.   This has numberlefs ill effeas.   It not only
 increafes  the number of puftules, hut likewife tends to make
 them run into  one another;  and when they have  been pufh-
 ed out with too great violence,  they  generally fall in before
 they come to maturity.
   The good women, as foon as they fee the fmall-pox begin
 to  appear, commonly ply their  tender charge with cordials,
 faffron and marigold teas, wine,  punch, and  even brandy it-
 felf.  All thefe are given with a view,  as  they term it, to
 throw out the eruption from  the heart.  This, like moft other
 popular miftake?,  is  the  abufe of a very  juft obfervation,
 That when there is a moifture on the fkin, the pox rife better, ana]
 the patient is eafier, than when it continues dry and parched.  But
 that is no reafon for forcing the patient into a fweat. Sweat-
 ing never relieves unlefs where it comes fpontaneoufly, or  is
 the effea  of drinking weak diluting liquors.
                                                 Children

  * Convulfion-fits  are no  doubt very alarming, but their effefts
 are often falutary.   They feem  to be one  of the means made ufe
 of by Nature for breaking the force of  a fever.   I  have always ob-
served the fever abated, and fometimes quite removed,  after one or
 more convulfion-fits.  This readily accounts for convulfions being
 a favourable fymptom in the fever which precedes the eruption  of
the fmall-pox, as everything that mitigates this  fever lellcns the
eruption. 
      OF   THE   SMALL-POX.      igf

  Children#re often fo peevifh, that they will not lie a-bed
without a  nurfe  conftantly  by them.   Indulging  them in
this, we have reafon  to believe,  has many bad effects both
upon the nurfe and  child.   Even  the natural heat of the
nurfe cannot fad to augment  the fever  of the child ; but if
fhe too proves feverifh,  which is often  the  cafe, the danger
muft be increafed *.                             ,
  Laying feveral  children who have the fmall-pox in the
fame bed, has many ill confequences.  They ought,  if pof-
fible, never to be in the fame chamber, as the perfpiration,
the heat, the fmell, &c.  all tend to augment the fever, and
to heighten  the difeafe.   It is common  among the  poor,  to
fee  two or three children lying in the fame bed, with  fuch a
load of puftules,  that even their fkins flick together.   One
can hardly view a fcene of this kind without  being fickened
by the fight.  But how muft the effluvia'affea the poor pati-
ents, many of whom  periih by this ufage f !
  A very dirty cuftom  prevails amongft  the lower clafs of
people, of allowing children in the fmall-pox to keep on the
fame linen during the whole  period of that loathfome difeafe.
This is done left they fhould catch cold, but it has many ill
confequences.  The linen becomes hard  by the  moifture
which it abforbs,  and frets the tender fkin.   It likewife oc-
cafions a bad fmell, which is very pernicious both to the pa-
tient and thofe about him ; befides, the filth  and fordes which
adhere to the linen being reforbed, or taken  up again into the
body, greatly augment the difeafe.
  A patient fhould not be fuffered to be dirty in an internal
difeafe, far  lefs in the fmall-pox.  Cutaneous diforders are
                       •                            often
  * I have known a nurfe, who had the fmall-pox before, fo in-
fected by lying conftantly a-bed with  a child in a bad kind  of
fmall-pox, that (he had not only a great number of puftules which
broke out all over her body,  but afterwards a malignant fever,
which terminated in a number of impofthumes or boils, and from
which (he narrowly efcaped with her life.  We mention  this  to
put others upon their guard againft the danger of this virulent in-
fection.
  f This obfervation  is  likewife applicable to hofpitals, work-
houfes, &c. where numbers of  children happen to have the fmall-
pox at the fame  time.   I have feen above forty children cooped up
in one apartment all the while they had this difeafe, without any
of them being  admitted to  breathe the  frelh air.  No one  can be
at a lofs to fee the impropriety  of fuch  conduct.  It ought to be a
rule, not only in hofpitals for the fmall-pox, but likewife for other
difeafes, that no patient  fhould be within  light  or hearing of an-
other.  This is a matter to which too little regard is, paid.  In moft
hofpitals  and infirmaries, the fick,  the dying,  and the dead,  are
t'ueu to be fecu in the fame apartment. 
 i82      OF   THE   SMALL-POX,

 often occafioned by naftinefs alone,  and are alwlys increafed
 by it.   Were the patient's linen to be changed every day, it
 would greatly refrefh him.   Care indeed is to be taken that
the linen be thoroughly dry.  It ought likewife to be warm-
ed, and put on when the patient is moft cool.
   So ftrong is the vulgar prejudice in this country, notwith-
standing all that has been  faid againft the hot regimen in the
fmall-pox, that numbers ftill fall a facrifice to that error.   I
have feen poor women travelling in the depth of winter, and
carrying  their children along with them in  the fmall-pox;
and have frequently obferved others begging by the way-fide,
with infants in their arms,  covered with the puftules ;  yet 1
could never learn that one of thefe children died by  this fort
of treatment.   This  is certainly a fufficient  proof, of the
fafety at leaft, of expofing patients in the fmall-pox to the  o-
pen air.   There can  be no  reafon, however,  for expofing
them to public view.   It is  now very common in the envi-
rons of great towns to meet patients in the fmall-pox on the
public  walks.   This praaice,  however  well it  may fuit the
purpofes of boafting inoculators, is dangerous to the citizens,
and contrary to the laws of humanity and found policy.
   The food in this difeafe ought to be very light, and  of a
cooling nature,  as  panado,  or bread boiled with equal quan-
tities  of milk  and water,  good apples roafted or boiled  with
milk, and fweetened with a  little fugar,  orsfuch like.
   The drink may be equal  parts of milk and water,  clear
fweet whey, barley-water, or thin gruel, &c.  After the pox
are full,  butter-milk being of an opening and cleanfing na-
ture, is a very proper drink.
  M E D I C I N E-------This difeafe is generally divid-
ed into four different periods, viz.  the fever which precedes
the eruption, the eruption itfelf, the fuppuration, or matura-
tion ofthe puftules, and the fecondary  fever.
   It has  already been obferved, that little more is neceflary
during the primary fever than to keep  the patient cool and
quiet, allowing him to drink diluting liquors, and bathing his
feet frequently  in  warm water.   Though this  be generally
the fafeft courfe that can be taken with infants, yet adults  of
a ftrong conftitution and plethoric  habit fometimes  require
bleeding.   When  a full pulfe, a dry fkin, and other fymp-
toms of  inflammation, render  this  operation  neceffary,  it
ought to be performed ; but, unlefs thefe fymptoms are ur-
gent, it is fafer to let it alone;  if the body is bound, emolli-
ent clyfters may be thrown in.
                                                       If 
     OF   THE   SMALL-POX.      18 j

  If there be a great naufea or inclination to vomit, weak ca-
momile-tea or lukewarm water may be drank, in order to
clean the ftomach.   At the beginning of a fever, Nature ge-
nerally attempts a difcharge,  either upwards or downwards*
which, if promoted by gentle means, would tend greatly to a-
bate the violence of the difeafe.
  Though every method is to be taken during the primary
fever, by a cool regimenr &c.  to-prevent too great an erup-
tion ; yet, after the puftules have made their appearance, our
bufinefs is to promote the fuppuration,  by  diluting  drink,
light food, and, if Nature feems to flag, by generous cordials.
When a low, creeping pulfe, faintifhnefs,, and great lofs of
ftrength, render cordials neceflary,  we  would recommend
good wine,  which may be made  into negus, with an equal
quantity of water, and fharpened with the juice of orange, the
jelly of currants, or the like.   Wine-whey, fharpened  as a-
bovc, is likewife a  proper drink in this cafe;  great care how-
ever muft be taken not to overheat the patient by any of  thefe
things. Thisr inftead of promoting, would retard the eruption.
  The rifing ofthe fmall-pox is often prevented by the  vio-
lence of the  fever; in this cafe, the cool regimen is  ftriaiy
to  be obferved.  The  patient's chamber muft not only  be
kept cool,  but he  ought likewife frequently  to be taken out
of bed,, and to be lightly covered with clothes while in it.
   Exceffive reftleffnefs often prevents the rifing and filling of
the fmall-pox.   When this happens, gentle opiates  are ne-r
ceffary.  Thefe,  however, ought always to be adminiftered
with a fparing hand.   To an infant,  a tea-fpoonful of the
fyrup of poppies may be given every five or  fix hours till it
has the defired effea.  An adult will require a table-fpoonful
in order to anfwer the fame purpofe.
  If the patient be  troubled with a ftranguary, or fuppreffion
of urine,.which often happens in the fmall-pox, he fhould be
frequently taken out  of bed, and, if he be able, fhould  walk
acrofs the room with his feet bare. When he cannot do this,
he may be frequently fet on his knees  in bed, and fhould en-
deavour to pafs his  urine as often as he can.   When thefe do
not fucceed,  a tea-fpoonful of the  fweet fpirits of nitre may
Be  occafionally mixed with his drink.  Nothing more cer-
tainly relieves the patient* or is more beneficial in the fmall-
pox, than a  plentiful difcharge of urine.
  If the mouth be foul, and the tongue dry  and chapped, it
ought to be frequently  wafhed,  and the throat  gargled  with
water and honey, fharpened with a little vinegar or currant- 
184      OF   THE   SMALL-POX,

  During the rifing of the fmall-pox, it frequently happens
that the patient is eight or ten days without a  ftool.  This
not only tends to heat and inflame the blood, but the faeces,
by lodging fo long in the  body,  become acrid*  and even pu-
trid ; from whence bad  confequences  muft enfue.   It will
therefore be proper, when the body is bound, to throw in an
emollient clytter every fecond or third day, through the whole
courfe of the difeafe*  This will greatly cool and relieve the
patient.
  When  petechia, Or purple,  black,  or livid fpots  appear
among the fmall-pox, the Peruvian bark muft immediately
be adminiftered in as large dofes as the patient's ftomach can
bear.   For a child, two drams  of  the bark in powder may
be mixed in three ounces of common  water*  one  ounce of
fimple  cinnamon-water,  and two  ounces  of  the  fyrup of
orange or lemon.   This may be fharpened with the fpirits of
vitriol, and a table-fpoonful of it given every hour.  If it be
given to an adult in the fame form, he may  take at leaft three
or four poonfuls every hour.   This medicine ought not to be
trifled with, but muft be adminiftered  as frequently as the
ftomach can bear it;  in which cafe it will often produce ve-
ry happy effeas.   1 have frequently feen  the petechial, difap-
pear, and the fmall-pox, which had a very threatening afpedtv
rife and fill with  laudable matter, by the ufe of the bark and
acids.
   The patient's  drink ought likewife in this cafe fo be gene^
rous, as wine or ftrong negus acidulated with fpirits of vitri-
ol, vinegar,  the juice of lemon, jelly of currants, or fuch
like.   His food muft confift of apples roafted or boiled* pre-
ferved  cherries, plums,  and other  fruitsof  an  acid nature.
   The bark  and acids are not only neceffary when the pete-
chia? or putrid fymptoms appear, but likewife in the lympha-
tic or chryftalline  fmall-pox, where the matter is thin, and
not  duly prepared.   The Peruvian bark feems topoffefsa
Angular  power  of affifting Nature in  preparing a  laudable
pus, or what is called good matter; consequently it muft be
beneficial both in this and other difeafes,  where the crifis de-
pends on a fuppuration.   I have often obferved  where the
fmall-pox were flat, and the matter contained  in them quite
clear and tranfparent, and where at firft they had the appear-
ance of running  into one another, that the Peruvian bark,
acidulated as above, changed  the  colour and  confidence of
 the matter, and produced the moft happy effeas.
   When the eruption fubfides fuddenly,  or, as the good wo-
                                                    men 
     OF   TH£   $ M  A L L - P  O X.      185

men term it, when the fmall-pox flrike in, before they have
arrived at maturity,  the  danger is  very great.   In this cafe
bliftering-plafters muft be immediately applied to the wrifts,
and ancles, and the patient's fpirits fupported with cordials.
  Sometimes bleeding has a furprifing  effea in railing the
puftules after they have  fubfided ;   but  it requires  fkill to
know when this is proper, or to what length the patient can
bear it.  Sharp cataplafms however  may be applied to the feet
and hands, as they tend to promote the fwelling  of thefe
parts, and by that means to draw the humours  towards the
extremities.
  The moft dangerous period of this difeafe is what we call
the fecondary fever.  This generally  comes on When the
fmall-pox begin to  blacken, or turn on the face,  and  moft:
of thofe who die of the fmall-pox  are carried off by this fe-
ver.
  Nature generally  attempts at the turn of the fmall-pox,
to relieve the  patient by loofe ftools.  Her endeavours this
way are by no means to  becounteraaed, but promoted, and
the patient at the fame time fupported by food and drink of a
nourifhing and cordial nature.
   If, at the approach of the fecondary fever, the pulfe be ve-
ry quick,  hard,  and ftrong* the heat intenfe, and the breath-
ing laborious,  with  other lymptoms of an  inflammation  of
the breaft, the patient  muft   immediately  be  bled.    The
quantity of blood to be let muft be  regulated by the patient's
ftrength,  age, and the urgency of  the fymptoms.
   But, in the fecondary fever, if the patient be faintifh, the
puftules become fuddenly pale, and if there be great coldnefs
bf the extremities, bliftering-plafters muft be  applied, and
the patient muft be fupported with generous cordials.   Wine
and even fpirits have fometimes been given in fuch cafes with
amazing fuccefs.
   As the fecondary fever is in  great meafure, if not wholly,
owing to the abforption of the matter, it would feem highly
confonant to reafon, that the puftules,  as foon as they  come
to maturity, fhould be opened.  This is every day praaifed
in  other  phlegmons  which tend to fuppuration ; and there
feems to be no reafon why it fhould be lefs proper here.   On
the contrary,  we have reafon to believe,  that by this means
the fecondary fever might always be leffened,  and  often
wholly prevented.
   The puftules fhould be opened when they begin to turn of
a yellow colour.   Very little art is neceffary for this opera-
                           X                       tion. 
 i86     OF   THE   SMALL-PO^

 fion.   They may either be opened with  a pair  of fciffar*
 or a needle, and the matter abforbed by a little dry lint.  As
 the puftules are generally firft ripe on the face, it will be pro-
 per to begin with opening thefe, and the others in courfe as
 they become ripe.  The puftules generally fill again,  a fe-
 condoreven a third time; for which  caufe the operation
 muft be  repeated, or rather  continued as  long  as there rs
 any confiderable appearance of matter in the puftules.
   We have ieafon to believe, that this operation,  rational
 as it is, has been negfeaed from  a piece of miftaken tender-
 nefs in  parents.  They believe, that it muft give great pain
 to the poor child;  and  therefore  would rather fee  it  die than
 have it  thus tortured.  This notion however is entirely with-
 out foundation.  I have frequently opened the puftules when
 the patient did not fee me, without his being in the leaft fen-
 fible of it; but fuppofe it were  attended with a little pain,
 that is nothing in comparifon  to the advantages which arife
 from it.
   Opening the puftules not only prevents the reforption of
 the matter into the blood,  but likewife takes off the tenfion
 of  the fkin, and  by  that means  greatly  relieves the pati-
 ent.  It likewife tends to  prevent  the  pitting, which is a
 matter of no fmall importance.  Acrid  matter, by  lodging
 long in the puftules,  cannot fail to corrode the tender fkin;
 by  which many a handfome face becomes fo deformed as
 hardly to bear a refemblance to the human  figure *.
   It is generally neceffary, after the fmall-pox are gone off,
 to purge the patient.  If however the body has been open
 through the  whole courfe of the difeafe,  or if butter-milk
 and other things of an opening nature have been drank freely
 after the height of the fmall-pox, purging becomes  lefs ne-
 ceffary ; but it ought never wholly to be negfeaed.
  For very young children, an infufion of  fenna and prunes*
 with a little rhubarb, may be fweetened with coarfe fugar,
 and given in   fmall quantities till it operates.   Thofe who
 are farther advanced muft take medicines of a (harper nature.
 For example,  a child of five  or fix years of age may take
eight or ten grains of fine rhubarb in powder over night, and
 the fame quantity of jalap in  powder next morning.  This
                                                     may

  * Though this operation can never do harm, yet it is only necef-
fary when the patient has  a great load of fmall-pox, or when the
matter which they contain is of fo thin and acrid  a nature, that there
 is reafon to apprehend bad confequences from its being too quickly
reforbed, or taken up again into the mafs of circulating humours- 
      OF   THE   S  M A  L L - P O X.      187

may be  wrought off with frefh broth  or water gruel,  and
may be repeated three or four times, five or fix days inter-
vening betwixt each dofe.   For children further  advanced,
and adults, the dofe muft be increafed in proportion to the
age and conftitution.
  When impofthumes happen after the fmall-pox, which is
not feldom the cafe, they muft be  brought to fuppuration as
foon as poffible, by means of ripening poultices; and, when
they have been opened,  or have broke of their own accord,
the patient muft be purged.   The  Peruvian bark and a milk
diet will likewife be ufeful in this cafe.
  When a cough, a difficulty of breathing, or other fymp-
toms of a confumption, fucceed to the fmall-pox, the pati-
ent muft be fent to a place where the air is good, and put up-
on a courfe of affes milk, with fuch exercife as he can bear,
For further direaions in this cafe,  fee the article  Confump-
tions.
        OF   INOCULATION.
  Though  no difeafe,  after it is  formed, baffles the powers*
of medicine more  than the fmall-pox, yet more may be done
before-hand  to render this difeafe favourable,  than any one
we know, as almoft all  the danger  from it may  be prevented
by inoculation.  This  falutary invention has been known in
Europe above half a century ; but,  like moft  other ufeful
difcoveries,  it has, till of late,  made but flow progrefs.  It
muft however be acknowledged, to the honour of this coun-
try, that inoculation has  met with a more favourable recep-
tion here, than among any  of  our  neighbours.   It is ftill
however  far from being general,  which we have reafon to
fear will  be tbe cafe, as  long as the praaice continues in the
hands ofthe faculty.
  No difcovery can be of general  utility while the praaice
of it is kept  in the hands of a few.  Had the inoculation of
the fmall-pox been introduced as a fafhion, and not as a medi-
cal difcovery, or had it been praaifed by the fame  kind of o-
perators here, as it is in thofe countries from whence we had
it, it had long ago been  univerfal.  The fears, the jealoufies,
the prejudices, and the oppofite intereftsof the faculty,,  are,
and ever  will be,  the moft effeaual obftacles to the progrefs
of any falutary difcovery.   Hence it is, that the praaice of
inoculation  never became, in any  meafure, general, even in
England, till taken up  by men not bred to phyfic.  Thefe
have not only rendered  the praaice more extenfive, but like-
wife more fafe, and, hy aaing under lefs reftraint than the
                                                 regular 
  188      OF   THE   S  M A L L - P  O X.

  regular praaitioners,  have taught them that  the  patient's
  greateft danger arofe, not from the want of care, but  from the
  excefs of it.
    They know very little ofthe matter, who impute the fuc-
  cefs of modern  inoculators to  any  fuperior fkill,  either in
  preparing  the patient or communicating the difeafe.  Some
  of them indeed, from  a fordid defiie of  engroffing the whole
  praaice to themfelves, pretend to have extraordinary fecrets
  or noftrums for preparing perfons for inoculation,  which ne-
  ver fail of fuccefs.  But this is only a pretence  calculated to
  blind the  ignorant and inattentive.   Common fenfe and pru,
  dence alone are  fufficient  both in the  choice of  the fubject
  and management of the operation.  Whoever is poffeffed of
  thefe may  perform this office  for  his children  whenever he
  finds it convenient, provided they be in a good ftate of health,
   This fentiment is not the refult of theory,  but of  obferva-
  tion.   Though  few phyficians have had more  opportunities
 of trying  inoculation  in  all its different form?,  fo little ap-
 pears to me to depend on thefe,  generally reckoned impor-
 tant circumftance?,  of preparing the body,  communicating
 the infeaion by this or the  other method, &c. that for feve-
 ral years paft I have caufed the parents or nurfes to perform
 the whole themfelves, and have found that method followed
 with equal fuccefs,  while it is free from many inconvenien-
 ces that attend the other *.
   The fmall-pox may be communicated in a great variety of
 ways with  nearly the fame degree of fafety and fuccefs.  In
                                                   Turkey,

  * A critical fituation, too often to be met with, firft put me upon
 trying this method.  A gentleman who had loft all his children ex-
 cept one fon by the natural fmall-pox, was determined to  have him
 inoculated.  He told me his intention, and defired I would  perfuade
 the mother and grandmother,  &c.  of its propriety.  But that was
 impoffible.   They were not to be perfuaded, and either could not
 get the better of their fears,  or were determined againft  conviftion.
 It was always a point with me, not to perform the operation with-
 out the confent of the parties  concerned.  I therefore advifed the fa-
 ther, after giving his fon a dofe or two of rhubarb, to go to a pa-
 tient who had the fmall-pox of a good kind, to open  two  or three
 cf the puftules, taking up the matter with a little cotton, and as
 foon as he came home to  take his  fon apart,  and give his arm a
 flight fcratch with a pm,  afterwards to rub the place well with the
 cotton, and  take no further notice of it. All this he  piinftually
 performed;  and at the ufual period the fmall-pox made their ap-
 pearance, which were of an  exceeding good kind, and fo mild as
 not to  confine the boy an hour to his bed.   None of  the other re-
lations knew but the difeafe had come in the natural way  till the
boy was well. 
     OF   THE   SMALL-POX.      189

Turkey, from whence we learned the praaice,  the women
communicate the difeafe  to children, by opening a bit of the
fkin with a needle, and putting into the wound a little mat-
ter taken from a ripe puftule.  On the coaft of Barbary they
pafs a thread wet  with the matter through the fkin, between
the thumb and fore-finger ;  and in fome of the ftates of Bar-
bary, inoculation  is  performed by  rubbing in the  variolus
matter between the thumb and fore-finger, or on other parts
of the body.   The praaice of communicating the fmall-pox,
by rubbing the variolus matter upon the fkin, has been long
known in many parts of Afia and Europe, as well as in Bar-
bary, and has generally gone by the name of buying the fmall-
pox.
  The prefent method of inoculating in Britain is to make
two or three flanting incifions in the arm,  fo  fuperficial  as
not to pierce quite through the fkin, with a  lancet wet with
frefh mat;er taken from a ripe puftule; afterwards the wounds
are clofed  up,  and left  without any dreffing.   Some make
ufe of a  lancet covered with the dry matter; but this is lefs
certain, and ought never to be ufed  unlefs where frefh matter
cannot be obtained : when this is the cafe,  the matter ought
to be moiftened by holding  the lancet for fome time in the
fteam of warm water.
   Indeed, if frefh matter be applied  long  enough to the fkin,
there is no occafion for any wound at all.  Let a bit of thread,
about half an inch long, wet with the matter, be immediately
applied to the arm, midway  between the fhoulderand elbow,
and covered  with  a piece  of  the common fticking-plafter,
and kept on  for eight or ten days.   T his will feldom fail  to
communicate the difeafe.  We mention this method, becaufe
many people are afraid of a wound ;  and  doubtlefs, the more
eafily the  operation can be performed,  it  has the  greater
chance to become general.   Some people imagine, that the
difcharge from a wound leifens the eruption; but there is no
great ftrefs to be laid  upon this notion : befides, deep wounds
often ulcerate, and become troublefome.
   We do not find that inoculation  is at all confidcred as  a
medical operation in thofe countries from whence we learned
it.  In Turkey it is performed  by the women, and in  the Eaft
Indies by the Brathmins or priefts.   In this country thecuf-
tom is ftill in its infancy  ; we make no doubt, however, but
it will foon become fo familiar,  that parents will think no
more of inoculating their children, than at prefent they do of
giving them a puro-e.
                                                    No 
 190     OF   THE   SMALL-POX.

   No fet of men have it fomuch in their power to render the
 praaice of inoculation general as the clergy, the greateft op-
 pofition to  it ftill arifing from fome fcruples  cf confcience,
 which they  alone can  remove.  I  would recommend it to
 them  not only to endeavour to remove the religious objedi-
 ons which weak minds  may have to  this falutary  praaice,
 but to enjoin it as a duty, and to point out the danger  of ne-
 gfeaing to make ufe of a mean which Providence  has  put  in
 our power for faving the lives of our offspring.  Surely fuch
 parents  as wilfully neglea the  means  of faving their chil-
 dren's lives, are as guilty as thofe who put them to death.  I
 wifh this matter were duly weighed.  No one is more ready
 to make allowance for human  weaknefs  and religious  prejuf
 dices, yet  1 cannot help recommending it, in the warmeft
 manner, to parents,  to confider how great an injury they do
 their children,  by negfeaing to give them this difeafe  in the
 early period of life.
   The numerous advantages arifing from the inoculation of
 the  fmall-pox have been pretty fully pointed out by the learn-
 ed Dr. M'Kenzie, in his Hiftory of Health *.  To thefe men*
                                                      tioned

  *  "  Many and great, (fays this humane author,) are the dangers
 attending  the natural infection, from all which the innoculation  ij
 quite fecure.   The natural infection may invade weak or diftenv?
 pered  bodies, by no means difpofed for  its kindly reception.   It
 may attack them at a feafon of the year either violently hot or in-
 tenfely cold.   It may be communicated from a fort of fmall-pox
 impregnated with  the utmoft  virulence.  It may lay hold upon
 people unexpectedly, when a  dangerous fort is  imprudently im-
 ported  into a maritime place.  It may  furprize us foon  after ex-*
 cefles  committed in  luxury, intemperance,  or lewdnefs.  It may
 likewife feize on the innocent  after indifpenfable  watchings, hard
 labour, or neceflary journies.  And is it a trivial  advantage, that
 all thefe unhappy circumftances can be prevented  by inoculation?
 By inoculation numbers are faved from deformity as well as from
 death.  In the natural fmall-pox,  how often are the fined features,
 and the moft beautiful complexions, miferably disfigured? Where-
 as inoculation rarely leaves any ugly marks or fears, even where
the number of puftules on the face has been very  confiderable,
 and  the fymptoms  by  no  means  favourable.  And many other
 grievous complaints, that are frequently fubfequent to the natural
 fort, feldom follow the artificial.  Does not inoculation alfo pre-t
 vent thofe  inexpreffible  terrors 'that perpetually  harrafs perfons
 who never had this difeafe, infomuch that when the fmall-pox is
 epidemical, entire villages  are depopulated, markets ruined, and
 the face  of diftrefs  fpread over the whole country?  From this
 terror it arifes, that juftice is frequently poftponed, or difcouraged,
 at feflions  or  affizes where the fmall-pox  rages.   Witnefles and
 juries dare not appear; and, by reafon of the neceffary abfenceof
                                                       fome 
      OF   THE   SMALL-POX:     191

 ttoned by the Doaor, we fhall only add, that fuch as have not
 had the fmall-pox in the early period  of life,  are not only
 rendered unhappy, but likewife in a great meafure, unfit for
 fuftaining many of the moft ufeful and important offices. Few
 people would chufe even to hire a fervant  who had not had
 the fmall-pox, far lefs to purchafe a flave who had the chance
 of dying of this difeafe.   How could a phyfician or a  furge-
 on, who had never had the fmall-pox himfelf, attend others
 under  that malady ?  How deplorable is the fituation  of fe-
 males, who arrive  at mature age without having had the
 fmall-pox ? A woman with child feldom furvives this difeafe:
 and if an infant happens to be feized with the fmall-pox up-
 on  the mother's breaft,  who has not had the difeafe herfelf,
 the fcene muft be diftreffing !  If fhe continues to fuckle the
 child,  it is at the peril of her own life;  and if fhe weans it,
 in all probability it will perifh.  How often is the affeaion-
 ate mother forced to leave her houfe, and abandon her chil-
 dren, at the very time when  her care is moft neceffary ? Yet
 fhould parental affeaion get the better of her fears, the con-
 fequences would often prove fatal.   I  have known the ten-
 der mother and her fucking  infant laid in the  fame  grave,
 both untimely viaims to this  dreadful malady.   But thefe
 are fcenes too fhocking even to  mention.   Let parents who
 run away with their children to avoid the fmall-pox, or who
 refufeto inoculate them in infancy, confider to what deplor-
 able fituations they may be reduced by this miftaken tender-
 nefs.
  As the fmall-pox has now become an epidemical difeafe in
 moft parts of the known world, no other  choice remains but
 to render the malady  as  mild as poffible.   This is the only
 manner of extirpation now  left in our power; and though
 it may feem paradoxical,  the artificial method of communi-
 cating  the  difeafe, could it be rendered univerfal,  would a-
 mount to nearly the fame thing as rooting it out.  It is a mat-
                                                     ter
 fome gentlemen, our honourable and ufeful judges are not attend-
 ed with that reverence  and fplendor due to their office and merit.
 Does not inoculation in like manner prevent our  brave  failors
 from being feized  with this diftemper on fliipboard, where they
 muft quickly fpread the infection among  fuch of the  crew who
 never had  it before, and where they have fcarce any chance to
 elcape,  being  half ftifled with the clofenefs of theincabins, and
but  very  indifferently nurfed?  Laftly,  with regard  to the fol-
diery, the miferies attending thefe poor  creatures, when attacked
by the fmall-pox on a march, are inconceivable, without attend-
ance, without  lodgings, without any accommodation ;  fo thai:
one  of three commonly  perii>l«s.', 
 192     OF    THE   SMALL-POX.

 ter of fmall confequence, whether a difeafe be entirely extir-
 pated, or rendered fo  mild as neither to deftrny life nor hurt
 the conftitution ;  but  that this may be done by inoculation,
 does not now admit of a doubt.   The  numbers who  die un-
 der inoculation hardly deferve to be named.  In the natural
way, one in four or five generally  dies ; but by inoculation
not one of a thoufand.  Nay, fome can boaft of having ino-
culated  ten thoufand without the lofs of a fingle patient.
   I have often wifhed to fee fome plan eftablifhed for render-
 ing this falutary praaice univerfal ; but am afraid I fhall ne-
ver be fo happy.  The difficulties indeed are many;  yet the
 thing is by no means  impraaicable.  The aim is great; no
lefs than faving the lives  of one-fourth part of mankind.
What ought not to be attempted,  in order to accomplifh fo
 defirable an end ?
   The firft ftep towards rendering the praaice univerfal, muft
be to  remove the religious prejudices againft it.   This, as
already  obferved,  can only be done by the clergy.   They
muft not only recommend it as a duty  to others, but likewife
praaife  it  on their own children.   Example will  ever have
more  influence than precept.
   The  next thing requifite is to put it in the power of all.
For this purpofe we would recommend it to the Faculty to
inoculate  the children of the poor gratis.  It is hard  that fo
 ufeful a part of mankind fhould,  by their poverty,  be  ex-
cluded from fuch a benefit.
   Should  this fail, it  is furely  in the power of any State to
render the  praaice general, at leaft as far as their dominion
extends.  We do not mean, that it ought to be enforced by
a law.  The beft way  to  promote it would be to  employ a
fufficient number  of operators at the public expence,  to ino-
culate the  children of  the poor.   This would only be necef-
fary till  the praaice became  general 5 afterwards cuftom, the
ftrongeftof all laws,  would oblige every  individual  to ino-
culate his children to prevent reffeaions.
   It may be objeaed to this fcheme* that the poor would re-
fufe to employ the inoculators :  This  difficulty  is  eafily re-
moved.   A fmall premium  to enable mothers to attend their
children while under the difeafe, would be a fufficient induce-
ment; befides,  the fuccefs   attending  the operation would
foon banifh all objeaions to it.  Even confiderations of pro-
fit would induce the poor to embrace this plan.  They often
bring up their children to the age of ten or twelve, and when
they come to be ufeful, they are fnatched away by this ma- 
OF   THE   SMALL-POX.
193
lady,  to the great lofs of their parents and detriment of the
public.
  The Britifh legiflature has* of late years, fhewn great at-
tention to the prefervation of infant-lives, by fupporting  the
foundling-hofpital, he.   But we will venture to fay, if one-
tenth  part of the fums laid out irt fupporting that inftitution,
had been  beftowed towards promoting the inoculation of  the
fmall-pox among  the poor, that not only more ufeful lives
had been  faved, but the praaice ere now tendered  quite uni-
verfal  in this ifland.   It is not to be imagined what effea ex-
ample and  a little money will have upon the  poor; yet, if
left to themfelves^ they would go on for ever in the old way,
without thinking of any improvement.   We only  mean this
as a hint  to the humane and public-fpirited.   Should fuch a
fcheme be approved,  a proper plan might eafily be laid down
for  the execution of It.
  But as public plans are very difficult to bring about, and
often, by the felfifh views and mifeondua of thofe intrufted
with  the execution of them, fail of anfwering the  noble
purpofes  for which  they were defigned ; we fhall  therefore
point  oUt fome other methods  by which the benefits of ino-
culation may be extended to the poor.  ,
  There is no doubt but inoculators will daily become more
numerous.   We would therefore have every parifh  in Britain
to allow one of them  a fmall annual falary for inoculating alt
the children  of the parifh at  a proper age.  This might be
done at a very trifling expence, and it would put it in  the
power of all to enjoy the benefit of this falutary invention.
  Two things chiefly operate to prevent the progrefs of ino-
culation^   The one is a wifh to put the evil day as far off as
poffible.  This is a principle in our nature; and as inocula-
tion feems  rather to be anticipating a future  evil, it  is  no
wonder mankind  are . fo averfe to it.  But this objeaion is
fufficiently  anfwered  by the. fuccefs.   Who  in   his  fenfes
would not prefer a lefl'er evil to-day to a  greater to-morrow,
provided  they were equally certain ?
  The other obftacle is the  fear of refleaions.   This  has
very great weight with the bulk of mankind.   Should  the
child  die, they think the world would blame them.   This
they cannot bear.  Here  lies the difficulty  which  pinches,
and till that be removed, inoculation will  make   but  fmall
progrefs.    Nothing however can remove  it but cuftom.
Make the praaice fafhionable,  and  all objeaions  will foon
vanifh.   It is  fafliion alone that has led the multitude  fince
                          Y                         the 
 194     OF   THE   SMALL-POX.

 the beginning of the world, and will lead them to the end.
 We muft therefore call upon the more enlightened  part of
 mankind to fet a pattern to the reft.  Their example, though
 it  may for fome time meet with oppofition,  will at length
 prevail.
   I am aware of an objeaion  to this praaice from  the ex-
 pence with which it may be attended ;  this is eafily obviated.
 We do not mean that every parifh ought to employ a Sutton
 or  a Dimfdale as inoculators.   Thefe have,  by their fuccefs,
 already recommended themfelves to crowned beads,  and are
 beyond  the  vulgar  reach;  but have not others an equal
 chance to fucceed ?  They certainly have.  Let them make
 the fame trial, and the difficulties will foon  vanifh.  There
 is  not a parifh,  and hardly a village in Britain, deftitute of
 fome perfon  who can bleed.  But this is a far more difficult
 operation,  and  requires both more  fkill and dexterity  than
 inoculation.
   The perfons to whom we would chiefly recommend the
 performance of  this operation are the clergy.   Moft of them
 know fomething of medicine.   Almoft all of them bleed,
 and can order a  purge, which are all  the qualifications ne-
 ceffary for the praaice of inoculation.  The Priefts  among
 the lefs enlightened  Indians  perform this office, and  why
 fhould a Chriftian teacher think  himfelf above it ?  Surely,
 the bodies of men, as well as their fouls, merit a part of the
 paftor's care;  at leaft the greateft Teacher who ever appear-
 ed among men feems to have thought fo.
  Should all  other methods fail, we would recommend  it to
 parents to perform the operation themfelves.   Let them take
 any method of communicating the difeafe they pleafe,  pro-
 vided the fubjea  be healthy, and of.a proper age,  they  will
 feldom fail to fucceed to their wifh.   I have known many in-
 ftances even of mothers performing the operation, and never
 fo much as heard of one bad confequence.  A  planter in one
 of the Weft India iflands is faid to have inoculated,  with
 his  own hand, in one year, three hundred of his flaves> who,
 notwithftanding  the warmth of  the climate,  and other unfa-
 vourable circumftances, all did  well.  Common  mechanics
 have often to my knowledge,  performed the operation  with
 as good fuccefs as phyficians.    We do not however mean to
difcourage thofe who have it in their power, from employing
 people of fkill to inoculate their children, and attend them
 while under the difeafe, but only to  fhew, that where  fuch
                                                  cannot 
OF   THE  SMALL-POX.
195
cannot be had, the operation ought not upon that account to
be negfeaed.
  Inftead of multiplying arguments to recommend this prac-
tice,! fhall juft beg leave to mention the method which I took
with my own fon, then an only child.  After giving him two
gentle purges, I ordered the nurfe to take a bit of thread which
had been previoufly wet with frefh matter from a pock, and
to lay it upon his arm, covering it  with  a piece of flicking
plafter.  This ftaid on fix  or feven days, till it was rubbed
off by accident.  At the ufual time the fmall-pox  made their
appearance,  and were  exceedingly  favourable.   Sure  this,
which is all that is generally neceflary, may be done without
any fkill in medicine.
  We have  been the more full upon this fubjea, becaufe the
benefits of inoculation cannot be  extended to fociety  by any
other means than  making the praaice general.   While it is
confined  to  a few, it muft prove hurtful to the whole.  By
means of it the contagion is fpread, and is communicated to
many who might otherwife never have had the difeafe.  Ac-
cordingly it  is  found,  that  more die of  the fmall-pox now
than before  inoculation was introduced ; and this important
difcovery, by which alone more lives might be faved, than by
all the endeavours of the faculty, is in a great meafure loft by
its benefits not being extended to the whole community.
  The fpring and autumn have  been  ufually  reckoned the
moft proper feafons for inoculation, on account of the  wea-
ther being moft temperate ;  but  it ought to be  confidered,
that thefe are generally the moft unhealthy feafons of the
whole year.  Undoubtedly the beft preparation for the difeafe
is a previous good ftate of health.   I have always obferved,
that children in particular are more fickly towards the end of
fpring and autumn, than at any other time of the year.   On
this account, as well as for the advantage of cool air, I would
propofe winter as  the moft  proper feafon for inoculation  ;
though, on every other confideration, the fpring would feem
vo be preferable.
  The moft proper age  for inoculation is betwixt three and
five.  Many approve of inoculating on the breaft, and where
no circumftances forbid this praaice, I have noobjeaion to
it.   Children, however, are more liable to convulfions at this
time than afterwards ; befides, the anxiety of the mother or
nurfe,  fhould the  child be  in  danger,  would  not fail  to
heighten it by fpoiling the milk.
  Children who have conftitutional difeafes, muft neverthe-
lefs be  inoculated.  It will often mend  the habit of body;
                                                    but 
196    OF   THE   SMALL-POX.

but ought to be performed  at a time when they are mofl
healthy.   Accidental difeafes fhould always be removed  be-;
fore inoculation.
   It is generally thought  neceffary  to regulate the diet  for
fome time before the difeafe be communicated.  In children,
however,  great alteration  in  diet is feldom neceflary,  their
food being  commonly  of the  moft  fimple and wholefome
kind;  as  milk, water-pap,  weak broths, bread, light pud-
ding, mild roots, and white meats.
   But children who  have been accuftomed to a hotter diet,
who are of a grofs habit, or abound with bad humours, ought
to be put upon a. fpare diet before they be inoculated. Their
food fhould  be of a light cooling nature ;  and their drink
whey,  butter-milk, and  fuch like.
   We would recommend  no other medicinal preparation but
two or three mild purges, which ought to be fuited to the age
and ftrength ofthe patient.  The fuccef? of inoculatprs does
not depend on  the preparation of their patients, but on their
management of them while under the difeafe.  Their con-
ftant care  is  to keep them  cool, and  their bodies gently open,
by which  means the fever is kept low, and the eruption great-
ly leffened.   The danger is feldcrn great  when the  puftules
are few ;  and their number is generally in proportion to the
fever which precedes and attends  the eruption.  Hence the
chief fecret of inoculation confifts in regulating the eruptive
fever, which generally  may  be kept fufficiently low by thq
methods mentioned above.
   The regimen during  the difeafe  is in all refpeas the fame
as under the natural fmall-pox.   The patient muft be kept
cool,  his diet fhould be light,  and his drink weak and dilut-
ing, &c.  Should any bad  fymptoms appear,  which is feldom
the cafe, they triuft be treated in the fame way as direaed in
the natural  fmall-pox.   Purging is not lefs neceffary after
the fmall-pox by inoculation,  than  in the natural way,  and
Ougbt by no means to be negfeaed.


                CHAP.    XXIV.

          OF   THE  MEASLES.

     THE meafles appeared in Europe about  the fame time
      with the fmall-pox, and have a great affinity to that
difeafe.  They both came from the fame quarter of the world,
                                                     arc 
        OF   THE   MEASLES.        197

q/e both infeaious, and feldom attack people more than once.
The meafles are  moft common in the fpring feafon,  and ge-r
nerally difappear in fummer.  The difeafe itfelf, when pro-
perly managed, feldom proves fatal; but its confequences are
often very troublefome.
   C A U S E.-------This difeafe, like the fmall-pox,  pro-
ceeds from infeaion, and is more or lefs dangerous according
to the conftitution  of the patient, the feafon of the year, the
climate, &c.
   SYMPTOM S.------The meafles, like other fevers;
are preceded by alternate fits of heat and cold, with ficknefs,
and lofs of appetite.   The tongue  is white,  but generally
moift.   There is a  fhort cough,  a heavinefs of the  head and
eyes, drowfinefs, and a running at the nofe.  Sometimes in-
deed the cough does not come before the eruption has  ap-
peared.  There is  an inflammation and heat in the eyes, ac-
companied with a defluxion of fharp tears, and great acute-
nefs of fenfation,  fo  that they cannot bear the  light without
pain.   The eye-lids frequently fwell foas to occafion blind-
nefs.   The patient generally complains of his throat;  and a
vomiting or loofenefs often precedes the eruption. The ftools
in children are commonly greenifh;  they  complain of an
itching of the fkin, and are remarkably peevifh.  Bleeding at
the nofe is common,  both before and in the progrefs of the
difeafe.
   About the fourth day, fmall  fpots, refembling flea-bites,
appear, firft upon  the  face,  then upon the breaft, and after-
wards on  the extremities : Thefe may be diftinguifhed from
the fmall-pox by their  fcarcely rifing above the fkin.   The
fever, cough, and difficulty of breathing, inftead of being re-
moved by the eruption as in the fmall-pox, are rather increaf-
ed ;  but the vomiting generally ceafes.
   About the fixth  or feventh day from the time of fickening,
the meafles begin to  turn pale  on the  face, and afterwards
upon the body ; fo that by the ninth  day they entirely dif-
appear.  The fever,  however, and difficulty of breathing, of-
ten continue, efpecially if the patient has been kept  upon too
hot a regimen.   Petechias, or purple fpots, may likewife be
occafioned by this  error.
   A violent  loofenefs  fometimes fucceeds  the meafles; in
which cafe the patient's life is in imminent danger.
   Such as die ofthe meafles generally expire about  the ninth
day from the invafion, and  are commonly carried  off by a
peripneumony,  or inflammation ofthe lungs.
                                                    The 
119S        OF   THE   MEASLES.

  The moft favourable fymptoms are,  a moderate loofeneft,
a moift fkin, and a plentiful difcharge of urine.
  When the eruption fuddenly falls in, and the  patient is
feized with a delirium, he is in the greateft danger.  If the
meafles turn too foon of a pale colour,  it is an  unfavourable
fymptom, as are alfo great weaknefs, vomiting, reftleflnefs,
and difficulty of fwallowing.  Purple or black fpots appear-
ing among the meafles, are very unfavourable. When a con-
tinual cough,  with hoarfenefs, fucceeds the difeafe,  there is
reafon to fufpeaan approaching confumption ofthe lungs.
  Our bufinefs in this difeafe is  to affift Nature  by proper
cordials,  in throwing out the morbific  matter, if her efforts
be too languid ;  but  when they are too violent, they muft be
reftrained by evacuations, and cool diluting liquors, he. We
ought likewife to endeavour to appeafe the moft urgent fymp-
toms, as  the cough, reftleffnefs, and difficulty of breathing.
  REGIME N.      The cool regimen is neceffary here
as well as in the fmall-pox.  The food  too muft be light,and
the drink diluting.   Acids however do not anfwer fo well in
the meafles as  in the  fmall-pox, as they  tend  to exafperate
the cough-  Small-beer likewife, though a good drink in the
fmall-pox, is here improper.   The moft fuitable  liquors are
decoaions of liquorice with marfh-mallow roots  and farfa-
parilla, infufions of linfeed, or of the flowers of elder, balm-
tea, clarified whey,  barley-water, and  fuch like.   Thefe, if
the patient be coftive, may be fweetened with honey; or, if
that fhould difagree with the ftomach, a little manna mayoc-
cafionally be added to them.
  MEDICiN E.-----The meafles being an inflamma-
tory difeafe, without any critical difcharge of matter, as in
the fmall-pox,  bleeding is commonly neceffary, efpecially
when the fever runs  high,  with difficulty of breathing,  and
great oppreffion  of  the breaft.  But  if the difeafe be of a
mild kind, bleeding may be omitted.
   Bathing the feet and legs frequently in lukewarm water
both tends to abate the violence of the fever, and to promote
the eruption,
   The patient is often greatly relieved by vomiting.  When
there is a tendency this way,  it ought to be  promoted  by
drinking lukewarm water, or weak camomile tea.
   When thecougfris very troublefome, with drynefsof the
throat,  and difficulty of breathing, the patient may hold his
head over the fteam  of  warm water, and draw the fteam in-
to his lungs.
                                                     He
                                             i 
OF   THE   MEASLES.
199
  He may likewife lick a little fpermaceti and  fugar-candy
pounded together; or take now and then a fpoonful of the
oil  of fweet almonds,  with fugar-candy diflblved in  it.
Thefe will foften the throat, and relieve the tickling cough.
  If at the return of the  difeafe the fever affumes new vi-
gour, and there appears great danger of fuffocation, the pa-
tient muft be bled according to his ftrength,  and bliftering-
plafters applied, with a view to prevent the load from being
thrown  on the lungs, where if the inflammation fhould fix
itfelf, the  patient's life will be in imminent danger.
  In cafe  the meafles fhould fuddenly  difappear,  it will be
neceflary  to purfue  the fame method which we have recom-
mended when the fmall-pox recede.  The patient muft be
fupported  with wine and cordials.  Bliftering-plafters  muft
be applied to the legs and arms,  and the body rubbed all over
with  warm  flannels.  Warm poultices may  likewife be ap-
plied  to the feet and palms of the hands.
  When  purple or  black  fpots appear, the   patient's drink
fhould be  fharpened with fpirits of vitriol ; and if the putrid
fymptoms increafe,  the Peruvian bark muft be adminiftered
in the fame manner  as direaed in the fmall-pox.
  Opiates are fometimes neceflary, but fhould never be giv-
en  except in cafes of extreme reftleffnefs, a  violent loofe-
nefs, or when the cough is very troublefome.   For children,
the fyrup of poppies is fufficient.  A tea-fpoonful  or two
may be occafionally given,  according to the patient's age, or
the violence of the  fymptoms.
   After the meafles are gone off, the patient ought to  be
purged.   This may be conduaed in the fame manner as di-
reaed in  the fmall-pox.
   If  a  violent loofenefs fucceeds  the meafles,  it may  be
checked by  taking for fome days a gentle dofe of  rhubarb  in
the morning, and  an opiate over  night;  but  if thefe  do
not remove it, bleeding will feldom fail to have that effea.
   Patients  recovering after the meafles fhould be careful
what they eat or drink.  Their  food, for fome time, ought
to  be light, and in  fmall quantities, and their drink  dilut-
ing,  and  rather of an opening nature; as butter-milk, whey,
and fuch  like.   They ought alfo to beware of expofing them-
felves too foon to the cold  air, left a fuffocating  catarrh,  an
afthma,  or a confumption of the lungs fhould enfue.
   Should a  cough,  with difficulty of breathing, and other
fymptoms of a confumption, remain  after the meafles,  fmall
quantities of blood may be frequently let at proper intervals,
                                                       as 
200
OF   THE   MEASLES.
 as the patient's ftrength and conftitution will permit.  He1
 ought likewife to drink affes milk, to remove to  a free air,
 if in a large town, and to ride daily on horfeback.  He muft
 keep clofe to a diet  confifting of milk  and vegetables; and
 laftly,  if thefe do not fucceed,  let him remove to a warmer
 climate *.

      OF   THE   SCARLET  FEVER.
   The fcarlet fever is fo called from the colour of the pati-
 ent's fkin,  which appears as if it were tinged with red wine.
 It happens  at any feafon of the year, but is moft common
 towards the end of fummer ; at which time  it  often  feizes
 whole families :  Children and young perfons are moft fubjecT;
 to it.
   It begins like other fevers, with'  coldnefs  and fhivering,
 without any violent ficknefs.  Afterwards the fkin is covered
 with red fpots, which are broader, more florid, and lefs uni-
 form than  the  meafles.   They continue two or three days,
 and then difappear;  after  which the cuticle, or fcarf-fkin,
 falls off.
   There is feldom any occafion for medicine in this difeafe.
 The patient ought however to keep within doors, to abftain
 from flefh,  ftrong liquors,  and cordials, and to drink freely
 of cool diluting liquors.  If the fever runs  high, the body
 muft be kept gently open by emollient clyfters, or fmall dofes
 of nitre and rhubarb.   A  fcruple  of the former, with five
 grains of the latter, may be taken thrice ar-dayy or oftener,
 if neceffary.
                                                  Children

   * Attempts have been made to communicate the meafles, as well
 as the fmall-pox, by inoculation,  and we  make  no doubt but in
 time the practice may fucceed.  Dr. Home of Edinburgh fays, he
 communicated the difeafe by the blood.  Others have tried this
 method, and have not found  it  fucceed. Some think the difeafe
"would be more certainly communicated by rubbing the fkin of  a
 patient  who has the meafles with cotton, and afterwards applying
 the  cotton to a wound, as in the fmall-pox;  while others recom-
 mend a bit of flannel which had been applied to the patient's fkin,
 all the time  of the difeafe, to be afterwards laid upon the arm or
 leg of the perfon to whom the infection is to be communicated.
 There is no doubt but this difeafe, as well  as the fmall-pox, may
 be communicated various ways; the moft probable,  however, is
 either from cotton nibbed upon the fkin, as mentioned above, or
 by introducing a little of the fharp humour which diftils from the
 eyes of  the patient into the blood.  It is  agreed  on all hands that
 fuch patients as have been inoculated had the difeafe very mildly;
 we therefore wifli the  practife we^e, juok general, as thY meafles
 Save of late  become, yery fatal. 
      OF  THE  SCARLET  FEVER.      ioi

  Children and young perfons are fometimes feized, at  the
beginning of this difeafe,  with a kind of ftupor and epilep-
tic fits.   In this cafe the  feet and legs fhould be bathed  in
warm water, a large bliftering-plafter applied to the neck,
and a dofe of the fyrup of poppies given every night till the
patient recovers *.
  The fcarlet fever, however, is not always of fo mild a na-
ture.   It  is  fometimes attended  with  putrid or malignant
fymptoms, in which cafe it is always dangerous.  In the ma-
lignant fcarlet fever the patient is not only affeaed with cold-
nefs and  fhivering,  but with languor, ficknefs, and  great
oppreffion ;  to thefe fucceed exceffive heat,  naufea,  and  vo-
miting, with a forenefsof the throat;  the pulfe is extremely
quick, but fmall and  depreffed ; the breathing frequent and
laborious ; the fkin hot, but not quite dry ; the tongue moift,
and covered with a whitifh mucus; the tonfils inflamed and
ulcerated.  When the eruption appears,  it brings no relief:
On the  contrary,  the fymptoms generally grow worfe,  and
frefh ones come on, as purging,  delirium, &c.
   When this difeafe is miftaken for a  fimple  inflammation,
and treated  with repeated  bleedings,  purging and cooling
 medicines, it generally proves fatal.   The only medicines
 that  can be depended on in this cafe are cordials, and anti-
 feptics,  as  the  Peruvian  bark,  wine, fnake-root,  and  the
 like.  The  treatment muft be in general fimilar  to that  of
 the putrid fever, or of the malignant ulcerous  fore throat f.

    OF   THE   BILIOUS   FEVER.
   When a continual, remitting, or intermitting fever is ac-
 companied with a frequent or copious evacuation of bile, ei-
 ther  by  vomit or ftool, the fever is denominated bilious.   In
 Britain the bilious fever generally makes its appearance about
 the end  of fummer, and  ceafes towards the approach of win-
 ter.   It is moft frequent and fatal in warm countries, efpeci-
 ally  where the foil is  marlhy, and when great rains are fuc-
 ceeded  by fultry heats.   Perfons who work without doors,
                             Z                         lie

           * Sydenham.
   •f  In the year 1774, during winter, a very  bad fpecies of this
 fever pievaiicd in Edinburgh.  It raged chiefly among young peo-
 ple.   The «ru: '.ion  was generally accompanied  with  a quinfey,
 and  the iui:.' iinatory fymptoms were fo blended with others of a
 putrid nature a.1- . > render the  treatment  of the difeafe very diffi-
 cult.  Many of tin. paiients towards the  decline of the fever were
 aflHifted  with large fwcllings of the lubmaxillary glands, and not a
 few had a fuppuiu.ion  in one or both ears. 
 202      OF   THE  BILIOUS  FEVER.

 lie in camps, or who are expofed to the night air, are  moft
 liable to this kind of fever.
   If there be fymptoms of inflammation  at the  beginning
 of this fever, it will be neceflary to bleed,  and to put the pa-
 tient  upon the cool  diluting regimen recommended in the
 inflammatory  fever.   The  faline  draught may likewife be
 frequently adminiftered, and the patient's body may be kept
 open by clyfters or mild purgatives.   But if the fever fhould
 remit or intermit,  bleeding will feldom be neceffary.  In this
 cafe a vomit may be adminiftered, and, if the body be bound,
 a gentle purge;  after which  the Peruvian bark will general-
 ly complete the  cure.
   In cafe of a violent loofenefs, the patient muft be  fup-
 ported with chicken broth, jellies of hartfhorn, and the like;
 and he may ufe  the white decoclion for his ordinary drink*.
 If a bloody-flux fhould accompany  this fever, it muft be
 treated in the manner recommended under the article Dyfen-
 tery.
   When there is a burning  heat, and the patient does not
 fweat, that evacuation may  be promoted by giving him,  three
 or four  times a  day,  a table-fpoonful of Mindererus's fpi-
 rit f mixed in a  cup of his ordinary drink.
   If the bilious fever  be attended  with a  nervous, malig-
 nant, or putrid  fymptoms,  which is  fometimes the cafe, the
 patient muft be treated in the fame manner as direaed under
 thefe difeafes.
   After this fever proper care is neceffary to prevent a relapfe.
 For this purpofe the patient, efpecially towards the  end of
autumn, ought to continue  the ufe of the Peruvian bark for
fome time after he is well.   He fhould likewife abftain from
all trafhy  fruits, new liquors, and every kind  of flatulent
aliment.
                CHAP.    XXV.

OF  THE  ERYSIPELAS,  OR  ST.  AN-
                THONY'S  FIRE.

      THIS  difeafe, which in fome parts of Britain  is called
      the rofe, attacks  perfons at any period of life,  but is
moft common between the age of thirty and forty. Perfons of
  fanguine or plethoric habit are moft liable  to  it.  It often
                                                  attacks
         * See Appendix, White Decoction.
         f See Appendix, Spirit of Mindererus.
1 
     OF  THE  ERYSIPELAS,  &c.     203

attacks  young  people, and pregnant women ;  and fuch as
have once been affliaed with it are very liable to have it again.
Sometimes it is a primary difeafe, and at other times only a
fymptom of  fome other malady.  Every  part of the body is
liable to be attacked by an eryfipelas,  but it moft frequently
feizes the legs or face, efpecially the latter.   It is moft com-
mon in autumn,  or when hot weather is fucceeded by cold
and wet.
  CAUSE S.<-------The eryfipelas may be occafioned by
violent paffions or affeaions of the mind ;  as fear, anger,
&c.  When the body has been heated to a great degree,  and
is  immediately expofed to the cold air, fo that the perfpira-
tion  is fuddenly checked, an eryfipelas will often enfue *.  It
may alfo be occafioned by drinking to excefs,  by continuing
too long in a warm bath, or by any thing that overheats the
blood,  if any of the natural evacuations be obftruaed, or
in too fmall  quantity, it may caufe an eryfipelas.  The fame
effea will follow from the ftoppage of artificial evacuations ;
as iffues, fetons, or the like.
   SYMPTOM S.------The eryfipelas attacks with fhi-
vering,  thirft,  lofs of  ftrength,  pain in  the head and back,
heat, reftleffnefs, and a quick pulfe; to which may be added
vomiting, and fometimes a delirium.  On the fecond, third,
or fourth day,  the part fwells, becomes red,  and fmall puf-
tules appear;  at which time the fever generally abates.
   When the eryfipelas feizes the foot, the parts contiguous
fwell, the fkin fhines ; and, if the pain  be violent, it will a-
fcend to the leg, and will not bear to be touched.
   When it attacks the face, it fwells, appears red, and the
fkin  is  covered with fmall puftules  filled with clear water.
One or both eyes are generally clofed with the fwelling;  and
there is a difficulty of breathing.   If the  mouth and noftrils
be very dry, and  the patient drowfy, there is reafon to fufpe&
an inflammation ofthe brain.
   If the eryfipelas affeas  the breaft,  it fwells  and becomes
exceedingly hard,  with great pain, and  is apt to fuppurate.
There is a violent  pain in the arm-pit,  on the  fide affeaed,
where an abfcefsis often  formed.                         Tf

  *  The country people in  many parts of Britain call this difeafe
a blaft,  and imagine it proceeds from foul air, or ill wind, as they
term it.   The truth is, they often lie down to reft them,  when
warm and fatigued, upon the damp ground,  where they fall afleep,
and  lie fo long  as to catch cold,  which occafions the eryfipelas.
This difeafe may indeed proceed  from other caufes, but we  may
venture  to fay,  that nine times out of ten it is occafioned by cold
caught after the body has been greatly heated or fatigued. 
 204       OF  THE  ERYSIPELAS,

   If in a day or two the fwelling fubfides, the heat and pain
 abate, the colour of  the  part turns yellow,  and the cuticle
 breaks and falls off in fcales, the danger is over.
   When the eryfipelas is large, deep, and affeas a very fenfi-
 ble part ofthe body, the danger is great.  If the red colour
 changes into a livid  or black,  it will end in a mortification.
 Sometimes the inflammation  cannot be difcuffed, but comes
 to a fuppuration ; in which cafe fiftulas, a gangrene or mor-
 tification, often enfue.
   Such as die of this difeafe are commonly carried off by the
 fever,  which is attended with difficulty of  breathing, and
 fometimes with a delirium and great drowfinefs.   They ge*
 nerally die about the feventh or eighth  day.
   REGIME N------In the eryfipelas the patient muft
 neither be kept too hot nor cold, as either of thefe extremes
 will tend to make it retreat, which is always to be guarded a-
 gainft.   When the difeafe is mild, it will be fufficient to keep
 the patient  within doors,  without confining him to his bed,
 and to promote the perfpiration by diluting liquors, &c.
   The diet ought to be flender, and of a moderately cooling
 and rrioiftening quality, as groat gruel, panado, chicken or
 barley-broth,  with cooling herbs  and   fruits, &c.  avoiding
 flefh, fifh, ftrong drink, fpices, pickles, and all other things
 that may heat and inflame the blood ;  the drink may be bar-
 ley-water, an  infufion of elder flowers,  common whey, and
 fuch like.
   But  if the  pulfe be low, and the fpirits funk, the patient'
 muft be fupported with negus,  and other things of a cordial
 nature.  His food may be fago  gruel with a little wine, and
 nourifhing broths taken in fmall quantities, and often repeat-
 ed.  Great  care however muft be taken not to overheat him,
   M E D I C I N E.------In this difeafe much mifchief
 is often done by medicine, efpecially by external applications.
 People,  when they fee an inflammation,  immediately  think
 that fomething ought to be applied to it.   This indeed is ne-
 ceffary in large phlegmons ;  but in an  eryfipelas  the fafer
 courfe is. to apply nothing.  Almoft all  ointments, falves, and
 plafters, being of a greafy nature, tend  rather to obftrua and
 repel, than promote any difcharge from the part.  At the be-
 ginning of this difeafe, it is neither fafe to promote a fuppu-
 ration,  nor to repel  the matter too quickly.   The eryfipelas
 in many refpeas refembles the gout, and is to be  treated with
the greateft caution.   Fine wool, or very foft  flannel are the
(afeit applications to  the  part.  Thefe  not  only defend  it
                                                    from 
     OR  ST.   ANTHONY'S   FIRE.    205

from the external  air,  but likewife promote the perfpiration,
which has a great tendency to carry off the difeafe.  In Scot-
land the common people generally apply  a meally cloth to
the parts affeaed, which is far from being  improper.
  It is common to bleed in the eryfipelas;  but this likewife
requires caution.   If however the fever be high,  the pulfe
hard and  ftrong,  and the patient vigorous,  it will be  proper
to bleed ;  but the  quantity muft be regulated by thefe cir-
cumftances, and the operation repeated as the fymptoms may
require.  If the  patient has  been accuftomed to ftrong li-
quors, and the difeafe attacks his head, bleeding is abfolutely
neceffary.
  Bathing the feet and legs frequently in  lukewarm  water,
when the difeafe attacks the  face or  brain, has an excellent
effea.  It tends to make a derivation  from  the head, and fel-
dom fails to relieve the patient.   When bathing proves.in-
effeaual, poultices or fharp finapifms, may be applied to the
foles of the feet for the fame purpofe.
  In cafes where bleeding is requifite, it is likewife neceflary
to keep the body  open.   This may be effeaed by emollient
clyfters, or fmall dofes of  nitre and rhubarb.   Some  indeed
recommend very  large dofes of nitre in  the eryfipelas ;  but
nitre feldom fits  eafy on  the  ftomach when taken in large
dofes.  It is however one of the beft  medicines when  the fe-
v::r  and inflammation run high.   Half a dram of it, with
three or four grains of rhubarb, may be taken in the patient's
ordinary drink, four times a-day.
   When the eryfipelas leaves the extremities, and feizes  the
head, fo as to occafion a delirium or  ftupor, it is abfolutely
neceffary to open the body.  If clyfters and mild purgatives
fail to have this effea, ftronger ones muft be given. Blifter-
plafters muft likewife  be  applied to the neck,  or behind the
ears, and fharp cataplafms  laid to the  foles of the feet.
   When the inflammation cannot be difcuffed, and the part
has a tendency to ulcerate, it will then be proper to promote
fuppuration, which may be done by the application of ripen-
ing poultices with faffron, warm  fomentations, and fuch like.
   When the black, livid,  or blue colour of the part fhews a
tendency to mortification, the Peruvian bark muft be admi-
niftered.    It may be taken along with acids, as recommend-
ed  in the fmall-pox, or in any other  form  more agreeable to
the patient.  It mutt not however be  trifled with, as the pa-
tient's life is at ftake.  A dram  may be given every two hours,
jf the fymptoms  be threatening, and cloths dipped in warm
                                            camphorated 
 &06    OF   THE   ERYSIPELAS,  &c.

 camphorated fpirits of wine, or the tinaure of myrrh and a-
 loes, may be applied to the part, and frequently renewed.  It
 may likewife be proper in this cafe, to apply poultices of the
 bark, or to  foment the part affeaed with a ftrong decoction
 of it.
   In  what is commonly called the fcorbutic eryfipelas, which
continues for a confiderable time, it will only be neceffary to
 give gentle  laxatives,  and fuch  things as purify the blood,
 and promote the perfpiration.  Thus, after the inflammation
 has been checked by opening medicines, the decoaion of
 woods* may be drank, after which a courfe of bitters will be
 proper.
   Such as are liable to frequent attacks of the eryfipelas ought
 carefully to  guard  againft all violent  paffions; to  abftain
 from ftrong liquors, and all fat, vifcid, and highly nourifhing
 food.   They fhould likewife take fufficient exercife, careful-
 ly avoiding the extremes of heat or cold.  Their food fhould
 confift chiefly of milk,  and fuch fruits, herbs, and roots, as
 are of a cooling quality ; and their drink ought to be fmall
 beer, whey, butteT-milk, and fuch like.  They  fhould never
fuffer themfelves to be too long coftive.  If  that cannot be
prevented by fuitable diet, it will be proper to take frequent-
ly a gentle dofe of rhubarb, cream of tartar, the lenitive elec-
 tuary, or fome other mild purgative.
               CHAP.     XXVI.

OF   THE   PHRENITIS,   OR  INFLAM-
         MATION  OF  THE  BRAIN.

      TH I S  is fometimes a primary difeafe,  but oftener only
       a fymptom of fome other malady ; as the inflamma-
tory,  eruptive,  or  fpotted fever,  &c.  It is very common
however  as a primary difeafe in warm climates,  and is moft
incident  to perfons about the prime or vigour of life.   The
paffionate, the ftudious, and thofe whofe nervous fyftem is ir-
ritable in a high degree, are moft liable to it.
  CAUSE S.------This  difeafe is  often occafioned by
night-watching, efpecially when joined with hard ftudy : It
may likewife proceed from hard drinking, anger, grief, or
anxiety.   It is often occafioned by the ftoppage  of ufual eva-
cuations ; as the bleeding piles in men, the cuftomary  dif-
                                                 charges
         * See Appendix, Decoction of woods. 
      OF  THE  P H R E N I T I S,  &c.     207

charges of women, &c.   Such as imprudently expofe them-
felves to the heat of the fun, efpecially by fleeping without
doors in a hot feafon, with their heads uncovered,  are often
fuddenly feized with an inflammation of the brain,  fo as  to
awake  quite delirious.  When repellents  are  imprudently
ufed in an eryfipelas,  an inflammation of the brain is fome-
times the confequence.  It may likewife be occafioned  by
external injuries, a-s blows or bruifes upon the head, &c.
  SYMPTOM S.-----The fymptoms which ufual-
ly precede a true inflammation of the brain are, pain of the
head, rednefs of the eyes,  a violent flufhing of  the face, di-
fturbed fleep, or a total wan* of it, great drynefs of the fkin;
coftivenefs,  a retention of  urine, a fmall dropping of blood
from the nofe,  ringing of the ears,  and extreme infenfibility
of the nervous fyftem.
  When the inflammation is formed, the fymptoms in gene-
ral  are  fimilar  to thofe of the inflammatory  fever.  The
pulfe indeed is often weak, irregular, and trembling;  but
fometimes it is hard and contraaed.  When the brain itfelf
is inflamed,  the pulfe is always foft and low ; but when the
inflammation only affeas the integuments of the brain, viz.
the dura  and pia mater, it is hard.  A remarkable quick-
nefs of hearing  is a common fymptom of  this  difeafe ;  but
that feldom  continues long.   Another ufual  fymptom  is  a
great throbbing or pulfation in the arteries  of the neck and
temples.   Though the tongue is often black and  dry; yet
the patient feldom complains  of thirft, and even refufes drink.
The mind chiefly runs upon  fuch objeas as have before made
a deep impreffion on  it; and fometimes, from  a fullen  fi-
lence, the  patient becomes  all of a fudden quite  outrage-
ous.
  A conftant trembling  and ftarting of the tendons, is  an
unfavourable fymptom, as  are alfo a foppreflion of urine ; a
a total want of fleep ; a conftant fpitting ;  a grinding of the
teeth, which laft may be confidered as a kind of convulfion.
When a  phrenitis fucceeds  an inflammation of the lungs,
of the inteftines, or of the throat,  &c. it is  owing to  a
tranflation of the difeafe from thefe parts to the brain, and
generally  proves fatal.  This fhews the neceflity of proper
evacuations, and the danger  of repellents in all inflammato-
ry difeafes.
  The favourable fymptoms are,  a free perfpiration or fweat-
ing, a copious difcharge of blood from the nofe, the bleed-
ing piles,  a  plentiful difcharge of urine which lets fall a co-
                                                  pious 
408     OF  THE  PHRENITIS,  OR

pious fediment.   Sometimes the difeafe is  carried off by a
loofenefs, and in women by an exceffive flow of the menfes.
  As this difeafe often proves fatal in a few days,  it requires
the moft fpeedy applications.  When it is prolonged, or im-
properly treated, it fometimes ends in madnefs, or a kind of
ftupidity which continues for life.
  In the cure, two things are chiefly to be attended to,  viz.
to leffen the quantity of blood in the brain, and to retard the
circulation towards the head.
  REGIME N.------The  patient  ought  to be kept
very quiet.   Company,  noife, and every thing  that  affects
the fenfes, or difturbs the imagination, increafes the difeafe.
Even too much light  is hurtful;  for which reafon the pati-
ent's chamber ought  to be a little darkened,  and  he fhould
neither be kept too hot  nor cold.   It is not however  necef-
fary to exclude the company of an agreeable  friend, as thi9
has a tendency to footh and quiet the mind.  Neither ought
the  patient  to be kept  too much in the dark, left it fhould
occafion a gloomy melancholy,  which  is  too often the confe-
quence of this difeafe.
   The patient muft be  foothed and humoured  in everything.
Contradiction will ruffle his  mind, and  increafe his mala-
dy.   Even when he calls for things which are not  to be ob-
tained, or which might prove hurtful,  he is not  to be poffi-
tively denied them, but rather put off with the promife of
having them as  foon as they can be  obtained, or by fome
other excufe.  A little of any thing that the mind is fet upon,
though not quite  proper, will hurt the patient lefs than a po-
fitive refufal.  In a word, whatever he was fond of,  or ufed
to be delighted with when  in health,  may  here  be tried, a9
pleafing ftories,  foft  mufic,  or whatever has  a tendency to
footh the paffions, and  compofe the mind.  Boerhaave  pro-
pofes feveral mechanical experiments  for  this purpofe; as
the foft noife of water diftilling by drops into a bafon,  and
the patient trying to reckon them, he. Any uniform found,
if low and continued, has a tendency  to procure fleep,  and
confequently may be  of fervice.
   The aliment ought to be light,  confifting chiefly of farina-
ceous fubftances;  as  panado, and  water-gruel fharpened  with
jelly of currants,  or juice of lemons,  ripe  fruits roafted or
 boiled, jellies, preferves, &C.  The drink fmall, diluting,
 and cooling; as whey,  barley-water, or decoaions of barley
 and tamarinds, which latter not only  render the liquor more
 palatable, but likewife  more  beneficial, as they  are of an
 opening nature.
                                          MEDICINES. 
INFLAMMATION OF  THE BRAIN.
   MEDICINE S.------In  an  inflammation  of  the
brain, nothing more certainly relieves the patient than a free
difcharge of blood from the nofe.   When this comes of its
own accord, it is by  no means to be ftopped,  but promoted,
by applving cloths dipped in warm water to the part.  When
bleeding at the nofe does not happen fpontaneoufly,  it may
be provoked,  by  putting a ftraw, or any  other fharp body up
the noftril.
   Bleeding in the temporal arteries greatly relieves the head ;
but as this operation  cannot always be  performed, we would
recommend in its ftead bleeding in the jugular veins.  When
the patients pulfe and fpirits are fo low, that he cannot bear
bleeding with the lancet, leeches may be applied to the tem-
ples.  Thefe not only draw  off the blood  more gradually,
but by being  applied nearer to the part  affeaed, generally
give more immediate relief.
   A difcharge of blood from the haemorrhoidal veins is like-
wife of great fervice,  and ought by all means to be promoted.
If the patient has been  fubjea to the bleeding piles,  and that
difcharge has been ftopped,  every  method muft be tried  to
reftore it;  as the application of leeches to the parts, fitting o-
ver the  fleams of warm water, fharp clyfters or  fuppofitories
made of honey, aloes, and rock fait.
   If the inflammation ofthe brain be occafioned by the ftop-
page of evacuations either natural or artificial, as the menfes,
iffues, fetons, or fuch like,  all means muft be ufed to reftore
them as foon as poffible,  or to fubftitute others in their ftead.
   The patient's  body  muft be kept open by ftimulating clyf-
ters or  fmart purges; and fmall quantities of nitre ought  fre-
 quently to be mixed with his drink.  Two or three drams,
or more,  if the cafe  be dangerous,  may  be ufed in the fpace
of twenty-four hours.
    The head  fhould befhaved and frequently rubbed  with vi-
 negar  and rofe-water.  Cloths dipped in this mixture may
 likewife be applied to  the temples. The feet ought frequent-
 ly to be bathed in lukewarm water, and foft poultices of bread
 and milk may be kept  conftantly applied to  them.
    If the difeafe  proves obftinate,  and does  not yield to thefe
 medicines, it will be necefLry to apply a bliftering-plafter to
 the whole head.
A  a
CHAP. 
[     2IO   ]
               CHAP.    XXVII.

£>F  THE  OPHTHALMIA, OR  INFLAM-
          MATION  OF  THE  EYES.

      THIS difeafe may be occafioned by external  injuries;
       as blows, burns, bruifes, and the like.   It may like-
 wife  proceed  from duft,  quicklime, or  other fubftances,
 thrown into the eyes.   It is often caufed by the ftoppageof
 cuftomary evacuations ; as the healing of old fores, drying up
 of iffues, the fuppreffing of gentle  morning fweats,  or ofthe
 fweating of the feet, &c.   Long expofure to the night  air,
 efpecially in  cold  northerly  winds,  or  whatever fuddenly
 checks the perfpiration,  efpecially  after  the body has been
 much heated,  is very apt to  caufe an inflammation  of  the
 eyes.  Viewing fnow or other white bodies for a long time,
 or looking ftedfaftly at the fun, a clear fire, or any bright ob-
 jea,  will likewife occafion this malady.  A fudden tranfition
 from darknefs  to very bright  light  will often have the fame
 effea.
   Nothing more certainly occafions an inflammation ofthe
 eyes, than night-watching,  efpecially reading or writing by
 candle-light.   Drinking fpiritous liquors,  and excefs of ve-
 nery, are likewife very hurtful  to the eyes.   The acrid fumes
 of metals, and of feveral kinds  of fuel,  are alfo pernicious.
 Sometimes an inflammation of  the eyes proceeds from a ve-
 nereal taint, and often from a fcrophulous  or gouty habit. It
 may likewife be  occafioned by hairs in  the eye-lids turning
 inwards, and hurting the eyes.  Sometimes the  difeafe is e-
 pidemic,  efpecially after wet feafons; and I have frequently
 known it prove infeaious, particularly to thofe who lived in
 the fame houfe with the patient.  It may be occafioned by
 moift air, or living in low, damp houfes, efpecially in per-
 fons who are not accuftomed to fuch fituations.  In children,
 it often  proceeds  from imprudently drying  up of fcabbed
 heads, a running behind the ears,  or any  other difcharge of
 that kind. Inflammations of the eyes often  fucceed the fmall-
 pox or meafles, efpecially in children of a fcrophulous habit.
   SYMPTOM S.------An inflammation of the eyes is
 attended with  acute pain, heat, rednefs, and fwelling.  The
 patient is not able to bear the  light, and fometimes  he feels a
 pricking pain, as if his eyes were pierced with a thorn. Some-
 times he imagines his eyes are full of motes, or thinks he fees
                                                      flies 
Of THE  OPHTHALMIA,  &c.
2X1
flies dancing before him.   The eyes are filled with a fcalding
rheum, which rufhes forth in great quantities,  whenever the
patient attempts to look up.   The pulfe  is generally quick
and hard, with fome degree of fever.  When the difeafe  is
violent, the neighbouring parts fwell, and there is a throb-
bing or pulfation in the temporal arteries, &c.
  A flight inflamation of the eyes, efpecially from an  exter-
nal caufe,  is eafily cured ; but when the difeafe is violent,
and continues long, it often leaves fpecies upon the eyes, or
dimnefs of fight, and fometimes total blindnefs.
  If the patient be feized with a loofenefs, it has a good ef-
fea ;  and when the inflammation paffes from one eye to ano-
ther, as it were by infeaion, it is  no unfavourable fymptom.
But when the difeafe is accompanied  with a violent pain  of
the head, and continues long, the patient is in danger of lof-
ing his fight.
  REGIMEN.-----The  diet, unlefs in  fcrophulous
cafes, can hardly be too fpare, efpecially  at the beginning.
The patient muft abftain from every thing of  a  heating na-
ture.   His food muft confift chiefly of mild vegetables, weak
broths and gruels.  His  drink may  be  barley-water, balm-
tea, common whey, and fuch like.
   The patient's chamber muft be darkened, or his eyes (had-
ed by a cover, fo as to exclude the light, but not to prefs up-
on the eyes.   He fhould not look  at a candle, the fire, or any
luminous objea;  and ought to avoid all finoke, as the fumes
of tobacco, or any thing that may caufe coughing, fneezing,
or vomiting.   He fhould be  kept quiet,  avoiding all violent
efforts, either of  body or  mind, and encouraging fleep as
much as  poffible.
   MEDICINE.------This  is   one of  thofe  difeafes
wherein great  hurt is often  done by  external applications.
Almoft every perfon pretends to be poffeffed of a remedy for
the cure  of fore eyes.  Thefe  remedies generally confift of
eye-waters 3nd ointments, with  other external applications,
which do mifchief twenty times for once they do good. Peo-
ple ought therefore to be very cautious  how  they  ufe  fuch
things, as the very preffure upon the eyes often increafes the
malady.
   Bleeding, in a violent inflammation of the eyes, is always
neceffary.  This fhould be performed as near the part affea-
ed  as poffible.   An adult may lofe ten or twelve ounces of
blood from the jugular vein, and the  operation may be re-
peated according to the urgency of the fymptoms. If it fhould
                                                     not 
 212     OF  THE  OPHTHALMIA,  OR

 not be convenient to bleed in the neck,  the  fame quantity
 may be let from the arm, or any other part ofthe body.
   Leeches are often applied to the temples, or under the eyes,
 with good effea.  The wounds  muft be fuffered to bleed
 for fome hours, and  if the bleeding flop foon, it may be pro-
 moted by the application of cloths dipt in warm water.  In
 obftinate cafes, it will be neceflary to repeat this operation fe-
 veral times.
   Opening and diluting medicines are by no means to be ne-
 gfeaed.  The patient  may take  a fmall  dofe of Glauber'j
 falts, and cream of tartar, every fecond or  third day, or a de-
 coaion of tamarinds with fenna.  If  thefe be not agreeable,
 gentle dofes  of rhubarb and nitre, a little ofthe lenitiveelec-
 tuary, or any other mild purgative, will anfwer the fameend.
 The patient at the fame time muft drink freely of water-gru-
 el, tea, whey, or any other weak diluting  liquor.  He ought
 likewife to take, at bed-time,  a  large draught of very weak
 wine whey,  in order to promotef perfpiration.   His feet and
 legs muft frequently be bathed  in lukewarm water, and his
 head fhaved twice or thrice a-week, and afterwards wafhed in
 cold water.  This has often a remarkably  good effea.
   If the inflammation  does not yield to thefe evacuations,
 bliftering-plafters muft be applied to the temples, behind the
 ears, or upon the neck, and kept open for fome time  by the
 mild bliftering ointment.  I have feldom known thefe, if long
 enough kept open,  fail to remove the moft obftinate inflam-
 mation of the eyes ; but, for this  purpofe, it is often neceffa-
 ry to continue the difcharge for feveral weeks.
   When the difeafe  has been of long ftanding,  I  have feen
 very extraordinary effeas from a feton in the neck,  or be-
 twixt the fhoulders, efpecially the latter.   It  fhould  be put
 upwards and downwards, or in the direaion of the fpine, and
 in the middle between the fhoulder-blades. It  may be dreffed
 twice a-day with yellow bafilicon.  I have known patients,
 who had been blind  for a confiderable time, recover fight by
 means of a fetoa placed as above.   When  the feton is puta-
 crofs the neck,  it foon wears out, and is both more painful
 and troublefome than between  the  fhoulders ;  befides, it
 leaves a difagreeable mark,  and does  not difcharge fo free-
 ly.
.  When the heat and pain of the  eyes are  very great, a poul-
 tice of bread  and milk foftened with fweet oil or frefh butter,
 may be applied to them, at leaft all night; and they may be
 bathed with lukewarm milk and water in the morning. •
                                                 5    If 
  INFLAMMATION OFTHE EYES.  213

  If the  patient cannot fleep,  which is fometimes the cafe,
he  may  take twenty  or thirty drops of laudanum,  or two
fpoonfuls of the fyrup of poppies, over night, more or lefs ac-
cording to his age, or the  violence ofthe fymptoms.
  After the inflammation is gone off, if the eyes ftill remain
weak and tender,  they may be bathed every night and morn-
ing with  cold water and a little brandy, fix parts of the former
to one of,the latter.  A method fhould be contrived  by which
the eye can be quite immerfed in the brandy and water, where
it fhould  be kept for fome time.  I have generally found this,
or cold water and vinegar, as good a  ftrengthener of the eyes,
as any of the moft celebrated collyriums.
  When an inflammation  ofthe eyes  proceeds from a fcro-
phulous habit, it generally proves very obftinate.   In this
cafe the patient's diet muft not be too low, and he may be al-
lowed to drink fmall negus, or now and then a glafs of wine.
The moft proper medicine is the Peruvian bark,  which may
either  be given in fubftance, or prepared  in  the  following
manner :
   Take an ounce of bark  in powder, with  two drams of
Winter's bark, and boil them in an  Englifh quart of water
to a pint ; when  it has boiled nearly long enough,  add half
an ounce of liquorice root fliced.  Let the liquor be ftrained.
Two, three, or four table fpoonfuls, according to the age of
the patient,  may be taken three or four times a-day. It is im-
poffible to fay how long this medicine  fhould be continued,
as the cure is  fooner performed in fome than in others ; but
in general it requires a confiderable time to produce any lad-
ing effeas.
  Dr. Cheyne fays,  " That aethiops  mineral never fails in
obftinate inflammations ofthe eyes, even fcrophulous ones, if
given in a fufficient dofe, and duly perfifted in." There is no
doubt but this^ and other preparations of mercury may  be of
lingular fervice in ophthalmias of long continuance, but they
ought always to be adminiftered  with the greateft caution, or
by perfons of fkill in  phyfic.
   It will be proper frequently to look into the  eyes, to fee  if
any hairs be turned inwards, or preffing upon them, in  order
that they may be cut off without delay.
   Such as are liable to frequent returns of this difeafe, ought
conftantly to have an iffue in one or both arms.  Bleeding
or purging in the fpring and autumn, will  be very beneficial
to fuch perfons.  They ought likewife to live with  the great-
                                                     eft 
214     OF  THE OPHTHALMIA, &c.

eft  regularity, avoiding ftrong liquor,  and every thing of a
heating quality.  Above all, let them avoid the night-air  and
late ftudies *.
              CHAP.     XXVIII.

OF  THE  QUINSEY,   OR  INFLA-MMA-
         TION  OF THE  THROAT.

      THIS difeafe is very common in  Britain, and  is fre-
      quently attended  with great danger.  It prevails in the
winter and fpring, and is moft fatal to young people of a fan-
guine temperament.
  CAUSE S.——-In general it  proceeds from the fame
caufes as other inflammatory diforders, viz. an obftruaed per-
fpiration,  or whatever heats or inflames the blood.  An in-
flammation ofthe throat is often occafioned by omitting fome
part ofthe covering ufually worn about the neck,  by drink-
ing cold liquor when the body is warm, by riding or walking
againft a cold  northerly  wind, or any thing that greatly cools
the throat, and parts adjacent.   It may likewife proceed from
the neglea of bleeding, purging, or any cuftomary evacuation.
  Singing, fpeaking aloud  and long,  or whatever ftrains the
throat, may likewife caufe an inflammation of that organ.  I
have often known the quinfey prove fatal to jovial compani-
ons, who, after fitting long in a warm room,  drinking hot
liquors,  and finging with vehemence, were fo imprudent as
to go abroad in  the cold night-air.   Sitting with wet feet,
or keeping on wet clothes,  are very apt to occafion this mala-
dy.   It is likewife frequently occafioned by continuing long
in a moift place, fitting  near an  open window, fleeping in a
damp bed, fitting in a room that has been newly plaftered, &c.
I know people who never fail to have a fore throat  if they
fit even but a fhorttime  in a room that has been lately wafhed.
  Acrid or irritating  food  may likewife inflame the throat,
and occafion  a  quinfey.   It may alfo proceed from bones,
pins, or other fharp fubftances flicking in the throat, or from
the cauftic fumes of metals or minerals, as arfenic, antimony,
&c. taken in by the breath.   This difeafe is fometimes epide-
mic and infeaious.                        SYMPTOMS.

  * As moft people are  fond of ufing eye-waters and ointmenta
in this and other difeafes of the eyes, we have inferted fome of the
moft  approved forms of  thefe medicines in the Appendix.  See
Appendix, Eye-water and Eye-fafre. 
OF  THE  Q.UINSEY,   &c.
215
  SYMPTOM S.------The inflammation of the throat
is evident from infpeaion, the parts appearing red and fwell-
ed ; befides, the patient complains of pain in fwallowing. His
pulfe is quick and hard,  with other fymptoms of a fever.   If
blood be let,  it is generally covered with a tough coat of a
whitifh colour, and the  patient fpits a tough phlegm.   As the
fwelling and inflammation increafe,  the breathing and fwal-
lowing become more difficult; the pain affeas the ears; the
eyes generally appear red ;  and the  face fwells.   The patient
is often obliged to keep himfelf in an erea pofture, being  in
danger of fuftbcation ;  there is a conftant naufea, or inclina-
tion to vomit,  and the  drink,  inftead of paffing into the fto-
mach, is  often returned by the nofe.   The patient  is fre-
quently ftarved at laft, merely from an inability of fwallowing
any kind of food.
  When  the breathing is  laborious, with  ftraitnefs  of the
breaft, and anxiety, the danger is great.  Though  the pain
in  fwallowing be very  great,  yet  while  the patient breathe*
eafy, there is not fo  much danger.  An external fwelling is
no  unfavourable fymptom ; but if it fuddenly falls,  and the
difeafe affiea§ the breaft, the danger is very great.  When a
quinfey is  the confequence of fome other difeafe, which has
already weakened the patient,  his fituation is dangerous.  A
frothing at the mouth, with a fwelled tongue, a pale,  ghaftly
countenance, and coldnefs of the extremities, are fatal fymp-
toms.
  REGIME N.------The regimen in this difeafe is in
all  refpeas the fame as in  the pleurify, or peripneumony.
The food muft be light, and in fmall quantity,  and the drink
plentiful, weak and diluting, mixed with  acids.
  It  is highly neceflary,  that the patient be  kept eafy and
quiet.  Violent affeaions of the mind, or great efforts of the
body, may prove fatal.   He fhould  not even attempt to fpeak
but in a low voice.  Such a degree of warmth  as to promote
a conftant gentle fweat, is proper. When the patient is in
bed,  hishead ought to be raifed a little higher than ufual.
   It is  peculiarly neceflary that the neck be kept warm ;  for
which purpofe feveral folds of foft flannel may be wrapt round
it.   That alone will often remove a  flight complaint of  the
throat, efpecially if applied  in due time.   We cannot here o-
mit obferving, the propriety of a cuftom which prevails a-
mongft the peafants of this country.   When  they feel any
uneafinefs of  the  throat,  they wrap  a  flocking about it all
night.  So effeaual is this remedy,  that in many  places it 
 ai6      OF   THE  Q.UINSEY,  OR

 paffes for a charm, and the flocking is applied with particular
 ceremonies : The cuftom,  however, is undoubtedly a good
 one,  and fhould never be  negfeaed.   When the throat has
 been thus wrapt  up all night,  it muft not be expofed to the
cold air through the day,but ahandkerchief or a piece of flan-
nel, kept about it till the inflammation be removed.
  The jelly of black currants is a medicine very  much in
efteem for complaints of the throat;  and indeed it is of fome
 ufe.   It fhould be almoft conftantly kept in the mouth, and
 fwallowed down  leifurely.   It may likewife  be mixed in the
patient's drink, or taken any other way.   When it cannot be
obtained,  the jelly of red currants, or of mulberries,  maybe
 ufed in its ftead.
  Gargles for the throat are very beneficial.   They may be
 made of fage-tea, with a little vinegar and honey, or by add-
 ing to half an Englifh pint of  the peaoral decoaion two or
 three fpoonfuls of honey, and the fame quantity of currant
jelly. This may be ufed three or four  times  a-day; and if
 the patient be troubled with  tough vifcid phlegm,  the gargle
 may be rendered more fharp and cleanfing, by adding to it a
 tea-fpoonful of the fpirit of  fal ammoniac.  Some recom-
 mend gargles made of a decoaion of the leaves or bark of the
 blackberry-bufh; but  where the jelly can be  had,  thefe are
 un neceffary.
   There is no difeafe wherein  the benefit of bathing the feet
 and legs in  lukewarm water is more apparent :  That prac-
 tice ought therefore never  to be negfeaed.   If people were
 careful to keep warm,  to wrap up their throats with flannel,
 to bathe their feet and legs in warm water, and to ufe a fpare
 diet,  with diluting liquors, at the beginning  of this difeafe,
 it would feldom proceed to a great height, or be attended with
 any danger ; but when thefe precautions are negfeaed, and
 the difeafe becomes violent,  more powerful medicines are ne-
 ceffary.
   M E D I C I N E.------An  inflammation  of the throat
 being a moft acute and dangerous diftemper, which fometimes
 takes off the patient very fuddenly, it will be proper, as foon
 as the fymptoms  appear, to bleed in the arm, or rather in the
 jugular vein, and to repeat the operation if circumftances re-
 quire.
   The body fhould likewife be kept gently open.  This may
 either be done by giving the patient for his ordinary drink  a
 decoaion of figs and tamarinds, or fmall dofes of rhubarb and
 nitre, as recommended in eryfipelas.  Thefe may  be increaf-
                                                      ed 
     INFLAMMATION OF THE THROAT,    af

 ed according to the age of the patient, and repeated till they
 have the defired effea.
  I have often known very good effeas from a bit of falpru-
 nel, or purified nitre, held in the mouth, and fwallowed down
 as it melted.  This promotes the difcharge  of faliva,  by
 which means it anfwers  the end  of a  gargle, while at the
 fame time it abates the  fever,  by promoting the difcharge of
 urine, he.
  The throat ought likewife to be rubbed twice or thrice a-
 day with a little of  the volatile liniment.   This  feldom fails
 to produce fome  good  effeas.  At the  fame time the neck
 ought to be carefully covered with wool or flannel, to pre-
 vent the cold from penetrating the fkin,  as this application
 renders  it  very  tender.   Many other  external applicati-
 ons are  recommended  in  this difeafe, as  a fwallerw's  neftj
 poultices made of the fungus called Jews ears,album grecum,
 he.  But as we do not look upon any of thefe to be preferable
 to a common poultice of bread and milkj  we fhall take no
 farther notice of them.
  Some  recommend the gum  guaiacum as a fpeCifie in this
 difeafe.   Haifa dram of the gum in powder may be made in-
 to an eleauary with the  rob  of elder  berries,  or the jelly of
 currants for a dofe, and repeated occafionally *,
  Bliftering upon the neck or behind  the ear9 in violent in-
 flammations of the throat, is very beneficial ;  and  in  bad
 cafes it will be neceflary to lay a bliftering pi after quite acrofs
 the throat, fo as to reach from ear to ear.   After the plafters
 are taken off,  the parts ought to be kept running by the ap-
 plication of iffue ointment, till the inflammation is gone ;  o-
 therwife, upon their  drying up, the  patient will be in danger
of a relapfe.
  When the patient has been treated as above, a fuppuration
 feldom happens.   This however is  fometimes the cafe,  in
fpite of all endeavours to prevent it.  When the inflammation
and fwelling  continue,   and it is evident that a  fuppuration
will  enfue,  it ought to be promoted by drawing the fteam of
warm water into  the throat  through a tunnel, or fhe  like.
 Soft poultices ought likewife to be  applied outwardly, and
the patient may keep a roafted fig conftantly in his mouth.
  It fometimes happens, before the tumour breaks,  that the
fwelling is fo great,  as  entirely to  prevent any  thing  from
getting down into the ftomach.  In this cafe the patient muft
inevitably perifh,  unlefs he can be  fupported  in fome other
                           B b                    way*
         *  Dr. Home* 
21&       OF  THE  QMUINSEY,  OR

way. This can only be done by nourifhing clyfters of broth,
or gruel with milk, &c.   Patients have often been fupported
by thefe for feveral days, till the tumour has broke ; and af-
terwards they have recovered.
  Not only the fwallowing, but the breathing, is often pre-
vented by the tumour.   In this cafe nothing can fave the pa-
tient's life, but opening  the trachea or wind-pipe.  As  that
has been often done with  fuccefs,  no perfon,  in fuch defpe-
rate circumftances, ought to hefitate a  moment about the ope-
ration; but as  it can only be performed by  a  furgeon,  it is
not neceffary here to give any direaions about it.
  When a difficulty of  fwallowing is  not attended with an
acute pain or  inflammation,  it is generally owing to an ob-
ftruaion of the glands about the throat, and only requires
that the part be kept warm, and  the throat frequently garg-
led with fomething that may gently ftimulate the glands, as a
decoaion of figs with vinegar and honey ;  to  which may be
added a little muftard, or a fmall quantity of fpirits.  But this
gargle is never to be ufed where there are figns of an inflam-
mation.   This fpecies of angina has various names among the
common people,  as the pap ofthe throat, the falling down of
the almonds of the ears, he. Accordingly, to remove it, they
lift the patient up by the hair of  the head,  and  thruft their
fingers under his jaws,&c. all which praftices  are at beft ufe-
lefs, and often hurtful.
  Thofe who are fubjea  to inflammations of  the throat, in
order to avoid that difeafe, ought  to live temperate.  Such as
do  not chufe  to obferve this  rule,  muft have frequent re-
courfe to purging and other evacuations, to difcharge the fu-
perfluous humours. They ought likewife to beware of catch-
ing  cold,  and fhould abftain from aliment and medicines of
an aftringent or ftimulating nature.
  Violent exercife, by'increafing  the motion and force ofthe
blood, is apt to occafion an inflammation of the throat,  efpe-
cially if cold liquor be drank immediately after it, or the bo-
dy fuffered fuddenly to cool-  Thofe  who  would avoid this
difeafe ought therefore, after fpeaking aloud, finging, running,
drinking warm liquor, or doing  any thing-that  may ftrain the
throat, or increafe tbe circulation of the  blood  towards it, to
take care to cool gradually,  and to wrap fome additional co-
verings about their necks.
  I have often  known perfons who had been fubjea to fore
throats, entirely freed from that complaint by only wearing a
ribband, or a bit of flannel, conftantly about their necks, or
                                                      by 
    INFLAMMATION OF THE THROAT.    219

by wearing thicker  fhoes, a  flannel waiftcoat,  or the like.
Thefe may feem trifling, but they have great effea.   There
is danger indeed in leaving them off after perfons have been
accuftomed  to them ; but furely the inconveniency  of ufing
fuch things for life, is  not to be compared with the danger
which may attend the neglea of them.
,  Sometimes, after an inflammation, the glands of the throat
continue fwelled, and become hard and callous.  This com-
plaint is not eafily removed,  and is often rendered dangerous
by the too frequent application of ftrong ftimulating and ftyp-
tic medicines.  The beft method is to keep it warm, and to
gargle it twice a-day with a decoaion  of figs fharpened a lit-
tle with the elixir or fpirit of vitriol.

OF  THE MALIGNANT  QUINSEY, OR
  PUTRID,  ULCEROUS  SQRE THROAT.

  This kind of quinfey is but little  known in the northern
parts of Britain, though, for fome time patt,  it has been very
fatal in the  more fouthern counties. Children are more liable
to it than adults,  females than males,  and the delicate  than
thofe who  are hardy  and robuft.  It prevails chiefly in au-
tumn,  and is  moft frequent after a long courfe of damp, or
fultry weather.
   CAUSE S.——— This is evidently a contagious diftem-
per, and is generally  communicated by infeaion.   Whole
families, and even entire villages, often receive the  infeaion
from one perfon.  This ought to put people upon their guard
againft  going near fuch patients as labour under the diforder;
as by that means they endanger not only their own lives, but
likewife thofe  of their friends and connexions.  Whatever
tends to produce putrid or malignant fevers, may likewife oe-
cafion the  putrid ulcerous fore throat,  as  unwholefome air,
damaged provifions, neglea of cleanlinefs, he.
   SYMPTOM S.------It begins with alternate fits of
fhivering and heat.  The pulfe is quick,  but low  and une-
qual, and  generally continues fo through the whole courfe of
the difeafe.  The patient complains greatly of weaknefs and
oppreffion  of the breaft; his fpirits are low,  and he is apt to
faint away when fet upright; he is troubled  with  a naufea,
and often with a vomiting or purging.  The two  latter are
moft common in children.   The eyes appear red and watery,
 and the face fwells.   The urine is at  firft pale and crude ;
 hut, as the difeafe advances, it turns more of a yellowifh co-
                                                    lour* 
220   OF THE  MALIGNANT  QUINSEY,  OR

lour.   The tongue is white, and generally moift, which dif.
tinguifhes this from an inflammatory  difeafe.  Upon looking
into the throat it appears fwelled, and of a florid red colour.
Pale or afh-coloured  fpots, however, are  here and  there in-
terfperfed, and fometimes one broad patch or fpot,  of an irre-
gular  figure,  and pale white colour,  furrounded with florid
red, only appears.   Thefe whitifh fpots or floughs  cover fo
many ulcers.
  An eflforefcence, or eruption upon the neck, arms, breaft,
and fingers, about the fecond  or third day, is a  common
fymptom of this difeafe.   When it appears, the purging and
vomiting generally ceafe.
  There is often a flight degree of delirium, and the face fre-
quently appears bloated,  and the infide of the noftrilsredand
inflamed.  The patient  complams of a difagreeable putrid
fmell, and his breath is very oftenfive.
  The putrid, ulcerous fore throat may  be  diftinguilhed
from  the inflammatory by the vomiting and loofenefs  with
which it is generally ufhered in ; the  foul ulcers in the throat
covered with a white or livid coat; and by the exceffive weak
nefs of  the patient;  with other fymptoms of a putrid fever.
  Unfavourable fymptoms  are, an  obftinate purging, ex-
treme weaknefs, dimnefs of the fight, a livid or black colour
of  the fpots, and  frequent fhiverings,  with a weak, flutter-
ing pulfe.  If the eruption upon the fkin fuddenly difappears,
or becomes of a livid colour, with a difcharge of  blood from
the nofe or mouth, the danger is very great.
  If a gentle fweat break out about tbe third or fourth day,
and continue with allow, firm and unequal pulfe;  if the
Houghs caft off in  a kindly manner, and appear clean and flo-
rid  at the botom ;  and if the breathing be  foft and free, with
a lively colour of the eyes, there is reafon to hope for a falu-
tary crifis.
  REGIME N.»   ■■■ -The patient muft be kept quiet,
and,  for the  moft; part,  in  bed, as  he will be apt to faint
when taken out of it.  His food muft: be nourifhing and re-
ftorative ; as fago-gruel with red wine, jellies, ftrong broths,
he.  His drink ought  to be generous, and of an antifep-
tic  quality; as red wine negus,  white  wine whey,  and fuch
like.
  M  E D 1 C I N E.»—■—The medicine in this kind of
quinfey, is entirely different from that which is proper in the
inflammatory.  All evacuations, as  bleeding, purging, &c.
which weaken the  patient, muft be avoided.  CoolingVnedi-
                                                   cines, 
   PUTRID, ULCEROUS  SORE THROAT.    221

cines, as nitre and  cream of tartar,  are  likewife hurtful.
Strengthening cordials  alone can  be ufed with fafety; and
thefe ought never to be negfeaed.
  If,  at the beginning, there be a great naufea, or inclina-
tion to vomit, the patient muft drink an infufion of green tea,
camomile flowers, or carduus benedidus, in  order  to  cieanfe
the ftomach.  If thefe be not fufficient, he may take  a few
grains of the powder of ipecacuanha, qr any other gentle vo-
mit.
  If the difeafe be mild,  the throat may be gargled with an
infufion of fage and  rofe leaves, to  a gill of which may be
added a  fpoonful or two of honey, and as much vinegar as
will make  it  agreeably acid; but, when the  fymptoms  are
urgent, the floughs large  and thick, and the breath very of-
fenfive, the following gargle may be ufed :
  To fix or feven ounces of the peaoral  decoaion,  when
boiling, add half an ounce of contrayerva root;  let  it boil
for fome time, and afterwards ftrain the liquor; to which add
two ounces of white wine vinegar,  an ounce of fine honey,
an ounce of the tinaure of myrrh.  This ought not only to
be ufed as a gargle,  but a little of  it fhould frequently be in-
jeaed with a fyringe to clean the  mouth, before  the patient
takes any meat or drink.   Tbis method is peculiarly neceffa-
ry for children, who cannot ufe a gargle.
  It will be of great benefit if the patient frequently receives
into  his mouth,  through  an inverted funnel,  the fleams of
warm vinegar, myrrh, and honey.
  But when the putrid fymptoms run high, and  the difeafe
is attended with danger, the only medicine that can be de-
pended upon is the Peruvian bark.   It may be taken in fub-
ftance, if the  patient's ftomach  will  bear  it.  If not,  an
ounce of  bark grofsly powdered, with two drams of Virgin
nian fnake-root, may be  boiled in an Englifh pint  and an
half of water, to half a pint; to which a tea-fpoonful ofthe
elixir of vitriol may  be added, and an  ordinary tea-cupful of
it taken every three or four hours.   Bliftering-plafters are ve-
ry beneficial  in  this difeafe,  efpecially  when the patient's
pulfe and  fpirits are low.   They may be applied to the throat,
behind the ears,  or upon  the back part of the  neck.
  Should the vomiting prove  troublefome, it  will be proper
to give the patient  two table-fpoonfuls  of the faline julep
every hour.  Tea made of mint and a little cinnamon, will
be very proper for his ordinary  drink, efpecially if an  equal
quantity of red wine be mixed with it,
                                                     In 
■m    OF TH£ MALIGNANT  QUINSEY,  &c.

  In cafe of a violent loofenefs,  the fize of a nutmeg of di-
afcordium,  or the japonic confeaion, may be taken two or
three times a-day, or oftener if neceffary.
  If a difcharge of blood from the nofe happens, the fleams
of warm vinegar may be received up the noftrils frequently;
and the drink muft be fharpened with the fpirits of vitriol,
or tinaure of rofes.
  In cafe of a ftranguary, the belly muft be fomented with
warm water,  and emollient clyfters given three or four times
a-day.
  After the violence of the difeafe is over, the body fhould
ftill be  kept  quite open with  mild purgatives; as manna,
fenna,  rhubarb,  or the like.
  If great weaknefs and dejeaion of fpirits, or night-fweats,
with other  fymptoms of a confumption,  fhould remain after
this difeafe, we would advife the patient to continue the ufe
of the Peruvian bark, with the  elixir of vitriol, and to take
frequently a glafs of generous wine.  Thefe, together with a
milk-diet, and riding on horfeback, are the moft likely means
for recovering his ftrength.
               CHAP.    XXIX.

   OFCOLDS    AND   COUGHS.

   IT has already been obferved, that colds are the effea of
    an obftruaed perfpiration ; the common caufes of which
we have likewife endeavoured to point out, and fhall not here
repeat  them.  Neither fhall we fpend time in enumerating
all the various fymptoms of colds,  as they are pretty gene-
rally known.  It may not however  be amifs to obferve, that
that  almoft every cold is a kind of  fever, which only differs
in degree from fome of thofe that have already been treated
of.
  No age, fex, or conftitution is exempted from this difeafe:
neither is it in the power of any medicine or regimen to pre-
vent it.   The inhabitants of every climate are liable to catch
cold, nor can even the greateft circumfpeaion defend them at
all times from its attacks.   Indeed,  if the human body could
be kept conftantly in an uniform degree of warmth, fuch  a
thing as catching cold would be impoffible: But as that can-
not be effeaed by any means, the  perfpiration muft be lia-
ble, to many changes.   .Such changes,  however, when fmall 
    OF  COLDS  AND  COUGHS.     223

do  not affea the health; but, when great, they muft prove
hurtful.
  When oppreffion of the breaft, a fluffing of the nofe,  un-
ufual wearinefs, pain of the head, &c. give ground to believe
that the perfpiration is obftruaed,  or,  in other words,  that
the perfon has caught cold, he  ought immediately to leffen
his  diet, at leaft the ufual quantity of his folid  food, and to
abftain from  all ftrong liquors.   Inftead of flefh, fifh, eggs,
milk, and other nourifhing diet, he  may  eat  light  bread-
pudding, veal or chicken  broth, panado, gruels, and fuch
like.  His drink may be water-gruel fweetened with  a little
honey;  an infufion of balm,  or linfeed fharpened with the
juice of orange or lemon ;  a decoaion of barley  and  liquo-
rice with tamarinds, or any other cool, diluting, acid liquor.
  Above all, his fupper fhould  be light; as fmall pofiet, or
water-gruel fweetened with honey,  and a little toafted bread
in it.   If honey fhould difagree with  the ftomach, the gruel
may be fweetened with treacle or coarfe fugar,  and fharpen-
ed with  the jelly of currants.  Thofe who have been accuf-
tomed  to  generous liquors  may take wine-whey inftead of
gruel, which may be fweetened  as above.
  The patient ought  to lie longer than ufual a-bed,  and to
encourage a gentle fweat, which is eafily brought on towards
morning,  by drinking  tea, or any  kind of warm diluting li-
quor.   I  have often known this praaice carry off a cold in
i)ne day,  which in all probability,  had  it been negfeaed,
would have coft the patient his life, or have confined him for
fome months.  Would people facrifice a little time  to  eafe
and warmth, and  praaife a moderate degree of abftinence
when the firft fymptoms of a cold appear, we have reafon to
believe, that moft of the bad effeas which flow from  an ob-
ftruaed perfpiration, might be prevented.   But, after the dif-
eafe has gathered ftrength by delay, all attempts to remove it
often prove  vain.  A  pleurify,  a  peripneumony, or  a  fatal
confumption of the lungs, are  the common efteas of colds
which have  either been totally  negfeaed,  or treated impro-
perly.
  Many attempt to cure a cold, by getting drunk.  But this,
to fay no worfe of it,  is a very hazardous experiment.  Nu
doubt  it may fometimes fucceed,  by fuddenly  reftoring the
perfpiration  ; but when there is any degree of inflammation,
which is  frequently the cafe, ftrong liquors,  inftead of re-
moving the malady, will increafe it.  By this means a com-
mon cold may be convertedinto an  inflammatory fever.
                                                  When 
M4     OF COL£>S  AND  COttGtfS.

  When  thofe who labour for  their daily bread have the
misfortune to catch cold,  they cannot afford to lofe a day or
two, in order to keep themfelves warm, and take a little me-
dicine ;  by which means the diforder is often fo aggravated as
to confine them for a lohg time*  or even to render them ever
after unable to fuftain hard labour.  But even fuch of the la-
bouring poor as can afford to take care of themfelves, are of-
ten too  hardy to do  it;  they arrea to defpife colds, and as
long as they can crawl about, fcorn to be confined by what
they call a common cold.   Hence it is, that colds deftroy fuch
numbers of mankind.  Like  an enemy defpifed, they gather
ftrength  from delay, till,  at length, they become invincible.
We often fee this verified  in travellers, who, rather than lofe
a day in the profecution of their bufinefs, throw away their
lives by purfuing their  journey,  even in the fevereft weather,
with this difeafe upon them.
  It is certain, however,  that colds may be too much indulg-
ed.  When a perfon, for every flight cold, fhuts himfelf up
in a warm room,  and drinks great quantities of warm liquor,
it may occafion fuch a general relaxation of the  folids as will
not be eafily removed.  It will therefore be proper, when the
difeafe will permit, and  the weather is mild,  to join to the
regimen mentioned above, gentle exercife j as walking, rid-
ing on horfeback, or in a machine, &c. An obftinate cold,
which no medicine can remove, will yield to gentle exercife
and a proper regimen of the diet.
  Bathing the feet and legs  in warm  water has a great ten-
dency  to reftore the  perfpiration.  But  care  muft be taken
that the water be not too warm, otherwife it will do hurt.  It
fhould never be much warmer than the Mood, and the pati-
ent fhould go immediately to bed after ufing it.  Bathing the
feet in warm water, lying in bed,  and drinking warm water-
gruel,  or other weak liquors,  will fooner take off a fpafm,
and reftore the perfpiration, than all the hot  fudorific medi-
cines in the world.  This is all that is neceffary for remov-
ing a common cold j and if  this  courfe be taken at the be-
ginning, it will feldom fail.
  But when the fymptoms do not yield to abftinenee, warmth,
and diluting liquors,  there is reafon to  fear the approach of
fome other difeafe,  as  an  inflammation of the breaft, an  ar-
dent fever, or the like.   If the pulfe therefore be hard and
frequent, the fkin hot  and dry,  and the patient complains of
his head or breaft,  it will be neceffary to bleed, and to  give
the cooling powders recommended in the fcarlet fever, every
three or four hours, till they give a ftool.
                                                       It 
     OF  COUGHS  AND  COLDS.     225

  It will likewife be proper to put a bliftering-plafter on the
back, to give two table-fpoonfuls of the faline mixture eve-
ry two hours, and,  in fhort to treat the patient in all refpeas
as for a flight fever.  I have often feen this courfe, when ob-
ferved at the beginning, remove the complaint in two or three
days, when the patient had all the fymptoms of an approach-
ing ardent fever, or an inflammation of the breaft.
   The chief fecret of preventing colds lies in avoiding as far
as poffible, all extremities either of heat or cold, and in taking
care, when the body is heated, to let it cool gradually. Thefe
and other circumftances relating  to  this important fubjea,
are fo fully treated  of under the article  Obflrucled Perfpiration,
that it would be needlefs here to refume the confideration of
them.

     OF    A   COMMON   COUGH.

   A cough is generally the effea of a cold,  which has ei-
ther been improperly treated, or entirely negfeaed. When it
proves obftinate, there is always reafon to fear the confequen-
ces, as this  fhews  a weak  ftate of the lungs, and is often the
 forerunner of a confumption.
   If the cough be violent, and the patient young and ftrong,
 with a  hard quick pulfe,  bleeding  will be proper; but in
 weak and relaxed  habits, bleeding rather prolongs the difeafe.
 When  the  patient fpits freely,  bleeding is unneceffary, and
 fometimes hurtful, as it tends to leflen that difcharge.
   When the cough is not attended with  any degree of fever,
 and the fpittle  is  vifcid and tough, fharp peaoral medicines
 are to be adminiftered ; as gum ammoniac, fquills, &c. Two
 table-fpoonfuls of the folution of gum ammoniac may be ta-
 ken three or four  times a-day, more or lefs, according to the
 age  and conftitution  of the patient.  Squills may be given
 various ways : Two ounces of the vinegar, the oxymel, or
 the fyrup,  may be mixed with the fame quantity of fimple
 cinnamon  water,  to which may be added an ounce of com-
 mon water and an ounce of balfamic fyrup. Two table-fpoon-
 fuls of this mixture may  be taken three or four times a-day.
    A fyrup made of equal parts of lemon-juice, honey,  and
 fugar-candy, is likewife very proper in this kind of cough. A
 table fpoonful of it may be taken at pleafure.
    But when the  defluxion is fharp and thin, thefe medicines
  rather do hurt. In this cafe gentle opiates, oils and mucilages
  are more proper.   A cup of an infufion of wild poppy leaves
                           C c                        and 
  ;25      OF  A  COMMON  COUGH.

  and marfh-mallow roots, or the flowers of colts-foot, may be
  taken frequently ; or a tea-fpoonful  of the paregoric elixir
  may be  put  into the patient's drink twice a-day.   Fuller's
  Spanifh infufion is alfo a very proper medicine in  this cafe,
  and may be taken in the quantity of a  tea-cupful three or
  four times a-day *.
    When a cough is occafioned by acrid humours tickling the
 throat and fauces,  the patient fhould keep  fome foft peaoral
 lozenges almoft conftantly in his mouth ; as the Pontefraa li-
 quorice cakes, barley-fugar,  the common balfamic lozenges,
 Spanifh juice, &c. Thefe blunt the acrimony ofthe humours,
 and by taking off their ftimulating quality, help to appeafe
 the cough f.
    In obftinate  coughs, proceeding from a flux of  humours
 upon the lungs, it will often be neceffary, befides expeaorat-
 ing medicines, to have recourfe to iffues, fetons,  or fomeo-
 ther drain.   In this cafe I have often obferved the moft hap-
 py effeas from a Burgundy pitch  plafter applied between the
 fhoulders.  I have ordered this fimple remedy in the moft ob-
 ftinate coughs, in a great number of cafes, and in many dif-
 ferent conftitutions, without ever  knowing it fail to  give re-
 lief,  unlefs where there were evident figns of an ulcer in the
 lungs.
   About the bulk of a nutmeg of Burgundy-pitch may be
 fpread thin upon a piece of foft leather, about the fize of the
 hand, and  laid between the fhoulder-blades.  It may be ta-
 ken off and wiped every three or four days, and ought to be
 renewed once a fortnight or three  weeks.   This is  indeed a
 cheap and  fimple medicine,  and  confequently apt to be de-
 fpi fed;  but  we will venture to affirm,  that the  whole materia
 medica does not afford an application more efficacious in almoft
 every kind of cough.   It has not  indeed always an  immedi-
 ate effea; but, if kept on for fome time, it will fucceed where
 moft other medicines fail.
   The  only inconvenienc^'attending this plafter is the itch-
 ing which it  occafions;  but furely this may  be difpenfed
                                                    with,
          *  See Appendix, Spanifh infufion.
  -T In the laft  edition  of this  book I recommended,  for an ob-
 ftinate tickling  cough,  an oily emulfion, made with the paregoric
 elixir of the Edinburgh  Difpenfatory   inftead  of the common  al-
 kaline fpirit.  I hrfve fince been told by feveral  practitioners, that
 they found it to  be an  excellent medicine in this diforder, and
 every way  deferving of the character which I had given it.   Where
this elixir  is  not kept, its place may  be fupplied by adding to the
 common oily emulfion, an adequate  proportion, of the  Thebaic
tinfture, or liquid laudanum. 
OF  A  COMMON  COUGH.
227
with, confidering the advantage which the patient may ex-
pea to reap from the application ;  befides, when the itching
becomes  very  uneafy, the plafter may be taken off, and the
part rubbed with a dry cloth, or wafhed with a little warm
milk and water.  Some  caution indeed is  neceffary  in dis-
continuing the ufe of fuch a plafter;  this however may be
fafely done by making it fmaller by degrees,  and  at length
quitting it altogether in  a warm feafon*.
  But coughs proceed from many other caufes befides defec-
tions  upon the  lungs.   In thefe cafes the cure is  not to be
attempted by peaoral medicines.  Thus, in  a cough  pro-
ceeding from a foulnefs and debility of the ftomach, fyrups,
oils, mucilages, and all  kinds of balfamic medicines do hurt.
The Jlomach cough may be known from one that is owing to a
fault in the lungs by this, that in the latter the patient coughs
whenever he infpires, or  draws in his breath fully; but in the
former that does  not happen.
  The cure of this cough depends chiefly upon cleanfing and
ftrengthening the ftomach ;  for which purpofe  gentle  vo-
mits and bitter purgatives are moft proper.   Thus, after  a
vomit or two,  the facred tinaure, as it is called, may be ta-
ken for a confiderable time in the dofe of one or two table-
fpoonfuls twice a-day, or as often as it is found neceffary to
keep the body  gently open.  People may make this tinaure
themfelves,  by infufing an ounce of hierapicra f in an Eng-
lifh pint of white wine,  letting it ftand a few days,  and then
ftraining it.
  In  coughs which  proceed from  a debility ofthe ftomach,
the Peruvian bark is likewife of confiderable fervice.  It may
either be chewed,  taken in  powder, or made into a tinaure
along with other ftomachic bitters.
  A nervous cough can only be removed by change of air, and
proper exercife;  to which may  be added the ufe of  gentle o-
piates.  Inftead of the faponacious pill,  the paregoric elixir,
&c. which are only opium difguifed, ten, fifteen, twenty, or
twenty-five drops of liquid laudanum, more or lefs,  as cir-
cumftances require, may be taken at bed-time,  or  when the
cough is moft troublefome.   Immerfing the feet and hands in
                                                   warm
  * Some cornplain.that the pitch plafter  adheres too faft, fo that
they find it difficult  to remove it, while others  find difficulty in
keeping it on.  This proceeds from the different kinds of pitch
made  ufe of, and likewife from the manner of fpreading it.  I ge-
nerally find it anfwer beft  when mixed with a little bees-wax, and
fpread as cool  as poffible.  The  clear,  hard,  tranfparent pitch
anfwere the purpofe beft.
          f See Appendix, Hiera-picra. 
218       OF  A  COMMON  COUGH.

warm  water will often appeafe the violence  of a nervous
cough.
   When a cough is only the fymptom of fome other malady,
it i» in vain to attempt to remove it  without firft curing the
difeafe from which  it proceeds.   Thus, when a cough is oc-
cafioned by teething, keeping the body  open,  fcarifying the
gums, or whatever facilitates the cutting of the teeth, likewife
appeafes the cough.  In like manner, when worms  occafion a
cough, fuch medicines as remove thefe vermin  will generally
cure the cough ;  as bitter purgatives, oily clyfters, and fuch
like.
   Women,  during the laft months of pregnancy, are often
greatly affliaed with a cough,  which is generally relieved by
bleeding, and keeping the body open.   They ought to avoid
 all flatulent food, and  to wear a loofe eafy drefs.
   A cough is not only a fymptom,  but is often likewife the
 forerunner of difeafes.   Thus,  the gout is frequently ufhered
 in by  a very troublefomc cough, which affeas the  patient for
 fome days before the coming on of the fit.  This cough is
 generally removed  by a paroxyfm of the gout,  which fhould
 therefore be promoted,  by keeping the  extremities  warm,
. drinking warm liquors,  and bathing  the feet and legs fre-
 quently in lukewarm water.

   OF  THE   HOOPING-COUGH,   OR
                 CHIN-CO UGH.

   This cough feldom affeas adults, but proves often  fatal
 to children.   Such children as live upon thin  watery  diet,
 who breathe unwholefome air, and  have  too  little exercife,
 are moft liable to this difeafe,  and generally fuffer moft  from
 it.
   The  chin-cough is fo well known, even to nurfes, that a
 defcription of it is unneceffary.  Whatever hurts the  digeft-
 ion, obftruas  the perfpiration, or relaxes the folids,  difpofes
 to this  difeafe:  Consequently its  cure  muft depend upon
 cleanfing and ftrengthening the ftomach,  bracing  the folids,
 and, at the fame time,  promoting perfpiration, and the dif-
 ferent fecretions.
   The diet muft be light, and of eafy digeftion ; for children,
 good bread  made into pap  or pudding, chicken-broth,  with
 other  light fpoon-meats, are proper ; but thofe who are far-
 ther advanced  may be  allowed fago-gruel,  and  if the  fever
 be not high, a little boiled chicken, or other white  meats.
                                                     The 
 OF  THE  HOOPING-COUGH, &c.  229

The drink may be  hyffop, or penny-royal  tea,  fweetened
with  honey  or  fugar-candy,  fmall  winc-whey;  or, if  the
patient be weak, he may fometimes be allowed a little negus.
  One of the moft effeaual remedies in  the  chin-cough is
change  of air.  This often removes the  malady even when
the change feems to be from a purer to a lefs  wholefome  air.
This may in fome  meafure depend on the patient's being re-
moved from the place where the infeaion prevails.  Moft of
the difeafes of children are infeaious; nor is it at all uncom-
mon to find the chin-cough prevailing in one town or village,
when  another, at a very fmall  diftance, is quite free from it.
But whatever be  the  caufe,  we are fure of  the faa.   No
time ought therefore to be loft in removing the patient at fome
diftance from the  place where he caught  the difeafe,  and, if
poffible,  into a more pure and  warm air *.
   When the  difeafe proves violent,  and the patient is in dan-
ger of being fuffocated by the  cough, he  ought to be bled,
efpecially  if there be a fever with a hard  full  pulfe.  But as
the chief intention of bleeding is to prevent an inflammation
of the lungs, and to render it more fafe to  give vomits, it
will feldom be neceffary to repeat the operation ; yet if there
be fymptoms  of  an inflammation of the lungs, a fecond, or
even a third bleeding may be requifite.
   It is generally reckoned  a favourable fymptom when a fit
of coughing makes the  patient vomit.   This cleanfes  the
ftomach,  and greatly relieves the cough.   It   will therefore
be proper to promote this difcharge, either by fmall dofes of
ipecacuanha,  or the vomiting julep  recommended in the Ap-
pendix f.
  It is very difficult to make children drink after a  vomit.  I
have  feen  them happily deceived,  by infufing a fcruple or
half a dram of the powder of ipecacuanha in  a tea-pot, with
half an Englifh  pint of  boiling water.  If this be difguifed
with a few drops of milk, and a little fugar,  they will ima-
gine it tea, and drink it very greedily.  A fmall tea-cupful of
this may be given every quarter of  an hour,  or rather every
ten minutes,  till it operates.  When the. child begins to puke,
                                                    there

  * Some think the air ought not to be changed till the difeafe be
on the decline; but there feems to be  no fufficient reafon for  this
opinion,  as patients  have  been known to reap benefit  from a
change of air at  all periods  of the difeafe.  It is not fufficient to
carry the patient  out daily in a  carriage.  This  feldom  anfwers
any good purpofe; but often does hurt,  by giving  him cold.
         t See Appendix, Vomiting Julep. 
230   OF  THE   HOOPING-COUGH,

there will be no occafion for drinking any more, as the wa-
ter already on the ftomach will be fufficient.
   Vomits not only cieanfe the ftomach, which in this difeafe
is generally loaded with vifcid phlegm, but they likewife pro-
mote the perfpiration and other fecretions ; and ought there-
fore to be repeated according to the obftinacy of the difeafe.
They fhould not however be ftrong ; gentle vomits frequent-
ly repeated are both lefs dangerous,  and more beneficial, than   '
ftrong ones.                                                 :
   The body ought to be kept gently open.  The beft medi-
cines for this purpofe are rhubarb and its preparations, as the
fyrup,  tinaure, &c.   Of thefe a tea-fpoonful or two may be
given to an infant twice or thrice a-day,  as there is occafion.
To fuch as are farther  advanced, the dofe muft be  proporti-
onally increafed,  and repeated till it has the defired  effea.
   Thofe who cannot be brought to take  the bitter tinaure,
may have an infufion  of fenna  and prunes,  fweetened with
manna, coarfe fugar, or honey;  or a few .grains of rhubarb
mixed with a tea-fpoonful or two of fyrup, or currant-jelly,
fo as to difguife the tafte.   Moft children are  fond of fyrups
and jellies,  and feldom refufe even a difagreeable  medicine
when mixed with them.
   Many people believe that oily, peaoral, and balfamic me-
dicines poffefs wonderful virtues for the cure of the chin-
cough, and accordingly exhibit them  plentifully to patients
of every age and  conftitution, without confidering that every
thing of this nature muft load the ftomach, hurt the digefti-
on, and of courfe aggravate the diforder.
   The millepedes, or woodlice,  are greatly recommended for
the cure of  a chin-cough.   Thofe who chufe to make ufe of
thefe infea$,  may infufe two ounces of them  bruifed in an
Englifh pint of fmall white wine for one night.  Afterwards
the liquor may be ftrained through  a cloth, and a table-fpoon-
ful of it given to the patient three or four times a-day.
   Opiates are fometimes  neceflary to allay the violence of
the cough.   For this purpofe a  little of the fyrup of poppies,
or five,  fix, or feven drops of laudanum,  according  to the
age of the patient,  may  be  taken in a cup of  hyffop or pen-
ny-royal tea,  and repeated occafionally *.
                                                     The

   * Some recommend the extract of hemlock as  an extraordinary
 remedy in the hooping-cough; but fo far as I have been able  to
 obferve,  it is  no  way fuperior to opium, which, when properly
 adminiftered,  will often relieve fome of the  moft troublefdme
 fymptoms of this diforder.                                 ,-, 
OR; CHIN-COUGH.
231
   The garlic ointment is a well known  remedy  in  North
 Britain for the chin-cough.   It is made by beating in a mor-
 tar garlic with on equal quantity of hogs lard.   With this
 the foles of the feet may  be rubbed twice  or thrice a-day ;
 but the beft method is to  fpread it upon a rag, and apply  it
 in the form of plafter.  It fhould be renewed every night and
 morning at leaft,  as the garlic foon lofes its virtue.   This is
 an exceeding good medicine both in the chin-cough,  and  in
 moft  other coughs of an  obftinate nature   It  ought not
 however to be ufed when the patient is very hot or feverifh,
 left it fhould increafe thefe fymptoms.
  The feetlhould be bathed once every two or three days  in
 lukewarm water; and .a  Burgundy-pitch plafter kept con-
 ftantly betwixt the fhoulders.  But when the difeafe  proves
 very violent,  it will be neceflary, inftead of it, to apply a
 bliftering-plafter,  and   to keep the part open for  fometim«
 with iffue ointment.
  When the difeafe is prolonged, and the patient is free from
 a fever, the Peruvian bark,  and  other bitters, are the moft
 proper medicines.  The bark may either be taken in  fub-
 ftance,  or in a decoaion or  infufion, as is  moft agreeable.
 For a child,  ten,  fifteen,  or twenty grains,  according to the
 age of the patient,  may be given three or four times  a-day.
 For an adult, half a dram  or two  fcruples  will be  proper.
 Some give the extraa of the bark with cantharides;  but  to
 manage this requires a confiderable attention.  It is more fafe
 to give a few grains of  caftor along with the bark.  A child
 of fix or feven  years of age, may take feven or eight grai.is
of caftor,  with fifteen  grains of powdered  bark for a dofe.
 This may be made into a mixture with two or three ounces of
any fimple diftilled water, and a little fyrup, and taken three
 or four times a-day.
                CHAP.    XXX.

INFLAMMATION OF  THE  STOMACH,
           AND  OTHER VISCERA.

     AL L  inflammations of the bowels are  dangerous,  and
      require the moft fpeedy affiftance ; as they frequently
end in a fuppuration, and fometimes in a mortification, which
is certain death.
  CAUSE S.-------An inflammation of the ftomach may
protqfd from any of the caufes which produce an inflammato-
                                                     ry 
232    INFLAMMATION OF THE  STOMACH,

ry fever; as cold liquor drank while the body is warm, ob-
ftruaed perfpiration, or the fudden ftriking in  of any erup-
tion.   It may likewife proceed from the acrimony of the bile,
or from acrid and ftimulating fubftances taken into  the  fto-
mach ; as ftrong  vomits or purges,  corrofive poifons,  and
fuch like.  When the gout has been repelled from the extre-
mities, either by cold or improper applications,  it often occa-
fions an inflammation of the  ftomach.  Hard or indigeftible
fubftances taken into the ftomach, as bones, the ftones of
fruit, &c. may likewife have that effea.
   SYMPTOM S.------It is attended with a fixed pain
and burning heat in the ftomach ; great reftleffnefs and anx-
iety ; a fmall, quick and hard pulfe ;  vomiting,  or, at leaft, a
naufea and ficknefs ; exceffive thirft;  coldnefs of the extre-
mities ; difficulty of breathing ; cold clammy fweats;  and
fometimes  convulfions  and fainting  fits.  The  ftomach is
fwelled, and often feels hard to the touch.  One of  the moft
certain figns of this  difeafe  is the fenfe of pain, which the pa-
tient  feels  upon taking any kind of food or drink, efpecially
if it be either too hot or cold.
   When the patient vomits every thing he eats or drinks, is
extremely reftlefs, has a hiccup,  with an intermitting pulfe,
and frequent fainting fits, the danger is very great.
   REGIME N.------All acrimonious, heating, and irri-
tating food and drink are carefully to be avoided. Theweak-
nefs of the patient may deceive the by-ftanders,  and induce
them to give him  wines, fpirits, or other cordials ; but thefe
never fail to increafe the difeafe, and often occafion fudden
death.  The inclination to vomit may likewife impofe on the
attendants,  and  make them  think a vomit neceffary ; but
that too is almoft certain death.
   The food muft be light,  thin,  cool, and eafy of digeftion.
It muft be given in fmall quantities,  and fhould neither be
quite cold, nor too hot.  Thin gruel made of barley or oat-
meal, light toafted bread diflblved in boiling  water,  or very
weak chicken broth, are the moft proper.   The drink fhould
be clear whey,  barley-water,  water  in which  toafted bread
has been boiled, or decoaions of emollient vegetables; as li-
quorice and marfh-mallow roots,  farfaparilla, &c.
   MEDICINE.-------Bleeding in this difeVe  is abfo-
lutely neceffary, and is  almoft the only thing  that can be de-
pended on.  When the difeafe proves obftinate,  it will often
be proper to repeat this operation feveral times,  nor  muft the
low ftate of the pulfe deter  us from doing fo.  The  pulfe in-
                                                    deed 
AND OTHER  VISCERA.
233
deed generally rifes upon bleeding, and as long as that is the
cafe, the operation is fafe.
  Frequent fomentations with  lukewarm water, or a decoc-
tion of emollient vegetables, are likewife  beneficial.  Flannel
cloths dipped  in thefe muft be  applied to the  region of the
ftomach, and  removed as they grow  cool.  They muft nei-
ther be applied loo warm, nor be fuffered to continue till they
become quite cold, as either of thefe extremes would aggra-
vate the difeafe.
  The feet and legs ought likewife to be frequently bathed in
lukewarm water,  and warm bricks or poultices  may be ap-
plied to the foles of the feet.   The  warm bath, if it can be
conveniently ufed, will be of great fervice.
  In this, and all  other inflammations ofthe bowels, an epif-
paftic, or bliftering plafter,  applied over the part affeaed,  is
one of the beft remedies I know.   I  have often ufed it,  and
do not recolfea one inftance wherein it did not give relief to
the patient.
  The only  internal  medicines which we fhall venture to re-
commend in  this difeafe,  are  mild clyfters.   Thefe may be
made of warm water, or thin water-gruel; and if the patient
be coftive, a little fweet oil, honey or manna, may be added.
Clyfters anfwer the purpofe of an internal fomentation, while
they keep the belly open,  and  at the fame time nourifh the
patient,  who is  often,  in this difeafe,  unable to retain any
food upon his ftomach.  For thefe reafons they muft not be
neglected, as  the patient's life may depend on  them.

   INFLAMMATION  OF  THE  INTESTINES.

  This is one of the moft painful  and dangerous difeafes
that mankind is liable to.   It  generally proceeds  from the
fame caufes as the inflammation of  the ftomach;  to which
may be added coftivenefs, worms,  eating unripe fruits, or
great quantities of nuts, drinking hard  windy malt liquors,
as ftale bottled beer or ale,  four wine, cyder, &c.  It may like-
wife be occafioned by a rupture, by fcirrhous tumours of the
inteftines, or by their oppofite fides growing together.
  The inflammation ofthe inteftines  is denominated Iliac paf-
fion, Enteritis, he. according to the name of the parts affea-
ed. The treatment however is  nearly the fame whatever part
of the inteftinal canal be  the  feat of the difeafe;  we fhall
therefore omit thefe diftinaions,  left they fhould perplex the
reader,
                         D d                      The 
 234  INFLAMMATION OF THE INTESTINES.

   The fymptoms here are nearly the fame as in the foregoing
 difeafe ;  only the pain, if poffible,  is more acute, and is fi-
 tuated lower.   The vomiting is likewife  more  violent,  and
 fometimes  even the excrements, together with the clyfters
 and fuppofitories, are difcharged by the mouth. The patient
 is continually belching up wind, and has often an obftruaion
of his urine.
   While the pain ihifts,  and the vomiting only returns at
certain intervals, and while the clyfters  pafs downwards,there
 is ground to  hope ; but when the clyfters and faces are vo-
 mited, and the  patient  is exceeding weak, with a low flutter-
 ing pulfe, a pale countenance,  and a difagreeable or {linking
fcreath, there is  great reafon to fear that the  confequences will
 prove  fatal.  Clammy fweats,  black  foetid  ftools,  with a
 fmall intermitting pulfe,  and  a total  ceflation of pain,  are
•figns of a mortification already begun, and of approaching
death.
   REGIME N.-----The regimen in  this difeafe is in
general the fame as in an inflammation ofthe ftomach. The
patient muft be kept quiet, avoiding cold, and all violent paf-
fions of the mind.   His food ought to be very  light, and given
 in fmall quantities : his drink  weak and diluting ; as clear
Whey, barley-water, and fuch like.
   M E D I C I N E.------Bleeding in this, as  well as in
 the inflammation of the ftomach,  is of the  greateft impor-
 tance.   It  fhould be performed  as foon as  the fymptoms ap-
 pear, and muft be repeated according to the  ftrength of the
 patient, and the violence ofthe  difeafe.
   A bliftering  plafter is here likewife to  be applied immedi-
 ately over the part where the moft violent pain is.   This not
 only relieves  the pain of the bowels, but  even clyfters and
 purgative medicines, which before had no effea, will operate
 when the blifter begins to rife.
   Fomentations and laxative clyfters are  by  no means to be
 omitted.   The patient's feet and legs  fhould frequently be
 bathed in warm water ; and cloths dipped in  it  applied to his
belly.  Bladders filled with warm water may  likewife be ap-
plied to the region of the navel,  and warm bricks,  or bottles
filled with warm water, to the foles ofthe feet.  The clyfters
may be made  of barley-water or thin gruel with fait, and foft-
ened with fweet oil or frefh butter.   Thefe  may  be  admini-
ftered every two or three hours,  or oftener, if the patient con-
tinues coftive.
   if the difeafe does not  yield  to clyfters and fomentations,
recourfe muft be had to pretty ftrong purgatives; but as thefe,
                                                      by 
  INFLAMMATION OF THE INTESTINES.  235

 by irritating the bowels, often increafe their contraaion, and
 by that means fruftrate their own intention, it will be necef-
 fary to join them  with  opiates,  which by allaying the pain,
 and relaxing the fpafmodic contraaions cf the guts, greatly
 affift the operation of purgatives in this cafe.
  What anfwers the purpofe of opening the body very well,
 is a folution ofthe bitter purging  falts.  Two  ounces of thefe
 may  be  diflblved  in an Englifh  pint of warm water, or thin
 gruel, and a tea-cupful of it taken every half hour till it ope-
 rates.  At the fame time, fifteen,  twenty,  or  twenty-five
 drops of laudanum may be given in a glafs of pepper-mint or
 fimple cinnamon water,  to appeafe the irritation  and prevent
 the vomiting, &c.
  Acids have often a very happy effea in ftaying the vomit-
 ing,  and appeafing the other violent fymptoms of this difeafe.
 It will therefore be of ufe to fharpen the patient's drink with
 cream of tartar, juice  of lemon ; or, when thefe cannot be
 obtained, with vinegar.
  But it often happens that no  liquid whatever will ftay ort
 the ftomach. In this cafe the patient muft take purging pills.
 I have generally found the  following anfwer very  well. Take
jalap in powder,  and vitriolated tartar,  of each half a dram,
 opium one grain,  Caftile foap as much as will make the mafs
 fit for pills.  Thefe muft be taken at one dofe,  and if they
 do not operate in a few hours, the dofe  may be repeated.
  If a ftool cannot be procured  by any of the above means,
 it will be neceffary to immerfe the patient in  warm water up
 to the breaft.  I have often feen this  fucceed  when other
 means had been tried in vain.  The patient muft continue in
 the water as long  as he  can eafily bear it without  fainting,
 and if one immerfion has not the defired effea, it may be re-
 peated as foon as the patient's ftrength and fpirits are recruit-
 ed.   It  is more fafe for him to go frequently into the  bath,
 than to continue too long at a time;  and it is often neceffary
 to repeat it feveral times before it has the defired effea.
  It  has fometimes happened, after  all other means of pro-
 curing  a ftool had been tried  to no purpofe, that this was
 brought about by  immerfing the patient's lower extremities
 in cold water,  or making him walk upon a  wet pavement,
and dafhing  his legs and thighs  with the cold water.   This
method, when others fail,  at leaft merits a trial.  It is indeed
attended with fome danger; but a doubtful remedy is better
 than none.
  In defperate cafes it is common to give quickfilver.   This
may  be given to  the quantity of feveral ounces, or even a
                                                 pound;, 
 236  INFLAMMATION OF THE INTESTINES.   *j

 pound, but fhould not exceed that*.   When there is reafon
 to  fufpea a mortification of the guts, this  medicine ought
 not to be tried.   In that cafe it cannot  cure the patient, and
 will only  haften his death.  But when the obftruaion is oc-
 cafioned by any caufe that can be removed by  force, quick-
 filver is not only a proper medicine, but the  beft that can be
 adminiftered, as it is  the fitteft body we know for making its
 way through the inteftinal canal.
   If  the difeafe proceeds from a rupture,  the patient muft be
 laid with his head very low, and the inteftines returned  by
 gentle preffure with  the  hand.   If this, with  fomentations
 and clyfters, fhould not fucceed, recourfe muft be had to a
 furgical operation, which may give the patient relief.
   Such as would avoid this excruciating and dangerous dif-
 eafe,  muft  take care  never to be too long without  a ftool.
 Some who have died of it have had feveral pound* of hard,
 dry faces taken out of their guts.   They fhould likewife be-   '
 ware of eating too freely of four or unripe fruits, or drinking
 ftale, windy liquors,  &c.   I have known it brought on by
 living too much on baked fruits, which are feldom good.  It
 likewife proceeds frequently from cold caught by wet clothes,
 &c. but efpecially from wet feet.

             OF   THE   COLIC.
   The colic  has a great refemblance  to the two preceding
 difeafes,  both  in its fymptoms  and method of cure.   It is
 generally  attended  with  coftivenefs and acute pain of the
 bowels;  and requires diluting diet, evacuations, fomentati-
 ons,  he.
   Colics are varioufly denominated according to their caufes,
 as the flatulent,  the  bilious, the  hyjleric, the   nervous, &c
 As each of thefe requires  a particular method of treatment,
 we fhall point out their moft general fymptoms, and the means
 to be ufed for their relief.
   The flatulent, or wind-colic, is generally occafioned by
 an  indifcreet ufe of unripe  fruits,  meats of hard  digeftion,
 windy vegetables, fermenting  liquors, and fuch  like.  It
 may likewife proceed from  an obftruaed perfpiration,  or
 catching cold.   Delicate people, whofe digeftive powers are
 weak, are moft liable to this kind of colic.
                                                     The
  * When quickfilver is given in  too  large quantities,  it defeats
 its own intention, as it pulls down the bottom of the ftomach by
is great weight, which prevents its getting over the Pylorus.  In
this cafe it will  be neceflary to hang up the patient by the heels;
in order that the quickfilver may be difcharged by his mouth. 
        O  F   T  H  E    C  O  L I  C.         237

   The flatulent colic may either affea the ftomach  or in-
teftines.   It is attended with a painful ftretching of the af-
feaed part.  The patient feels a rumbling in his guts, and  is
generally relieved by a difcharge  of wind either upwards or
downwards.  The pain is feldom confined to any particular
part, as the vapour wanders from one divifion of the bowels
to another, till it finds a vent.
   When the difeafe proceeds from windy liquor, green fruitf
four herbs, or the like, the beft medicine on the firft appear-
ance of the fymptoms is a dram of brandy, gin, or any good
fpirits.   The patient fhould likewife fit with his feet upon  a
warm hearth-ftone, or apply warm bricks to  them ;   and
warm cloths may be applied to his ftomach and bowels.
   This  is the only colic wherein ardent fpirits,  fpiceries, or
any thing of a hot nature, may be ventured upon.  Nor in-
deed are they to be ufed here unlefs at the very beginning,
before there be any fymptoms of inflammation.  We have
reafon to believe, that a colic occafioned. by wind or flatulent
food might  always be cured by fpirits and warm liquors, if
they were  taken immediately upon perceiving the firft unea-
finefs; but when the pain  has  continued for  a confiderable
time, and there is reafon to fear an inflammation of the bow-
els is already begun, all hot things are to be avoided as  poi-
fon, and the patient is  to be treated in the fame manner as for
the inflammation of the inteftines.
   Several  kinds of food, as honey,  eggs, he. occafion  co-
lics in fome particular conftitutions.   I have generally found,
the beft method of  cure for thefe was to drink plentifully of
fmall diluting liquors, as water-gruel, fmall poffet, water
with toafted  bread foaked in it, &c.
   Colics which proceed from excefs and indigeftion general-
ly cure  themfelves,  by occafioning  vomiting  or  purging.
Thefe difcharges are by no means to be ftopped, but promot-
ed by drinking plentifully of warm  water, or weak poffet.
When their  violence is over,  the patient may  take a dofe of
rhubarb, or any other gentle purge,  to carry off the dregs of
his debauch.
   Colics which are occafioned by wet feet, or catching cold,
may generally be  removed at the beginning,  by bathing the
feet and legs in warm water, and drinking fuch warm dilut-
ing liquors as will  promote the perfpiration, as weak wine-
whey, or water-gruel with a fmall quantity of fpirits in it.
   Thefe flatulent  colics,  which prevail fo  much  among
country  people, might generally be prevented were they care-
                                                     ful 
238        O  F   T  H  E    C  O  L  I  C.

ful to change their clothes when they get wet.  They ought
likewife  to take a dram, or to drink fome warm liquor after
eating any kind of green trafh.  We do not mean to recom-
mend the praaice of dram-drinking, but in this cafe  ardent
fpirits prove a real medicine, and indeed the beft that can be
adminiftered.   A glafs of good peper-mint water will have
nearly the fame effea as a glafs of brandy,  and in  fomtfcafcs
is rather to be preferred.
  The bilious colic is attended with very acute pains  about
the region of the navel.   The patient complains of great
thirft, and is generally coftive.  He vomits a hot, bitter, yel-
low-coloured bile, which being difcharged,  feems to afford
fome relief,  but is quickly followed by the fame violent pain
as before.  As the diftemper advances,  the propenfity to vo-
mit  fometimes  increafes fo as to become almoft  continual,
and  the proper  motion of the inteftines is fo far perverted,
that there are all the  fymptoms of an  impending iliac paf-
fion.
  If the patient be young and ftrong, and the pulfe full and
frequent, it will be proper to bleed, after which clyfters may
be adminiftered.  Clear whey or  gruel, fharpened with the
juice of lemon,  or  cream of tartar, muft  be drank  freely.   ,
Small chicken broth, with a little manna diflblved in it, or   *
a flight decoaion of tamarinds, are likewife  very  proper, or
any other thin, acid,  opening liquor.
  Befides bleeding and plentiful dilution,  it will be neceffary
to foment the belly with cloths dipped in warm water,  and if
this  fhould not fucceed, the patient muft be immerfed up to
the breaft in warm water.
  In the bilious colic the  vomiting is often very  difficult to
reftrain.   When this happens, the patient may drink a de-
coaion  of toafted bread, or  an infufion of  garden-mint in
boiling water.  Should thefe not  have the defired  effea, the
faline draught,  with a few  drops of laudanum in it, may be
given, and repeated according to the urgency of the fymp-
toms.   A fmall quantity of Venice treacle may be fpread  in
form of a cataplafm,  and applied to the pit of the ftomach.
Clyfters,  with a proper quantity  of Venice treacle or liquid
laudanum in them, may likewife be frequently adminiftered.
  Such as are liable to frequent  returns of the bilious colic
fhould ufe flefh fparingly,  and live chiefly upon a light veget-
able diet-   They fhould  likewife take frequently a dofe of
cream of tartar with tamarinds, or any other cool acid purge.
  The hyjleric coiic bears  a great refemblance to the bilious.
                                                       It 
       O  F    T  H  E   C  O  L  I  C.        239

It is attended with acute pains about the  region  of the fto-
mach,  voniting, &c.  But what the patient vomits in this
cafe is  commonly of  a greenifh  colour.   There is a  great
finking of  tie fpirits,  with dejeaion of mind  and  difficulty
of breathingAwhich  are the charaaeriftic fymptoms of this
diforder.   Sometimes it is accompanied  with  the jaundice,
but this generalW goes off of its own accord in a tew days.
  In this colic ad evacuations, as bleeding,  purging, vomit-
ing, &c. do hurt  Every thing that weakens the patient, or
finks the fpirits, is to be avoided.   If however the  vomiting
fhould  prove violent,  lukewarm water, or fmall poffet, may
be drank  to cieanfe the ftomach.   Afterwards the patient may
take fifteen, twenty,  or twenty-five drops  of  liquid  lauda-
num in a glafs of cinnamon-water.   This may  be repeated
every ten or twelve hours till the fymptoms abate.
  The patient may likewife take  four or  five of the  foetid
pills every fix hours,  and drink  a cup of penny-royal tea  af-
ter  them,  if afafoetida fhould prove difagreeeble,  which is
fometimes  the cafe,  a tea-fpoonful of the tinaure  of  caftor
in a cup of penny-royal tea, or thirty or forty drops of the
balfam of Peru  dropped upon  a  bit of loaf-fugar, may  be
taken in  its ftead.  The anti-hyfteric plafter may alfo be ufed,
which  has often a good  eftea *.
  The nervous colic  prevails among miners, fmelters of lead,
plumbers, the manufaaurers of white lead, &c.   It is very
common in the cider counties of England, and is fuppofed
to be occafioned by the leaden veffels ufed  in preparing that
liquor.   It is likewife a frequent difeafe  in  the Weft-Indies,
where  it  is termed the dry belly-ach.
  No difeafe  ofthe bowels is attended with more excruciat-
ing  pain this.  Nor  is  it foon at  an  end.  1 have  known it
continue eight or ten days with very little  intermiffion, the
body all the while continuing bound in  fpite  of medicine,
yet at length  yield,  and the patient recover f.  It generally,
however  leaves the patient weak, and often ends in a palfy.
  The general treatment of this difeafe is fo nearly the fame
with that ofthe iliac  paffion,  or inflammation ofthe guts,
that we  fhall  not infift upon it.   The body is to be opened
by mild purgatives given in fmall dofes,  and frequently  re-
                                                 peated,
  *  See Appendix,  Anti-hyfteric plafter.
  t As the fmoke of tobacco thrown into the bowels  will often
procure a  ftool when all other means  have failed, an apparatus for
this purpofe ought to be kept by every furgeon. It may be pur-
chafed  at a fmall expence, and will be of fervice in  feveral other
cafes, as  the recovery  of drowned perfons,  ice.. 
240        OFTHE    COLIC.
 peated, and their operation muft  be affifted by foft oily clyf-
 ters, fomentations, &c.  The caftor oil is reckone* peculiarly
 proper in this  difeafe.   It may both be mixed with the clyf-
 ters and given by the mouth.
   The Barbadoes tar is faid to bean efficacious medicine in
 this difeafe.   It may be taken  to the quantity of  two drams
 three times a-day, or oftener if  the ftomach will bear  it. This
 tar, mixed with an equal quantity of ftrong rum,  is likewife
 proper for rubbing the  fpine,  in cafe  any tingling,  or other
 fymptoms of a palfy are felt.   When the tar cannot be ob-
 tained, the back may be rubbed with ftrong fpirits, or a little
 oil of nutmegs or of rofemary.
   If the patient remains weak  and languid after this difeafe,
 he muft take exercife on horfeback, and ufe an infufion ofthe
 Peruvian bark in  wine.  When the difeafe ends  in a palfy,
 the Bath-waters are  found to be extremely proper.
   To avoid this kind of colic,  people muft fhun all  four fruits,
 acids and auftere liquors, &c.  Thofe who work inleadousjht
 never  to go to their bufinefs fafting, and their food fhould°be
 oily or fat.   They may take a  glafs of fallad oil, with a little
 brandy or rum every morning,   but fhould never take fpirits
 alone.   Liquid aliment is  beft  for them ;  as fat broths, &c.
 hut low living  is bad.   They fhould frequently go a littleout
 of the tainted air;  and fhould never fuffer themfelves to be
 coftive.   In the Weft Indies, and on the coaft of Guinea, it
 has been found of great  ufe, for preventing this colic, to wear
 a  piece of flannel  round the waift, and to drink an  infufion of
 ginger by way of tea.
   Sundry other kinds of this difeafe might be mentioned, but
 too many diftinaions would tend only  to  perplex the reader.
 Thefe already mentioned are the moft material,  and fhould
 indeed be attended to, as their treatment is very different. But
 even perfons  who are not in a condition to diftinguifh very ac-
 curately in thefe matters, may neverthelefs be of great fervice
;to patients in colics of every kind, by only obferving the fol-
 lowing general rules, viz. To bathe  the feet and legs in
 warm  water  ; to  apply bladders filled with warm  water3, or
 cloths  dipped in it, to the ftomach  and  bowels; to make the
patient drink freely of  diluting mucilaginous liquors; and,
,laftly,to give him an emollient clyfter every two or three hours.

     INFLAMMATION  OF THE  KIDNEYS.

   CAUSE S.------This difeafe may proceed from any of
 thofe caufes which produce an  inflammatory  fever.  It may
                                                  likewife 
   INFLAMMATION OF  THE  KIDNEYS,   i±t

likewife be occafioned by wounds or bruifes of the kidheys ;
fmall ftones or gravel lodging within them ; by ftrong diure-
tic medicines ;  as  fpirits of  turpentine,  tinaure of  cantha-
rides, &c. Violent motion ;  as hard riding or walking,- efpe-
cially in hot weather, or whatever drives the blood  too for-
cibly into the  kidneys, may occafion this malady.   It may
likewife proceed from lying too foft,  too much on the back,
involuntary contraaions, or fpafms, in the urinary veffels, &c.
  SYMPTOM S.------There is a fharp pain about the
region ofthe kidneys,  with fome degree of fever* and a ftu-
por or dull pain in the thigh of the affeaed fide.   The urine
is at firft clear, and afterwards of a reddifh colour; but in the
worft kind of the  difeafe it generally continues pale, is paffect
with difficulty, and commonly in fmall quantities at a time.
  The patient feels  great uneafinefs when he endeavours to
walk or fit upright;   He lies with moft eafe on  the affeaed
fide, and has generally a naufea or vomiting,  refembling that
which happens in the colic.
  This difeafe however may be diftinguifhed from  the colic
by the pain being feated farther back, and by the difficulty of
paffirtg urine with which it is conftantly attended.
   REGIME N.-------Every thing of a heating or fti-
mulating nature is to be avoided.  The food muft be thin
and light; as panado, fmall broths, with mild vegetables and
the like^ Emollient and thin liquors muft be plentifully drank 5
as clear whey, or balm-tea fweetened with honey, decoaions
of marfh-mallow roots, with barley and liquorice, he.  The
patient, notwithftanding the vomiting,  muft conftantly keep
fipping fmall quantities of thefe or other diluting liquors. No-
thing fo fafely and certainly abates the inflammation, and ex-
pels the obftruaingcaufe, as copious dilution.   The patient
muft be kept eafy, quiet, and free from cold,  as long as any
fymptoms of inflammation remain.
   MED1GIN  E.------Bleeding is generally neceflary,
efpecially at the beginning.  Ten or twelve ounces may be
let from the arm or foot with a lancet, and if the pain and  in-
flammation continue, the operation may be repeated  in twen-
tv-four  hours, efpecially  if the patient be of  a full habit.
Leeches may likewife be applied to the haemorrhoidal veins,
as a difcharge from thefe will greatly relieve the  patient.
   Cloths dipped in  warm water, or bladders filled with  it,
muft  be applied to  the part affeaed, and renewed as  they
grow cool.   If the bladders be filled with a decoaion of mal-
lows and camomile flowers, to which a little faffron is added,
                      E e                           and 
 242    INFLAMMATION OF THE KIDNEYS.

 and mixed with about a third part of new milk, it will be ftill
 more beneficial.
   Emollient clyfters ought frequently  to be adminiftered;
 and if thefe do not open the body, a little fait and honey or
 manna may be added to them.
   The fame courfe is to be  followed where gravel or a ftonc
 is lodged in the kidney ; but when the gravel or ftone is fc.
 parated from the kidney, and lodges in the Ureter *, it will
 be proper, befides the fomentations, to  rub the part with  a
 little fweet oil, and to give gentle diuretics: as juniper-water
 fweetened with the fyrup of marfh-mallows ;  a tea-fpoonful
 of the fweet fpirits  of nitre,  with a few drops of laudanum,
 may now and  then be put in a cup of the patient's drink. He
 ought likewife to take exercife on horfeback,  or in a coach,
 if he be able to bear it.
   When the difeafe is protraaed beyond the fevenrh or eighth
 day, and the patient complains of a ftupor, and heavinefs of
 the part,  has frequent returns of chillnefs,  fhivering, &c.
 there is reafon to fufpea,  that matter is forming in the kid-
 ney, and that an abfcefs will  enfue.
   When matter in  the  urine fhews,  that an ulcer is already
 formed in the  kidney,  the patient muft be careful to abftain
 from all acrid, four and falted provifions ;  and to live chiefly
 upon mild mucilaginous herbs and fruits,  together with the
 broth of young animals, made with barley and common pot-
 herbs, &c. His drink may be whey, and butter-milk that is
 not four.   The latter is by fome reckoned a fpecific remedy
 in ulcers of the kidneys.  To anfwer this charaaer, however,
 it muft be drank for a confiderable time.   Chalybeate waters
 have likewife been found beneficial in this difeafe.  This me-
 dicine is eafily obtained, as it is found in every part of Great-
 Britain.   It muft likewife  be ufed for a confiderable time, in
 order to produce any falutary  effeas.
•   Thofe who are liable to frequent returns of inflammation,
 or obftruaion  ofthe kidneys, muft abftain from wines, efpe-
 cially fuch as abound with tartar ; and their food ought  to be
 light, and of eafy digeftion.  They fhould ufe moderate ex-
ercife, and fhould not lie too hot, nor too much on their back.

                                   INFLAMMATION

  * The Ureters are  two long and fmall canals, one on each fide,
which carry the urine  from the bafon ofthe kidneys to the bladder.
They are fometimes  obftructed by fmall ftones or gravel falling
down from the kidneys and lodging in them. 
[   243   1
INFLAMMATION  OF THE BLADDER.

   The inflammation of the bladder proceeds in a great mea-
fure, from the fame caufes as that of the kidneys. It is known
by an  acute pain towards the bottom of the belly, and diffi-
culty of palling urine, with fome degree of fever, a conftant
inclination to go to ftool, and a perpetual defire to make water.
   This difeafe. muft be treated on the fame principles as the
one immediately  preceding.  The  diet muft  be light and
thin,  and the drink of a cooling nature.   Bleeding is very
proper at the beginning, and in robuft conftitutions it will
often be neceffary to repeat it.  The lower part of the belly
fhould be fomented with warm water, or a decoaion of mild
vegetables ;  and emollient clyfters ought frequently to be ad-
miniftered, &c.
   The patient fhould abftain  from every thing that is of a
hot, acrid, and ftimulating quality,  and fhould live entirely
upon fmall broths, gruels, or mild vegetables.
   A ftoppage of urine may proceed from other  caufes befides
an inflammation of the bladder;  as a fwelling of the hemor-
rhoidal veins, hard faces lodged in the reclum; a ftone in
the bladder, excrefcences in the urinary paffages, a palfy of
the bladder, hyfteric affeaions, &c.   Each of thefe requires
a particular treatment,  which does not fall under our prefent
confideration.  We fhall  only obferve, that in all of  them
mild,and gentle applications are the fafeft, as ftrong diuretic
medicines, or things  of an irritating  nature,  generally  in-
creafe  the danger.   I have known fome perfons kill them-
felves by  introducing probes into the urinary paffages,  tore-
move,  as they thought, fomewhat that obftruaed the dif-
charge of  urine, and others bring on a violent  inflammation
of the bladder,  by ufing ftrong diuretics,  as oil of turpen-
tine, &c.  for that purpofe.

  INFLAMMATION  OF  THE  LIVER.

   The liver is lefs fubjea to inflammation than moft ofthe
other vifcera, as in it the circulation is flower ; but when an
inflammation does happen, it  is with difficulty removed, and
often ends in a fuppuration or fcirrhus.
   CAUSE S.——— Befides the common caufes of inflam-
mation, we  may here  reckon the following,  viz.  exceffive
fatnefs, a  fctrrhus of the  liver itfelf, violent fhocks from
                                                  ftrong 
244      INFLAMMATION  OF  THE  LIVER.

ftrong vomits when the liver was before unfound, an aduft or
atrabiliarian ftate of the blood, any thing that fuddenly cools
the liver after it has been greatly heated, ftones obftruaing
the  courfe  of the  bile, drinking ftrong wines and fpiritous
liquors,  ufing hot fpicy  aliment, obftinate  hypochondriacal
affeaions, &c.
   SYMPTOM S„-----This difeafe is  known by a
painful tenfion of the right fide under the falfe ribs, attended
with fome degree of fever,  a fenfe of weight, or fullnefs of
the  part, difficulty  of breathing, loathing of  food,  great
thirft, with a pale or yellowifh colour of the fkin and eyes.
   The fymptoms here are various, according to the degree of
inflammation, and  likewife according to the particular part
of the liver where the inflammation happens.  Sometimes the
pain is foinconfiderable, that an inflammation is not fomuch
as fufpeaed ; but when it  happens  in  the upper or convex
part of the liver,  the pain is more acute, the pulfe quicker,
and the patient is often troubled with a dry cough, a hiccup,
 and a pain extending to the fhoulder, with difficulty of lying
pn the left fide,  &c.
   This difeafe rnay be diftinguifhed from the pleurify by the
pain being lefs violent, feated under  the falfe ribs, the pulfe
not fo hard, and by  the difficulty of lying on the left fide.
It may be diftinguifhed  from the hyfteric and hypochondriac
diforders by the degree pf  fever with which it is always at-
tended.
   This  difeafe, if properly treated, is feldom  mortal.   A
conftant  hiccuping, violent fever, and exceffive  thirft, are
bad fymptoms.   If  it ends in a fuppuration, and  the matter
cannot be difcharged outwardly, the danger is great.   When
a fcirrhus of the liver  enfues, the patient,  if he obferves  a.
proper regimen, may neverthelefs live a number of years to-
lerably eafy ;  but if he indulges in animal food and ftrong li-
quors,  or takes medicines  of an acrid or irritating nature, the
fcirrhus will be converted into a cancer,  which muft infalli-
bly  prove fatal.
   REGIME N.-----The fame regimen is to be obferv-
ed in this as in other inflammatory diforders.  All hot things
are to be carefully avoided, and cool diluting liquors, as whey,
barley-water, &c. drank freely.  The food  muft be light and
thip, and the body, as well as the mind, kept eafy and quiet.
   MEDICIN  E.       Bleeding is proper at the begin-
 ning of this difeafe,  and it will often be neceflary even though
the  pulfe fhould not feel hard,  to repeat it,   All violent pur-
                                                   gatives. 
     INFLAMMATION  OF  THE  LIVER.     24S

gatives are to be avoided;  the body  however muft be kept
gently open.  A decoaion of  tamarinds, with a little honey
or manna,  will  anfwer this purpofe very well.   The  fide af-
feaed muft be fomented in the manner direaed in the fore-
going difeafes.  Mild laxative clyfters fhould be  frequently
adminiftered ; and, if the pain mould notwithftanding con-
tinue violent, a bliftering-plafter may  be applied over the part
affeaed.
  Medicines  which  promote the fecretion of  urine  have a
very good effea here.   For this purpofe half a dram  of pu-
rified nitre, or  half a tea-fpoonful of the fweet fpirits of ni-
tre,  may be taken in a cup of  the patient's drink three or four
times a-day.
   When there is an inclination to fweat, it ought to be pro-
moted, but not by warm fudorifics.   The only thing to be
ufed for that purpofe is plenty of diluting liquors drank about
the warmth of the human blood.  Indeed the patient in this
cafe, as well as in all other topical inflammations, ought to
drink nothing that is colder than the blood.
   If the ftools fhould be loofe, and even ftreaked with blood,
no means  muft be ufed to ftop them, unlefs they be fo fre-
quent as to weaken the patient.   Loofe ftools  often prove
critical,  and carry off the  difeafe.
   If an abfcefs or impofthume is formed in the liver,  all me-
thods  fhould be  tried  to  make  it break and difcharge itfelf
outwardly, as  fomentations,  the application  of poultices,
ripening cataplafms, he.   Sometimes indeed the matter of
an abfcefs comes away  in the urine, and fometimes it is dif-
charged by ftool,  but thefe are efforts of  Nature which  no
means can promote.  When the abfcefs burfts into the cavity
of the abdomen  at large, death muft enfue; nor will the event
be more favourable  when  the abfcefs is opened by an incifi-
on,  unlefs  in cafes where the liver adheres to the peritoneum,
fo as to form a bag for the matter, and prevent it from falling
into the cavity  of the abdomen; in which cafe  opening  the
abfcefs by  a fufficiently large incifion will probably fave  the
patient's life.
   If the diforder, in fpite of all  endeavours to the contrary,
fhould end in a fcirrhus, the patient muft be careful to regu-
late his diet, he. in fuch a manner as not to  aggravate the
difeafe.  He muft not  indulge in flefh, fifh,  ftrong liquors,
or any highly  feafoned or falted  provifions; but fhould, for
the  moft part, live on mild  vegetables,  as fruits and roots;
taking  gentle  exercife, and drinking whey,  barley-water,
                                                      9* 
146     INFLAMMATION  OF  THE  LIVER.

or butter-milk.   If he takes any thing ftronger, it fhould be
fine mild ale, which is lefs heating than wines or fpirits.
   We fhall take no notice of inflammations of the other vif-
cera.   They muft in general be treated upon the fame prin-
ciples .as thofe already mentioned.   The chief rule with re-
fpea to all of them,  is  to avoid every thing that is  ftrong,
or of  a heating nature, to apply warm fomentations to the
part affeaed, and  to caufe  the patient to drink a fufficient
quantity of warm diluting liquors.
               CHAP.    XXXI.

OF  THE  CHOLERA  MORBUS,  AND  OTHER
  EXCESSIVE  DISCHARGES  FROM THE STO-
  MACH AND BOWELS.

      TH E cholera morbus is a violent purging and vomiting,
      attended with gripes, ficknefs, and a conftant defire to
go to ftool.  It comes on fuddenly,  and  is moft common in
autumn.  There is hardly any difeafe that kills more quickly
than this, when proper means are not ufed  in  due time for
removing it.
  CAUSE S. -■ ■ -*It is occafioned  by a redundancy and
putrid acrimony  of the  bile; cold;  food  that eafily turns
rancid or four  on  the ftomach; as butter, bacon, fweet-
meats, cucumbers, melons,  cherries and other  cold fruits*.
It is fometimes the effea  of ftrong  acrid purges or vomits;
or of poifonous /ubftances taken into the ftomach. It may
likewife proceed from  violent paffions  or affeaions of the
mind; as fear, anger, &c.
  SYMPTOM S------It  is generally preceded  by a
eardialgia, or  heart-burn,  four belchings,  and flatulences,
with pain of the ftomach and inteftines.   To  thefe fucceed
exceffive vomiting, and purging of green, yellow,  or black-
ifh coloured  bile, with a diftention of the ftomach, and vio-
lent griping  pains.  There is likewife  a great thirft, with a
very quick unequal pulfe, and often a fixed acute pain, about
the region of the navel.   As the difeafe advances, the pulfe
often finks fo low as to become quite imperceptible, the ex-
tremities grow cold, or cramped, and are often  covered with
a clammy fweat, the urine is obftruaed, and there is a pal-
                                                pitation

  * I have been twice brought to the  gates of death by this dif-
eafe, and both times it was occafioned by eating rancid bacon. 
     OF  THE  CHOLERA  MORBUS,  &c,     247

pitation of the heart.  Violent hiccuping, fainting, and con-
vulfions, are the figns of approaching death.
  M E D ICIN E.------At the beginning of this difeafe
the  efforts of Nature to expel the offending  caufe fhould be
affifted, by promoting the purging and vomiting.  For this
purpofe the  patient muft drink freely of diluting liquors ;  as
whey, butter-milk, warm water, thin water-gruel, fmall pof-
fet,  or, what is perhaps preferable to any of them, very weak
chicken broth.  This fhould not only be drank plentifully
to promote the vomiting, but a clyfter of it given every hour
in order to promote the purging.
  After thefe evacuations have been continued for fome time,
a decoaion of toafted oat-bread may be drank to flop the vo-
miting.  The bread fhould be toafted till it is of a brown co-
lour,  and afterwards boiled in fpring-water.   If oat-bread
cannot be had, wheat-bread  or oat-meal well toafted, may be
ufed in its ftead.   If this does not put a flop to the vomiting,
two table-fpoonfuls ofthe faline julep, with ten drops of lau-
danum, may be  taken every  hour till it ceafes.
  The vomiting and purging, however, ought never to be
ftopped too foon.  As long as thefe difcharges do not weaken
the patient, they are falutary, and may be allowed to go on,
or  rather ought to be promoted.  But when the patient is
weakened by  the evacuations, which may be known from the
finking of his pulfe, &c. recourfe muft immediately be had to
opiates, as recommended above; to which  may be added
ftrong  wines, with fpirituous cinnamon waters,and other ge-
nerous cordials.   Warm  negus,  or ftrong wine-whey,  will
likewife be neceffary to fupport the patient's fpirits, and pro-
mote  the perfpiration.  His legs fhould  be bathed in warm
water, and afterwards rubbed with flannel cloths, or wrapped
in warm blankets, and warm bricks applied to the foles of his
feet.   Flannels  wrung out  of warm fpirituous  fomentations
fhould likewife  be applied to the region of the ftomach.
  When the  violence of the difeafe is over, to  prevent  a re-
lapfe, it will be  neceffary, for fome time, to continue  the ufe
of fmall dofes of laudanum.   Ten  or twelve  drops  maybe
taken in a glafs  of wine, at leaft twice a-day, for eight or ten
days.  The patient's food ought to be nourifhing, but taken
in fmall quantities, and heihould ufe moderate exercife.   As
the ftomach and inteftines are generally much weakened,  an
infufion of the bark, or other bitters, in fmall wine, fharpen-
ed with the elixir of vitriol, may  be drank for fome time.
  Though phyficians are feldom called in  due time in this
difeafe, they ought not to defpair of relieving the patient even
                                                     in 
248     OF THE  CHOLERA  MORBUS,  he*

in the moft defperate circumftances.   Of this  I lately faw i
very ftriking proof in an old man and his fon, who had been
both feized with it about the middle of the night.  I did not
fee them till next morning* when they had much more the
appearance of dead than of  living men.   No pulfe could be
felt; the extremities were cold, and rigid ; the countenance
was ghaftly, and  the ftrength almoft quite exhaufted.  Ye<
from this deplorable condition they were both recovered by
the ufe of opiates and cordial medicines.

   •OF  A DIARRHCEA,  OR  LOOSENESS.

   A looseness,  in many cafes, is not to be confidered as *
difeafe,  but rather as a falutary evacuation.  It ought there-
fore never to be ftopped unlefs when it continues too long, or
evidently weakens the patient.   As this however fometimej
happens, we fhall point out the moft common caufes of $
loofenefs, with the proper method of treatment.
   When a loofenefs is occafioned by catching cold, or an
obftruaed perfpiration* the patient ought to keep warm,  ttf
drink freely of weak  diluting liquors, to  bathe his feet arrd
legs frequently in lukewarm water,  to wear flannel next his
fkin, and to take every other method  to reftore the perfpira-
tion.
   In a loofenefs which proceeds from excefs or repletion, a
vomit is the proper medicine.  Vomits not only cieanfe the
ftomach, but promote all the fecretions, which renders them
of great importance in carrying off a debauch.  Half a dram
of ipecacuanha in powder will anfwer this purpofe very welb
A day or two after the vomit, the fame quantity of rhubarb
may be  taken, and repeated two or three times, if the loofe-
nefs continues.  The patient ought to live upon light veget-
able food  of eafy digeftion, and  to drink whey,  thin gruel,1
or barley-water.
   A loofenefs occafioned by the obftruaion of any cuftoma-
ry evacuation, generally requires bleeding.  If that does not
fucceed, other evacuations may be fubftituted in the room of
thofe  which are obftruaed.  At  the fame  time,  every me-
thod is to be taken to reftore the ufual difcharges,  as not on-
ly the cure of the difeafe, but the patient's life, may depend
on this.
  A periodical loofenefs ought never to be ftopped.  It is al-
ways an effort of Nature to carry off fome offending matter,
Which,  if  retained in  the  body, might  have fatal  effeas.
                                               Children 
   OF  A  DIARRHEA,  OR  LOOSENESS.    dtf

Children are very liable to this kind of loofenefs, efpecially
while teething.  It is however  fo far from being hurtful  to
them, that fuch children generally get their teeth  with leaft
trouble.  If thefe loofe ftools  fhould  at any time prove four
or griping,  a tea-fpoonful of magnefia alba, with four  or
five grains of rhubarb, may be  given to the  child in a little
panado, or any Other food.  This, if repeated three Or four
times, will   generally  correa the acidity, and carry off the
griping ftools.
  A diarrhoea, or  loofenefs,  which  proceeds  from violent
paffions or affeaions of the mind, muft  be treated with  the
greateft caution.   Vomits in  this Cafe are highly  improper.
Nor are purges fafe,  unlefs they be very mild, arid given  in
fmall quantities*.   Opiates, arid other  antifpafmodic medi-
cines, are rrioft proper.  Ten or twelve drops of liquid lau-
danum may  be taken in a Cup of Valerian or penny-royal tea,
every eight or ten hoursj till   the fymptoms abate.   Eafe^
cheerfulnefs, and tranquillity of niind, are: here of the great-
eft importance:
  When a  looferiefs  proceeds frorri  airid or poifonous fub-
ftances taken into the ftomach, the patient muft drink large
quantities of dilutirig liquors,' with oil or fat broths, to pro-
mote vomiting and purging.  Afterwards, if there be reafoni
to fufp'ea that the bowels ate inflamed, bleeding will be ne-
ceflafy.   Small dofes of laudanum m'ay likewife be taken to
remove their irritation.
   When the gout, repelled frorri the extremities,  occafions
a loofenefs,  it ought to be promoted  by gentle dofes of rhu-
barb, or other mild purgatives.  The gouty matter is  like-
wife to be folicited towards the  extremities by warm foment-
ations, cataplafms, &c.  The perfpiration ought at the fame
time to be promotedb'y warm diluting liquors; as wine-whey,
with fpirits of hartfhorn, Or a  few drops of liquid laudanum
in it.
   When a  loofenefs  proceeds  frorri  worms, which may be
known from the fliminefs of the ftools mixed  with  pieces of
decayed worms,  &c. medicines  muft be given to kill and car-
ry off thefe  vermin, as the powder of tin with purges of rhu-
barb and calomel.   Afterwardis  lime-water, either alone, or
with  a fmall quantity of rhubarb infufed, will be proper to
ftrengthen   the  bowels,  and prevent the new generation of
worms.
   A loofenefs is often occafioned by  drinking bad  water.
When this is the cafe,  the difeafe generally proves epiuemi-
                           F  f                      cal. 
250   OF  A  DIARRHOEA,  OR  LOOSENESS.

cal.   When there is reafon to believe that this or any other
difeafe proceeds from the ufe of unwholefome water, it ought
immediately to be changed,  or, if that cannot  be done, it
may be correaed by mixing with it quick-lime, chalk, or the
like.
  In people whofe ftomachs are weak, violent exercife im-
mediately after eating will occafion a loofenefs.  Though the
cure of this is obvious,  yet it  will be proper, befides avoid-
ing violent exercife, to  ufe  fuch medicines as tend to brace
and  ftrengthen the ftomach; as infufions of the  bark, with
other bitter and aftringent ingredients, in white-wine.  Such
perfons ought likewife to take frequently a glafs or two of old
red port,  or good claret.
  From whatever caufe a loofenefs proceeds, when it is found
neceffary to check it, the diet ought to confift of  rice, boiled
with milk, and flavoured with  cinnamon;  rice jelly; fago,
with  red  port;   and  the lighter forts of flelh-meat roafted.
The  drink  may be thin water-gruel, rice-water, or weak
broth made from lean veal, or with  fheep's head, as being
more gelatinous  than mutton, beef, or chicken broth.
  Perfons who,  from a  peculiar weaknefs, or too great an
irritability of the bowels, are liable  to frequent  returns of
this difeafe, fhould live  temperately,  avoiding crude fummer
fruits, all unwholefome food, and meats of hard digeftion.
They ought likewife to beware of cold, moifture, or what-
ever may  obftrua the perfpiration, and fhould wear flannel
next  their  fkin.  All  violent paffions, as fear,  anger, &c.
are likewife carefully to be guarded againft.

             OF   VOMITING.

  Vomiting may proceed  from various caufes ;  as excefs in
eating or  drinking; foulnefs of the  ftomach ; the acrimony
of the aliments;  a tranflation of the morbific matter of ul-
cers, of the gout, the eryfipelas, or other difeafes to  the fto-
mach.  It may likewife proceed from a loofenefe having been
too fuddenly ftopped; from  the  ftoppage of any cuftomary
evacuation; as the bleeding piles,  the menfes, he.   from  a
weaknefs  of the  ftomach, the colic,  the iliac paffion, a rup-
ture, a fit of the gravel, worms ;  or from any kind of poifon
taken into the ftomach. It is an ufual fymptom of injuries
done to  the brain ; as contufions, corapreffions,  &c.  It is
likewife a fymptom of wounds, or inflammations of the dia-
phragm, inteftines, fpleen,  liver, kidneys,  &c.
                                               Vomiting 
OF    VOMITING.
  Vomiting may be occafioned by unufual motions ; as fail-
ing,  being drawn backwards in a cart or coach, &c.   It may
likewife be excited by violent paffions, or by the idea of nau-
feous or difagreeable objeas, efpecially of fuch things as have
formerly  produced vomiting. Sometimes it proceeds from a
regurgitation of the bile into the ftomach : In this cafe, what
the patient vomits is generally of a yellow or greenifh colour,
and has a bitter tafte.  Perfons who are fubjea to nervous af-
feaions are often fuddenly feized with violent fits  of vomit-
ing.   Laftly,  vomiting is a common fymptom of pregnancy.
In this cafe it generally comes on about two weeks after the
ftoppage of the menfes,  and continues during the firft three or
four  months.
  When vomiting proceeds from a foul ftomach or indigef-
tion, it is not to be confidered as a  difeafe, but as the cure of
a difeafe.   It ought therefore to be  promoted  by drinking
lukewarm  water, or thin gruel.   If this does not put a ftop
to the vomiting,  a dofe  of ipecacuanha may  be taken, and
worked off with weak camomile-tea.
  When the  retroceffion  of the gout, or the obftru.aion of
cuftomary evacuations, occafion vomiting, all means muft be
ufed to reftore thefe difcharges; or, if that cannot be effbaed,
their place muft be fupplied by others, as bleeding, purging,
bathing the extremities in warm water, opening iflues, fetons,
perpetual blifters, he.
  When vomiting is the effea of pregnancy, it may general-
ly be mitigated by bleeding,and keeping the body gently open.
The bleeding however ought to be in  fmall quantities at a
time,  and  the purgatives fhould be of the mildeft kind, as
figs, ftewed prunes, manna, or fenna.  Pregnant women are
moft apt to vomit in the morning, immediately after getting
out of bed, which is owing partly  to the change  of pofture,
but more to the emptinefs of the ftomach.  It may generally
be prevented  by taking a difh of tea, or fome light breakfaft
in bed.  Pregnant women, who are affliaed with vomiting
ought to be kept eafy both in body and mind.  They fhould
neither allow their ftomachs to be quite empty,  nor fhould
they eat  much at once.   Cold water is a  very proper drink
in this cafe ;  if the ftomach be weak,  a little brandy may be
added  to it.  If the fpirits be  low, and  the  perfon apt to
faint, a fpoonful of cinnamon-water, with a little marmalade
of quinces or oranges, may be taken.
   If vomiting proceeds from weaknefs of the ftomach, bitters
will be of fervice.  Peruvian bark infufed in wine or brandy,
                                                   with 
iS*
OF    VOMITING.
with as much rhubarb as will keep the body gently open, is
an excellent medicine in this cafe.  The elixir of vitriol is
alfo a good medicine.   It may be taken  in the dofe of fifteen
or twenty drops, twice or thrice a-day,  in a glafs of wine or
water.
  A vomiting, which proceeds frorn acidities in the ftomach,
is relieved  by alkaline purges.   The beft medicine  of this
Kind is the magnefia alba,  a tea-fpoonful of which  may be
taken in a difh of tea or a little rpilk, three or four times a-
day, or oftener if neceffary, to keep the body open.
   When vomiting proceeds from violent paffions, or affecti-
ons of the mind, all evacuants muft be carefully avoided, efpe-
cially vomits.  Thefe are exceeding  dangerous.  The pati-
ent in this cafe  ought to be kept perfeaiy eafy and quiet, to
have the mind foothed, and to take fome gentle cordial, as
negus, or a  little brandy and water, to  which afewdrpps of
laudanum may occafionally be added.
   When vomiting proceeds from fpafmodic affeaions ofthe
ftomach, mufk,  caftor, and other antifpafmodic medicines,are
of ufe.  Aromatic plafters have likewife a good effea.  The
ftomach-plafter ofthe London or Edinburgh difpenfatory may
be applied to the pit of the ftomach,  or a plafter of theria(q,
which will  anfwer rather better.  Aromatic medicines may
likewife be taken inwarrjly,  as cinnamon  or mint-tea, wine
with fpiceries boiled  in it,  &c.  The region of the ftomach
may be rubbed  with aether,  or, if that  cannot be had,  with
ftrong brandy, or other fpirits.   The belly fhould be foment-
ed with  warm water, or the patient immerfedup to the breaft
in a warm bath,
   I have always found the faline draughts taken in the aaof
effervefcence, of fingular  ufe in flopping a vomiting,  from.
whatever caufe it proceeded. Thefe may be prepared by dif-
folving a dram of the fait  of tartar in an ounce and half of
frefh lemon juice, and adding to it an ounce of peppermint-
water, the fame quantity of fimple cinnamon-water, and a
little white fugar.   This draught rrjuft be fwallowed before
the  effervefcence is quite  over,  and may  be repeated every
two hours, or oftener, if the vomiting be violent.  A violent
vomiting has fometimes been ftopped by  pupping on the regi-
on of the ftomach after all other means had  failed.
   As the leaft motion will often bring on the vomiting again,
even after  it has  been ftopped, the patient muft avoid all
rnanner  of aaion.  The  diet muft be  fo regulated as to fit
                                                    ealy 
        OF    VOMITING.        251

eafy upon the ftomach, and nothing fhould be taken that is
hard of digeftion.   We do not however mean, that the pati-
ent fhould live entirely upon flops.  Solid food, in this cafe,
often fitseafier on the ftomach than liquids.
              CHAP.     XXXII.

OF THE DIABETES, AND OTHER DISORDERS
      OF THE KIDNEYS AND  BLADDER.

      TH E diabetes is a frequent and exceffive difcharge of
      urine.   It is feldom to be met with among young peo-
ple ; but often attacks perfons in the decline of life, efpecial-
ly thofe who follow the more violent employments,  or have
been hard drinkers in their youth.
   CAUSE S......"A diabetes is often the confequence of
acute difeafes, as fevers, fluxes, he. where the patient has fuf-
fered by exceffive evacuations ; it may alfo be  occafioned by
great fatigue, as riding long journies  upon a hard trotting
horfe,  carrying heavy burdens, running,  &c.  It  may be
brought on by hard drinking, or the ufe of ftrong ftimulating
diuretic medicines, as tinaure of cantharides,  fpirits of  tur-f
pentine, and fuch like.  It is often the effea of drinking too
great quantities of mineral waters.  Many imagine that thefe
will do them no fervice unlefs they be drank in great quanti-
ties,  by which miftake it happens that they  often  occafion
worfe difeafes than thofe they were intended to cure.   In a
word, this difeafe may either proceed from too  great a  laxity
of the organs which  fecrete the urine,  from fomething  that
ftimulates the kidneys too much,or from a thin diflblved ftate
of the blood,  which makes too great a quantity of it run off
by the urinary paffages.
   SYMPTOM S.-   .. .-In a diabetes the urine generally
exceeds in quantity all the liquid food which the patient takes.
It is  thin and pale, of a fweetifh tafte, and an agreeable fmell.
The patient has a continual thirft, with fome degree of fever;
his mouth is dry, and he fpits frequently a frothy fpittle. The
ftrength fails, the appetite decays, and the flefh waftes away
till the patient is reduced to fkin and bone.  There  is  a  heat
of the bowels ; and frequently the loins, tefticles, and feet are
fwelled.
   This difeafe may generally be cured at the beginning ;  but,
after it has continued long,  the cure becomes very  difficult.
                                                     In 
254       OF   A   D  I  A B E T E  S,  &c.

In drunkards, and very old people, a perfea cure is not to be
expeaed.
  REGIME N..------Every thing that ftimulates the uri-
nary paffages, or  tends to relax the  habit, muft be avoided.
For this  reafon the patient fhould live chiefly on folid food.
His thirft may be quenched  with acids ; as forrel, juice of
lemon, or vinegar.  The mucilaginous vegetables ;  as rice,
fago, and falep, with milk, are the moft proper food.  Of ani-
mal fubftances, fhell  fifh are to be preferred ; as  oyfters,
crabs, &c.
  The  drink may be  Briftol-water.  When that  cannot be
obtained, lime-water, in which a due proportion of oak-bark
has been macerated, may be  ufed.  The  white decoaion *,
with ifinglafs diflblved  in it, is likewife a very proper drink.
  The patient ought daily to  take exercife,  but it  fhould be
fo gentle as not to fatigue him.  He  fhould lie upon a hard
bed or mattrefs.   Nothing hurts the kidneys more than lying
too foft.   A  warm dry air, the ufe ofthe flefh- brufh, and eve-
ry thing  that promotes   perfpiration,  is of fervice.   For this
reafon the patient ought to wear  flannel  next  his fkin,  A
large ftrengthening plafter may be applied to the back ; or,
what will  anfwer the fame purpofe,  a broad girdle may be
worn about the loins.
  M E D i C I N E.------Gentle purges,  if the  patient be
not too  much weakened  by the difeafe,  have a good effea.
They may confift of rhubarb, with cardamum feeds,  or any
other fpiceries, infufed  in wine, and may be taken in fuch
quantity as to keep the body gently open.
  The  patient muft next  have recourfe to aftringents and
corroborants.  Half a  dram  of powder  made  of equal
parts of allum and the infpiffated juice commonly called Ter-
ra Japonica, may be  taken four times a-day, or oftener, if the
ftomach  will bear it.   The allum muft firft be melted  in a
crucible; afterwards they may be both be  pounded together.
Along with every dofe of this powder the patient may  take
a tea-cupful of the tinaure of rofes f.
  If the  patient's ftomach cannot bear the allum in  fubftance,
whey may be made of it, and  taken in the dofe of a tea-cupful
three or  four times a-day.   The allum whey is  prepared by
boiling two Englifh quarts of milk over a flow fire, with three
drams of allum, till the curd feparates.
  Opiates are of fervice in this difeafe, even though the pati-
ent refts  well.  They take off fpafm  and hritation,  and at
                                                      the
          * See Appendix, White decoction.
          ■f See Appendix,  Tincture of rofes. 
       OF  A   DIABETES,   &c.       25$

the fame time leffen the force of  the  circulation.   Ten  or
twelve drops of  liquid laudanum may be taken in a cup of
the patient's drink three or four times a-day.
   The beft corroborants which we know, are the Peruvian
bark and wine.  A dram of bark may be taken in a glafs of
red port or claret three times a-day.   The medicine will  be
both more efficacious and lefs difagreeable, if fifteen or twenty
drops ofthe  acid elixir of vitriol be added to each dofe. Such
as cannot  take the bark in fubftance may ufe the decoaion,
mixed  with an equal quantity of red wine, and fharpened as a-
bove.
   There is a difeafe pretty  incident to labouring people in
the decline of life,  called  an 1N CO NT 1N EN CY of
Urine.  But this is entirely different from a diabetes, as the
water  paffes off involuntarily by drops, and does not exceed
the ufual quantity.  This difeafe is rather troublefome than
dangerous.  It is owing to a relaxation  of  the fphinaer of
the bladder,  and  is often the  effea of a palfy.   Sometimes it
proceeds from hurts, or injuries occafioned by blows, bruifes,
preternatural labours, &c.  Sometimes it is the effea of a fe-
ver.  It may likewife be occafioned  by a long  ufe of ftrong
diuretics, or of ftimulating medicines injeaed into the bladder.
   This difeafe may be mitigated by the ufe  of aftringent and
corroborating medicines,  fuch as have  been  mentioned a-
bove ;  but we do not remember ever to have feen it cured.
   In an incontinency of urine from whatever  caufe,. a piece
of fponge ought to be worn, or a bladder applied  in fuch a
manner as to prevent the urine from galling and excoriating
the parts.

   OF  A   SUPPRESSION   OF  URINE.

   It has already been obferved, that a fuppreffion of urine
may proceed from various caufes ; as an  inflammation of the
kidneys, or bladder ;  fmall ftones or gravel lodging in the  u-
rinary  paffages, hard faces lying in  the reclum, a fpafm or con-
traction of the neck of the bladder, clotted blood in the blad-
der itfelf, a fwelling of the hasmorrhoidal veins, &c.
  Some of thefe cafes require the catheter, both to remove
the obftruaing matter, and to draw off the urine;  but as this
inftrument can only be managed with fafety by perfons (kill-
ed in forgery,  we fhall fay nothing further of its ufe.  A Bou-
gee may be ufed by any cautious hand, and will often fucceed
better than the catheter.
                                                    We 
 •5156      OF  A  SUPPRESSION OF tJRltffe

   We would chiefly recommend, in all obftruaions of uririey
 fomentations and evacuants.   Bleeding, as far as the pati-
 ent's ftrength will permit, is neceffary, efpecially where there
 are fymptoms of topical inflammation.  Bleeding in this cafe
 not only abates the fever, by leflening the force of the circu-
 lation,  but,  by relaxing the folids,  it takes off the fpafm or
 ftriaure upon the veffels which occafioned the obffruction.
   After bleeding, fomentations mnft be ufed.   Thefe may
 either confift of warm water"alone,  or of decoaions of mild
 vegetables;  as mallows,  camomile-flowers, &c.    Cloths
 dipped in thefe may either be applied to the part affeaed, or
 a large  bladder filled with the decoaion  may be kept conti-
 nually upon it.  Some put the herbs themfelves into a flan-
 nel-bag,  and apply them to the part, which is far from being
 a bad method.  Thefe continue longer warm than cloths dip-
 ped in  the decoaion,  arid at the  fame time keep the part
 equally moift.
   In all obftruaions of urine, the  body Ought to be kept
 open. This is not however to be attempted by ftrong purga-
 tives, but by emollient clyfters,  or gentle infufions of fenna
 and manna. Clyfters  in this cafe riot  only open the body, but
 anfwer the purpofe  of an internal fomentation, and greatly'
 affift in removing the fpafms of the bladder and parts ad-
 jacent.
   The  food muff be  fight, arid1 taken  in fmafl  quantities;
 The drink may be weak broth,  or  decoaions and  infufions
 of mucilaginous vegetables;  as  marfh-rriallow roots, lime-
 tree buds, &c.  A tea-fpoonful of the fweet fpirits of nitre,
 or a dram  of Caftile foap, may be frequently put into the pa*
 tient's  drink; and,  if there  be no inflammation, he may
 drink fmall gin-punch without acid.-
   Perfons fubjea  to a fuppreffion of uririe ought to live very
 temperate.  Their diet fhould be light,  and their liquor di-
 luting.  They fhould avoid all acids and auftere wines, fhould
 take fufficient exercife,' He hard, and avoid ftudy and fedenta-
 ry occupations.

       OF   THE   GRAVEL  AND  STONE.

  When fmall ftones are lodged  in the kidneys, or difcharg-
ed with the urine,the patient  is faid to  be affliaed with the gra-
vel. If one of thefe ftones happens to make a lodgment in the
bladder for fome  time,  it accumulates frefh matter, and at
length becomes  too large to  pafs off with the urine.  In this
 cafe* the patient is  faid to have the ftone,
                                           CAUSES, 
      OF  THE  GRAVEL  AND  STONE.      257

   CAUSE S.------The ftone and gravel may be occa-
fioned by higbr*living ; the ufe of ftrong aftringent wines ; a
fedentary life ; lying too hot, foft, or too much on the back;
the conftant ufe of  water  impregnated with earthy or ftony
particles; aliments of an aftringent or windy nature, &c.   It
may likewife proceed from an hereditary difpofition.  Perfons
in the decline of life, and thofe who have been much afflia-
ed with the gout or rheumatifm, are moft liable to it.
  SYMPTOM S.-----Small ftones or gravel in the
kidneys occafion pain in the loins; ficknefs; vomiting ;  and
fometimes bloody urine.  When the  ftone  defcends into the
ureter, and is too large to pafs along wifh eafe, all the above
fymptoms are increafed; the pain extends towards the blad-
der; the  thigh and leg of the affeaed fide are benumbed ;
the tefticles are drawn upwards, and  the urine is obftruaed.
  A ftone in the bladder is known from a pain  at the time,
as well as before and after making water;  from the urine
coming away by  drops, or flopping  fuddenly when it  was
running in a full ftream ; by a violent pain in the neck of the
bladder upon motion, efpecially on  horfeback, or in a coach
on rough road ; from a white, thick,  copious, ftinking, mu-
cous fediment in the urine ; from an itching in the top of the
penis;  from bloody  urine ;  from an  inclination to go to ftool
during the difcharge of urine ;  from  the patient's paffing his
urine more eafily when lying than in  an erea pofture;  from
a  kind of convulfive motion occafioned by the fharp pain  in
difcharging the laft drops of the urine; and laftly, from found-
ing or fearching with the catheter.
   REGIME N.------Perfons affliaed  with the gravel
or ftone fhould  avoid aliments of a windy or heating nature;
as fait meats, four fruits, &c.  Their diet  ought chiefly  to
confift of fuch things  as  tend to  promote the fecretion  of
urine, and to keep the body open.   Artichokes, afparagus,
fpinnage, lettuce, parfley, fuccory,  purflane, turnips, pota-
toes, carrots, and radifhes may be fafelyeat.  Onions, leeks,
and cellary are, in this cafe, reckoned medicinal.  The moft
proper drinks  are whey, butter-milk, milk and  water,  bar-
ley-water;  decoaions  or  infufions  of the  roots of marfh-
mallows, parfley, liquorice, or of other mild  mucilaginous
vegetables ; as linfeed, &c. If  the  patient has  been accu-
ftomed to generous liquors, he may drink fmall gin-punch
without  acid.
   Gentle exercife is proper; but violent motion is apt to oc-
cafion bloody  urine.  We  would  therefore  advife that it
                         G g                     fhould 
458      OF  THE  GRAVEL  AND   STONE.

 fhould be taken in moderation.   Perfons affliaed  with the
 gravel, often pafs a great number of ftones  after riding ©n
 horfeback, or in a carriage ;  but thofe who have a ftone in
 the bladder  are feldom able to bear thefe kinds of exercife,
 Where there is a hereditary tendency to this difeafe, a feden-
 tary life ought never to be indulged.  Were people careful,
 ■upon the firft fymptoms of the gravel, to obferve  a proper
 regimen of diet,  and to take fufficient exercife, it might of-
 ten be carried off,  or, at leaft, prevented  from  increafing;
 but if the fame courfe which occafioned  the difeafe be per-
 fifted in,  it cannot fail to aggravate it.
   MEDICINE.------In  what is called a  fit of the
 gravel, which is commonly occafioned by a ftone flicking in
 the ureter or fome  part of the urinary paffages, the patient
 muft be bled,  warm fomentations fhould likewife be applied
 to the part affeaed, emollient clyfters adminiftered, and  di-
 luting mucilaginous liquors drank, &c.  The treatment of
 this cafe has been fully pointed out under the articles, inflam-
mation of the kidneys and bladder, to which we refer.
   Dr. Whytt advifes patients who are fubjea to frequent fits
 of gravel in  the kidneys, but have no ftone in the bladder,
to drink every morning,  two or three hours before breakfaft,
an Englifh pint of  oyfter or  cockle-fhell lime-water.  The
Doaor very  juftly  obferves,  that though this quantity might
be too fmall to have any  fenfible effea in diffolving  a  ftone
in the bladder; yet it may very probably prevent its growth.
   When  a ftone is formed in the bladder, the Doaor recom-
mends Alicant foap, and oyfter  or cockle-fhell lime-water*,
to be taken in the following manner : The patient muftfwal-
low every day, in any form that is leaft difagreeable, an ounce
of the internal part of  Alicant foap,  and drink three or four
Englifh pints of oyfter or cockle-fhell lime-water.  The foap
is to be divided into three dofes; the largett to be taken fall-
ing in the morning early ; the fecond at noon ;  and  the third
at feven in the evening,  drinking above each  dofe a large
draught of the lime-water; the remainder of which he  may
take any time betwixt dinner and  fupper, inftead  of other
liquors.
   The patient fhould  begin  with a  fmaller quantity of the
lime-water and foap than that mentioned above; at firft an
Englifh pint  of the former and three  drams  of the latter may
be taken daily.  This quantity,  however,  he may  increafe
by degrees, and ought to perfevere in the ufe of thefe medi-
cines, efpecially if he finds any  abatement of his complaints,
                                                      for
         •* See Appendix, Lime water. 
      OF  THE  GRAVEL  AND  STONE.      259

for feveral months;  nay,  if the ftone be very large, for years.
It may likewife be proper for the patient, if he be  feverely
pained, not  only  to begin with the foap and  lime-water in
fmall quantities, but to take the fecond or  third lime-water
inftead of the firft.  However, after he has been for fome
time accuftomed to thefe  medicines, he may not only take
the firft water, but, if he finds he can eafily bear it,  height-
en its diffolving power ftill more by pouring it a fecond time
on frefh calcined (hells.                           .. a   .
  The cauftic alcali, or foap-lees, is the medicine chiefly in
vogue at  prefent for the ftone.   It is of a very acrid nature,
and ought therefore to be given in fome gelatinous or muci-
laginous  liquor, as veal-broth, new  milk, linfeed-tea, a fo-
lution of gum arabic,  or a decoaion of marfh-mallow roots.
The patient muft begin with fmall dofes of the lees, as thirty
or forty drops, and increafe by degrees, as far as the ftomach.
will bear                          ....              ,
   The cauftic alcali may be prepared by mixing two parts of
quick-lime with one of potafhes,  and fuffering them to ftand
till the lixivium be formed,  which muft be carefully filtrated
before it be ufed.   If the folution does not happen readily, a
fmall quantity of water may be added to the  mixture.
   Though the foap-lees and lime-water are  the moft power-
ful medicines which have hitherto  been difcovered  for  the
ftone ; yet  there  are fome things of a more fimple nature,
which  in certain cafes are  found to be beneficial, and therefore
deferve a trial.  An infufion of the  feeds of daucus fylvejlris*
or wild carrot, fweetened  with  honey, has been found to give
confiderable eafe in cafes  where the  ftomach could  not bear
any thing of an acrid nature.  A decoaion of raw  coffee-
berries taken morning and evening, to the quantity of eight or
ten ounces,  with ten drops of fweet fpirit of nitre, has like-
wife been found very efficacious in bringing away large quan-
tities of earthy matter in flakes.  Honey is likewife found to
be of confiderable fervice, and may  be taken in gruel, or in
any other form that is more agreeable.
   The only other medicine which we lhall  mention is the w-
va urfi.  It has been  greatly  extolled of late  both for  the
gravel and ftone.   It  feems,  however, to be, in all refpeas,.
inferior  to  the foap and  lime-water; but it is lefs difagree-
able, and has frequently,  to my knowledge, relieved  gravel-
ly complaints.  It is generally taken in powder from half a
dram to a whole  dram, two or three  times a-day.   It may
however be taken to the  quantity of feven or eight drams a-
day, with great fafety and good effea,           CHAP 
[   260   ]
               CHAP.    XXXIII.

 OF INVOLUNTARY DISCHARGES OF  BLOOD.

    SPONTANEOUS, or involuntary difcharges of blood,
     often happen from  various parts of the body.  Thefe,
 however are fo far from being  always dangerous,  that they
 prove often  falutary.   When  fuch  difcharges aie critical,
 which is frequently the cafe in fevers, they ought not to be
 ftopped.  Nor indeed is it proper at  any time to  flop them,
 unlefs they be fo great as to endanger the patient's life. Moft
 people, afraid of  the fmalleft  difcharge of blood  from any
 part of the body,  fly immediately to the ufe of ftyptic and  a-
 ftringent medicines, by which  means an inflammation of the
 brain, or fome other fatal difeafe, is occafioned, which, had
 the difcharge been allowed to  go on, might  have been pie-
 vented.
   Periodical difcharges of  blood,  from whatever part of the
 body they proceed, muft not  be ftopped.  They are always
 the efforts of Nature to relieve herfelf; and fatal difeafes have
 often been the confequence of obftruaing them.   It may in-
 deed be fometimes neceffary to check the violence of  fuch
 difcharges ;  but even  this requires  the greateft caution.  In-
 ftances  might be given where the  flopping a fmall  periodical
 flux of blood, from one ofthe fingers,  has proved fatal.
   In the early period of life, bleeding at the nofe is very com-
 mon.   Thofe who are farther advanced in years are more li-
 able to  a haemoptoe,  or  difcharge of blood from the lungs.
After the middle period of life,   hemorrhoidal fluxes are moft
common ; and in the decline of life, difcharges of blood from
 tbe urinary paffages.
   Involuntary fluxes of blood may proceed from very differ-
 ent, and often from quite oppofite caufes.   Sometimes they
 are owing to a particular conftruaion of  the body, as a fan-
 guine temperament, a laxity ofthe veffels, a plethoric habit,
 &c.  At other, times  they  proceed from a determination of
 the blood towards one  particular part,  as the head, the hae-
morrhoidal veins, &c.   They  may likewife proceed from an
inflammatory difpofition of the blood,  in which cafe there is
generally fome degree of fever ; this  likewife happens when
the flux is occafioned by an obftruaed perfpiration, or a ftric-
ture upon the fkin, the bowels, or any particular part of the
fyftem.
                                                    But 
     INVOLUNTARY DISCHARGES,  he.     261

  But  a diflblved  ftate  of the blood will likewife occafion
haemorrhages.  Thus, in putrid  fevers,  the dyfentery, the
fcurvy,  the  malignant fmall-pox,  he. there are often very
great difcharges of blood from different parts of the body.
They may likewife be brought on  by too liberal an ufe of
medicines which  tend to  diffolve the blood,  as  cantharides,
the volatile alcaline falts, &c.  Food of an acrid or irritating
quality,  may likewife occafion haemorrhages ;  as alfo ftrong
purges and vomits, or any thing  that greatly ftimulates the
bowels.
  Violent paffions or agitations of the mind will  likewife have
this effea.   Thefe often caufe bleeding at  the  nofe, and  I
have known them fometimes occafion an haemorrhage in the
brain.   Violent  efforts of the body, by overftraining or  hurt-
ing the  veffels, may have the fame effea, efpecially when the
body  is long kept  in an  unnatural pofture, as hanging the
head very low, &c.
  The cure of an haemorrhage muft  be adapted to its caufe.
When it proceeds from too much blood, or a tendency to in-
flammation,  bleeding, with gentle purges and other evacua-
tions,  will be neceffary.  It  will likewife be proper for the
patient in this cafe to live chiefly on a vegetable diet, to avoid
all  ftrong liquors, and food that is of an acrid, hot, or ftimu-
lating quality.   The body fhould be kept cool, and the mind
eafy.
   When an haemorrhage is  owing  to a putrid or diflblved
ftate of the blood,  the patient ought  to live  chiefly upon acid
fruits with milk  and vegetables of a nourifhing  nature,  as fa-
go, falep,  &c.  His drink may be wine diluted with water,
and fharpened with the juice of lemon, vinegar,  or fpirits of
vitriol.   The beft medicine in this cafe is the Peruvian bark,
which may be taken according to the urgency  of the fymp-
toms.
   When a flux  of blood is the effea of acrid food,or of ftrong
ftimulating medicines,  the cure is to be effeaed by  foft and
 mucilaginous diet.  The patient may likewife take frequent-
ly  about the bulk of a nutmeg of Locatelli's balfam, or the
 fame quantity of fperma ceti.
   When an obftruaed  perfpiration,  or  a ftriaure upon any
 part ofthe fyftem,is the caufe of  an  haemorrhage, it may be
 removed by  drinking warm  diluting liquors,  lying a-bed,
 bathing the extremities  in warm  water, he.
OF 
[   262   j
      OF BLEEDING  AT  THE  NOSE.

    Bleeding at the nofe is commonly  preceded by fome de-
 gree of quicknefs of the pulfe, flufhing in the face, pulfation
 of the  temporal arteries, heavinefs in the head, dimnefs ofthe
 fight, heat and itching of the noftrils, &c.
    To  perfons who abound with blood  this difcharge is  very
 falutary.  It often cures a vertigo, the head-ach, a phrenzy,
 and even an epilepfy.   In fevers where there is a great deter-
 mination  of blood towards the head, it is of the utmoft fer-
 vice.   It is likewife  beneficial in inflammations of  the liver
 and fpleen, and often in the gout andiheumatifm. In all dif-
 eafes where bleeding is neceflary, a fpontaneous difcharge of
 blood from the nofe  is of much  more fervice than the fame
 quantity let with a lancet.
   In a difcharge of blood from the nofe, the great point is to
 determine whether it ought to  be ftopped or not. It is a com-
 mon praaice to flop the bleeding,  without confidering whe-
ther it be a difeafe, or the cure of the difeafe.  This conduct
 proceeds from fear; but it has often bad, and fometimes fa-
 tal confequences.
   When a difcharge of blood  from the  nofe  happens in an
 inflammatory difeafe, there is always reafon to believe  that it
 may prove falutary ; and therefore it fhould be fuffered to go
 on, at leaft as long as the patient is  not weakened by it.
   When it happens to perfons in perfea health, who are full
 of blood, it  ought not to be  fuddenly ftopped, efpecially if
the fymptoms of plethora, mentioned above, have preceded it.
In this cafe it cannot be ftopped without rifkirtg the patient's
life.
   In fine, whenever bleeding  at the nofe relieves  any bad
fymptom,  and does not proceed fo far as to endanger the pa-
tient's life, it ought not to be ftopped.  But when it returns
frequently, or continues till the pulfe becomes low,  the ex-
tremities begin to  grow cold,  the  lips  pale,  or the patient
complains of being fick,  or faint, it muft immediately be
ftopped.
   For this purpofe the patient fhould be fet  nearly  upright,
with his head reclining a little, and his legsimmerfed in wa-
ter about the warmth of new milk.  His hands  ought like-
wife to  be put in lukewarm water,  and his garters may be
tied a little tighter than  ufual.   Ligatures may be applied to
the arms,  about  the  place  where they are ufually made for
bleeding, and with nearly the fame degree of tightnefs. Thefe 
       OF  BLEEDING  AT  THE NOSE.      263

muft be gradually flackened as the blood begins to flop, and
removed entirely as foon as it gives over.
  Sometimes dry lint put up the noftrils will flop the bleed-
ing.  When this does not fucceed, doffils of lint dipped in
ftrong fpirits of wine, may be put up the noftrils, or if that
cannot be had,  they may be dipped in brandy.   Blue vitriol
diflblved in water may likewife be ufed for this purpofe, or a
tent dipped in the white of an egg well beat  up, may be roll-
ed in a powder made of equal parts of white fugar, burnt al-
lum, and white  vitriol,  and put up the noftril from whence
the blood iffues.
  Internal medicines can  hardly be of ufe here, as they have
feldom time to operate. It may not however be amifs to give
the patient  half an ounce of  Glauber's fait, and the fame
quantity of manna, diflblved in four or five ounces of barley-
water.  This may be taken at a draught, and repeated if it
does not operate in a few hours.  Ten or  twelve grains of
nitre may be taken in a glafs of cold water and vinegar every
hour, or oftener, if the ftomach will bear it.  If a ftronger me-
dicine be neceffary,  a tea-cupful ofthe tinaure of rofes, with
twenty or thirty drops of the fmall fpirit of vitriol, may  beta-
ken every hour.  When  thefe things cannot be had, the pa-
tient may drink water, with a little common fait in it, or e-
qual parts of water and vinegar.
  If the genitals be immerfed for fome time  in cold water, k
will generally flop a  bleeding at the  nofe.—1  have feldom
known this fail.
  Sometimes when the bleeding is ftopped outwardly, it con-
tinues inwardly.  This  is  very troublefome,  and requires
particular attention, as the patient is apt to be fuffocated with
the blood, efpecially if he falls afleep,  which he is very ready
to do after lofing a great quantity of blood.
  When the patient is in danger of fuffocation from the blood
getting into his throat, the paffages may be  ftopped by  draw-
ing threads up  the noftrils,  and bringing them  out  at the
mouth, then fattening pledgets  or fmall rolls of linen cloth
to their extremities ; afterwards drawing them back and ty-
ing them on the outfide with a fufficient degree of tightnefs.
  After the bleeding is ftopped,  the patient ought to  be kept
as eafy and quiet as  poffible.   He fhould not pick his nofe,
nor take away the tents or clotted blood, till they fall  off of
their own accord, and fhould not lie  with his head low.
  Thofe who are affeaed with frequent bleeding at the nofe
ought to  bathe their feet often in warm water, and to keep
                                                   them 
264     OF  BLEEDING  AT  THE  NOSE.'

them warm and  dry.   They ought to wear nothing  tight
about their necks,  to  keep their body as much in an erect
pofture as poffible, and never to  view any objea obliquely.
If they have too  much blood, a vegetable diet, with now and
then a cooling purge,  is the fafeft way to leffen it.
  But when the  difeafe proceeds from  a thin diflblved ftate of
the blood, the diet fhould be rich and nourifhing;  as ftrong
broths and jellies, fago-gruel with wine and fugar, &c.  In-
fufions of the Peruvian bark in wine ought likewife to be ta-
ken and perfifted in for a confiderable time.

  OF   THE  BLEEDING  AND BLIND  PILES*.

  A discharge of blood from the haemorrhoidal veffels is
called  the bleeding piles.  When the veffels only  fwell, and
difcharge no blood, but are exceeding painful, the difeafe is
called the blind piles.
  Perfons of a loofe fpungy fibre, of a bulky fize, who live
high, and lead  a fedentary inaaive life, are moft fubjea to
this difeafe.   It is  often owing  to  a hereditary difpofition.
Where this is the cafe, it  attacks perfons more early in life
than when it  is accidental.   Men are more^liable to it  than
women, efpecially thofe of  a fanguine  plethoric habit, or of a
melancholy difpofition.
   The piles  may be occafioned by an excefs of blood, by
ftrong aloetic purges,  high-feafoned food, drinking  great
quantities of fweet  wines,  the neglea of bleeding, or  other
cuftomary evacuations, much  riding, great coftivenefs, or
any thing that occafions  hard  or difficult ftools.   Anger,
grief, or other  violent paffions, will likewife  occafion the
piles.   I have often known them brought on by cold, efpeci-
ally about the feat.   A pair of thin breeches will excite the
diforder in a perfon who is fubjea to  it,  and fometimes even
in thofe who never  had it before.  Pregnant women are often
affliaed with the piles.
   A flux of blood from the anus is  not always  to be treated
as a difeafe.   It is even more falutary than bleeding at the
nofe, and often  prevents or carries oft difeafes.   It is  pecu-
liarly beneficial in the gout, rheumatifm, afthma, and hypo-
chondriacal complaints, and often proves critical in colics,
and inflammatory fevers.
   In the management of the patient,  regard  muft be had
to his habit of body,  his age, ftrength, and manner of liv-
ing. A difcharge which might be exceffive and prove hurt-
                                                      ful 
       BLEEDING  AND  BLIND  PILES.       165

ful to one, may be very moderate, and even falutary to ano*
ther.  That only is to be efteemed dangerous which  conti-
nues too long, and is in fuch quantity as to wafte the patient's
ftrength, hurt the digeftion, nutrition, and other  funaions
neceffary to life.
  When this is the cafe,  the difcharge muft be checked by a
proper regimen,  and aftringent medicines.   The  DIET
muft be cool but nourifhing, confifting chiefly of bread, milk,
cooling vegetables, and broths.   The DRINK may be
chalybeate-water, orange-whey,  decoaions or infufions of
the aftringent and mucilaginous plants, as the tormentil root,
biftort,  the marfh-mallow-roots,  &c.
  Old conferve of red rofes is a very good  medicine  in  this
cafe.  It may be mixed  with new  milk,  and taken  in the
quantity of  an ounce three or four times a-day.  This medi-
cine is in no great repute, owing to its being feldom taken in
fuch quantity as to produce any effeas ; but when taken as
here direaed, and duly perfifted in, I have known it perform
very extraordinary cures  in violent haemorrhages,  efpecially
when affifted by the tinaure of rofes ; a tea-cupful of  which
may be taken about an hour after  every dofe of the conferve.
  The  Peruvian bark is likewife proper in  this cafe, both as
a ftrengthener and aftringent.  Half a dram of it may be ta-
ken in a glafs of red wine, fharpened with a few drops of the
elixir of vitriol, three or four times a-day.
  The  bleeding  piles  are  fometimes periodical,  and return
regularly once a-month, or  once in three weeks.  In  this
cafe they are always to be confidered as a falutary  difcharge,
and by no means to  be ftopped.  Some have entirely  ruined
their health  by flopping a periodical difcharge of  blood from
the haemorrhoidal veins.
   In the blind piles bleeding  is generally of ufe.   The diet
muft be light and thin, and the drink cool and diluting.  It
is likewife neceflary that the body be kept gently open.  This
may be done by fmall dofes of the flowers of  brimftone and
cream of tartar.  Thefe  may be  mixed in  equal  quantities,
and a tea-fpoonful taken two or three times a-day, or often-
er if neceffary.   Or an ounce of the flowers of brimftone and
half an  ounce of purified nitre may be mixed with three pr
four ounces of the lenitive eleauary, and  a tea-fpoonful of
it taken three or four times a-day.
   Emollient clyfters are here likewife beneficial; but there is
fometimes  fuch an  aftriaion of the anus, that they  cannot
                         H h                        be 
 266       BLEEDING  AND  BLIND  PILES.

 be thrown up.   In this cafe I have known a vomit have a ve«<
 ry good effea.
   When  the piles are exceeding painful and fwelled,  but dif-
 charge nothing, the patient muft fit over the fleams of warm
 water. He may likewife apply a lino;; cloth dipped in warm
 fpirits of  wine to the party  or  poultices  made of bread and*
 milk, or of leeks fried with butter.  If thefe do not  produce
 a difcharge, and the piles appear large, leeches muft be appli-
 ed as near them as poffible,  or, if they will fix upon the piles
 themfelves, fo much the better.  When  leeches will not fix,
 the piles may be opened with a  lancet.  The operation is ve-
 ry eafy, and is attended with no danger.
   Various ointments, and other external  applications, are re-
 commended in the piles; but I do not remember to have feen
 any effeas from thefe  worth mentioning.   Their principal
 ufe is to keep the  part moift, which may be done as well by
 a foft poultice, or an emollient cataplafm.  When the pain
 however is  very great, a liniment  made of two  ounces of
 emollient ointment, and half an ounce of liquid laudanum,
 beat up with the yolk of an egg, may be  applied.

       SPITTING   OF   BLOOD.

   We mean here to treat of that difcharge of blood from the
 lungs only which is called an hamoptoe, or fpitting of blood.
 Perfons of a flender make,  and a lax  fibre,  who have long
 necks and ftrait breafts, are moft liable to this difeafe.  It is
 moft common in the  fpring,  and generally attacks people be-
 fore they arrive at  the prime or middle period of life.   It is a
 common obfervation, that thofe who  have  been fubjea to
 bleeding at the nofe  when young, are afterwards moft liable
 to an haemoptoe.
   CAUSE S.—----An haemoptoe may proceed from ex-
 cef* of blood,  from a peculiar weaknefs  of the lungs or a
 bad conformation of the breaft.   It is often occafioned by ex-
 ceffive drinking, running, wreftling,  finging,  or fpeaking
 aloud.  Such  as have weak lungs ought to avoid all  violent
 exertions  of that organ, as  they value life.    They  fhould
 likewife guard againft violent  paffions, exceffive drinking,
 and  every  thing that occafions a rapid  circulation of the
blood.
   This difeafe may likewife proceed from  wounds ofthe
lungs.  Thefe may either be received from without, or they
snaybe occafioned by hard bodies getting into the wind-pipe,
                                                    and 
       SPITTING  OF   BLOOD.       267

and fo falling down upon the lungs, and hurting that tender
organ.  The obftruaion of any  cuftomary evacuation may
occafion a fpitting of blood; as the negfea of bleeding or
purging at the ufual feafons, the ftoppage of the bleeding piles
in men, or the menfes in women,  he.   It may likewife pro-
ceed from a polypus, fcirrhus concretions, or any thing that
obftruas the circulation of the blood in the lungs.  It is often
theeffea of a long and violent cough;  in which cafe it is ge-
nerally the forerunner of a confumption.  A  violent degree
of cold   fuddenly applied to the external  parts of the body
will occafion an haemoptoe.  It may likewife be cccsfioned
by breathing air which is too much rarefied to be able proper-.
ly to expand the lungs.   This is  often the cafe with thofe
who work in hot places, as furnaces, glafs-houfes, or  the like.
It may likewife happen  to fuch as afcend to the top of very
high  mountains, as the Peak of Teneriff, &c.
   Spitting of blood is not always to be confidered as a prima-
ry difeafe.   It is often only a fymptom,  and in fome difeafes
not an unfavourable one.  This is the cafe in pleurifies, pe-
ripneumonies, and  fundry other fevers.   In a dropfy, fcurvy,
or confumption, it is a bad fymptom, and fhews that the lungs
 are ulcerated.
   SYMPTOM S.  .. .  .Spitting of blood is generally
 preceded by a fenfe of weight, and oppreffion  of the breaft, a
 dry tickling cough, hoarfenefs, and a difficulty of breathing.
 Sometimes it is ufhered in with fhivering, coldnefs of the ex-
 tremities, coftivenefs, great laffitude, flatulence, pain ofthe
 back and loins, &c.   As thefe fhew a general ftriaure upon
 the veffels,  and a tendency ofthe  blood 40 inflammation, they
 are commonly  the forerunners of a very copious difcharge.
 The above fymptoms do not attend a difcharge of blood from
 the gums or fauces, by which means thefe may always be dif-
 tinguifhed from an haemoptoe.   Sometimes the blood  that is
 fpit up is thin, and of a florid red colour ; and at other times
 it is thick, and of a dark or  black ifh colour;  nothing  how-
 ever can be inferred from this circumftance,but that the blood
 has lain a longer or a fhorter time in the breaft before it was
 difcharged.
    Spitting of blood,  in a ftrong  healthy  perfon, of a found
 conftitution, is not very dangerous; but when it  attacks the
 tender and delicate, or perfons of a weak lax  fibre, it is with
 difficulty removed.   When it proceeds from a fcirrhus or po-
 lypus of the lungs,  it  is bad.   The danger  is greater when
 the difcharge proceeds  from  the rupture of a large veffel than 
268       SPITTING  OF   BLOOD.

of a fmall one.  When the extravafated blood is not fpit up,
but lodges in the breaft, it corrupts, and greatly increafes the
danger.  When the blood proceeds from an ulcer in the lungs,
it is generally fatal.
   REGIME  N.------The patient ought to  be  kept
cool and eafy.   Every thing that heats the body or quickens
the circulation, increafes the danger.   The mind ought like-
wife to befoothed, and every occafion of exciting the paflions
avoided.   The diet fhould be  foft, cooling, and flender;  as
rice boiled with milk,  fmall  broths,  barley-gruels,  panado,
&c. The diet, in this cafe, can  fcarce be too low.  Even
water-gruel is fufficient to  fupport the patient for fome days.
All ftrong liquors muft be avoided.  The patient  may drink
milk and water, barley-water, whey,  butter-milk, and fuch
like.   Every thing however fhould be drank  cold,  and  in-
fmall quantities at a time.  He fhould  obferve the ftriaeft fi-
lence, or at leaft fpeak with  a very low voice.
   M •£ D 1 C I N  E.------This,  like the other involun-
tary difcharges of blood, ought not  to  be  fuddenly flopped
by aftringent medicines.   More mifchief is often done by
thefe, than if it  were fuffered to go on.   It may however
proceed fo far  as  to weaken the patient,  and even endanger
his life, in which cafe proper means muft be ufed for re-
ftraining it.
   The body fhould be kept gently open by  laxative diet;  as
roafted apples, ftewed prunes, and fuch like.   If thefe fhould
not have the effea,  a tearfpoonful of the lenitive eleauary
may be taken twice or thrice a-day, as is found  neceffary.  If
the bleeding proves violent,  ligatures may be applied to the
extremities, as direaed for  the bleeding at the nofe.
   If the patient  be hot or feverifh, bleeding and fmall dofes
of nitre will be of ufe ; a fcruple or half a dram of nitre may
be taken in a cup  of his ordinary drink twice or thrice a-day.
His drink may likewife be  fharpened with acids, as juice  of
lemon, or a few drops ofthe fpirit of vitriol; or he may take
frequently a cup of the tinaure of rofes.
   Bathing the feet and legs  in lukewarm water has likewife a
very  good effea in this difeafe.  Opiates too are fometimes
beneficial; but thefe muft be adminiftered with caution. Ten
or twelve drops of laudanum  may be given in a cup of bar-
ley-water twice a-day, and  continued  for fome time, provid-
ed they be found beneficial.
  The conferve of rofes is  likewife a very good medicine in
this cafe,  provided it  be taken in fufficient quantity,  and
                                                    long 
       SPITTING  OF   BLOOD.       269

long enough perfifted in.   It  may be taken to the quantity
of three or four ounces a-day  ; and if the patient be troubled
with a cough, it fhould be made into an eleauary with bal-
famic fyrup, and a little ofthe fyrup of poppies.
   If ftronger aftringents be neceffary, fifteen or twenty drops
of the acid elixit of vitriol may be given in a glafs of water,
three or four times a-day.
   Thofe who are fubjea to frequent returns of this difeafe,
fhould avoid all excefs. Their diet fhould  be light and cool,
confifting chiefly of  milk  and vegetables.  Above all, let
them beware of vigorous efforts of the body, and violent agi-
tations of the mind.

      VOMITING  OF  BLOOD.

   This is  not fo common as the other  difcharges  of blood
which have already been mentioned;  but it is  very danger-
ous, and requires particular attention.
   Vomiting of blood is generally preceded by pain ofthe fto-
mach, ficknefs, and naufea ;  and is accompanied with great
anxiety, and frequent fainting fits.
   This difeafe is fometimes  periodical; in which cafe it is
lefs dangerous.   It often proceeds  from an obftruaion of the
menfes  in women;  and fometimes from the flopping of the
haemorrhoidal flux in men.   It  may be occafioned by any
thing that greatly ftimulates or wounds the ftomach, as ftrong
vomits or purges, acrid poifons, fharp or hard fubftances ta-
ken into the ftomach, &c.  It is often the effea of obftruc-
tions in the liver, the fpleen or fome ofthe other vifcera.  It
may likewife proceed  from  external violence, as  blows or
bruifes, or from any of the caufes which produce inflammation.
   A great part  of the  danger  in this difeafe arifes  from the
extravafated blood lodging in the bowels,  and becoming pu-
trid, by which means a dyfentery or putrid fever may  be oc-
cafioned.  The beft  way of  preventing this,  is to  keep the
body gently open, by frequently exhibiting emollient clyfters.
Purges muft not be given  till the difcharge is ftopt, otherwife
they will irritate the ftomach,  and  increafe the diforder.   All
the food and drink muft be of a mild cooling nature, and ta-
ken in fmall quantities. Even drinking cold water has fome-
times proved a  remedy,  but  it  will fucceed better,  when
fharpened with  the fpirits of vitriol.   When there are figns
of an inflammation, bleeding  may be neceffary ; but the pa-
tient's weaknefs wiU feldom permit it.  Opiates  may  be of 
270     VOMITING   OF  BLOOD.

ufe ; but they muft be given in fmall dofes,  as four or five
drops of liquid laudanum twice or thrice a-day.
   After the difcharge is over, as the patient is generally trou-
bled with gripes, occafioned by the  acrimony  of the blood
lodged in the inteftines, gentle purges will be neceflary.

        OF   BLOODY    URINE.

   This is  a  difcharge of blood from the veffels of  the kid-
neys or bladder,  occafioned by their being either  enlarged,
broken, or eroded.  It is more orlefs dangerous according to
the different  circumftances which attend it.
   When pure blood is voided fuddenly without interruption
and without  pain,  it proceeds from  the kidneys ; but if the
blood be in fmall quantity, of a dark colour,  and emitted
with heat and pain about the bottom ofthe belly, it proceeds
from the bladder.   When bloody urine is  occafioned by a
rough ftone defcending from the kidneys to the bladder, which
wounds the ureters, it is attended with a fharp pain in  the
back,  and  difficulty of making water.  If  the coats of the
bladder are hurt by a ftone, and the bloody urine follows, it
is attended with the moft  acute pain, and a previous flop-
page of urine.
   Bloody  urine may likewife be occafioned  by falls, blows,
the lifting or carrying  of heavy burdens,  hard  riding, or any
violent motion.  It may alfo proceed from ulcers or erofions
of the  bladder, from a ftone lodged in the kidneys, or from
violent purges, or fharp diuretic medicines, efpecially cantha-
rides.
   Bloody urine is always attended with fome degree of dan-
ger ; but it is peculiarly fo when mixed with purulent mat*
ter^ as this fhews  an ulcer fomewhere in the  urinary paffages.
Sometimes this difcharge proceeds from excefs  of  blood, in
which cafe it is rather to be confidered  as a  falutary evacua-
tion than a difeafe.   If the difcharge however  be very great,
it may wafte the patient's ftrength, and occafion an ill habit
of body, a dropfy, or a confumption.
   The treatment of this diforder muft be varied according to
the different caufes from which it proceeds.
    When it is owing to a ftone, in the bladder,  the cure de-
 pends upon an operation ; a defcription of  which  would be
 foreign to  our purpofe.
    If it be  attended with a plethora^  and fymptoms  of inflam-
 mation, bleeding  will be neceffary.  The body muft likewife
                                                       be 
OF   B  L O O-D Y   URINE.
 be kept open by emollient clyfters,  or cooling purgative me-
 dicines ; as cream of tartar,  rhubarb, manna, or fmall dofes
 of lenitive eleauary.
   When bloody urine proceeds from a diflblved ftate of the
 blood,  it is commonly the fymptom of fome malignant dif-
 eafe ; as the fmall-pox, a putrid fever,  or the like.  In this
 cafe the patient's life depends on the liberal ufe of the Peru-
 vian bark and acids, as has already been fhewn.
   When there is  reafon to fufpea an ulcer in the kidneys or
 bladder, the patient's diet muft be cool, and  his drink of a
 foft, healing, balfamic quality,as decoaions of marfh-mallow
 roots with  liquorice, folutions  of  gum-arabic,  &c.  Three
 ounces of marfh-mallow roots,  and  half an ounce of liquo-
 rice, may  be boiled in two Englifh quarts of water to one;
 two ounces of gum arabic,  and half an ounce of purified
 nitre, may be diflblved in the ftrained liquor,  and a tea-cup-
 ful of it taken four or five times a-day.
   The early ufe of  aftringents in this  difeafe has often bad
 confequences.   When the flux is ftopped too foon, the gru-
 mous blood, by being  confined  in  the veffels, may produce
 inflammations,  abfcefs, and ulcers.   If however the cafe be
 urgent, or  the patient feems to  fuffer from the lofs of blood,
 gentle aftringents may be neceffary.  In this  cafe the patient
 may take three or  four ounces of lime-water, with half an
 ounce ofthe tinaure of Peruvian bark, three times a-day.

•OF  THE DYSENTERY, OR BLOODY FLUX.

   This difeafe prevails in the fpring and autumn.  It is moft
 common in marfhy countries, where, after hot and dry fum-
 mers, it is apt to become  epidemic.  Perfons are moft liable
 to it who are much expofed to the night-air,  or who live in
 places where the air is confined  and unwholefome.  Hence ic
 often proves fatal in camps,  on  fhipboard, in  jails, hofpitals^
 and fuch like places.
   CAUSE S. '   ■  vThe dyfentery may be occafioned by
 any thing that obftruas the perfpiration, or renders the hu-
 mours putrid ; as damp beds, wet  clothes,  unwholefome di-
 et, air, he. But it is moft frequently communicated by in-
 feaion.  This ought  to make  people extremely cautious in
 going near fuch  perfons as labour  under the  difeafe.  Even
 the fmell of the patient's excrements has been  known lo com-
 municate the infeaion.
   SYMPTOM  S.------It is known by a flux of the
 belly attended with violent pain of the bowels, a conftant in-
                                               clination 
 272       OF  THE  DYSENTERY,

 clination to go to ftool, and generally lefs or more  blood in
 the ftools.   It begins, like other fevers,  with chillnefs, lofs
 of ftrength, a quick pulfe, great thirft,  and an  inclination
 to vomit.   The ftools are at firft greafy or frothy, afterwards
 they are ftreaked with blood, and, at laft,  have frequently the
 appearance of pure blood, mixed with fmall  filaments refem-
 bling bits of fkin.   Worms are fometimes paffed both up-
 wards and downwards through the whole courfe of the dif-
 eafe.  When  the  patient goes  to  ftool, he feels a  bearing
 down,  as  if the whole bowels were falling out,  and fome-
 times a  part  of the inteftine  is aaually protruded, which
 proves  exceeding troublefome, efpecially in children.  Fla-
 tulency  is  likewife  a troublefome fymptom, efpecially to-
 wards the end of the difeafe.
   This  difeafe may  be diftinguifhed from  a diarrhoea or loofe-
 nefs, by the acute pain of the bowels, and the blood which
 generally appears in the ftools.   It may be diftinguifhed from
 the cholera morbus by its not being attended with fuch violent
 and frequent fits of vomitmg, &c.
   When the dyfentery attacks  the old, the delicate, or fuch
 as have been wafted by the gout,  the fcurvy,  or other linger-
 ing difeafes, it generally proves fatal.  Vomiting and hiccup-
 ing are  bad figns, as they fhew  an inflammation  of the fto-
 mach.   When  the  ftools are green, black, or have an ex-
 ceeding  difagreeable cadaverous  fmell, the  danger  is  very
 great,  as it fhows the difeafe to be of the putrid kind.  It is,
 an  unfavourable fymptom  when clyfters are  immediately re.
 turned;  but ftill more fo, when  the paflage is fo  obftinately
 fhut, that they  cannot be injeaed.  A feeble pulfe, cold-
 nefs of  the  extremeties,  with difficulty of  fwallowing, and
 convulfions, are figns of approaching death.
  REGIME N.——— Nothing is of more importance in
 this difeafe than cleanlinefs. It  contributes greatly to the re-
 covery of the patient, and no lefs to the fafety of fuch as at-
 tend him.   In all contagious difeafes the danger is increafed,
 and the infeaion fpread, by the  negfea of cleanlinefs; but
 in no one  more than this.  Every thing  about the  patient
 fhould  be frequently changed.  The excrements fhould ne-
 ver be fuffered to continue in his chamber, but removed im-
 mediately  and buried under ground.  A  conftant ftream of
 frefh air  fhould be admitted into  the chamber; and  it ought
frequently to  be fprinkled with vinegar, juice of  lemon, or
 fome other ftrong acid.
  The patient muft not be difcouraged, but  his fpirits  kept
 up  in hopes  of  a cure.  Nothing tends more to render any
                                                   putrid 
OR   BLOODY   FLUX.
m
putrid difeafe mortal, than the fears and apprehenfions of the
fick.   All difeafes of this nature have a tendency to fink and
deprefs the fpirits, and when that is increafed by  fears and
alarms from thofe whom the patient believes to be  perfons of
fkill, it cannot fail to have the worft effeas.
   A flannel waiftcoat worn next  the fkin has often a very
good effea in a dyfentery.   This promotes the perfpiration
without  over-heating the  body.   Great caution however is
neceffary  in leaving it off.   I  have often known a dyfentery
brought on by imprudently throwing off a flannel Waiftcoat
before the feafon was fufficiently warm.  For whatever pur-
pofe this piece of drefs is worn, it fhould never be left off but
in a warm feafon.
   In this difeafe the greateft attention muft be paid  to the pa-
tient's diet.  Flefh, fifh, and every thing that has a tendency
to  turn  putrid or rancid on the ftomach,  muft be  abstained
from.  Apples boiled in  milk, water-pap,  and plain light
pudding, with broth made of the gelatinous parts of animals,
may be eat.  Gelatinous broth not only anfwers the purpofe
of  food, but likewife of medicine.  I have often known dy-
fenteries, which were not of a  putrid nature, cured by it, af-
ter pompou6 medicines had proved  ineffeaual *«
   Another kind of food very proper in the dyfentery,  which
may  be ufed  by fuch as cannot take the broth mentioned  a-
bove, is  made by boiling a few handfuls of fine flour, tied in
a cloth,  for  fix or feven  hours, till  it becomes  as hard as
ftarch.  Two  or three table fpoonfuls of this may  be grated
down, and boiled in fuch a quantity of  new milk  and  water
                          I i                           as

  * The  manner of  making this broth is, to take a fheep's head
and feet with the fkin upon them, and to burn the wool off with a
hot iron.  Afterwards to boil  them till the broth is quite a jelly.
A  little cinnamon or mace  may be added, to give the broth  an
agreeable flavour, and the patient may take a little of it  warm
with toafted bread, three or tour times a-day.   A clyfter of it may
likewife be given twice a-day.  Such as cannot ufe the broth made
in  this way, may have the head and feet fkinned;  but we have
reafon to believe that this hurts  the  medicine.   It is not  our
bufinefs here  to  reafon upon the  nature and qualities of medicine,
otherwife this might  be lhewn to poiTefs virtues every way fuited
• to  the cure of a dyfentery which does not proceed from a putrid
ftate  of the humours.  One thing we know, which is preferable
to  all reafoning, that  whole families have often been cured by it,
after  they had "ufed many other  medicines in vain.  It will how-
ever be proper that the patient take a vomit,  and  a dofe or two
of  rhubarb, before he begins to ufe  the broth.  It will  likewife
be  neceflary to continue the ufe ofit for a ccmfiderable time, ind to
make it the principal food. 
274
OF   THE  DYSENTER Y,
as to be of the thicknefs of pap.  This may be fweetened to
the patient's tafte, and taken for his ordinary food *.
   In a putrid dyfentery the patient may be allowed to eat free-
ly of molt kinds of good ripe fruit;  as apples, grapes, goofe-
berries, currant-berries, ftrawberries, he. Thefe may either
be eat  raw or boiled, with or without milk,  as the patient
chufes.   The prejudice againft fruit in this difeafe is fo great,
that many believe'it to be the common caufe of dyfenteries.
This however is an egregious miftake.   Both reafon and ex«
perience fhew,  that  good fruit  is one ofthe  beft medicines,
both for the prevention and cure of the dyfentery. Good fruit
is in every refpea calculated to counteraa that tendency to
putrefaaion,  from whence the  moft dangerous kind of dy-
fentery  proceeds.   The patient in  fuch  a cafe ought there-
fore to be allowed to eat as much fruit as he pleafes, provid-
ed it be good f.
   The moft proper drink in this diforder is whey.   The  dy-
fentery  has often been cured by the ufe  of clear whey alone,
It may be  taken both for drink, and in form of clyfter. When
they cannot  be had, barley-water  fharpened with  cream of
tartar maybe drank, or  a decoaion of barley and tamarinds j
two ounces of the former and one of  the  latter may be boiled
                                          ,               in

   *  The  learned and humane Dr. Rutherford,  late profeflbr of
medicine in the univerfity of Edinburgh, ufed ta mention this food
in his public lectures with great encomiums.  He directed it to be
made by tying a  pound or two of the fmeft  flour, as tight as pof-
fible, in a lmen rag, afterwards to dip it frequently in  water, and
to dridge  the outfide with flour,  till a  cake or cruft was formed
around it,  which prevents the water from  foaking into it while
boiling.  It is then to be boiled till it becomes a  hard dry inafs,
as directed above.   This, when  mixed with milk and water,  will
not only anfwer  the purpofe of food, but may likewife be given
m clyfters.
   f I lately faw a yotlng man who had been feized with a dyfen*
tery in North America. Many things had been tried there for his
relief, but to no purpofe.  At length, tired out  with  difappoint-
ments from medicine,  and reduced to fkin and bone, he came over
to Britain, rather with a view to die  among his relations, than with
any hopes of a  cure.   After taking fundry medicines here with
no better fuccefs than abroad, I  advifed him to leave off the ufe
of drugs, and to tmft entirely to a diet of milk and fruits, with'
gentle exercife.   Strawberries was the only fruit he could procure
at that  feafon.    Thefe  he eat with  milk  twice, and fometimes
thrice a-rlay.  The confequence was, that in a fhort time his ftools
were reduced from upwards of twenty in a day,  to  three or four,
and fometimes  not fo many.   He ufed the other fruits  as  they
came in, aad was, in a few weeks, fo well as to  leave that part
&f the country where I was, with a view to return to America. 
OR   BLOODY   FLUX.
275
in two Englifh quarts of water to one.   Warm water, wa-
ter-gruel,  or water  wherein  hot iron has been frequently
quenched, are all very proper,  and may be drank in turns.
Camomile tea,  if the ftomach will bear it,  is an exceeding
proper drink.   It both ftrengthens the ftomach, and by its
analeptic quality tends to prevent a mortification  of the
bowels.
  M E D I  C I N E.——-At the beginning of this dif-
eafe it 13 always neceffarv to cieanfe the firft paffages.  For
this purpofe  a  vomit of ipecacuanha  muft be given, and
wrought  off with  weak  camomile tea.   Strong vomits are
feldom neceffary here.  A  fcruple, or at moft half a dram of
ipecacuanha, is generally fufficient for an adult, and fome-
times a very few grains will fuffice.  The day after the vo*
mit, half a dram, or two fcruples of rhubarb, muft be taken.
This dofe may be repeated every other day for  two or three
times.  Afterwards fmall dofes of ipecacuanha may be taken
for fome time.  Two or three grains of the powder may be
mixed  in a table-fpoonful of the fyrup of poppies,  and taken
three times a-day.
  Thefe evacuations, and the regimen prefcribed above, will
often be fufficient to effea a cure.  Should it however hap-
pen  otherwife,  the  following ajftringent medicines may be
ufed.
   A clyfter  of ftarch or fat mutton broth, with thirty or for-
ty drops of liquid laudanum in it, may  be adminiftered twice
a-day.  At the fame time an ounce of  gum arabic, and half
an ounce of gum tragacanth,  may be diflblved  in an Englifh,
pint of barley-water,  over a flow fire, and  a table-fpoonful
of it taken every hour.
   If thefe have not the defired effea,  the patient may take,
four times a-day, about the bulk of a nutmeg of the Japonic
confetlion, drinking after it a tea-cupful of the decoaion of
logwood *.
   Perfons who have been cured of this difeafe are very liable
to fuffer a relapfe;  to prevent which, great circumfpeaion
with  refpea to diet  is  neceffary.   The patient muft abftain
from all fermented liquors, except now and then  a  glafs of
good wine;  but he muft drink no kind of malt liquor.  He
fhould likewife abftain  from animal food,  as fifh and flefh,
and live principally on  milk and vegetables.
   Gentle exercife and wholefome air are likewife  of im-
portance.   The patient fhould go  to the  country as foon as
                                                     his.
         #  See Appendix, Decoction of  logwood. 
£76     OF   THE   DYSENTERY, &c.

his ftrength will permit, and fhould take  exercife daily on
horfeback, or in a carriage.   He may likewife ufe bitters in-
fufed in wine or brandy, and may drink twice a-day a gill of
lime-water mixed with an equal quantity of new milk.
   When  dyfenterjes prevail, we would recommend a Ariel
attention to cleanlinefs,  a fpare  ufe of animal food, and  the
free  ufe of found ripe fruits, and other vegetables. The nighf
air is to be carefully avoided,  and  all communication with
tbe fick.  Bad fmells are likewife to be  fhunned, efpecially
thofe which arife from putrid animal fubftances.  The office*
houfes where the fick go are carefully to be avoided.
   When the fymptoms  of the  dyfentery appear,  the patient
ought immediately to take a vomit, to go to  bed, and drink
plentifully of weak warm liquor, to promote a fweat.  This,
with a dofe or two of rhubarb at the beginning, would often
carry off  the difeafe.   In  countries where  dyfenteries pre-
vail, we would advife fuch  as are liable  to them, to take ei-
ther a vom jf-or a purge every fpring or autumn, as a preventive,
   There are fundry  other fluxes ofthe belly,  as the LI EN-
T E R Y  and  C CE L  I A  C  PASS I ON,which, though
lefs dangerous  than the dyfentery, yet  merit confideration.
Thefe difeafes generally proceed from a relaxed ftate of the
ftomach and inteftines,  which is fometimes fo great, that the
food paffes through them without almoft any fenfible  altera-
tion ; and the patient dies merely from the want of nourifh-
ment.
   When  the lintery or cceliac paffion  fucceed a dyfentery,
they often prove fatal.   They  are always dangerous  in  old
age, efpecially when the conftitution has been broken  by ex-
cefs or acute difeafes.   If the  ftools be very frequent, and
quite crude, the thirft great, with little urine, the mouth ul-
cerated, and the face marked with fpots of different colours,
the danger is very great.
   The  treatment of  the patient is in general  the fame as in
the dyfentery.   In all obftinate fluxes of the belly,  the cure
muft be attempted,  by firft  clearing the ftomach and  bowels
with  gentle vomits  and purges.  Afterwards fuch a diet a?
has a tendency to heal and ftrengthen the bowels, with opiates
and aftringent medicines, will generally perfea the cure.
   The  fame obfervation holds with refpea to a TENES-
MUS, or frequent defire of going to ftool.   This difeafe
refembles  the dyfentery  fo much, both in  its fymptoms and
method pf cure, that we think it needlefs to infill upon it.
CHAP. 
C   *77   3
               CHAP.    XXXIV.

        OF   THE   HEAD-  A.C H.

     ACHES and pains proceed from very different caufes,
      and may affea any part ofthe body;  but we fhall point
out thofe only which occur moft frequently, and are attend-
ed with the greateft danger.
  When the head-ach is flight,  and affeas a particular part
of the head only,  it is  called cephalalgia ; when the whole
head is affeaed, cepbalaea ; and when on one fide  only,  he-
micrania.  A fixed pain in the  forehead, which may be co-
vered with the end of the thumb, is called the clavis hyflericus.
  There  are alfo other diftinaions.  Sometimes the pain is
internal, fometimes external; fometimes it is an original dif-
eafe, and at other times only fymptomatic.   When the head-
ach proceeds from a hot bilious habit, the pain is very acute
and throbbing, with a confiderable heat of the part affeaed.
When from a cold phlegmatic habit, the  patient complains
of a dull heavy pain, and has a fenfe of coldnefs in the part.
This kind of head-ach is fometimes attended with a degree of
ftupidity or folly.
  Whatever  obftruas  the free circulation of the  blood
through the veffels of the head, may occafion a head-ach. In
perfons of a full habit, who abound with blood, or other hu-
mours, the head-ach often proceeds from the fuppreffion of
cuftomary evacuations ;  as bleeding at the nofe, fweating of
the feet, &c.   It may likewife proceed  from any caufe that
determines a great flux of blood towards the head ; as cold-
nefs of the extremities, or  hanging down the head  for a long
time.  Whatever prevents the return of the  blood from  the
head will likewife occafion a head-ach ; as looking obliquely
at any objea, wearing any thing tight about the neck, or the
like.
  When a head-ach proceeds from a  ftoppageofa running at
the nofe, there is a heavy  obtufe, preffing pain in the fore-
part of the head,  in which these feems to  be fuch a  weight,
that the patient can fcarce hold it up.   When it is occafion-
ed by the  cauftic matter of the venereal difeafe, it generally
affeas the fkull, and often produces a  caries of the bones.
  Sometimes the head-ach proceeds  from  the  repulfion, or
retroceffion of the gout, the eryfipelas, the fmall-pox, meafles,
itch, or other eruptive difeafes.   What is called a bemicrania.
                                               generally 
278         OF   THE   HEAD-ACH.

generally proceeds from crudities or indigeftion.  Inanition,
or emptincfs, will alfo occafion head-.~chs.  1  have often feen
inftances of this in nurfes  who gave  fuck too long, or who
did not take a fufficient quantity of folid food.
  There is Jikewife a moft violent, fixed, conftant, and al-
moft intolerable head-ach,  which occafions great debility both
of body and mind, prevents fleep, deftroys the appetite, cau-
fes a vertigo, dimnefs of fight, a noife  in fhe ears, convulfi-
ons,  epileptic fits, and fometimes vomiting, coftivenefs, cold-
nefs  of the extremities,  &c.
  The head-ach is often fymptomatic in continual and inter-
mitting fevers,  efpecially quartans. It is likewife a very com-
mon fymptom in  hyfteric  and hypochondriac  complaints.
  When an head-ach attends an acute  fever,  with pale urine,
it is an  unfavourable fymptom.  In  exceffive  head-achs,
coldnefs of  the extremities is a bad fign.
  When the difeafe continues long,  and is very violent, it
often terminates in blindnefs, an apoplexy, deafnefs, a verti-
go,  the palfy, epilepfy,  &c.
  In this difeafe the cool regimen in general  is to be obferv-
ed.  The diet ought  to confift of fuch emollient  fubftances
as will correa the acrimony of the  humours,  and keep  the
body open; as apples boiled in milk, fpinnage, turnips, and
fuch like.   The drink ought to be diluting; as barley-water,
infufions of mild  mucilaginous vegetables, decoaions of  the
fudorific woods, &c.  The feet and  legs ought  to be kept
warm, and  frequently bathed in luke-warm water;  the head
fhould be fhaved, and bathed with water and vinegar.  The
patient ought,  as much as poffible, to keep  in an  ereft  po-
fture,  and not to  lie with  his head too low.
   When the head-ach is owing to excefs of  blood, or an hot
bilious conftitution,  bleeding is  neceffary.  The patient may
be  bled in  the jugular  vein, and the  operation  repeated if
there be occafion. Cupping alfo, or the application of leech-
es to the temples, and  behind the ears, will be of fervice.
Afterwards  a  bliftering-plafter may  be applied to the neck,
behind the  ears,  or  to any part of the head  that is moft af-
feaed.  In fome  cafes it will be proper to blifter the whole
head.   In perfons of  a grofs habit, iffuesor perpetual blifters
will be of fervice.  The belly ought likewife to be kept open
by gentle laxatives.
   But when the  head-ach proceeds from  a copious vitiated
ferum ftagnating in the membranes, either within or without
t.he  fk.ull,   with a dull, heavy,  continual  pain,  which  will
                                                   neither 
        OF   THE   HEAD-ACH          279

neither yield to bleeding nor gentle laxatives, then more pow-
erful purgatives are neceffary ;  as pills made of aloes, refin of
jalap, or the like.   It will alfo be neceffary in this cafe to blif-
ter the whole head,  and to keep the back part  of the neck
open for a confiderable time by a perpetual blifter.
   When the head-ach is occafioned by a ftoppage of a run-
ning at the nofe, the patient fhould frequently fmell to a bot-
tle of volatile falts; he may likewife take fnuff,  or any thing
that will irritate the nofe,  fo as to  promote  a difcharge from
it; as the herb maftich, ground-ivy, &c.
   A hemicrania, efpecially a periodical one, is generally ow-
ing to  a  foulnefs of the ftomach, for which gentle vomits
muft  be  adminiftered, as  alfo  purges of rhubarb.   Af-
ter the bowels have been fufficiently cleared, chalybeate wa-
ters, and fuch bitters as ftrengthen the ftomach, will be  ne-
ceffary.
   When the head-ach arifes from  a vitiated ftate of the hu-
mours, as in the fcurvy and venereal difeafe, the  patient, after
proper  evacuations, muft  drink freely  of the decoaion of
woods, or the  decoaion of farfaparilla, with raifins and li-
quorice *.   Thefe promote perfpiration,  fweeten the  hu-
mours, and,  if duly perfifted in,  will produce very happy ef-
feas.   When a colfeaion of  matter is felt under  the fkin.,
it muft be difcharged  by an incifion,  otherwife it will render
the bone carious.
   When the head-ach is fo intolerable as to endanger the pa-
tient's  life, or is attended with continual watching,  deliri-
um, &c.  recourfe muft be had to opiates.  Thefe, after pro-
per evacuation  by clyfters, or mild  purgatives, may be  ap-
plied both externally and internally.   The affeaed part may
be rubbed with Bate's anodyne balfam,  or a cloth dipped in it
may be applied to the part.  Tbe patient  may, at the fame
time, take twenty drops of laudanum,  in a cup of valerian
or penny-royal tea, twice or thrice i-day.   This  is only to
be done in cafe of extreme pain.   Proper evacuations ought
always to accompany and follow the  ufe of opiates.
   When the patient cannot  bear the lofs of blood, his  feet
ought frequently to be bathed in  lukewarm water, and well
rubbed with a coarfe  cloth*   Cataf>lafms with muftard or
horfe-radifh  ought likewife to  be applied to them.   This
courfe is peculiarly neceffary when the pain proceeds from  a
gouty humour affeaing the head.
   When the head-ach is occafioned  by great heat, hard la-
bour,  or violent exercife of any  kind,  it may be allayed by
                                                  cooling
          * See Appendix. Decoction of farfapariila. 
 a86         OF  THE  HEAD-ACH.

cooling medicines; as the faline draughts with nitre, and the
like.
   A  little of Ward's effence, dropt into the palm of the
hand  and applied to the  forehead, will fometimes remove a
violent head-ach; and fo will  aether,  when  applied  in  the
fame  manner.

          OF  THE  TOOTH-ACH.

   This difeafe is fo well  known, that it needs no defcripti-
on.   It  has great  affinity with the rheumatifm, and often
fucceeds pains of the fhoulders and other parts of the body.
   It may proceed from obftruaed perfpiration,  or any ofthe
other  caufes of  inflammation.   I  have often known the
tooth-ach occafioned by negfeaing fome part of the ufual co-
verings of the head, by fitting  with the  head  bare near  an
open  window,  or expofing it any how to a draught  of cold
air.   Food or drink taken either too hot or too cold  is very
hurtful to the teeth.   Great quantities  of fugar, or other
fweet-meats, are likewife hurtful.  Nothing is more deftruc-
tive to the teeth than cracking nuts,  or chewing any kind of
hard  fubftances.   Picking the  teeth with  pins, needles, or
with  any thing that may hurt the enamel with which they are
covered, does great mifchief, as the tooth is fure to be fpoilt
whenever the air gets into it.  Breeding women are very fob*
jea  to the tooth-ach,  efpecially during  the  firft three or
four months of pregnancy.   The tooth-ach  often proceeds
from fcorbutic humours affbaing the gums.  In this cafe the
teeth  are fometimes wafted, and  fall out without any confi*
derable degree of pain.   The more immediate  caufe  of the
tooth-ach is a rotten or carious tooth.
   In  order to relieve the tooth-ach, we muft firft endeavour
to draw off the humours  from  the part affeaed.  This may
be done by mild purgatives,  fcarifying the gums, or applying
leeches to them, and bathing the feet frequently in warm wa-
ter.   The perfpiration ought likewife to  be promoted  by
drinking freely  of  weak  wine-whey,  or  other  diluting  li-
quors, with fmall dofes of nitre.  Vomits too have often  an
exceeding good effea in the  tooth-ach.   It is feldom  fafe to
adminifter opiates, or any kind of heating medicines, or even
to draw a tooth till proper evacuations have  been  premifed,
and thefe alone will often effea the cure.
   If this  fails, and, the  pain  and inflammation ftill increafe,
a fuppuration may be expeaed;  to promote which a  toafted 
        OF  THE  TOOTH-ACH.       281

fig fhould be held between the gum and the cheek; bags filled
with boiled  camomile flowers, flowers of elder, or the like,
may be applied to the part affeaed, with as great a degree of
warmth as the patient can bear, and renewed as they grow
cool: the patient may likewife receive the fleams of warm
water into his mouth, through an inverted  funnel, or by hold-
ing his head over the mouth of a porringer filled with warm
water,  he.
  Such things as promote the  difcharge of faliva, or caufe the
patient to fpit, are generally of fervice.  For this purpofe bit-
ter, hot, or pungent vegetables may be chewed ; as gentian,
calamus aromaticus, or pellitory of Spain.    Allen recom-
mends  the root of yellow  water flower-de-luce in this cafe.
Tbis root may either be rubbed  upon the tooth, or a little
of it chewed.  Brookes fays,  he hardly ever  knew it fail to
eafe the tooth-ach.  It ought however to  be ufed with  cauti-
cjn.
  Many other herbs, roots, and feeds, are recommended for
curing the tooth-ach ;  as the leaves or roots  of millefoil or
yarrow chewed, tobacco fmoked or chewed,  ftaves-acre, or
the feeds of  muftard chewed, &c.  Thefe bitter,  hot,  and
pungent things, by occasioning a great flow of faliva,  fre-
quently give eafe in the tooth-ach.
   Opiates often relieve the tooth-ach.  For this purpofe a lit-
tle  cotton wet with laudanum may be held between the teeth;
or a piece of (licking-plafter, about the bignefs of a fhilling,
with a bit of opium in the  middle of it,  of a fize not to pre-
vent the flicking of the other, may be laid  on  the temporal
artery, where the pulfation is moft fenfible.   De la Motte af-
firms,  that there are few cafes wherein this will not give re-
lief.   If there be a hollow  tooth, a fmall pill made of equal
parts of camphire and  opium, put into the hollow, is often
beneficial.   When this cannot be had, the hollow tooth  may
be filled with gum rnaftich, wax, lead, or any fubftance that
will flick in it, and keep out  the external air.
   Few applications give more relief in the tooth*ach than blif-
 tering-plafters.   Thefe may  be applied betwixt the fhoulders,
 but they have the beft effea when put behind  the  ears, and
 made fo large as to cover a great  part of the jaw.
   After all, when the tooth  is carious, it is often  impoffible
 to remove the pain without extraaing it;  andi as a fpoilt tooth
 never  becomes found again,  it is prudent to draw it foon, left
 it fhould affea the reft.  Tooth drawing, like bleeding, is
*ery much  praaifed by mechanics as well  as perfons of the
  •"•■                      K k                    medical 
 282       OF   THE  .TOOTH-AC H.

 medical profeffion.  The operation however is not without
 danger, and ought always  to be  performed with care.  A
 perfon unacquainted with the ftruaure of the parts will be in
 danger of hurting  the jaw-bone, or of drawing a found tooth
 inftead of a rotten one.
    When  the  tooth-ach returns periodically,  and the pain
 chiefly affeas the gums, it may be cured by the bark.
    Some pretend to have found great benefit in the tooth-ach,
 from the application of an artificial magnet to the affeaed
 tooth.   We fhall not attempt to account for its mode of ope-
 ration, but, if it be found to anfwer, though only in parti-
 cular cafes,  it certainly def erves a trial, as it is attended with
 no expence, and cannot do any harm.  Efearicity has like-
 wife been recommended,  and particular inftruments have
 been invented for fending a fhock through  the affeaed tooth.
    Perfons who have returns of tbe tooth-ach at certain fea-
 fons, as fpring and autumn,  might often prevent it by taking
 a purge at thefe times.
    Keeping the teeth clean has no doubt a tendency to prevent
 the tooth-ach.  The beft method  of doing this  is to wafh
 them  daily with fait and water,  or with cold water  alone.
 All brufhing and fcraping of the teeth is dangerous, and, un-
 lefs it be performed with great care, does mifchief.

        OF    THE.  EAR-AC  H.

   This diforder chiefly affeas the membrane which lines the
 inner cavity of  the ear called the  metus auditorius.  It is often
 fo violent as  to occafion great  reftleffnefs and  anxiety, and
 even delirium.   Sometimes  epileptic fits, and other convul-
 five diforders, have been brought on by extreme pain in the
 ear.
   The ear-ach  may proceed  from any of the caufes which
 produce inflammation.  It often proceeds from a fudden fup-
 preffion of perfpiration, or from  the head being expofed  to
 cold when covered with fweat.  It rnay alfo be occafioned by
 worms, or other infeas  getting into the ear, or being bred
 there;  or from any hard body fticking in  the  ear.   Some-
 times it proceeds fiom the tranflation  of morbific matter  to
 the ear.   This often happens in the decline of malignant fe-
 vers, and occafions deafnefs, which is generally reckoned a
 favourable fymptom.
  When the ear-ach proceeds from  infeas, or any hard bo-
dy fticking in the ear,  every method muft be taken to remove
                                                    them 
         OF   THE   EAR-AC H.         283

them as foon as poffible.   The membranes may be relaxed by
dropping into the ear, oil of fweet almonds, or olive oil.  Af-
terwards the patient fhould be made to fneeze, by taking fnuff,
or fome ftrong fternutatory.  If  this fhould not force out the
body, it muft be extraaed by art.  I have feen infeas, which
had got into the ear, come out  of their own accord  upon
pouring in oil, which is a thing they cannot bear.
   When the pain of the ear proceeds from inflammation,  it
muft be treated like other topical inflammations, by  a cool-
ing regimen and opening medicines.   Bleeding at the begin-
ning either  in  the arm or jugular vein, or cupping in the
neck, will  be proper.  The ear may likewife be fomented
with fleams of warm water,  or flannel bags filled with boil-
ed mallows and camomile flowers may be applied to it warm;
or bladders filled with warm  milk and  water..  An exceed-
ing good method of fomenting the ear is to apply it clofe to
the mouth  of a jug filled wiih warm water,  or a ftrong de-
coaion of camomile flowers.
   The patient's feet fhould be frequently  bathed  in luke-
warm water,  and  he ought to take  fmall dofes of nitre and
rhubarb, viz. a fcruple of the former, and  ten grains of the
latter,  three times a-day.  His  drink may be whey, or de-
coaions of barley and liquorice with figs or  raifins.   The
parts behind the ear ought frequently to be rubbed with cam-
phorated oil, or a little of the volatile liniment.
   When the inflammation cannot be difcufled, a poultice of
bread and milk, or roafted onions, may be applied to the ear,
and  frequently renewed, till the abfcefs breaks, or  can be
opened.  Afterwards the humours may be diverted from the
part by gentle laxatives,  blifters,  or iffues ;  but the difcharge
muft not be fuddenly dried up by any external application.

    PAIN  OF   THE STOMACH,  &c.

   This may  proceed from various  caufes ;  as indigeftion ;
wind;  the acrimony  of  the bile; fharp, acrid, or  poifonous
fubftances taken into the ftomach, &c.  It may likewife pro-
ceed from worms ; the ftoppage  of cuftomary evacuations ;
a tranflation of gouty matter to the ftomach, the bowels, he.
   Women  in the decline of life are very liable to pains ofthe
ftomach and bowels,  efpecially fuch as are affliaed  with  hy-
fleric complaints.  It is  likewife very common to hypochon-
driac men of a fedentary and luxurious life. In fuch perfons
it often proves fo extremely obftinate as  to  baffle  all the
powers of medicine.
                                                  Whea 
284     PAIN  OF  THE  STOMACH,  &c.

  When the pain ofthe ftomach is moft violent after eating,
there is reafon to fufpea that it proceeds from fome fault ei-
ther  in the digeftion or the  food.  In  this cafe the patient
ought to change  his diet, till he finds what kind of food a-
grees beft with his ftomach,  and fhould continue chiefly to
ufe it,   If a change of diet does  not  remove the complaint,
the patient may take a gentle vomit, and afterwards a dofe or
two  of rhubarb.  He ought  likewife to  take an infufion of
Camomile flowers, or fome other ftomachic  bitter,  either in
wine or water.   I have often known exercife  remove this
complaint, efpecially failing, or a long journey on horfeback,
or in a machine.
  When a pain ofthe ftomach proceeds from flatulency, the
patient  is conftantly belching up wind, and feels an uneafy
diftenfion of the ftomach after  meals.  This is a moft de-
plorable difeafe,   and is feldom thoroughly cured.  In gene-
ral,  the patient  ought to avoid  all  windy diet, and every
thing that fours on the ftomach, as greens, roots, &c.  This
rule  however admits of fome exceptions.   There  are many
inftances of perfons very  much  troubled with wind, who re-
ceived great benefit  from eating  parched  peafe,   though that
grain is generally fuppofed to be of a  windy nature *.
  This complaint may likewife be greatly relieved by labour,
efpecially digging, reaping,  mowing,  or any kind of aftive
employment by  which the bowels are alternately compreffed
and  dilated.  The moft  obftinate cafe of  this  kind  I ever
met  with  was in a perfon of a fedentary occupation, whom I
advifed, after he  tried every kind of medicine in vain, to turn
gardener, which he did, and has everfinceenjoyed good health.
  When a pain ofthe ftomach is occafioned by the fwallow-
ing of acrid or poifonous fubftances, they muft be difcharged
by vomit; this may  be excited by butter, oils,  or other foft
things, which fheath and defend the  ftomach from the acri-
mony of its contents.
  When pain of the ftomach proceeds from a tranflation of
gouty matter* warm cordials are neceffary, as generous wines,
French brandy,  &c.   Some have drank a whole bottle of
brandy or rum, in this cafe, in a few hours, without being in
the leaft intoxicated, or even feeling the ftomach warmed by
it.   It is impoffible to afcertain  the quantities neceffary upon
thefe occafions.   This muft be left to the feelings and dif-
                                                 cretion

  * Thefe are prepared by fteeping or foaking peafe in water, and
afterwards drying  them in  a pot or kiln till they be quite hard.
They may be ufed at pfeafure. 
    PAIN  OF THE  STOMACH, &c.    285

cretion of the patient.   The fafer way however is, not to go
too far.   When there is an inclination to vomit,  it may be
promoted by drinking  an infufion of camomile  flowers, or
carduus bcnediclus.
  If a pain of the ftomach  proceeds from the ftoppage of
cuftomary evacuations, bleeding will  be neceflary,  efpecially
in fanguine and very full habits.   It will  likewife be of ufe
to keep the body gently open by mild purgatives; as  rhu-
barb orfenna, &c.   When  this difeafe affeas women in the
decline of life, after the ftoppage of  the  menfes,  making an
iffue in the leg or arm will be of peculiar  fervice.
  When the  difeafe is occafioned by worms, they muft be
deftroyed, or expelled by fuch means as are recommended
in the following feaion.
   When the ftomach is greatly relaxed and the digeftion bad,
which often occafion flatulencies, the acid elixir  of vitriol
will be of Angular fervice.  Fifteen or twenty drops of it may
be taken in a glafs of wine or water twice or thrice a-day.
   Perfons affliaed with flatulency are generally unhappy un-
lefs they be taking fome purgative medicines ; thefe, though
they may give immediate eafe, tend to weaken and relax the
ftomach and bowels, and confequently increafe the diforder.
Their beft method is to mix purgatives and ftomachics  toge-
ther.  Equal parts of Peruvian bark and  rhubarb may be in-
fufed in brandy or wine,  and taken in fuch  quantity  as to
keep the body gently open.
              CHAP.    XXXV.

             OF    WORMS.

     THESE are chiefly of three kinds, viz, the tania,  or
      tape-worm ; the teres, or round and long worm ; and
the afcarides, or round and fhprt worm.  There are many o-
ther kinds of worms found in the human body  ; but as they
proceed, in a great meafure, from fimilar caufes, have nearly
the fame fymptoms, and require almoft the fame method  of
treatment, as thefe already mentioned, we fhall not fpend time
in enumerating them.
  The tape-worm  is white, very long, and full of joints.  It
is generally bred either in  the ftomach  or fmall  inteftines.
The round and long worm is likewife bred in the fmall guts,
and fometimes in the ftomach.  The round and fhort worms-
                                             commonly 
286           OF     WORMS.
commonly lodge in the reclum, or what is called the end gut,
and occafion a difagreeable itching about  the feat.
   The long round worms occafion fqueamifhnefs, vomiting,
a difagreeable breath, gripes, loofenefs, fwelling of the belly,
fwoonings, loathing of food, and at other times a voracious
appetite, a dry cough,  convulfions,  epileptic fits, and fome-
times a privation of fpeech.   Thefe worms have been known
to perforate the inteftines,  and get into the cavity of the bel-
ly.  The effeas of the tape-worm  are nearly  the fame with
thofe of the long and round, but rather more violent.
   Andry fays, the following fymptoms particularly attend the
folium, which is a fpecies of the tape-worm, viz.  fwoonings,
privation of fpeech, and  a voracious appetite.   The round
worms called afcarides, befides an itching of the anus, caufe
fwoonings, and tenefmus, or an inclination to go to ftool.
   CAUSE S.-------Worms may proceed  from various
c  ufes ;  but they are feldom found except in weak and relax-
ed ftomachs, where the digeftion is bad.   Sedentary perfons
are more liable to them than the aaive and laborious. Thofe
who eat  great quantities of unripe fruit, or who live much
on raw herbs and roots, are generally fubjea to worms. They
are often a fymptom of fevers, and other acute  difeafes. There
feems  to be a  hereditary  difpofition in  fome  perfons to this
difeafe.  1 have often  feen all the  children of a family fub-
jea to worms of a particular kind.   They feem likewife fre-
quently  to be owing to the nurfe.   Children  of the fame fa-
mily, nurfed by one woman,  have often  worms,  when thofe
nurfed by another have none.
   SYMPTOM  S.-----The common fymptoms of
worms, are palenefs of the countenance, and,  at other times,
an univerfal flufhing of the face ;  itching of the nefe ; this
however is doubtful,  as children pick their nofes in all dif-
eafes; ftarting,  and grinding of the teeth  in fleep; fwelling
of the upper lip ; the appetite fometimes  bad,  at  other times
quite voracious; loofenefs;  a four or  ftinking  breath ; a
hard fwelled belly ;  great thirft; the urine frothy, and fome-
times of a  whitifh colour; griping, or colic pains; an invo-
luntary difcharge of faliva, efpecially when afleep ; frequent
pains of the fide, with  a dry cough,  and unequal pulfe; pal-
pitations of the heart;  fwoonings;  drowfinefs ; cold fweats;
palfy ; epileptic fits, with many othe^unaccountable nervous
fymptoms, which were formerly attributed to  witchcraft, or
the influence of evil  fpirits.   Small  bodies in the excrements
refembling melon or cucumber feeds are fymptoms of the
tape-worm.
                                                  I lately 
O  F    W  O  R  M   S.            287
  I lately faw fome very furprifing effeas of worms in a girl
about five years of age, who ufed to lie for whole hours as if
dead.  She at laft  expired, and, upon opening her body, a
number ofthe teres, or long round worms, were found in her
guts, which wereconfiderably inflamed; and what anatomifts
call an intuffufceptio, or involving of one part of the gut with-
in another, had taken place in no lefs than four different parts
of the inteftinal canal.
  M E D 1 C I N E.       Though numberlefs medicines
are extolled for killing and expelling worms *, yet no difeafe
more frequently baffles the phyfician's fkill.  In general, the
moft proper medicines, for their expulfion are ftrong  purga-
tives ; and  to prevent their breeding, ftomachic bitters,  with
now and then a glafs of good  wine.
   The beft  purge for an  adult is jalap and calomel.   Five
and twenty or thirty grains ofthe former with fix or feven of
the latter, mixed in fyrup, may be  taken early in the morn-
ing, for  a dofe.  It will be proper  that the patient keep the
houfe all day, and drink nothing cold.  The dofe may be re-
peated once or twice a-week,  for a  fortnight or three weeks.
On the intermediate days  the patient may take a dram of the
powder  of tin, twice or thrice a-day, mixed with fyrup, ho-
ney or treacle.
   Thofe who do not chufe to take calomel may make ufe of
the bitter purgatives  ; as aloes, hiera picra, tinaure of fenna,
 and rhubarb, &c.               ,.,,,-.» r      1
   Oily medicines  are fometimes found beneficial for expel-
 ling worms.  An ounce of fallad oil and a table-fpoonful of
common fait, may be taken in a glafs of red port wine thrice
 a-day, or oftener  if  the ftomach will bear it.   But the com-
 mon form of ufing oil is in clyfters.   Oily clyfters fweetened
 with fugar or honey, are very efficacious  in bringing  away
 the fhort round worms called  afcarides, and likewifes the teres.
   The  Harrowgate  water is an excellent medicine for ex-
 pelling worms,  efpecially the afcarides.  As this water evi-
 dently abounds with fulphur,  we may  hence infer, that ful-
 phur alone muft be" a good medicine in this cafe; which is
 found to be a faa.  Many praaitioners give flour of  fulphur
 in very large dofes,  and with great fuccefs.   It fhould be
 made into an efeauajy with  honey or treacle, and taken in
 fuch quantity as to purge the patient.
                                                  Where
  * \ medical writer of the prefent age has enumerated upward^
of fifty Britiih plants, all famous for falling and expelling warms. 
288            OF     WORMS.
  Where Harrbwgate water cannot be  obtained,  fea-water  ,
may be ufed, which is far from  being a contemptible medi-
cine in this cafe.  If fea-water cannot be had, common fait
diffolved in water may be drank.  I have often feen this ufed
by country nurfes with very good effea.  Some flour of ful-
phur may  be  taken  over night, and  the falt-water in the
morning.
  But worms, though expelled, will foon breed again, if the
ftomach remains weak and relaxed ; to prevent  which, we  j
would recommend the Peruvian bark.  Half a dram of bark
in powder may be taken in a glafs of red port wine, three or
four times a-day, after the above medicines have been ufed.  |
Lime-water  is likewife  good for this  purpofe,  or a table-
fpoonful of the chalybeate wine taken twice or thrice  a-day.
Infufions  or decoaions of  bitter  heibs may  likewife be  j
drank; as the infufion of tanfy, water-trefoil,  camomile-
flowers, tops of wormwood, the leffer centaury, &c.
   For  a child of four or five years old, fix grains of rhu-
barb, five of jalap, and two of calomel, may be  mixed in a
fpoonful of fyrup or honey, and given in the morning.  The
child fhould  keep the houfe  all  day,  and take nothing cold.
This dofe may be repeated  twice a-weak for three or four
weeks.  On the intermediate days the child may  take a fcru-
ple  of powdered tin  and ten grains of aethiops mineral in a
fpoonful of treacle twice a-day.  Thefe dofes muft be increaf-
ed  or diminifhed according to the age of the patient.
   Biflet fays, the great baftard black hellebore, or bears foot,
is  a moft powerful vermifuge  for the* long round  worms.
He orders the decoaion of about a dram of the green leaves,
or  about fifteen grains of the dried  leaves in  powder, for a
dofe to a child betwixt four and feven years  of  age.   This
dofe is to be repeated  two or  three times.  He adds, that the
green leaves made into a fyrup with coarfe fugar, is almoft
the only  medicine he has ufed  for  round worms for three
years  paft,    Before  preffing out the juice, he moiftens the
bruifed leaves with vinegar, which  corrects  the  medicine.
The dofe is a tea-fpoonful at bed-time, and one or two next
 morning.
   I have frequently known thofe big bellies,  which in chil-
dren are commonly reckoned a fign of worms, quite remov-
ed by giving them white foap in their pottage, or other food.
Tanfy, garlic, and rue, are all good againft worms, and may
 be ufed various  ways.  We  might here mention many other
 planfs, both for  external and internal ufe;  as the cabbage-
                                                tret-bark, 
OF     WORMS.             289
tree-bark, &c. but think the powder of  tin with asthfops mi-
neral, and the purges of rhubarb and calomel,  are more to
be depended on.
  Ball's  purging vermifuge powder is a very powerful medi-
cine.  It is  made  of equal  parts of  rhubarb, fcammony,
and calomel, with as much'double refined fugar as is equal to
the weight of all the other ingredients.   Thefe muft^ be well
mixed together* and reduced to a fine powder.   The dofe
for a child is from ten grains to twenty, once or twice a-week.
An adult may take a dram for a dofe.
  Parents who would  preferve  their   children from  worms
ought to allow them plenty of exercife in the open air ; to
take care that their food be wholefome and  fufficiently  folid ;
and, as far as poffible, to prevent their eating raw herbs, roots,
or green trafhy fruits.  It will not  be amifs to allow  a child
who is fubjea to worms^ a glafs of red  wine after meals; as
every thing  that braces and ftrengthens the ftomach  is good
both for preventing and expelling thefe vermin *.
              CHAP.    XXXVI.

        OF   THE   JAUNDI C E.

      THIS difeafe is firft obfervable imthe wbjiteof the eye,
       which  appears  yellow.   Afterwards the  whole fkin
puts on a yellow appearance.  The urine too  is of a faffron
hue, and  dies a white cloth  of  the fame colour.  There is
likewife a fpecies of this difeafe called the Black Jaundice.
  CAUSE S.-------»The immediate caufe qf the jaundice
is an obftruaion ofthe bile.   The remote or occafional caufes
are, the bites  of poifonous animals, as the viper, mad dog,
&c. the bilious or hyfteric colic; violent paffions, as grief,
anger, &c.   Strong purges or vomits will likewife occafion
                         LI                          the


  * We think it neceffary here to warn people of their  danger
who buy cakes, powders, and  other worm medicines, at random
from quacks, and give them to  their children without proper care.
The principal ingredients in moft  of thefe medicines is mercury,
which is never to be trifled with.  I lately faw a mocking inftauce
of the danger of this conduct.  A girl who had taken a dofe of
worm powder, bought of a travelling quack, went out/ and per-
haps was fo imprudent  as to drink cold water, during its opera-
tion.  She immediately  fwelled, and died on  the  following day,
with all t^c fymptoms of having been poifoucd. 
OF    THE   JAUNDICE.
 the jaundice.  Sometimes it proceeds from obftinate agues,
 or from that difeafe being prematurely ftopped by aftringent
 medicines.   In infants it is often occafioned by the meconium
 not being fnfficiently purged off.  Pregnant women are very
 fubjea to it.  It is likewife a fymptom in feveral kinds of fe-
 ver.   Catching cold, or the  ftoppage of cuftomary evacua-
 tion, as the menfes, the bleeding piles, iffues,  he. will occa-
 fion the jaundice.
   SYMPTOM S.----—The patient at firft complains
 of exceffive wearinefs, and has great averfion to every kind of
 motion.  His fkin is dry, and he generally feels  a kind of
 itching or pricking pain over  the  whole  body.   The ftools
 are of a whitifh or clay colour, and the urine, as was obferv-
 ed above, is yellow.  The breathing is difficult, and the pa-
 tient complains of an unufoal  load or oppreffion on his breaft.
 There is a  heat in the noftrils, a bitter tafte in  the mouth,
 loathing of food,  ficknefs at  the  ftomach, vomiting,  flatu-
 lency,  and frequently all objeas appear to the eye of a yel-
 low colour.
   If the patient be young, and the difeafe complicated with
 no other malady, it is feldom  dangerous;  but in old people,
 where it continues long, returns frequently, or is complicated
 with the drcpfy or hypochondriac fymptoms,  it generally
 proves  fatal.   The black jaundice is more dangerous than
 the yellow.
   REGIMEN.-----The  diet fhould  be  cool,  light,
 and diluting, confifting chiefly of ripe fruits and mild veget-
 ables ;  as apples boiled or roafted,  ftewed prunes, preferved
 plums, boiled fpinage,  &c.   Veal or chicken  broth, with
 light bread, are likewife  very proper.  Many have been cur-
 ed by living almoft wholly for fome days on raw eggs.  The
 drink fhould be butter-milk, whey fweetened with honey, or
 decoaions of cool opening vegetables;  or  marfh-mallow
 roots, with liquorice, &c.
   The patient fhould  take as  much exercife as he can  bear,
 either on horfeback, or in a carriage; walking, running, and
 even jumping,  are likewife  proper, provided he can  bear
 them without pain, and there be no fymptoms of inflamma-
 tion.  Patients have been often cured  of this difeafe  by  a
 long journey, after medicines  had proved ineffeaual.
   Amufements are likewife  of great ufe  in the jaundice.
 The difeafe is often occafioned by a  fedentary life, joined to
a .dull melancholy  difpofition.   Whatever therefore tends to
                                                 promote 
       OF   THE   JAUNDICE.      iqt

promote the circulation, and to cheer the fpirits, muft  have
a good effea; as dancing, laughing, finging, &c.
  M E D 1 C I N E.—■----If the patient be young* of a full
fanguine  habit, and complains of pain in the right fide about
the region of the liver, bleeding Will be neceffary.  After this
a vomit muft be adminiftered, and if the difeafe proves obfti-
nate,  it may be repeated once or twice.  No medicines are
more beneficial in the jaundice than vomits,  efpecially where
it is not attended with inflammation.  Half a dram  of ipeca-
cuanha in powder will be a  fufficient dofe for an adult.  It
may be wrought  off with weak camomile-tea, or lukewarm
water.  The'body muft likewife be kept open by  taking  a
fufficient quantity of  Caftile  foap, or  the pills for the jaun-
dice recommended in the Appendix.
   Fomenting the parts about the  region  of the ftomach and
liver, and rubbing them  with  a  warm hand or  flefh-brufh*
are likewife beneficial; but it is ftill  more fo for the patient
to fit in  a veffel of warm  water up to the breaft.   He ought
to do this frequently, and fhould continue in it as long as his
ftrength will permit.
   Many dirty things are recommended for  the  cure of the
jaundice; as lice, millepedes, &c.   But thefe do more  harm
than good, as people truft to them, and negfea more valua-
ble medicines; befides, they are feldom taken in fufficient
quantity to produce any effeas.  People always expea that
fuch  things  fhould aa as charms, and confequently feldom
perfift in the ufe of  them.  Vomits, purges,  fomentations,
and exercife will feldom fail  to cure the jaundice when it  is
a fimple difeafe; and when  complicated with the  dropfy, a
a fcirrhus liver,  or other chronic complaints, it is hardly to
be cured by any means.
   Numberlefs Britifh herbs are  extolled for the cure of this
difeafe.  The author of the Medicina  Britannica  mentions.
near a hundred, all  famous for curing  the  jaundice.  The
faa is, the difeafe often goes off of its own accord ; in which
cafe the  laft medicine is always faid to  have "performed the
cure.  I have fometimes however feen  confiderable  benefit,
in a very obftinate jaundice, from a decoaion of hemp-feed.
Four ounces of the feed may be boiled in two Englifh quarts
of ale, and fweetened with coaife fugar.   The dofe is half
an Enwlifh pint every morning.   It  may  he continued  for
eight or  nine days.
   I  have likewife known Harrowgate  fulpher-water cure a,
jaundice of very long Handing.   It fhould be ufed for fome
weeks, and the patient muft both drink and bathe.
                                                    The 
292       OF   THE   JAUNDICE.

  The foluble tartar is a very proper medicine in the jaun-
dice.  A dram  of  it may be taken every  night and morning
in a cup of tea  or water-gruel.   If it does not open the bo-
dy, the dofe may be increafed.    A  very obftinate jaundice
has been cured by fwallowing raw eggs.
  Perfons fubjea to the jaundice ought to take as much ex-
ercife as poffible, and to avoid all heating and aftringent ali-
ments.
              CHAP.    XXXVII.

        OF    THE    DROPSY.

       TH E dropfy is a preternatural fwelling of the whole bo-
       dy, or fome part  of it,  occafioned by a colfeaion of
 watery humour.   It is diftinguifhed by different names, ac-
 cording to the part affeaed, as the anafarca,cr a colfeaion of
 water under  the fkin ; the a/cites,  or a colfeaion of water in
 the belly ; the hydrops peel or is, or  dropfy of the breaft; the
 hydrocephalus, or dropfy of the brain, he.
   CAUSE S.-------The dropfy is often owing to an he*
 reditary difpofition.  It  may likewife proceed from drinking
 ardent fpirits, or other ftrong liquors.  It is true almoft to a
 proverb, that great drinkers die of a dropfy. The want of ex-
 ercife is alfo  a very common caufe of  the dropfy.  Hence it
 is juftly reckoned among the difeafes of the fedentary.  It of-
 ten proceeds  from exceffive evacuations, as frequent and copi-
 ous bleedings, ftrong purges  often repeated, frequent faliva-
 tions, &c. The fudden ftoppage of cuftomary or neceffary
 evacuatfons,  as the  menfes, the haemorrhoids,fluxes ofthe bel-
 ly, &c. may  likewife caufe a dropfy.
   I have known  the dropfy occafioned by drinking large
 quantities of cold,  weak, watery liquor,  when the body was
 heated by violent exercife.   A low, damp, or marfhy fitua-
 tion  is likewife a frequent caufe of it.  Hence it  is a com-
 mon difeafe in moift,   flat, fenny countries.  It may alfo be
 brought on by a long ufe of poor watery diet, or of  vifcous
 aliment that is hard of digeftion.   It  is  often the effe&. of
Other difeafes, as the jaundice, a fcirrhus of the liver, a vio-
lent ague of long continuance, a  diarrhcea, a dyfentery, an
empyema, or  a confumption of the lungs.  In fhort, what-
ever obftruas the  perfpiration, or  prevents the blood from
being duly prepared, may occafion a dropfy.
                                    SYMPTOMS. 
         OF   THE   D  R OP S Y.         293

  SYMPTOMS.------The anafarca generally begins
with a fwelling of  the feet and ancles towards night, which,
for fome time, difappears in the morning.  In the evening the
parts, if preffed with the finger,  will pit.  The fwelling gra-
dually afcends, and occupies the trunk of the body, the arms.
and the head.   Afterwards the breathing becomes difficult,
the urine is in fmall quantity, and the  thirft great;  the bel-
ly is bound, and the perfpiration is greatly obftruaed.   To
thefe fucceed torpor, heavinefs, a flow wafting fever,  and a
troublefome cough.  This laft is generally a fatal fymptom,
as it fhews that  the lungs are affeaed.
  In  an afcites,  befides  the above fymptoms,  there is a fwel-
ling of the belly, and often a fluauation,  which may be per-
ceived by ftriking the belly on one fide, and laying the palm
ofthe hand on the oppofite.  This may be diftinguifhed from
a tympany by  the weight of the fwelling, as well as by the
fluauation.  When the anafarca and  afcites are  combined,
the cafe is very dangerous.   Even a fimple afcites  feldom ad-
mits of a cure.   Almoft all  that can be done, is to let off the
water by tapping, which feldom affords more than a tempo-
rary relief.
   When the difeafe comes fuddenly on, and the patient is
young and ftrong, there is reafon however to hope for a cure,
efpecially if medicine be given  early.   But if the patient be
old, has led an irregular or a fedentary life, or if there be rea-
fon to fufpea that the liver, lungs,  or  any  of the vifcera are
upfound, there is  great ground to fear that the confequences
will prove fatal.
   REGIME  N.------Tbe patient muft abftain,   as
 much as poffible, from all drink,  efpecially weak and watery
liquors, and muft  quench his thirft with muftard-whey,  or
acids, as juice of lemons, oranges, forrel, or fuch like.  His
 aliment ought to be dry, of a heating and diuretic  quality,  as
toafted bread, the  flefh of birds, or  other wild animals roaft-
ed ;  pungent and aromatic vegetables,  as  garlic,  muftard,
onions, creffes, horfe-radifh,  rocambole,  fhalot,  &c.   He
may  alfo eat fea-bifcuit dipt in  wine or a little brandy. This
is not only nourifhing, but  tends  to  quench thirft.  Some
have been aaually cured of a  dropfy  by a total abftinence
 from all liquids,  and living entirely upon fuch things as are
 mentioned above.  If the patient muft have drink, the Spaw-
water,  or Rhenifh wine, with diuretic medicines infufed in it,
 are the beft.
   Exercife is of the greateft importance in  a dropfy.  If the
 patient be able to walk, dig, or the like, he ought to conti-
                                                      nue 
 294         OF   THE   DROPSY.

 nue thefe exerfcifes as long as he can.  If he be not able to
 walk or labour, he muft ride on horfeback, or  in a carriage,
 and the more violent the motion fo much the better, provid-
 ed he can bear it.   His bed ought to be hard, and the air of
 his apartments warm and dry.  If he lives in  a damp coun-
 try, he ought to be removed into a dry one, and,  if poffible,
 into a  warmer climate.  In a word, every  method fhould  be
 taken  to promote  the perfpiration, and to brace the  folids. For
 this purpofe it will likewife be proper to rub the patient's bo-
 dy, two or three times a-day,  with a hard cloth or the ffefh-
 brufh  ; and he ought conftantly to wear flannel next his fkin.
   M E D 1 C I N E.----->-If the patient be young, his con-
 ftitution good, and the difeafe has come on fuddenly,  it may
 generally be  removed by  ftrong  vomits,  brifk purges, and
 fuch medicines as promote a  difcharge  by fweat  and urine.
 For an adult half a dram of ipecacuanha in powder, and half
 an ounce of oxymel of fquills, will be a proper vomit.  This
 may be repeated as often as is found neceffary,  three or four
 days intervening  between the dofes.  The patient muft not
 drink much after  the vomit, otherwife he deftroys its effea.
 A cup or two of camomile tea will be fufficient to work it off.
   Betwixt each vomit, on one ofthe intermediate  days, the
 patient may take the following purge: Jalap in  powder half
 a dram, cream of tartar two drams, calomel fix grains. Thefe
 may be made into a bolus with a little fyrup of pale rofes, and
 taken early in the morning.  The lefs the patient  drinks af-
 ter it the  better.  If he be much griped, he may take now
 and then a cup of chicken-broth.
   The patient may likewife take every night at bed-time the
 following bolus :  To four or five grains of camphor, add one
 grain of opium, and as much fyrup of orange-peel as is fuffici-
 ent to  make them into a bolus. This will generally promote
 a gentle fweat, which fhould be encouraged by drinking now
 and then a cup of wine-whey,  with a tea-fpoonful of the
 fpirits of hartfhorn in it.  A tea-cupful  of the following di-
 uretic infufion may likewife be taken every four or  five hours
 through the day.
   Take juniper-berries, muftard-feed,  and horfe-radifh, of
 each half an  ounce,  afhes  of broom half a pound ; infufe
 them in a quart of Rhenifh wine or ftrong ale for a few days,
 and afterwards ftrain offthe liquor. Such as cannot take this
 infufion, may ufe the decoaion of feneka-root, which is both
 diuretic and fudorific.  I  have known an obftinate anafarca
cured by an infufion of the afhes of broom in wine.
                                                   The 
OF   THE   DROPSY.
m
   The above courfe will often  cure an incidental dropfy,  if
 the conftitution be good; but when the difeafe proceeds from
 a bad habit, or  an unfound ftate of the vifcera,  ftrong purges
 and vomits  are not to be ventured upon.  In this cafe, the
 fafer courfe is to palliate the fymptoms by the ufe of fuch me-
 dicines as promote the fecretions, and to fupport the patient's
 ftrength by  warm and nourifhing cordials.
   The fecretion of urine may be greatly promoted  by nitre.
 Brookes fays, he knew a young  woman who was cured of a
 dropfy by taking a dram of nitre every morning in a draught
 of ale, after fhe had been given over as incurable. The  pow*
 der of fquills is likewife a good diuretic.   Six or eight grains,
 of it, with a fcruple of nitre, may be given twice a-day in a
 glafs of ftrong  cinnamon-water.   Ball fays, a large fpoonful
 orunhruifed muftard-feed  taken every  night  and  morning,
 and drinking half an Englifh pint ofthe decoaion of the
 tops of green broom after it, has  performed a cure, after other
 powerful medicines had proved ineffeaual.
   I have fometimes feen good effeas from cream of tartar  in
 this difeafe.   It promotes the difcharges by ftool and urine,
 and will often  perform a cure when duly perfifted in.   The
 patient may begin by  taking an  ounce every fecond or third
 day, and may increafe the quantity to two or even to  three
 ounces, if  the ftomach will bear  it.  This quantity is not,
 however, to be  taken a; once, but  divided into three or four
 dofes.
   To promote  perfpiration,  the patient may ufe the decoai-
 on  of feneka root,  as direaed  above ; or he may take two
 table-fpoonfuls  of Mindererus's fpirit in a cup  of wine-whey,
 three or four times a-day.   To promote a difcharge of urine,
 the following infufion of the London hofpitals will likewife be
 beneficial.
  Take of zedoary root, two drams ; dried fquills,  rhubarb,
 and juniper-berries bruifed,  of each  a dram;  cinnamon  in
 j-owder, three  drams;  fait  of  worm-wood, a dram and a
 I alf:  iufufe in  an Englifh pint and a half of old hock wine,
 indwhen fit for  ufe,  filter the  liquor.   A wine-glafs of it
 r. ay be taken three or four times  a-day.
  In the anafarca it is ufual  to fcai ify the feet and legs.   By
 this means the  water is often difcharged; but the operator
 r. ift be cautious nott^ make the  incifions too deep;  they
 c.^ht barely to  penetrate through the fkin, and  efpecial care
r, uft be taken,  by fpirituous fomentations and proper digef-
 t.  s, to prevent a gangrene. 
296        OF   THE   DROPSY.

  In an afcites, when the difeafe does not evidently and fpeedi-
ly give way to purgative and  diuretic medicines, the water
ought to be let off by tapping.  This is a very fimple and fafe
operation, and would often fucceed, if it were performed in
due time; but if it be delayed till the humours are  vitiated,
or the bowels fpoiled,  by long foaking in water, it can hard-
ly be expeaed that any permaneht relief will be procured.
  After the evacuation of the water, the patient is to be put
on a courfe of ftrengthening medicines; as the Peruvian bark;
the elixir of vitriol; warm aromatics, with a due proportion
of rhubarb, infufed in wine,  and fuch like.   His diet ought   I
to be dry and nourifhing, fuch as is recommended in the be-   j
ginning of the chapter; and he fhould  take as much exercife   I
as he can bear without fatigue.  He fhould wear flannel next
his fkin, and make daily ufe of the flelh-brufh.


                CHAP.  XXXVIII.

        OF      THE    GOUT.

      THERE  is no difeafe which fhews  the imperfection
       of medicine, or fets the advantages of temperance and
exercife in a ftronger light,  than the gout.   Excefs and  idle-
nefs are the true fources from whence it originally fprung, and
all who would avoid it muft be atlive and temperate.
  Though idlenefs and intemperance are the principle caufes
ofthe gout, yet many other things may contribute to bring on
the diforder in thofe who are not, and  to induce a paroxyfm
in thofe who are fubjea to it, as intenfe ftudy j too free an
ufe of acid  liquors ; night-watching ;  grief or uneafinefs of
mind ; an obftruaion or defea of any of the cuftomary dif-
charges, as the menfes, fweatingof the  feet, perfpiration, &c.
   SYMPTOM  S.------A  fit of the gout is generally
preceded  by indigeftion,,  drowfinefs,  belching  of wind,  a
flight head-ach, ficknefs, and fometimes vomiting.  The pa-
tient complains of wearinefs and dejeaion  of fpirits, and has
often a pain in the limbs, with a fenfation as if wind or cold
water  were paffing down the thigh.  The appetite is often
remarkably  keen  a day or two before the  fit,  and there is a
flight pain  in  paffing urine,  and fometimes an involuntary
fhedding of tears.
   Sometimes thefe fymptoms are much  more violent, efpeci-
ally upon  the near approach of the fit; and fome obferve,
                                                    that 
OF    THEGOUT.
that as the fever which ufhers in the gout, fo will the fit be;
if the fever be fhort and fharp,  the fit  will  be fo likewife ;
if it be feeble, long, and lingering, the fit will be fuch alfo.
But this obfervation can only hold with refpea to very regu-
lar fits of the gout.
   The regular gout generally makes its attack in the fpring,
or  beginning  of winter, in the following manner: About
two or three in the morning, the patient is feized with a pain
in his great toe,  fometimes in the heel,  and at other times in
the ancle or calf of the leg.  This pain is accompanied with
a fenfation, as if cold water were poured upon the part,wlrich
is fucceeded by a fhivering, with fome degree of fever.   Af-
terwards the pain increafes, and fixing among tbe fmall bones
of the foot, the patient feels all  the different kinds of torture,
as if the part were ftretched, burnt, fqueezed, gnawed, or torn
in pieces, he.   The part at length becomes fo  exquifitely
fenfible,  that the patient cannot bear to have it touched, or
even fuffer any perfon to walk acrofs the room.
   The patient is generally  in  exquifite  torture for twentyr
four hours, from the time of the coming on of the fit: He
then becomes eafier, the part begins  to  fwell, appears  red,
and is covered with a little  moifture.  Towards morning he
drops afleep, and generally falls  into a gentle breathing fweat.
This terminates the firft paroxyfm, a number of which con-
ftitutes a fit of the gout; which is longer or lhorter according
to the patient's age, ftrength, the feafon of the year,  and the
difpofition of  the body to this difeafe.
   The patient is always worfe towards night, and eafier in the
morning.   The paroxyfms however generally grow milder
every day, till at length the difeafe is carried off by perfpira-
tion, urine, and the other evacuations.   In fome patients this
happens  in a few days; in others,  it requires weeks, and  in
fome, months,  to finifh the fit.   Thofe  whom age and  fre-
quent fits of  the gout have greatly debilitated, feldom get free
of it before the approach of  fummer, and fometimes  not till
it be pretty far advanced.
   REGIMEN.-----*As there  are  no  medicines,  yet
known that will cure the gout,  we fhall  confine our obferva-
tions chiefly to regimen, both in and out of the fit.
   In the fit,  if the patient  be young and ftrong,  his diet
ought to be thin and cooling, and  his drink of a diluting na-
ture;  but where the conftitution is weak, and the patient has
been accuftomed to live high, this is  not a proper  time to re-
trench.   In this cafe he muft keep nearly to his ufual diet,
                            M m                    and 
 298         OF    THE   GOUT.

 and fhould  take frequently a cup of ftrong negus,  or a glafs
 of generous wine.   Wine-whey is a very proper drink in this
 cafe, as it  promotes the perfpiration without greatly heating
 the patient.   It will anfwer this purpofe better if a tea-fpoon-
 ful of fal volatile oleofum,  or fpirits of  hartfhorn, be put  into
 a cup of it twice a-day.  It will likewife be  proper to give at
 bed-time a tea-fpoonful of the  volatile  tinaure of guaiacum
 in a large  draught of warm wine-whey.   This will greatly
 promote perfpiration through the night.
   As the moft fafe and efficacious method of difcharging the
 gouty matter is by perfpiration, this ought to be kept up by
 all means,  efpecially  in  the affeaed part.   For this purpofe
 the leg and foot fhould be wrapt in foft flannel,  fur, or wool.
 The laft is moft readily obtained, and feems to anfwer the
• purpofe better than any  thing elfe.   The people of Lanca-
 shire look upon wool as a kind of fpecific in  the gout.  They
 wrap a great quantity of it about the leg and foot affeaed, and
 cover it with a fkin of foft dreffed leather.  This they fuffer
 to continue for eight or ten days,  and fometimes for a fort-
 night or three weeks, or  longer if the  pain does  not oeafe.  I
 never knew  any external application anfwer fo well in  the
 gout.  I have often feen it applied when the  fwelling and in-
 flammation  were very great, with  violent pain,  and  have
 found all thefe fymptoms relieved by it in a few days.  The
 wool which they ufe is generally greafed, and  carded or comb-
 ed.   They chufe the fofteft which can be had, and feldom or
 never remove it till the fit be entirely gone off.
   The patient ought likewife to be kept quiet and  eafy du-
 ring the fit.   Every thing that affeas  the mind difturbs the
 paroxyfm, and tends to  throw the  gout upon the nobler
 parts.  All external applications that  repel the  matter are to
 be avoided as  death.   They do not cure the difeafe, but re-
 move it from a fafer to a more dangerous part of the body,
 where it often proves fatal.  A fit of the gout is to be con-
 fidered as Nature's method of removing fomething that might
 prove deftruaive to the body, and all that we can  do, with
fafety, is to promote her intentions, and to affift her in ex-
pelling the enemy in her own  way.  Evacuations by bleed-
ing, ftool, &c. are likewife to be ufed with caution ; they do
not remove the caufe of the difeafe, and fometimes by weak-
ening the patient prolong  the fit: But, where the conftituti-
on is able to bear it, it will be of ufe to keep  the body gently
open by diet,  or very mild laxative medicines.
   Many things will indeed fhorten a fit  of the gout, and
                                                    fome 
OF    THE    GOUT.
fome will drive  it off altogether ;  but nothing  has  yet  been
found which will do this with fafety  to the patient.   In pain
we eagerly grafp at any thing that promifes immediate eafe,
and even hazard life itfelf for a temporary relief.  This is the
true reafon why fo many infallibleremedies have been propof-
ed for the gout, and why fuch numbers have loft their  lives
by the ufe of them.  It would be as prudent to flop the fmall-
pox from rifing, and to drive them into the blood,  as to at-
tempt to repel the gouty matter after  it has been thrown upon
the extremities.  The latter is as  much an effort of Nature
to free  herfelf from an offending  caufe as the former, and
ought equally to be  promoted.
  When the pain however is very great,  and the patient is
reftlefs, thirty or forty drops of laudanum,  more or lefs, ac-
cording to the violence of the fymptoms,  may be  taken at
bed-time.  This  will eafe the pain, procure reft,  promote
perfpiration, and forward the crifis ofthe difeafe.
  After the fit is over, the patient  ought to take a gentle dofe
or two of the bitter  tinaure of rhubarb, o» fome other warm
ftomachic purge.  He fhould alfo drink a weak  infufion of
ftomachic bitters in  fmall wine or  ale,  as the Peruvian bark,
with cinnamon, Virginian fnake-root, and orange-peel.  The
diet at this time fhould be light,  but nourifhing, and gentle
exercife ought to be taken on horfeback or in a carriage.
  Out of the fit, it is in the patient's power to  do  many
things towards preventing a return of the diforder, or render-
ing the fit, if it fhould return, lefs fevere.   This however is
not to be attempted  by medicine.  I have frequently known
the gout kept off  for  feveral years by the Peruvian  bark and
other aftringent medicines ; but in  all the cafes where! had
occafion to fee this  tried, the perfons died fuddenly, and,  to
all appearance,  for want of a regular fit  of the gout.   One
would be apt, from hence, to conclude,  that a fit of the gout,
to fome conftitutions, in the decline  of life, is rather falutary
than hurtful.
  Though it may be  dangerous to flop a  fit of the gout by
medicine, yet if  the  conftitution can  be fo changed by diet
and  exercife,  as to leffen or totally  prevent its return,  there
certainly can be no danger in following fuch a courfe.  It is
well known that the whole habit may be fo altered  by a pro-
per regimen, as quite  to eradicate  this difeafe;  and  thofe on-
ly who  have fufficient  refolution to  perfift in  fuch a ceurfe,
have  reafon  to expea a cure.
  The courfe which we would recommend for preventing the
gout, is as follows: In the firft place, univerfal temperance. In
                                                     the 
 3'oo        O  F   T  H  £    G  O  U  t.

 the next place, fufficient exercife.  By this we do  not  mean
 fauntering about  in an indolent manner, but labour, fweat,
 and toil.  Thefe only can render the  humours wholefome,  j
 and keep them fo.  Going early to bed, and rifing by time3,
 are alfo of great importance.   It  is likewife proper to avoid
 night ftudies,  and all intenfe  thought.  The fupper fhculd
 be light, arid taken early.   All ftrong liquors, efpecially ge-
 nerous wines and four punch, are to be avoided.
   We would likewife recommend fome dofes of magnefiaalba
 and rhubarb to be taken every fpring and  autumn ; and af-
 terwards a courfe of ftomachic bitters, as tanfey or  water-tre-
 foil tea,  an infufion of gentian and camomile  flowers, or a
 decoaion of burdock root, &c.  Any of thefe, or an infufion  !
 of any wholefome bitter that is more agreeable to the patient,
 may be drank for two or three  weeks in March and Oaober  *
 twice a-day.  An iffue  or  perpetual blifter has  a  great ten-
 dency to prevent the gout. If thefe were more generally ufed
 in the decline of life,  they would not only often prevent the
 gouti but alfo othe* chronic maladies. Such as can afford to go
 to Bath, will find great  benefit from bathing and  drinking the
 Water.  It both promotes digeftion and invigorates  the habit.
   Though there is little room for medicine during a regular
 fit of the gout, yet when it leaves the extremities, and falls
 on fome of the internal parts,  proper applications, to recal
 and fix it, become abfolutely neceiTary*   When the gout af-
 feas the head, the pain of the joints ceafes, and the fwelling
 disappears, while either fevere head-ach* drowfinefs,  trem-
 bling* giddinefs, convulfions, or delirium come on.  When
 it feizes the lungs* great oppreffion, with tough and difficulty
 of breathing, enfue.   If it attacks the ftomach, extreme fick-
 nefs, vomiting, anxiety, pain in the epigaftric region, and to-
 tal lofs of ftrength, will fucceed.
  When the gout attacks  the head or lungs,  every method
 muft be taken to fix it in the feet.  They muft be  frequent-
 ly bathed in warm water, and acrid cataplafms applied to the
 foles.   Bliftering-plafters ought likewife to be applied to the
 ancles or calves of the legs.   Bleeding in the feet or ancles is
 alfo neceflary,  and warm  ftomachic purges.   The patient
ought to keep in  bed  for the moft part, if there be any figns
of inflammation, and fhould be very careful not to catch cold.
  If it attacks the ftomach with a fenfe of cold,the moft warm
cordials are neceffary ; as  ftrong wine boiled up with cinna-
mon or other forces; cinnamon-water; peppermint-water  ;
and even brandy or rum.  The patient fhould  keep his bed, 
OF   THE    GOUT.
and endeavour to promote a fweat by drinking warm liquors;
and if he fhould be troubled with a naufea, or inclination to
vomit, he may drink camomile-tea, or any thing that  will
make him vomit  freely.
   When the gout attacks the  kidneys, and imitates gravel-
pains, the patient ought to drink freely of a  decoaion  of
marfh-mallows,  and to have the parts fomented with warm
water.  An emollient clyfter ought likewife to be given, and
afterwards an opiate.  If the pain be very violent, twenty or
thirty drops of laudanum may betaken in a cup of the decoc-
tion.
   Perfons who have had the gout fhould be very attentive to
any complaints that may happen to them about  the time when
they have reafon to ex pea a return of the  fit.  The gout
imitates  many other  diforders,  and by being miftaken for
them, and treated improperly, is often diverted  from  its regu-
lar courfe, to the great danger of the patient's life.
   Thofe who never had the gout, but  who, from their con-
ftitution or manner of living, have reafon to expea it,  ought
likewife  to  be very circumfpea  with  regard  to its firft ap-
proach.  If the difeafe,  by wrong condua or  improper me-
dicines, be diverted from  its proper courfe, the miferable pa-
tient has a chance to be ever after tormented with head-achs,
coughs, pains ofthe head and inteftines; and to fall, at laft,
a viaim  to its attack upon fome of the more noble parts.

    OF    THE   RHEUMATISM.

   This difeafe has often  a refemblance to the  gout.   It ge-
nerally attacks the joints with exquifite pain,  and  is fome-
times attended  with inflammation and  fwelling.  It is moft:
common in  the  fpring, and  towards  the end of  autumn.
It is  ufually diftinguifhed into acute  and chronic  ; or the
rheumatifm with and without a fever.
   CAUSE S.———-The caufes of a rheumatifm  are  fre-
quently the  fame as thofe of an inflammatory fever ; viz. an
obftruaed perfpiration, the immoderate ufe of ftrong liquors,
and the like.  Sudden changes of the weather, and all quick
tranfitions  from  heat to cold, are very apt to occafion the
rheumatifm.  The moft  extraordinary cafe of a rheumatifm
that I ever faw, where almoft every joint ofthe body was dif-
torted, was in a man who ufed  to work one part of the day
by the fire,  and the other part  of it in  the water.  Very ob-
ftinate rheumatifrns  have  likewife been brought on by per-
                                                    fons 
3oa
OF  THE  RHEUMATISM.
fons not accuftomed to it, allowing their feet to continue lotig
wet.  The fame effeas are often produced by wet clothes,
damp beds, fitting or lying on the damp ground, travelling in
the night, &c.
  The rheumatifm  may likewife be occafioned by exceffive
evacuations, or the ftoppage of cuftomary difcharges.  It is
often the effea of chronic difeafes,  which vitiate the hu-
mours ; as  the fcurvy, the lues venerea,  obftinate autumnal
agues, &c.
.  The rheumatifm prevails in  cold, damp, marfhy countries.
It is moft common amongft the poorer fort of peafants, who
are ill clothed, live in low,  damp houfes,  and eat coarfe un-
wholefome food, which contains but little nourifhment,  and is
not eafily digefted.
   SYM P T O M S.------The acute rheumatifm common-
ly  begins with wearinefs,  fhivering,  a quick pulfe, reftleff-
nefs, thirft, and other fymptoms  of fever.  Afterwards the
patient complains of flying  pains, which  are increafed by  the
leaft motion.  Thefe at length fix in the  joints,  which  are
often affeaed  with fwelling and inflammation.  If blood be
let in this difeafe, it  has generally  the fame appearance as in
the pleurify.
   In this kind of rheumatifm,  the treatment of the patient is
nearly the  fame as in an acute or inflammatory fever.  If he
be  young and ftrong, bleeding is neceffary, which may be re-
peated according to the  exigencies  of the cafe.  The body
ought likewife to be kept open by emollient clyfters, or cool
opening liquors ; as decoaions  of tamarinds,  cream of  tar-
tar whey, fenna tea, and the like.  The diet fhould be light,
and in fmall quantity, confifting  chiefly  of roafted apples,'
groat gruel, or weak chicken broth.  After the feverifh fymp-
toms have  abated, if the pain ftill continues, the  patient muft
keep his bed,  and take fuch things as promote perfpiration ;
as wine-whey, with fpjfitus Mindereri, he. He may likewife
take, for a few nights, at bed-time, in a cup of wine-whey, a
dram ofthe cream of tartar, and half a dram of gum  guaia-
cum  in powder.
   Warm bathing, after proper evacuations, has often  an ex-
ceeding good effea.   The  patient  may either  be put into a
bath of warm water, or have cloths wrung out of it applied to
the parts affeaed.   Great care muft be  taken that he  do not
catch cold  after bathing.
   The chronic rheumatifm  is feldom attended with any confi-
derable degree of fever, and is  generally confined to fome par-
                                                   ticular 
OF  THE  RHEUMATISM.      303
ticular part of the body,  as the fhoulders, the back, or the
loins.  There is  feldom any inflammation or fwelling in this
cafe.  Perfons in the decline of  life are moft fubjea to the
chronic  rheumatifm.   In  fuch  patients  it often proves ex-
tremely obftinate, and fometimes  incurable.
  In  this  kind of rheumatifm  the regimen fhould be nearly
the fame as in the acute.  Cool and diluting diet,  confifting
chiefly of vegetable fubftances, as  ftewed prunes, coddled ap-
ples, currants or goofeberries boiled in milk, is moft proper.
Arbuthnot fays,  " If  there be a fpecific in aliment for the
rheumatifm, it  is certainly whey;" and adds, " That he
knew a perfon fubjea  to tftis  difeafe,  who could never be
cured by any other method but a diet  of whey and  bread."
He likewife fays, " That cream of tartar in water-gruel, ta-
ken for feveral days, will eafe rheumatic paitis confiderably."
This I have often experienced, but found it always more ef-
ficacious when joined with  gum guaiacum, as already direa-
ed.   In this cafe the patient may take the dofe formerly men-
tioned twice a-day, and likewife a tea-fpoonful of the volatile
tinaure of gum guaiacum, at bed-time, in wine-whey.
   This courfe may be  continued for a week, or longer, if the
cafe proves obftinate,   and the patient's ftrength will permit.
It ought then to be omitted for a few days and repeated agaim
At the faine time leeches  or  a bliftering-plafter may he ap-
plied to the part affeaed.   What I have generally found an-
fwer better than either of thefe,  in obftinate fixed rheumatic
pains, is the warm plafler *.  I have likewife known a plafter
of Burgundy pitch worn  for fome time on the part affeaed
give great relief  in rheumatic pains.   My  ingenious friend
Dr. Alexander of Edinburgh fays, he has frequently cured
very obftinate rheumatic pains by rubbing the part affeaed
with tinaure  of cantharides.   When the common tinaure
did not fucceed,  he ufed it  of a double or treble ftrength.
Cupping upon  the part affeaed is likewife often very benefi-
 cial, and is greatly preferable to the application of leeches.
    Though this difeafe may not feem to yield to medicines for
 fome time, yet they ought ftilf to be  perfifted in.   Perfon*
 who are fubjea to frequent returns of the rheumatifm, will
 often find their  account in ufing medicines, whether they be
 immediately affeaed  with the difeafe  or not.   The chronic
 rheumatifm is fimilar to the gout in this refpea, that the moft
 proper  time for ufing medicines  to extirpate it, is when the
 patient is  moft free from the  diforder.

           * Sec Appendix,  Warm plafter. 
304
OF  THE  RHEUMATISM.
   To thofe who can afford the expence, I would recommend
the warm baths of Buxton or Matlock in Derbyfbire. Theft
have often, to my knowledge,  cured very obftinate rheuma-
tifms, and are always fafe either  in  or out of the fit.   When
the rheumatifm is  complicated  with fcorbutic complaints,
which is not feldom the cafe, the Harrowgate waters and thofe
of Moffat are proper.   They^ fhould both be drank and  ufed
as a warm bath.
   There are feveral of our own domeftic plants which may be
ufed with  advantage in the rheumatifm. One of the beft is
the white muflard.  A table-fpoonful of the feed of this plant
may be taken twice Or thrice a-day,  in a glafs of water or fmall
wine.  The water-trefoil is likewife of great ufe in this com-
plaint.   It may be infufed in wine or ale, or drank  in form
of tea. The grotnd-ivy, camomile, and feveral other bitters,
are alfo beneficial, and may be ufed  in the fame manner.  No
benefit however is to be expeaed from thefe, unlefs  they be
ufed for a confiderable  time.   Excellent medicines are often
idefpifed in this difeafe,  becaufe they do not perform an im-
mediate cure ;  whereas  nothing would be more certain than
their effea, were they  ufed for a fufficient  length of time.
Want of perfeverance in the ufe of medicines is one reafon
why chronic difeafes are fo feldom cured.
   Cold bathing,  efpecially  in  fait water, often  cures the
rheumatifm.  We would alfo recommend riding on horfe-
back, and  wearing flannel next the  fkim  Iffues are likewife
very proper, efpecially in chronic cafes.   If the pain affedts
the fhoulders,  an iffue may be made in the arm ; but  if it af-
feas the loins,  it fhould be put in the leg or thigh.
   Perfons affliaed with the fcurvy are very fubjea to the rheu-
matic complaints.  The heft medicines in this cafe are  bit-
ters and mild purgatives.  Tbefe may either be taken fepa-
jately or together, as the patient inclines.  An ounce of Pe-
ruvian bark, and half an ounce  of  rhubarb in powder, may
he infufed in a bottle of wine ; and  one,  two, or three wine
glaffes of it taken daily, as fhall  be  found neceffary for keep-
ing the body gently open.  In cafes where the  bark itfejf
proves fufficiently purgative, the rhubarb may be omitted.
   Such as are fubjea to frequent attacks  of the rheumatifm
ought to make choice of a dry, warm fituation, to avoid the
night-air, wet  clothes,  and  wet feet, as  much as poffible.
Their clothing fhould he warm,  and they fhould  wear flan-
nel next their fkin,  and make frequent ufe of the flefh-brufh.
CHAP. 
[   3<>5    3
              C   H   A  'P.     XXXIX.

       OF   THE   SCURVY.

      THIS difeafe prevails chiefly in cold  northern  counc-
       tries, efpecially  in  low  damp fituations, near  large
marfhes, or great quantities of ftagnating water.    Sedenta-
ry people of a dull  melancholy difpofition are more fubjea to
it.  It proves often fatal to failors on long voyages, particu-
larly in fhips that are not proper  ventilated, have many peo-
ple on board, or where cleanlinefs is negfeaed.
   It is not neceflary to mention the different fpecies  into
which this  difeafe has been divided,  as  they differ from one
another chiefly  in degree.  What is called the land fcurvy,
however,  is feldom attended with thofe highly  putrid fymp-
toms which appear in patients who have been long at fea,
and which,  we prefume, are  rather owing  to  confined air,
want  of exercife, and the unwholefome food eat  by  failors
on long voyages, than  to any fpecific difference in the dif-
eafe.
   CAUSE S.------The fcurvy is occafioned by cold moift
air ; by the Tong ufe of falted or fmoke-dried provifions, or
any kind of food that is hard of  digeftion, and affords little
nourifhment.   It may  alfo  proceed  from the fuppreffion of
cuftomary evacuations;  as the menfes, the haemorrhoidal flux,
&c.   It is fometimes  owing to a hereditary taint, in which
cafe a very fmall caufe will excite the latent diforder.  Grief,
fear,  and other depreffing  paffions, have  a great tendency
both to excite and aggravate this difeafe.   The fame obferva-
tion holds with regard,to  negfea of cleanlinefs ;  bad cloth-
ing ;  the  want of proper  exercife;  confined  air;  unwhole-
fome  food ;  or  any difeafe  which greatly weakens the body or
vitiates the humours.
   SYMPTOM S.-----This  difeafe may be known
by an unufual wearinefs, heavinefs, and difficulty of breath-
ing, efpecially after motion ; rottennefs of the gums,  which
are apt to  bleed on the flighted touch ; a ftinking breath ;
frequent bleeding at the nofe; cracking of the joints; diffi-
culty of walking; fometimes a fwelling and fometimes a fall-
ing away of the  legs,  on which there  are livid,  yellow, or
violet-coloured fpots ;  the face  is generally of a pale or lead-
en colour.   As the difeafe  advances, other fymptoms come
on;  as rottennefs  cf the  teeth, haemorrhages, or difcharges
                         N n                         of 
306         OF   THE   SCURVY.

of blood from different parts of the body, foul obftinate ul-
cers, pains in various parts,  efpecially about the breaft, dry
fcaly eruptions all over the body, &c.   At laft a wafting or
heaic fever comes on, and the miferable patient is often car-
ried off by a  dyfentery, a  diarrhoea, a  dropfy, the palfy,
fainting fits,  or a mortification of fome of the bowels.
  CUR E.______We know no method of curing this dif-
eafe, but by purfuing a method direaiy oppofite to that which
brings it on.   It proceeds from a  vitiated ftate  of the hu-
mours, occafioned  by errors in  diet, air, or exercife;  and
this can be removed no other way than by a proper attention
to thefe important articles.
  If the patient has been obliged to breathe  a cold, damp,
©r confined air, he fhould be removed, as foon as poffible, to
a dry, open, and moderately warm One.   If there  is reafon
to believe that the  difeafe proceeds  from a fedentary life, or
depreffing  paffions, as grief, fear, &c. the patient muft take
daily as much exercife in the open air as he can bear, and his
mind  fhould  be diverted  by cheerful company and  other
'amufements.   Nothing has a greater tendency either to pre-
vent, or remove this difeafe, than conftant cheerfulnefs  and
good humour.   But this,  alas !  is feldom the lot of perfons
affliaed  with the fcurvy ; they are  generally furly, peevifh,
and morofe.
  When the fcurvy has  been brought on by a long ufe of
falted provifions,  the proper medicine  is a diet confifting
chiefly of frefh  vegetables;  as oranges,  -apples,  lemons,
limes,  tamarinds,  water-creffes, fcurvy-grafs,  brook-lime,
&c.  The ufe of thefe with milk, pot-herbs, new bread,
and frefh beer or cider,  will feldom fail to remove a fcurvy of
this kind, if taken before it be too far advanced; but to have
this effea, they muft be perfifted in for a confiderable time.
When frefh vegetables  cannot be obtained, pickled or pre-
ferved ones may be ufed ;  and where thefe are wanting, re-
courfe muft be had to the chymical  acids.   All the patient's
food and drink fhould in  this cafe be fharpened with cream
of tartar, elixir of vitriol, vinegar,  or the fpirit of fea-falt.
  Thefe things however  will more certainly prevent  than
cure the fcurvy ;  for which reafon fea faring people, efpeci-,
ally on long voyages, ought to lay in plenty of them.  Cab-
bages, onions, goofe-berries, and  many other  vegetables,
may be kept a Jong time by pickling, preferving, he. and when
thefe fail, the  chymical acids, recommended above, which
will keep for any length of time, may be ufed.   We  have
                                                   reafon 
          OF   THE   SCURVY.         307

 reafon to believe, if fhips were well  ventilated, had good
 ftore of fruits, greens, cider, &c. laid in, and  if proper re-
 gard were paid to cleanlinefs and warmth, that  failors would
 be the  moft healthy people in the world,  and would  feldom
 fuffer either from the fcurvy or putrid  fevers, which are fo fa-
 tal to that ufeful fet of men ; but it is too much the temper
 of fuch people to defpife all precaution ; they will not think
 of any calamity  till it overtakes them, when it  is too late  to
 ward off the blow.
   It muft indeed be owned, that many of them have  it not
 in their power to make the provifion we arefpeaking of; but
 in this cafe it is  the duty of their employers to make  it for
 them ; and no man ought to engage in a long voyage without
 having thefe articles fecured.
   I have often  feen very extraordinary effeas in the land-
 fcurvy from a milk diet.  This preparation of Nature is a
 mixture of animal and vegetable  properties,  which  of all
 others is the moft fit for reftoring a decayed conftitution, and
 removing that particular acrimony  of the humours,  which
 feems to conftitute the very eflence of the fcurvy, and many
 other difeafes.   But people defpife this wholefome and nou-
 rifhing food, becaufe it is cheap, and devour with greedinefs,
 flefh, and  fermented liquors,  while milk is only deemed fit
 for their hogs.
   The  moft proper drink in  the fcurvy is whey or butter-
 milk.   When thefe cannot be had, found cider  or perry may
 be ufed.   Wort  has likewife been found to be a  proper drink
 in the fcurvy, and may be ufed at fea,  as malt will  keep du-
 ring the longeft voyage.   A decoaion of  the tops of the
 fpruce fir is likewife proper.  It may be drank in the quanti-
 ty of an Englifh pint twice a-day.  Tar-water may  be ufed
 for the fame purpofe, or decoaions of any of the mild mu-
 cilaginous  vegetables;   as  farfaparilla, marfh-mallow-rcots,
 &c.  Infufions of the bitter plants, as ground-ivy, the leffer
 centaury, marfh trefoil, &c. are likewife beneficial.   I have
 feen the peafants in fome parts of Britain exprefs the juice of
 the laft-mentioned plant, and drink it with  good effea  in
 thofe foul fcorbutic eruptions  with which they are often trou-
bled in  the fpring feafon.
   Harrowgate water is certainly an excellent medicine in the
 land fcurvy. I have often feen patients who had been reduced
 to the moft deplorable condition by  this difeafe, greatly re-
 lieved by drinking the fulphur-water, and bathing in it.  The
chalybeate water  may alfo be ufed  with advantage, efpe- 
308         OF   THE   SCURVy.

cially with a view to brace tbe ftomach after drinking the fol-
pbur-water, which, though it fharpens  the  appetite,  never
fails to weaken the powers of digeftion.
   A flight degree of fcurvy may be carried off by frequently
fucking a little of the juice  of a bitter  orange, or  a lemon.
When the difeafe aifoas the gums only, this praaice, if con-
tinued fir fome t.me, will generally carry it  off.  We would
however recommtnd the bit'er oiange as greatly preferable to
lemon; it ferns to be as good a medicine, and is not near fo
hurtful  to the ftomach.   Perhaps our own forrel may be lit-
tle inferior to cither of them.
   All kinds of fallad are good in the fcurvy, and ought to be
eat very plentifully, as fpinage,  lettuce,  parfley, cellery, en-
dive, radifh, dandelion, &c.  It is amazing to fee how foon
frefh vegetables in  the fpring  cure the brute animals of any
fcab or  foulnefs which is  upon  their fkins.  It is reafonable
to fuppofe that their effeas would be as great  upon the hu-
man fpecies, were  they ufed in proper quantity  for a fufficient
length of time.
   1 have  fometimes feen good effeas in fcorbutic complaints
cf very long Handing,  from the ufe of a decoaion  of the
roots of water-dock.  It is ufually made by boiling a pound
of the frefh root in fix Englifh pints of water, till about one-
third of  the water be confumed.  The dofe  is from half a
pint to  a  whole pint of the decoaion every  day.  But in all
the cafes where 1 have feen it prove beneficial, it was made
much ftronger,  and drunk in larger quantities.  The fafeft
way, however, is,  for the patient to begin with fmall dofes,
and increafe  them  both  in ftrength  and quantity as he  finds
his ftomach will bear it.   It muft be ufed for  a confiderable
time.   I have known fome take  it  for  many  months, and
have been told of others who had  ufed it for feveral years, be-
fore they were fenfible of any benefit, but who, neverthelefs,
Were cured by it at length.
   The Leprofy, which was fo common in this country long
ago,  feems to have been near a-kin to the fcurvy.   Perhaps
its appearing fo feldom now, may be owing to the inhabitants
of Britain eating more vegetable food than formerly, living
more upon tea and other diluting diet, ufing lefs falted meaU
being more cleanly, better lodged and clothed,  &c.—For the
cure of this difeafe we would recommend the fame courfe of
diet and medicine as in the fcurvy,
OF 
L   3°9   1
    OF THE SCROPHULA, OR KING's EVIL.

  This difeafe chiefly affeas the glands,  efpecially thbfe of
the neck.  Children and young perfons of a fedentary life are
very fubjea to it.   It is one of thofe difeafes which may  be
removed by proper regimen, but feldom yields to medicine.
The inhabitants of cold,  damp, marfhy countries are moft:
liable to the fcrophula.
  CAUSE S.-------This difeafe may proceed from a here-
ditary taint, from a fcrophulous nurfe, &c.  Children who
have the misfortune to be born of fickly parents, whofe con-
ftitutions  have been  greatly injured by the pox, or other
chronic difeafes, are apt to be affeaed with the fcrophula. It
may likewife proceed from fuch difeafes as  weaken the habit
or vitiate the humours, as the fmall-pox,  meafles, &c. Ex-
ternal injuries, as blows,  bruifes, and the like, fometimes
produce fcrophulous ulcers ; but we have reafon to believe,
when this happens, that there has been a predifpofition in the
habit to this difeafe.  In  fhort,  whatever tends to vitiate the
humours, or relax the folids, paves the way to the fcrophula;
as the want of proper  exercife,  too much heat or cold, con-
fined air, unwholefome food, bad water, the long ufe of poor,
weak, watery aliments, the negfea of cleanlinefs, he.   No-
thing tends more  to induce this difeafe in children than al-
lowing them to continue long wet.
   SYMPTOM S.------At firft  fmall  knots appear
under the  chin or behind the ears,  which gradually increafe
in  number and fize,  till they form one large hard tumour.
This often continues for a long time without breaking, and
when it does break, it only difcharges a thin fanies or watery
humour.   Other parts of the body  are likewife liable to its
attack, as the arm-pits, groins, feet, hands, eyes, breafts, &c.
 Nor are the internal parts exempt, from it.  It often affeas
 the lungs,  liver,  or fpleen ;  and I have frequently  feen the
 glands of the myfentery greatly enlarged by it.
   Thefe obftinate ulcers which break out upon the feet and
 hands with fwelling, and little or no rednefs, are ofthe fcro-
 phulous kind.  They feldom difcharge good matter, and are
 exceeding difficult to cure.  The white fwellings of the joints
 feem  likewife to  be of  this kind.   They are  with difficulty
 brought to a fuppuration, and  when opened  they  only dif-
 charge a  thin ichor.   There  is not a more general fymptom
 of the fcrophula than a fwelling of  the upper lip and nofe.
    REGIME N.------As this difeafe proceeds, in a great
 meafure, from relaxation,  the diet ought to be generous and
                                              nourifhing, 
310        OF  THE  SCROPHULA,

nourifhing, but at the fame time light and eafy of digeftion ;
as well fermented bread,  made of found  grain,  the flefh and
broth of young animals,  and now and then a glafs of gene-
rous wine, or good ale.   The air ought to be  open, dry, and
not too cold, and  the- patient fhould take as  much exercift
as he can bear. This is of the utmoft importance.  Children
who have enough of  exercife are feldom troubled with the
fcrophula.
   M E D I C IN E.       The vulgar are remarkably cre-
dulous with regard to the cure  of the  fcrophula,  many of
them believing in the virtue of the royal touch,  that of the
feventh fon, &c.  The truth is,  we know but little either of
the nature or cure of this difeafe, and  where reafon or medi-
cines fail, fuperftition always comes in their place.  Hence it
is, that in difeafes which  are the  moft difficult to underftand,
we generally hear of the greateft number of miraculous cures
being performed.   Here,  however, the deception is eafily ac-
counted for.   The fcrophula,  at a certain period of life, of-
ten cures of itfelf ; and, if the patient happens to be touched
about this time, the cure  is imputed to the touch, and not to
Nature, who is really the phyfician.  In the fame way the
infignificant  noftrums of quacks and old women often gain
applaufe when they deferve none.
   There is nothing more pernicious, than the cuftom of ply-
ing children in the fcrophula with ftrong purgative medicines.
People  imagine it proceeds from humours which muft be
purged  off, without  confidering,  that  thefe purgatives in-
creafe the debility, and ag'grava.te the  difeafe.   It has indeed
been found, that  keeping the body  gently open, for fome
time, efpecially with fea-water, has  a good effea ; but this
-fhould only be given in grofs habits,  and in fuch quantity as
to procure one, or at moft two ftools every day.
   Bathing in the fait water has  likewife a very good effect,
efpecially in the warm feafon.   I have often known a courfe
of bathing in fait water, and drinking it in fuch quantities as
to keep the body gently open, cure a fcrophula, after many
other medicines had  been tried in vain.  When fait water
cannot be obtained, the patient may be bathed in frefh water,
and  his body kept open by fmall  quantities of fait and water,
or fome other mild purgative.
   Next to cold bathing and drinking the fait water,  we
would recommend the Peruvian  bark.   The  cold bath  may
be ufed in fummer, and the bark in winter.  To an adult half
a^dram ofthe bark in powder may be given, in a glafs of red
                                                   wine, 
OR  KING'S   EVIL.
3H
wine, four or five times a-day.   Children,  and fuch as can-
not take it in  fubftance,  may ufe the decoaion made in the
following  manner.
  Boil an ounce of Peruvian bark and a dram of Winter's
bark, both grofsly powdered, in an Englifh quart of water to
a pint; towards the end,  half  an ounce offliced liquorice-
root, and a handful of raifins may be added,  which will both
render the decoaion lefs  difagreeable,  and make it take up
more of the bark.   The  liquor muft be ftrained, and two,
thwe, or four table-fpoonfuls, according to the age ofthe pa-
tient, given three times a-day.
  The Moffat and Harrowgate waters, efpecially the latter,
are likewife very proper medicines in the fcrophula.  They
ought  not however to be drank in large quantities, but fhould
be taken  fo as  to keep the body gently open, and  muft be
ufed for a confiderable time.
   The hemlock  may  fometimes be ufed with advantage in
the fcrophula.  Some lay it down as a general rule,  that the
fea-water  is moft proper before  there  are any fuppuration or
fymptoms of tabes;  the Peruvian bark, when there  are  run-
ning fores, and a degree of heaic fever; and the hemlock  in
old inveterate cafes, approaching to the fcirrhus or cancerous
ftate.  Either the extract or the frefh juice of  this plant may
be ufed.  The dofe muft be fmall at firft, and increafed gra-
dually as  far as the ftomach is able to bear it.
   External applications are of little ufe.  Before the tumour
breaks, nothing ought to be applied to it,  unlefs a piece of
flannel, or fomething to keep it warm.  After it breaks, the
fore may  be dreffed with fome digeftive ointment.  What I
have always found to anfwer beft, was the yellow bafilicon
mixed with about a fixth or eighth part of  its weight of red
precipitate of  mercury.  The fore may be dreffed with this
twice  a-day; and if it be very  fungous, and does not digeft
well, a larger proportion  of the precipitate may be added.
   Medicines which mitigate this difeafe, though they do not
cure it, are not to  be defpifed.   If the patient can  be kept
alive by any means till he arrives at the age of puberty,  he
has a gre^tchance to get well; but if  he does not recover at
this time, in all probability he never will.
   There  is no malady which parents are fo apt to communi-
cate to their offspring as the fcrophula, for which reafon peo-
ple ought to beware of marrying into  families affeaed  with
this difeafe.
   For means of preventing the fcrophula, we fhall refer the
£eadatotheobfervationsonnurfing,atthebeginningofthebook. 
[   3^   }
        OF     THE     ITCH.

  Though this difeafe is commonly communicated by infec-
tion, yet it feldom prevails where due regard is paid to clean-
linefs,  frefh air, and wholefome diet.   It  generally appears
in form of fmall watery puftules, firft about the wrifts, or
between  the  fingers; afterwards it  affeas  the arms, legs,
thighs, &c.  Thre puftules are  attended with an  intollera-
ble itching, efpecially when  the patient is  warm a-bed, or
fits by the £ re.   Sometimes indeed the fkin is covered  with
large blotches or fcabs, and at other times with a white fcurf,
or fcaly eruption.   This laft is called the dry itch,  and is the
moft difficult to cure.
   The itch is feldom a dangerous difeafe, unlefs when it is
rendered fo by negfea or improper treatment.   If it be fuf-
fered to continue  too long, it may vitiate the whole mafs of
humours; and, if it be fuddenly drove in, without proper
evacuations,  it may occafion fevers, inflammations of the vif-
cera,  or other internal diforders.
   The beft medicine yet known for the itch is fulphur, which
ought  to be ufed both externally and internally.  The parts
moft affeaed  may  be rubbed with an ointment made of the
flowers of fulphur  two ounces; crude fal ammoniac  finely
powdered two drams; hog's lard, or butter, four ounces.
If a fcruple or half a dram of the effenceof  lemon be added,
it will  entirely take away the difagreeable  fmell.  About the
bulk of a nutmeg of this may be rubbed upon  the extremi-
ties, at bed-time, twice or thrice a-week.   It is feldom ne-
ceffary to rub the whole body ; but when  it is,  it ought not
to be done all at once, but by turns, as it is dangerous to flop
too many pores at the fame time.
   Before the patient begins to ufe  the ointment, he ought,
if he be of a full habit, to bleeed or take  a purge or two. It
will be likewife proper,  during  the ufe of it,  to take every
night and morning  as much of the flower  of brimftone and
cream  of tartar, in  a little treacle or new milk,  as  will keep
the body gently open.  He fhould  beware  of catching cold,
fhould wear more clothes  than ufual, and take every thing
warm.  The fame clothes, the linen excepted,  ought to  be
worn all  the time of ufing the ointment; and fuch clothes as
have been worn while the patient was under the difeafe, are
not to  be ufed again, unlefs they have been fumigated with
brimftone, and thoroughly cleaned, otherwife they will com-
municate the infeaion anew.
                                                 I never 
OF    THE   ITCH.
  I never knew brimftone, when ufed as direaed above, fail
to cure the itch ; and I have  reafon to believe,  that, if duly
perfifted in, it  never will fail; but if it only be ufed  once or
twice, and cleanlinefs negfeaed,  it is  nd wonder if the dif-
order returns.  The quantity of  ointment mentioned above
will generally be fufficient for the cute of one perfon ; but, if
any fymptoms of the difeafe  fhould appear again, the medi-
cine may be repeated.   It  is both more fafe and efficacious
when perfifted in for a Confiderable time, than  when a large
quantity is applied at Once.   As moft people diflike the fmell
of fulphur, they may  ufe, in its  place,  the powder of white
hellebore root, made up into  an ointment, in the fame man-
ner, which will not fail to cure the itch.
  People ought to be extremely cautious left they take other
eruptions for the itch ;  as the ftoppage of thefe may be at-
tended with  fatal confequences.  Many of the eruptive dif-
orders to which children are  liable, have a near refemblance
to this difeafe ; and I have often known  infants  killed by
being rubbed with greafy ointments th3t made thefe eruptions
ftrike fuddenly in, which Nature had thrown out to preferve
the patient's life, or prevent fome other malady.
  Much mifchief is likewife done by the ufe of mercury in
this difeafe.  Some perfons are  fo fool-hardy as to  wafh the
parts affeaed with a ftrong folution of the corrofive fublimate;
Others  ufe the mercurial ointment,  without taking the leaft
care either to avoid  cold, keep the body open,  or obferve
a proper regimen.   The confequences of  fuch condua may
be  eafily gueffed.   I  have known  even the mercurial girdles
produce tragical effeas, and  would advife every perfon, as he
values his health, to beware how  he ufes them.   Mercury
Ought never to be ufed as a medicine without the greateft care.
Ignorant people look upon thefe girdles as a kind of charm,
without confideiing that the mercury enters the body.
  It is not to  be told what mifchief is done by ufing mercu-
rial ointment for curing the  itch and killing vermin ;  yet  it
is unneceffary for either: The  former may  be always more
certainly cured by fulphur, and the latter will never be found
where due regard is paid to cleanlinefs.
  Thofe who would avoid this detectable difeafe ought to be-
ware of infeaed perfons, to  ufe wholefome food, and to ftudy
univerfal cleanlinefs *.
                        O  o                   CHAP.

  * The itch is now by cleanlinefs banifhed from every genteel
family  in Britaia.  It  ftill howercr {retails among the poorer fort
                                                       oi 
t   31+   ]
                 CHAP.     XL.

           OF   THE   ASTHMA.

      THE afthma is a difeafe of the lungs, which feldom ad-
       mits of a cure.  Perfons in  the decline of life are moft
 liable to it.   It is diftinguifhed into the moift and dry, or
 humoural and nervous.  The-former is attended with expec-
 toration or fpitting ; but  in the latter  the  patient feldom
 fpits,  unlefs fometimes a little  tough phlegm  by the mere
 force of coughing.
   C A U S E S.------The afthma is fometimes hereditary,
 It may likewife proceed  from a bad formation of the breaft •
 the  fumes  of  metals or minerals taken into the lungs ; vio-
 lent exercife, efpecially running ; the obftruaion of cuftom-
 ary  evacuations, as the menfes, haemorrhoids, &c. the fudden
 retroceffion of the gout,  or ftriking  in of eruptions,  as the
 fmall-pox, meafles, &c. violent paffions of the mind,  as fud-
 den fear, or  furprife.  In a word,  the difeafe may proceed
 from any caufe that either impedes  the  circulation of tile
 blood through the  lungs,  or prevents their  being duly.ex-
 panded by the air.
   SYMPTOM S-----. An afthma is known by. a quick
 laborious breathing, which is generally performed with a kind
 of wheezing noife.   Sometimes the difficulty of breathing is
 fo great, that  the patient  is obliged to keep in an erea pof-
 ture, otherwife he is in  danger of  being fuffocated.  A fit or
 paroxyfm of the afthma generally  happens after a perfon has
 been expofed  to cold ealterly winds, or  has  been abroad in
 thick foggy weather,  or has  got wet, or continued long in a
 damp place underground, &c.
  The paroxyfm is commonly ufhered  in with liftleffnefs,
 want of fleep, hoarfenefs, a cough, belching of wind, a fenfe
 of heavinefs about the breaft, and difficulty of breathing  To
 thefefuccetd heat, fever, pain of the head, ficknefs and naufea,
 great oppreffion  of the breaft, palpitation of the heart, a weak
                                                     and

 of peafants in Scotland, and among the manufacturers in England.
Thefe are not only fufficient to keep the feeds of the difeafe alive,
but to fpread the infection among others.  It were  to be wifhed'
that  fome effectual method  could be devifed  for extirpating it al-
together. Several country clergymen have told me, that by get-
ting  fuch as were infected  cured, and ftrongly recommending an
attention to cleanlinefs, they have baniihed the itch entirely out
of their parilhes.  Why might not others do the fame? 
OF   THE   ASTHMA.
3'S
and fometimes intermitting pulfe,  an involuntary flow of
tears, bilious vomitings, &c.  All the fymptoms grow worfe
towards night ;  the patient is eafier when up than  in bed,
and is very defirous of cool air.
  REGIME N.-----The food ought to be light, and of
eafy digeftion.   Boiled  meats are to  be  preferred to roafted,
and the flefh of  young  animals to that of old.   All windy
food, and whatever is apt to fwell in the ftomach, is to be a-
voided.  Light puddings, white broths, and  ripe fruits  bak-
ed,  boiled, or roafted, are  proper. Strong liquors of all kinds,
efpecially malt-liquor, is hurtful.  The patient fhould  eat a
very light fupper, or rather none at all, and fhould never fuf-
fer himfelf to be long coftive.  His clothing fhould be warm,
efpecially in the winter-feafon.  As all diforders of the breaft,
are  much relieved by keeping the feet warm,  and promoting
the  perfpiration,  a flannel fhirtor waiftcoat, and  thick fhoes,
will be of Angular fervice.
  But  nothing is of fo great importance in the afthma as pure
and moderately warm air. Afthmatic people can  feldom bear
either the clofe heavy air of a large town,  or the fharp, keen
atmofphere of a bleak hilly country ; a medium  therefore be-
tween thefe is to be chofen.  The air near a large town  is
often better  than  at a diftance^ provided the patient be re-
moved fo far as not to  be affeaed by the fmoke.   Some
afthmatic patients indeed breathe eafier in town  than in the
country;  but  this  is feldom the cafe, efpecially in towns
where much coal is burnt.  Afthmatic perfons who are oblig-
ed to be in town all day,  ought, at leaft,  to  fleep out of it.
Even this will often prove of great fervice.   Thofe who can
afford it ought to travel into a warmer climate.   Many afth-
matic perfons, who cannot live in Britain, enjoy very  good
health in the fouthof France, Portugal, Spain,  or Italy.
  Exercife is likewife of very  great importance in the afth-
ma, as it promotes  the digeftion, preparation of the blood,
&c.  The blood of afthmatic perfons is feldom  duly prepa-
red, owing to the proper aaion of the lungs being impeded.
For this reafon fuch people ought daily to take as much exer-
cife, either on foot, horfeback, or in a carriage,  as they can
bear.
  MEDIC'IN E.------Almoft all that can be done by
medicine in this difeafe, is to relieve the patient  v/hen feized
with a violent fit.  This  indeed requires the greateft expedi-
tion, as the difeafe often proves fuddenly fatal.   In  the pa-
roxyfm or fit,  the  body is generally bound ;  a purging clyf-
                                                    ters 
316         OF   THE   ASTHMA,

ter, with a folution of afafoetida, ought therefore to be ad-
miniftered, and if there be occafion,  it may be repeated two
or three times.  The patient's feet and legs ought to be im-
merfed  in warm water, and afterwards rubbed with a warm
hand, or dry cloth.   Bleeding, unlefs extreme weaknefs or
old age fhould forbid it, is highly proper.  If there be a vio-
lent fpafm about  the breaft or ftomach,  warm fomentations,
or bladders filled  with warm milk and water may be applied
to the part affeaed,  and warm cataplafms to the foles of the
feet.  The patient muft drink freely of diluting liquors, and
may take a tea-fpoonful of  the tincture of caftor and of faf-
fron mixed together,  in a cup of valerian tea,  twice or  thrice
a-day.   Sometimes a vomit has a  very good  effea, and
fnatches the^patient,  as it  were, from  the jaws of death.
This however will be more fafe  after other evacuations have
been premifed.   A very ftrong infufion of roafted coffee is
faid to give eafe in an afthmatic  paroxyfm.
   In the moift afthma, fuch things as promote expeaoration
or fpitting ought to be ufed  ; as the fyrup of fquills, gum am-
moniac, and fuch like.  A common fpoonful ofthe fyrup or
oxymel of fquills, mixed with an equal  quantity of cinna-
mon-water, may be  taken  three or four times through the
day, and four or five pills,  made of equal parts of afafoetida
and gum ammoniac,  at bed-time,
   For the convulfive  or nervous afthma, antifpafmodics and
bracers are the moft proper medicines.  The patient may take
a tea-fpoonful of the paregoric elixir twice a-day.  The Pe-
ruvian bark is fometimes found to be of  ufe in this cafe.  It
may be taken in fubftance, or infufed in wine.  In fhort, every
thing that braces the nerves, or takes off fpafm,  may be of
pfe in  a nervous afthma.   It is  often relieved by the  ufe of
affes milk ; I have likewife known cows milk drank warm in
the morning have a very good effea in this cafe.
   In every fpecies of afthma,  fetons and iffues have a good
effea ; they may either be fet in the back or fide, and fhould
never be allowed to  dry up.  We fhall here, once for all,
obferve, that not only in the afthma, but in moft  chronic
difeafes, iffues are extremely proper.  They are  both  a fafe
and efficacious remedy ; and though they do not always cure
tbe difeafe, yet they will often prolong the patient's life.
CHAP? 
t   317   ]
                CHAP.     XLI.

       OF   THE    APOPLEXY.

      TH E apoplexy is a  fudden lofs of fenfe and  motion,
       wherein the patient is  to all appearance dead;  the
heart and lungs however ftill continue to move.  Though
this difeafe proves often fatal, yet it may fometimes  be car-
ried off by proper care.   It chiefly attacks fedentary perfons
of a grofs habit, who ufe a rich  and plentiful diet,  and in-
dulge in ftrong liquors.  People in the decline of life are moft
fubjea to the apoplexy.  It prevails moft  in winter, efpeci-
ally in long rainy feafons, and very low ftates of the  baro-
meter.
  CAUSE S.  ■   ■  The immediate caufe of an apoplexy
is  a compreffion  of the  brain, occafioned by an effufion of
blood, or  a colfeaion of watery humours.   The former is
called afanguine, and the latter a ferout  apoplexy.  It may be
occafioned by  any  thing that  increafes  the circulation to-
wards the brain, or  prevents the return  of  the blood  from the
head ;  as intenfe ftudy ; violent paffions * ;  viewing objeas
for a long time obliquely ; wearing  any thing too tight about
the neck ; a rich and  luxurious diet;  fuppreffion of urine ;
fuffering the body to cool fuddenly after having been greatly
heated; continuing long in a  warm bath; the exceffive ufe
offpiceries, or high-feafoned  food; excefs  of venery; the
fudden ftriking in of any eruption;  fuffering iffues, fetons,
&c. fuddenly to dry up, or the  ftoppage of any cuftomary e-
vacuation ; a mercurial falivation pufhed too far, or fuddenly
checked by cold ; wounds or bruifes on the head ; long ex-
pofure to exceffive cold; poifonous  exhalations, &c.
  S Y M P T O M  S, and Method of Cure.-------The ufu-
al forerunners of an apoplexy are giddinefs,  pain and fwim-
mingof the head ;  lofs of memory ; drowfinefs ;  noife in the
ears;  the night-mare ; a fpontaneous flux  of tears, and labo-
rious refpiration.  When  perfons of an apopfeaic make  ob-
                                                   ferve
  * I knew a woman who in a violent fit of anger was feized with
a fanguine apoplexy.  She at firft complained of  extreme pain, as
if daggers had been  thruft through her head, as- me exprelfed it.
Afterwards lhe became comatofe, her pulfe  funk very low,  and
was exceeding  flow.  By bleeding, bliftering, and other evacua-
tions, flie  was  kept  alive for about a fortnight.  When her head
was opened, a large quantity of extravafatetl blood was found U»
the left ventricle of the brain. 
3x8         OF  THE  APOPLEXY.

ferve thefe fymptoms, they have reafon to fear the approach
of a fit, and  fhould endeavour to  prevent it by bleeding, a
flender diet, and opening medicines.
   In the fanguine apoplexy,  if the patient does not" die fud-
denly, the countenance appears florid, the face is fwelled or
puffed up, and  the blood-veffels, efpecially about the neck
and temples, are turgid; the pulfe  beats ftrong ; the eyes are
prominent and fixed, and the breathing is difficult,  and per-
formed with a fnorting  noife'.  The  excrements and  urine
are often voided fpontaneoufly, and the patient is fometimes
feized with a vomiting.
  In this fpecies of apoplexy every method muft be taken to
leffen the force of the  circulation towards the head.  The
patient  fhould  be kept  perfeaiy  eafy and cool.  His head
fhould be  raifed pretty high, and his feet fuffered  to hang
down.  His  clothes ought to  be  loofened, efpecially about
the neck, and frefh air admitted into his chamber.  His gar-
ters fhould be tied pretty tight,  by which means the motion
ofthe blood from the lower extremities will be retarded.  As
foon as the patient is placed in a proper pofture, he fhould be
bled freely in the neck or arm,  and,  if there be occafion, the
operation may be repeated in two or three hours.   A laxa-
tive clyfter, with plenty of fweet oil, or frefh butter, and a
fpoonful or two of common fait in it, may be adminiftered
every two hours ;  and bliftering-plafters applied betwixt the
fhoulders, and to the calves of the  legs.
  As foon  as the fymptoms are a little  abated,  and the pa-
tient is able to fwallow,  he ought to drink freely of fome di-
luting opening liquor,  as a decoaion of tamarinds  and li-
quorice, cream-tartar-whey,  or common whey with cream of
tartar diflolved in it.  Or he may take any cooling purge, as
Glauber's falts, or manna diffolved  in an infufion of fenna, or
the like.  All fpirits and other ftrong liquors are to be avoid-
ed.  Even volatile falts held to the nofe do mifchief. Vomits,
for the fame reafon, ought not to be given, nor any thing that
may increafe the motion of the blood  towards the head.
  In the ferous apoplexy, the fymptoms are nearly the fame,
only the pulfe is not fo ftrong, the countenance is lefs florid,
and the breathing lefs difficult;  Bleeding is not fo neceffary
here, as in  the  former  cafe.  It may however generally be
performed once with fafety and advantage, but fhould not be
repeated.   The patient  fhould be placed in the fame pofture
as- direaed  above, and fhould  have  bliftering plafters  applied,
and receive opening clyfters in the fame manner. Purges here
                                                     are 
OF  THE   APOPLEXY.
319
are likewife neceffary, and the patient may drink ftrong balm
tea. ' If he be inclined to fweat, it ought to be promoted by
drinking frhall wine-whey,  or an infufion of carduus bene-
diaus.   A plentiful fweat  kept  up for a confiderable time,
has often carried off a ferous apoplexy.
  When apopfeaic fymptoms proceed from opium, or other
narcotic fubftances taken into the ftomach, vomits are necef-
fary.   The patient is generally relieved as foon as he has dif-
charged the poifon in this way.
  Perfons of an apopfeaic make,  or thofe who have been at-
tacked  by it, ought to ufe a very fpareand flender diet, avoid-
ing all ftrong liquors, fpiceries,  and high-feafoned  food.
They ought likewife to guard againft all violent paffions, and
to avoid the extremes of heat and  cold.  The head fhould be
fhaved, and daily wafhed with cold water. The feet ought to
be kept warm, and never fuffered to continue long wet. The
body muft be kept open either by food or medicine, and a lit-
tle  blood may be let every fpring and fall.   Exercife fhould!
by no means be negfeaed ; but it ought to be taken in mode-
ration.   Nothing has a more happy  effea in preventing an
apoplexy than perpetual iffues or fetons ; great care however
muft be taken not to fuffer them  to dry up, without opening
Others  in their ftead.   Apopfeaic perfons ought  never to go
to reft  with a full ftomach, or to lie with their heads low, or
wear any thing too tight about their necks.
               CHAP.    XLII.

OF  COSTIVENESS,  AND   OTHER  AFFECTS
  QNS OF THE  STOMACH  AND  BOWELS.

       WE do not here mean to treat of  thofe aftriaions of
        the bowels which are the fymptoms of difeafes, as of
the colic,  the iliac paffion,  &c.  but only to take notice of
that  infrequency  of  ftools  which fometimes happens, and
which in fome particular conftitutions may occafion difeafes.
  Coftivenefs may proceed'from an exceffive heat of the liver j
drinking rough red wines,  or other aftringent liquors; too
much exercife, efpecially on horfeback : It may likewife pro-
ceed  from  a-long ufe of cold infipid food, which does not fuf-
ficiently ftimulate the inteftines.  Sometimes  it  is owing  to
the bile not defcending to the inteftines,  as in the  jaundice;
and at  other times it proceeds from difeafes ofthe inteftines
                                            themfeiyes, 
 3i*     OF   C  O  S t I V E N E S S,   he

 themfelves, as a palfy,  fpafms,  tumours,  a cold dry ftate o(
 the inteftines, he.
   Exceffive coftivenefs  is apt to occafion pairts  of the head.
 Vomiting, colics, and other complaints of  the bowels.  It i0
 peculiarly hurtful to hypochondriac  and  hyfteric  pe.fons, as
 it generates wind and other grievous fymptoms-   Some peo-
 ple however can bear coftivenefs  to a  great degree.   I know
 perfons who enjoy pretty good health, yet do not go to ftool
 above once a-week, and othcri not above once a-fortnight.
   Perfons  who sire generally coftive fhould live upon a moif.
 tening and laxative diet, as roafted  or boiled apples, pears,
 ftewed prunes, raifins,  gruels with currants, butter, honey,
 fugar, and fuch like.  Broths with  fpihage, leeks, andothef
 foft pot-herbs, are likewife proper. Rye  bread, or that which
 is made of a mixture of wheat and rye together, ought to be
 eat.   No  perfon troubled  with  coftivenefs fhould eat white
 bread alone, efpecially that which is made of fine flour. The
 beft bread  for keeping the belly foluble is  what in fome parts
 of England they call meflin.  It is made of a mixture of wheat
 and rye, and is very agreeable to thofe  who are accuftomed
 to it.
   Coftivenefs is iricreafed by keeping the body too warm, and
 by every thing that  promotes the  perfpiration ;  as wearing
 flannel, lying too long  a-bed, &c. Intenfe thought,  and fe-
 dentary life, are likewife hurtful. All the fecretions and ex-
 cretions  are promoted  by  moderate exercife without dcors,
 and by a gay, cheerful,  fprightly temper of mind.
  The drink fhould be of an opening  quality.   Ail ardent
 fpirits,  auftere and aftringent  wines, as  port,  claret, &c.
 ought be avoided.  Malt-liquor  that is fine, and of a mode-
 rate ftrength, is very proper.  Butter-milk, whey, and other
 watery liquors, are  likewife proper,  and may  be drank in
 turns, as the patient's inclination direas.
   Thofe who are troubled with coftivenefs ought, if poffible,
 to remedy it by diet, as  the conftant ufe of medicines for that
purpofe,  is attended with many inconveniences,  and often
 with bad confequences *.  I never  knew  any one get into a
                                                     habit

  * The learned Dr.  Arbuthnot advifes thofe who are  troubled
with coftivenefs to ufe animal oils, as frefh butter, cream, marrow,
fat broths,  efpecially  thofe made of the internal parts of  animals,
as the liver, heart, midriff,  &c.   He likewife recommends the
txpreffed  oils of mild vegetables, as olives, almonds, paftaches,
and tbe fruits themfelves;  all oily and mild  fruits,  as figs)  de-
 coctions of mealy vegetables; thefe lubricate  the Inteftines; fome
                                               faponaeeous 
     OF   COSTIVENESS,   &c.      321

habit of  taking medicine for keeping the body open,  who
could leave it off.  In time  the  cuftom becomes neceffary,
and generally ends in a  total relaxation of the bowels, indi*
*>«.ftion, lofs of appetite, wafting ofthe ftrength, and death.
  When the body cannot be kept open without medicine, we
would recommend gentle dofes of rhubarb to be  taken twice
or thrice a week.  This is not near fo injurious to the  fto-
mach as aloes, jalap, or the other draftic purgatives fo much
in ufe.   Infufions of fenna and manna may likewife be taken,
or half an  ounce of foluble  tartar diffolved in water-gruel.
About  the fize of a nutmeg of lenitive eleauary  taken twice
•r thrice a-day, generally anfwers the purpofe very well.

       WANT   OF   APPETITE.

  This may proceed from a foul  ftomach;  indigeftion; the
want of free air and exercife; grief;  fear; anxiety, or  any
of the depreffing paffions ; exceffive heat; the ufe of ftrong
broths, fat meats,  or any thing that palls the appetite, or  is
hard of digeftion ; the immoderate ufe of ftrong liquors,  tea,
tobacco, opium, &c.
  The patient ought, if poffible, to make choice of an open
dry air ; to take exercife daily on horfeback or in a carriage ;
to rife  betimes;  and to avoid all intenfe thought.  He fhould
ufe a diet of eafy digeftion;  and fhould avoid  exceffive heat
and great fatigue.
  If want  of appetite proceeds from errors in diet, or any o-
tr ei p*rt of the patient's regimen, it ought to be changed.  If
naufea and reachings fhew that  the ftomach is  loaded  with
crudities, a vomit will  be of fervice.   After this a gentle
purge or two of rhubarb, or of any of the bitter purging falts,
                        P p                          may

faponaceous fubftances which ftimulate gently, as honey, hydro*
mel, or boiled honey and water, unrefined fugar, &c.
  The  Doctor  obferves, that fuch lenitive fubftances  are proper
for perfons of dry atrabilarian conftitutions,  who are fubject  to
aftriction of the  belly,  and the piles, and will operate  when
ftronger medicinal fubftances are fometimes ineffectual; but that
fuch lenitive diet hurts thofe whofe bowels are weak and lax.  He
likewife obferves, that all watery fubftances are lenitive,, and that
even common  water, whey, four milk, and butter-milk have that
effect;—That  new  milk,  efpecially  affes  milk,  fthmifates ftill
more when it fours  on  the ftomach; and that whey turned four
will purge ftrongly;—That  moft garden fruits are likewife laxa-
tive; and that fome of them, as grapes, will throw fuch as take
them immoderately, into  a cholera morbus, or  an incurable di>
arrhoe*. 
322    OF  WANT  OF  APPETITE.

may be taken.  The patient ought next to ufe an infufion in
wine of fome ofthe ftomachic  bitters.  Though gentle eva-
cuations be neceffary, yet ftrong purges and vomits are to be
avoided, as they weaken the ftomach, and hurt digeftion.
   Elixir of vitriol is an excellent medicine  in moft cafes of
indigeftion, weaknefs of  the ftomach, or want  of appetite.
Twenty or thirty drops of it may be taken twice or thrice a-
day in a glafs of wine or water.   It may  likewife be  mixed
with  the tinaure of the bark,  two drams of the former to an
ounce of the latter, and a tea-fpoonful of it taken in wine
or water, as above.
   Tbe chalybeate waters, if drank in moderation, are gene-
rally  of confiderable fervice in  this cafe.  The fait-watet, has
likewife good  effeas;  but  it muft not be ufed too freely.
The  waters of Harrowgate,  Scarborough, Moffat, and moft
other fpaws in  Britain, may be ufed with  advantage.  We
would advife all who are affliaed with indigeftion and want
-of appetite,  to repair  to thefe places  of  public  rendezvous.
The  very change of air,  and the cheerful  company, will be
of fervice ; not to mention the exercife, diffipation, amufe-
ments, he.

      OF   THE    HEART-BURN,

:  What is commonly called the heart-burn, is not a difeafe of
that organ, but an uneafy fenfation of heat or acrimony about
the pit of the ftomach,  which  is fometimes attended with
anxiety, naufea, and vomiting.
   It may  proceed  from debility of the  ftomach,  indigeftion,
bile, the abounding of an acid  in the ftomach, he.  Perfoni
who  are liable to this complaint ought  to avoid ftale liquors,
acids, windy or greafy aliments, and fhould never ufe viplent
exercife foon after a plentiful  meal.   I know many perfons
•who never fail to have the heart-burn,  if they ride foon after
dinner, provided they have drank ale, wine, or any fermented
liquor; but are never troubled with it  when  they have  drunk
rumor brandy and water, without any  fugar or acid.
   When  the heart-burn proceeds from debility  of the fto-
mach or indigeftion, the patient ought to t ke a  dofe or two
of rhubarb ; afterwards he may ufe infufions of the Peruvian
bark, or any ofthe ftomachic bitters, in wine or brandy. Ex-
ercife in the open air will likewife be of ufe, and  every thing
that promotes digeftion.
   When bilious humours occafion  the heart-burn, a tea-
fpoonful of the fweet fpirit of  nitre in a glafs of watex, or a
                                                     cup 
OF  THE  HEART-BURN.
3*5
cup of tea, will generally  give eafe.  If it proceeds from the
ufe of greafy aliments, a dram of brandy or rum may be taken.
  If acidity or fournefs ofthe  ftomach occafions the heart-
burn, abforbents are the proper  medicines.  In  this cafe art
ounce of powdered chalk, half an ounce of fine fugar, and a
quarter of an ounce of gum-arabic may be mixed in an Eng-
lifh quart of water, and a tea-cupful of it taken as often as is
neceffary.   Such as  do not chufe  chalk,  may  take a tea-
fpoonful of prepared oyfter-fhells,  or of the  powder called
crabs-eyes, in a glafs of cinnamon or peppermint-water. But
the fafeft and beft abforbent is magnefia alba.  This not only
aas as an abforbent,  but likewife as a purgative;  whereas
chalk, and  other abforbents of that kind, are apt to lie in the
inteftines,  and occafion obftruaions.  This  powder is not
difagreeable, and' may  be taken in a cup of tea, or a glafs of
mint-water.  A  large  tea-fpoonful  is the ufual dofe ; but it
may be taken in  a much  greater quantity when there is oc-
cafion.  Thefe things are now generally made up into lo-
zenges for the conveniency of being  carried in the pocket,
and taken at pleafure.
  If wind be the caufe of this complaint, the moft proper me*
dicines are thofe called carminatives; as anifeeds, juniper-
berries,  ginger,  canella alba, cardamum feeds, &c.   Thefe
mav either be chewed, or infufed in fpirits of wine.   One of
the fafeft medicines  of this kind is the tinaure made by in-
fufing an ounce of rhubarb, and a quarter of an ounce of the
leffer  cardamum  feeds, in an Englifh pint of brandy.  After
this has digefted  for two or three days, it ought to be ftrain-
ed, and four ounces  of white fugar-candy added to it.  It
muftftand to digeft a fecond time till the fugar be diffolved.
A table  fpoonful of it  may be taken occafionally for a dofe.
  I have frequently  known the heart-burn cured, particular-
ly in pregnant women, by chewing green tea.


                CHAP.    XLIII.

   OF   NERVOUS    DISEASES.

      OF  all difeafes incident to mankind, thofe of the nervous
      kind are the moft complicated and difficult to cure.  A
volume would not be fufficient to point out their various ap-
pearances.   They imitate almoft every difeafe ; and are fel-
dom alike in two different perfons, or even in the fame per-
                                                     fon 
 SH    OF   NERVOUS  DISEASES.

 fon at  different times.   Proteus-like, they are continually
 changing fhape; and upon every frefh  attack,  the patient
 thinks he feels fymptoms which he never experienced before.
 Nor do they only affea the body ; the mind likewife fuffers,
 and is  often thereby rendered extremely weak and peeviffi.
 The low fpirits, timoroufnefs,  melancholy,  and ficklenefs of
 temper, which generally attend nervous diforders, induce ma-
 ny  to  believe, that  they  are entirely difeafes of the mind ;
 but this change of temper  is rather a confequence,  than  the
 caufe of nervous difeafes.
   CAUSE S.——— Every  thing  that  tends to relax or
 weaken the body,difpofes  it to nervous difeafes, as indolence,
 exceffive venery, drinking too much  tea, or other weak wa-
 tery liquors,  frequent  bleeding, purging, vomiting,  &c.
 Whatever hurts the digeftion, or prevents the  proper aflimi-
 Jation of the aliment, has likewife this effea; as long fafting,
 excefs  in eating or drinking, the ufe of windy, crude, or un-
 wholefome aliments, an unfavourable pofture of the body,&c.
   Nervous diforders often  proceed from  intenfe  application
 to ftudy.  Indeed few ftudious perfons are entirely free from
 them.   Nor is this at all to be wondered at; intenfe thinking
 not only preys upon the fpirits, but prevents the perfon from
 taking proper exercife, by which means the digeftion is im-
 paired,  the nourifhment prevented,  the  folids relaxed,  and
 the whole mafs of humours vitiated.   Grief and  difappoint-
 xnent likewife produce the  fame effeas.   1 have known more
 nervous patients, who dated the commencement of their dif-
 orders from the lofs of a hufband, a favourite child, or from
 fome difappointment in life, than from any  other caufe.   In
 a word, whatever weakens  the  body,  or depreffes the fpirits,
 may occafion nervous diforders, as unwholefome air, want of
 fleep, great fatigue, difagreeable apprehenfions,  anxiety, vex-
 ation, he.
   SYMPTOM S.------We fhall only mention  fome
 of the moft general fymptoms of thefe diforders, as  it would
 be both an ufelefs and an endlefs talk to point out the whole.
 They generally begin with windy  inflations  or diftentions of
 the  ftomach  and inteftines; the  appetite and  digeftion  are
 ufually  bad ;  yet fometimes there is an uncommon craving
 for food, and a quick  digeftion.   The food often turns four
 on the ftomach ; and  the patient is troubled with vomiting
of clear water, tough phlegm, or a blackifh coloured liquor
refembling the grounds of coffee. Excruciating pains are of-
ten fe]t  about the navel, attended with a rumbling or mur-
                                                 muring 
     OF  NERVOUS  DISEASES.     325

muring noife in the bowels.   The belly is fometimes loofe,
but more commonly bound,  which  occafions a retention of
wind and great uneafineis.
  The urine is fometimes  in fmall quantity,  at other times
very copious and quite clear.   There is a great ftraitnefs of
tbe breaft, with difficulty of breathing ; violent palpitations
of the heart;  fudden flufhings of heat in various parts of the
body ;  at other times a fenfe of cold, as if water were poured
on them; flying pains in the arms and limbs; pains in the
back and belly,  refembling thofe  occafioned by gravel ;  the
pulfe very variable, fometimes uncommonly flow,  and ato-
ther times very quick ; yawning, the hiccup,  frequent figh-
ing, and  a fenfe  of foffocation, as if from a ball or lump in
the throat; alternate fits of crying and convulfive laughing;
the fleep is unfound and feldom refrefhing;  and the patient
is often troubled with the night-mare.
  As the difeafe increafes,  the patient is molefted with head-
achs, cramps, and  fixed pains in various parts of the body ;
the eyes are clouded, und often affeaed with pain and dry-
nefs; there is a noife in the ears, and uften a dulnefs of hear-
ing ; in fhort, the  whole animal funaions are impaired. The
mind isdifturbed on the moft trivial occafions, and is hurried
into the moft perverfe commotions, inquietudes, terror,  fad-
nefs, anger, diffidence, he.  The patient is apt to entertain
wild imaginations, and extravagant fancies; the memory be-
comes  weak, and the judgment  fails.
  Nothing is more charaaeriftic of this difeafe than a con-
ftant dread of death.   This renders thefe  unhappy  perfons
who labour under it peevifh,   fickle,  impatient, and apt to
run from one phyfician to another ; which is one reafon why
they feldom reap any benefit from medicine,  as they have  not
fufficient re folution to perfiftin any one courfe till it has time
to produce its  proper effeas.   They are likewife apt to ima-
gine, that they  labour under  difeafes  from which  they are
quite free, and are very angry  if any one attempts to fet them
right, or laugh them out of their ridiculous notions.
  REGIME N.-----Perfons affliaed with nervous dif-
eafes ought never  to  fail  long.  Their food fhould be folid
and nourifhing, but of eaf> digeftion.  Fat meats,  and heavy
fauces, are hurtful.  All excefs fhould be carefully avoided.
They ought never  to eat more at a time than they can eafily
digeft : but if they feel  themfelves weak and  faint betweea
meals, they ought  to eat a bit of bread, and drink a glafs of
wine. Heavy fuppers are to be avoided.  Though wine in ex- 
3*6     OF   NERVOUS   DISEASE $.

cefs enfeebles the body, and impairs the faculties of the mino*,
yet taken in moderati .n, it ftrengthens the ftomach, and pro-
motes digeftion.   Wine ind water is a very  proper drink at
meals : but  if wine fr.urs on  the ftomach, or the patient is
fnuch troubled with  wind, brandy and water, will anfwer
better.  Every thing that is windy, or hard of digeftion, muft
be avoided   All weak and warm liquors are  hurtful,  as tea",
coffee, punch, &c. People mav find a temporary relief in the
Ufe of thefe, but they always increafe  the malady,  as they
weaken the ftomach and  hurt digeftion.  Above all things',
drams are to be avoided.   Whatever immediate eafe the pa-
tient may feel from the ufe of ardent fpirits, they are fure to
aggravate the malady,  and  prove certain  poifons at laft.
Thefe  cautions are the more neceffary, as moft nervous peo-
ple are peculiarly fond of tea and ardent fpirits ; to the ufe of
which  many of them fall a viaim.
   Exercife in nervous diforders is fuperior to  all medicines.
Riding on horfeback is generally efteemed the beft, as it gives
motion to the whole body, without fatiguing it.  1 have known
fome patients,  however, with whom walking agreed better,
and  others who were moft benefited by riding in a carriage.
Every  one ought  to ufe that  which he finds moft beneficial.
Long fea-voyages have an excellent effea ; and to thofe who
can  afford to take them,  and have fufficient refolution,  we
would  by al! means recommend this courfe.   Even change of
place,  and the fight of new objeas,  by diverting the mind,
have a great tendency to remove thefe complaints.  For this
reafon  a long journey, cr a voyage, is of much more advan-
tage than riding fhort journeys near home.
   A cool and dry  air is proper,  as it braces and invigorates
the whole  body.   Few things tend more to  relax and ener-
vate than hot  air, efpecially that which is  rendered  fo by
great fires, or ftoves in fmall apartments.  But when the fto-
mach or bowels are weak, the body ought to  be well  guarded
againft cold, efpecially in winter,  by wearing a thin flannel
waiftcoat next  the fkin.  This will keep up  an equal per-
fpiration, and  defend the  alimentary  canal from many im-
preffions to which it would otherwife be fubjea, upon every
fudden change from warm to cold weather. Rubbing the bo-
dy frequently with a flefh-brufh, or a coarfe linen cloth, is
likewife benefical, as it promotes the circulation, perfpiration,
&c.  Perfons who have weak  nerves ought to rife early, and
take exercife before breakfaft, as lying too long a-bed cannot
fail to  relax the folids.   They ought likewife to be diverted, 
     OF   NERVOUS  DISEASES.     327

and to be kept as eafy and cheerful as poffible.  There is not
any thing which hurts the  nervous fyftem,  or weakens the
djgeftive powers more than fear, grief, or anxiety.
\ MEDICINES.------Though  nervous difeafes are
feldom radically cured, yet their  fymptoms  may fometimes
be alleviated, and the patient's life rendered,  at leaft, more
comfortable, by proper medicines.
  When the patient is coftive, he ought to take a little rhu-
barb, or fome other mild purgative, and fhould never fuffer
his body to be long bound.   All ftrong and violent purga-
tives are however to be avoided,  as aloes, jalap, &c.  I  have
generally feen an infufion of  fenna  and rhubarb in brandy
anfcve.- very well.  This may be made of any ftrength, and
taken in fuch quantity as the patient finds neceffary.  When
digeftion is bad, or the ftomach relaxed and  weak,  the fol-
lowing infufion of Peruvian bark  and other  bitters  may  be
ufed with advantage.
  Take of Peruvian bark an  ounce, gentian-root,  orange*
.peel and coriander-feed, of each half an ounce ; let thefe in-
gredients be all bruifed in a mortar, and infufed in  a bottle
of brandy pr whifky,  for the fpace of  five or fix days.   A
table-fpoonful of the ftrained  liquor may be  taken in half a
glafs of water an hour before breakfaft, dinner and fupper.
  Few  things tend more to  ftrengthen the  nervous fyftem
than cold bathing.   This praaice, if duly perfifted  in, will
produce very extraordinary effeas ; but when the liver or  o-
ther  vifcera are obftruaed,  or otherwife unfound, the cold
bath is improper.   It is therefore to be ufed  with very great
caution.  The moft proper feafons for it are fummer and au-
tumn.   It will be fufficient, efpecially  for  perfons of a fpare
habit, to go into the cold bath three or four times a week.  If
the patient  be weakened by it, or feels  chilJy for a long time
after coming out, it is improper.
  In patients affliaed with wind, I have always obferved the
greateft  benefit from the acid elixir of vitriol.   It may be  ta-
ken in the quantity of fifteen,  twenty, or thirty drops, twice
or thrice a-day in a glafs of water.  This both expels wind,
ftrengthens the ftomach,  and  promotes  digeftion.
  Opiates are generally  extolled in thefe  maladies ;  but  as
they  only palliate the fymptoms, and generally afterwards  in-
creafe the difeafe, we would advife  people to be extremely
fparing in the ufe of them, left habit  render them at laft ab-
folutely  neceffary.
  It would be an eafy matter to enumerate  many medicines
which have been extolled for relieving nervous diforders; but
                                                whoever 
328     OF  NERVOUS  DISEASES.

whoever wifhes for a thorough cure muft expea it from regi-
men alone;  we fhall therefore omit mentioning  more medi*
cines, and again recommend the ftriaeft attention to DIET,
air, exercise, and amusements.

          OF   MELANCHOLY.

  Melancholy is  that  ftate of alienation or  weaknefs of
mind which renders  people  incapable of enjoying  the plea-
fures, or performing the duties of life.   It is a degree of in-
fanity, and often terminates in abfolute madnefs.
  CAUSE S.------It may proceed from a hereditary dif-
pofition ; intenfe thinking, efpecially where trie mind is long
occupied about one  objea ; violent  paffions or affeaions of
the mind, as love, fear, joy, grief, over-weening pride,  and
fuch like.  It may alfo be occafioned  by  exceffive  venery;
narcotic  or ftupefaaive poifons; a fedentary life; folitude;
the fuppreffion of cuftomary  evacuations;  acute fevers, or
other difeafes.  Violent anger will change  melancholy into
madnefs ; and exceffive cold, efpecially of  the lower extre-
mities, will force the blood into the brain,  and  produce all
the fymptoms of madnefs.  It may likewife proceed from the
ufeof aliment that is hard of digeftion, or which cannot be
eafily affimilated; from a callous ftate of the integuments of
the brain, or a drynefs of the brain itfelf.   To all which we
may add gloomy or miftaken notions of religion.
   SYMPTOM S.-----When  perfons begin to be
melancholy, they are timerous ;  watchful; fond of folitude;
fretful;  fickle; captious  and inquifitive ;  folicitous  about
trifles; fometimes niggardly, and at other times prodigal.  The
belly is generally bound;  the urine thin, and in fmall quan-
tity ; the ftomach and bowels inflated with wind ; the com-
plexion pale ; the pulfe flow and weak.   The funaions of
the mind are alfo greatly perverted, in  fo much that the pati-
ent often imagines himfelf dead, or changed into fome other
animal.   Some  have  imagined  their  bodies were  made of
glafs, or other brittle fubftances, and were  afraid  to move
left they fhould be broken to pieces.   The unhappy patient,
in this cafe, unlefs carefully watched,  is apt. to put an end to
his own miferable life.
   When the difeafe is owing to an obftruaion of cuftomary
evacuations, or any  bodily  diforder,  it is eafier cured than
when it  proceeds from affeaions of the mind, or an  heredi-
tary taint.   A difcharge  of blood from the nofe, loofenefs,
                                                  fcabby 
OF    MELANCHOLY.
3*9
fe&bby eruptions,  the bleeding piles, or the menfes,  fome-
times carry off this difeafe.
  REGIME  N.-------The diet ought to confift chiefly
of vegetables of a  cooling  and opening  quality.   Animal
food, efpecially falted or fmoke-dried fifh or flefh,  ought to
be avoided.  All kinds of  flsell-ftfh  are bad.  Aliments pre-
pared with onions, garlic,  Or any thing that generates thick
blood, are  likewife improper.   All kind of fruits that are
wholefome may be eat with advantage.   Boerhaave gives an
inftance of a' patierit who,  by a long ufe of whey, water,
and garden-fruit,  recovered, after having evacuated a great
quantity of black-coloured matter.
  Strong  liquors  of every kind ought to be avoided as poi-
fon.   The moft proper drink is water,  whey, or very fmall
beer.  Tea and coffee  are improper.  If honey  agrees with
fhe patient, it may be ate  freely, or his drink may be  fweet-
ened with it.  Infufions of balm-leaves,-  penny-royal,  the
roots of wild valerian, or the flowers of the lime-tree, may
be drank freely* either by themfelves, or fweetened with ho-
ney, as the patient fhall chufe.
  The patient ought to take as much exercife in the open air
as he can bear.   This helps to diffolve the vifcid  humours,
it removes obftruaions, promotes  the perfpiration,  and all
the other fecretions.   Every kind of madnefs is attended with
a diminifhed perfpiration  ; all  means ought therefore to be
ufed to promote that neceffary and falutary difcharge.  No-
thing can have a more direa tendency to increafe the difeafe
than confining the patient  to a clofe apartment.  Were he
forced to ride or walk a Certain number of miles every  day,
it would tend greatly to alleviate his diforder;  but it  would
have ftill a better effea, if he were obliged to labour a piece
Of ground.  By  digging,  hoeing,  planting,  fowing,  he.
both the body and mind would be exercifed.   A long jour-
ney, or a voyage, efpecially towards a warmer climate, with
agreeable companions, has often very happy effeas.   A plan
of this kind, with a ftria attention to diet, is a much more
rational metkod of cure,  than confining  the patient  within
doors and plying  him with medicines.
   M E D 1 C 1  N  E.------In the cure of this difeafe par-
ticular attention muft be paid to the mind.  When the  pati-
ent is in a low ftate, his  mind ought to be foothed  and di-
verted with variety of amufements  ; as entertaining  flories,
paftimes,  mufic,   &c.   This feems to have been the  method
Of curing melancholy among the Jews,  as  we learn  frora
                             QL 1                     the 
Sp        OF   MELANCHOLY.

the ftory of King Saul; and indeed it is a very rational one,,
Nothing can remove difeafes of the mind foeffeaually as ap-
plications to the mind itfelf, the moft efficacious of which is
mufic.  The  patient's company ought likewife to confift of
fuch perfons as are agreeable to him.   People in  this ftate
are apt to conceive unaccountable averfions againft particular
perfons;  and the very  fight of fuch perfons is  fufficient  to
diftraa their minds, and throw them into the utmoft pertur-
bation.
   When  the patient is high,  evacuations are neceffary.   In
this cafe he muft be bled,  and have his body  kept open  by
purging medicines,  as  manna, rhubarb, cream of  tartar,  or
the foluble tartar.   I have feen the laft have very happy ef-
feas.   It may be taken in the dofe of half an ounce,  diffolv-
ed in water-gruel, every day,  for fundry weeks,  or even for
months, if neceflary.  More or lefs may be given  according
as it operates.  Vomits have likewife a good effea ; but they
muft be pretty ftrong,  otherwife they will not operate.
   Whatever increafes the evacuation of  urine or  promote*
perfpiration, has a tendency  to remove  this difeafe.   Both
thefe fecretions may be promoted by the ufe of nitre a*id vine-
gar.  Half a dram of purified nitre may be given three or four
times a-day in any way that is moft agreeable to the patient;
and an  ounce and an  half of diftilled vinegar may be daily
mixed with his drink.  Dr. Locker  feems to  think  vinegar
the beft medicine that can be given in this difeafe.
   Camphire and mufk have likewife been ufed in this cafe with
advantage.  Ten or twelve grains of camphire may be rub-
bed in a mortar with half a dram of nitre,  and taken twice
a-day, or oftener,  if the ftomach will bear it.  If it will not
fit upon the ftomach in this form, it may be made into pills
with gum afafostida and  Ruffian caftor, and  taken  in  the
quantity above direaed.  If mufk is to  be  adminiftered, a
fcruple or twenty-five grains of it may be made into  a bolus
with  a little honey or common  fyrup, and taken  twice  or
thrice a-day.  We do not mean that all thefe medicines fhould
be adminiftered at once; bur   whichever  of them  is  given,
muft be duly  perfifted in,  and where one fails another  may be
tried.
  As it is very difficult to induce patients in this  difeafe  to
take medicines, we fhall mention a few outward applications
which fometimes do good; the principal of thefe  are iffues,
fetons, and warm bathing.   Iffues may be made  in any part
of the body, but they generally have the  beft effea near the
                                                   fpine. 
OF    MELANCHOLY.
331
fpine.  The difcharge from thefe may be greatly promoted by
dreffing them with the mild bliftering ointment, and keeping
what are commonly called the orrice peafe in  them.   The
moft proper place  for a feton is between the fhoulder blades;
and it ought to be placed upwards and downwards, or  in the
direaion of the fpine.

            OF   THE    PALSY.

  The palfy is a  lofs or diminution of fenfe or motion, or of
both, in one or more parts of the body.  Of all the affeaions
called nervous, this is the moft fuddenly fatal.   It is more or
lefs dangerous, according to the importance ofthe part affea-
ed.   A palfy of the heart, lungs, or any part  neceffary for
life, is mortal.  When it affeas the ftomech, the inteftines,
or the bladder, it is highly dangerous.  If the face be affeaed,
the cafe is bad, as  it fhews that the difeafe proceeds from the
brain.   When the part affeaed feels cold,  is infenfible, or
waftes  away, or when the judgment and memory begin to tail,
there is fmall hopes of a cure.
  CAUSE S.———The immediate caufe of palfy  is any
thing that prevents the regular exertion ofthe nervous power
upon any particular mufcle or part of the body.  The  occa-
fional and predifpofing caufes are various,  as  drunkennefs ;
wounds of the brain, or fpinal marrow; preffure  upon the
brain or nerves;  very  cold or damp air ; the fuppreffion of
cuftomary evacuations ; fudden  fear; want of exercife ; or
whatever greatly  relaxes the fyftem,  as drinking much tea *,
or coffee, &c.  The palfy may likewife proceed from wounds
of the  nerves themfelves, from the poifonous fumes of  metals
or minerals, as mercury, lead, arfenic, &c.
  In young perfons of a full habit, the palfy muft be treated
in the  fame manner as the fanguine  apoplexy.  The patient
muft be bled, bliftered, and have his body opened by fharp
clyfters or purgative  medicines.   But, in old age, or when
the difeafe proceeds from relaxation  or debility, which is ge-
nerally the  cafe,  a quite contrary  courfe muft  be purfued.
                                                    The
  * Many people  imagine, that tea has no tendency to hurt the
nerv:s, and that drinking the fame  quantity of warm water would
be equally pernicious.  This however feems to be a miftake.  Many
perfons drink three or four cups of warm milk and water daily,
without feeling any bad confequences; yet the fame quantity of
tea  will make  their hands fliake for twenty-four hours.  That tea
affects the nerves is likewife evident from its preventing fleep,  oc«
cafioning giddinels, dimnefs of the fight, ficknefs, Sec. 
33*
-OF   THE   PALSY.
The diet muft be warm and invigorating, feafoned with fpief
and aromatic vegetables, as muftard, horfe-radifh, &c.  The
drink may be generous wine,  muftard whey,  or brandy and
water.  Friaion with the flefh-brufh, or a warm hand, is ex-
tremely proper, efpecially on the parts affeaed.  Bliftering-
plafters may likewife be applied to the affeaed parts with ad-
vantage.   When  this cannot be done, they  may be rubbed
with the volatile liniment,or the nerve ointment of the Edin-
burgh difpenfatory.   One of the beft external applications is
elearicity.  The fhocks fhould be received on the part affea-
ed; and they ought daily to be repeated for feveral weeks.
   Vomits are very beneficial in this kind of palfy, and ought
to be  frequently adminiftered. Caephalic fnuff, or any thing
that makes the patient fneeze, is likewife of ufe.   Some pre-
tend to have found great benefit from rubbing the parts affect-
ed, with nettles ;  but this does not feem  to be any way pre-
ferable to bliftering.   If  the  tongue is affeaed, the patient
may gargle his mouth frequently with brandy and muftard:
or he  may  hold  a bit of fugar  in his mouth wet with the
palfy-drops or compound fpirits  of lavender.  The wild va-
lerian-root  is a very proper medicine in this  cafe.  It rnay
either be taken in an infufion with fage-leaves, or half  a
dram of it in powder  may be given in a glafs of wine three
times a-day.   If the patient cannot ufe the valerian,  he may
take of fal volatile olfofum, compound fpirits of lavender,  and
tinaure of caftor,  each half  an  ounce;  mix thefe together,
and take forty or fifty drops in a  glafs of wine, three or four
times a-day.   A table-fpoonful   of  muftard-feed taken  fre-
quently is  a very good medicine.   The patient ought like-
wife to chew cinnamon-bark, ginger, or other warm fpiceries.
   Exercife is ofthe utmoft importance in the  palfy ; but the
patient muft beware of cold, damp, and moift air. He ought
to wear flannel next his fkin ;  and, if poffible, fhould remove
into a warmer climate.

OF  THE  EPILEPSY,  OR   FALLING  SICKNESS.

   The epilepfy  is a fudden deprivation  of all the fenfes,
wherein the patient falls fuddenly down,  and is affeaed with
violent convulfive motions.  Children, efpecially thofe who
are delicately brought up,  are moft fubjea to it.   It more
frequently attacks men than women, and is very difficult  to
cure.   When the epilepfy attacks children, there is reafon
to hope it may go off about the  time of puberty.  When it
                                                 attacki 
OF  THE   EPILEPSY,  &c.
133
attacks any perfon after twenty years of age, the cure is dif-
ficult;  but when after forty, a cure is hardly to be expeaed.
If the fit continues only for a fhort fpace, and returns feldom,
there is reafon to hope ;  but if it continues long and returns
frequently, tbe profpea is  bad.   It is a very unfavourable
fymptom when the patient is feized with the fits in his fleep.
  CAUSE S.-------The epilepfy is fometimes hereditary.
It may likewife  proceed from  frights of the mother when
with child ; from blows, bruifes, or wounds on the head ;  a
colfeaion of water, blood,  or ferous humours in the brain ;
a polypus ; tumours or concretions within the fkull; excef-
five  drinking;  intenfe ftudy ;  excefs  of  venery ; worms 5
teething ; fuppreffion  of cuftomary evacuations; too great
cmptinefs or  repletion ; violent paffions or affeaions o; the
mind, as fear, joy, &c. hyfteric affeaions; contagion receiv-
ed into the body, as the  infeaion of the fmall-pox,  meafles,
he.
  SYMPTOM S.----- An epileptic fit is generally pre-
ceded  by unufual  wearinefs j pain  of the head;  dulnefs ;
giddinefs;  noife  in the ears  ; dimnefs of fight; palpitation
of the heart; difturbed fleep ; difficult breathing ; the bow-
els are inflated with wind; the urine is in great quantity,
but thin ; the complexion is pale ;  the extremities are cold,
and the patient  often  feels  as it were a ftream of  cold air
afcending towards his head.
  In the fit, the patient generally makes an unufual noife ;
his thumbs are drawn in towards  the palms  of the  hands ;
his eyes are diftorted ; he ftarts,  and  foams at the  mouth ;
his extremities are bent or twifted various ways ;  he often dif-
charges his feed, urine, and fceces involuntarily;  and is quite
deftitute of all  fenfe and reafon,  After the fit  is over, his
fenfes gradually return, and he complains of a kind of ftupor,
wearinefs, and pain of his head ;  but has no remembrance of
what happened to him during the fit.
  The fits are fometimes excited by violent affeaions of the
mind,-a debauch of liquor, exceffive heat, cold, or the like.
  This difeafe, from the difficulty of inveftigating its caufes,
and  its ftrange  fymptoms,  was formerly  attributed to the
wrath of the gods, or the agency of evil fpirits.   In modern
times it has often, by the vulgar, been imputed to witchcraft
or fafcination.   It depends however as much upon natural
caufes as any other malady ; and its cure may often be effeGt-*
ed by perfifting in the ufe of proper  means.
  REGIME N.------Epileptic patients ought, if pof-
fible,  to breathe a pure and free air.  Their diet fhould be 
334
OF   THE   EPILEPSY,
 light but nourifhing.  They ought to drink nothing  ftrong,
 to avoid fwines flefh, water-fowl, and likewife all windy and
 oily vegetables, as cabbage, nuts, &c.   They ought to  keep
 themfelves cheerful,  carefully guarding  againft all  violent
.paffions, as anger, fear, exceffive joy, and the like.
   Exercife is likewife of great ufe ;  but the patient muft be
 careful to avoid all extremes either of heat or cold, all  dan-
 gerous fituations,  as ftanding upon precipices,  riding  deep
 waters, and fuch like; as any thing  that makes  him giddy is
 apt to occafion a fit.
   M E D 1  C I N E.       The  intentions of  cure  muft
 vary according to the caufe of the difeafe.  If the patient be
 of a fanguine temperament,  and there be reafon to fear an
 obftruaion of the  brain, bleeding and other evacuations will
 be neceffary.   When the difeafe is  occafioned  by the ftop-
 page of cuftomary evacuations, thefe, if poffible, muft be re-
 ftored ; if this cannot be done,  others may be fubftitutcd in
 their place.  Iffues or fetons,  in this cafe, have often a very
 good effea.  When there is reafon to believe that the difeafe
 proceeds from worms, proper medicines muft  be ufed to kill
 or carry off thefe vermin.  When the difeafe  proceeds from
 teething, tbe body fhould be kept open  by emollient clyfters,
 the feet frequently  bathed in warm water,  and,  if  the fits
 prove  obftinate, a bliftering-plafter  may  be  put betwixt the
 fhoulders.   The fame method is to be  followed,  when epi-
 leptic  fits precede the eruption ofthe fmall-pox or meafles,&c.
   When the difeafe is hereditary, or proceeds from a wrong
 formation of the brain, a cure is not to be expeaed. When it
 is owing to a debility, or too great an irritability of the ner-
 vous fyftem,  fuch medicines as tend to  brace and ftrengthen
 the nerves may be ufed,  as the  Peruvian bark, and fteel; or
 the  anti-epileptic  eleauaries  recommended  by  Fuller  and
 Mead *.
   The flowers of zinc have of late been  highly extolled for
 the cure ofthe epilepfy.   Though  this medicine will not be
 found to anfwer the expeaations which have been raifed  con-
 cerning it, yet  in  Obftinate epileptic cafes it deferves a trial.
 The dofe is from one to  three  or four grains, which may be
 taken  either  in pills or a bolus, as the patient inclines.  The
 beft method  is to begin  with a fingle grain four or five times
 a-day, and gradually to increafe the  dofe as far as the  patient
 can bear it.  1 have  known this medicine, when  duly  perfift-
 ed in, prove  beneficial.
                                                   Mufk
       * See Appendix, Electuary for the Epilepfy. 
     PR  FALLING  SICKNESS.      335

  Mufk has fometimes been found to fucceed in the epilepfy.
Ten or twelve grains of it, with the fame quantity of faaiti-
ous cinnabai, may be made up into a bolus* and taken every
night and morning.
  Sometimes the epilepfy has been cured by efearicity.
  Convulfion fits proceed from the fame caufes, and muft be
treated  in the fame manner as the epilepfy.
  There is one particular  fpecies of convulfion fits which
commonly goes by the name  of St.'Vitus's dance,  wherein
the patient is agitated with ftrange motions and gefticulations*
which by the common people are generally believed to be th©
effeas of witchcraft.  This difeafe may be cured by repeat-
ed bleedings and purges ; and afterwards ufing the medicines?
prefcribed above for the  epilepfy, viz. the Peruvian bark,
and fnake-root, &c. Chalybeate-waters are found to be be-
neficial in this  cafe.  The cold  bath is likewife of lingular
fervice, and ought never to be negfeaed when the patient can-
bear it.

     OF      THE     HICCUP.

   The hiccup is a fpafmodic  or eonvulfive affeaion of the
ftomach and  midriff, arifing from any caufe that irritates  their
nervous fibres.
   It may proceed from  excefs in eating  or drinking ;  from a
hurt ofthe ftomach ; poifons;  inflammations or fcirrhus tu-
mours  of the ftomach, inteftines, bladder, midriff, or the reft
of the  vifcera.  In gangrenes, acute and malignant fevers, a
hiccup is often  the forerunner of death.
   When the hiccup proceeds  from the  ufe of aliment that is
flatulent, or hard of digeftion, a draught of generous wine, or
a dram of any fpirituous liquor, will generally remove it.  If
poifon  be the caufe, plenty of milk and oil muft be drank,  as
has been formerly recommended.  When it proceeds from an
inflammation of the ftomach, &c. it is  very dangerous.  In
this cafe the  cooling regimen ought to  be ftriaiy obferved.
The patient muft be bled, and  take frequently a few  drops
of the  fweet fpirits of nitre in a cup of wine-whey.   His fto-
mach fhould likewife be fomented with cloths dipped in warn*
water ; or have bladders filled with warm milk and water ap-
plied to it.
   When  the hiccup proceeds from a gangrene or mortifica-
tion, the Peruvian bark,  with other antifeptics, are the only
medicines  which have a< chance to fucceed.  When it is a
                                                 primary 
tfi        df   frIE   flICCUP.

primary difeafe, and proceeds from a foul ftomach, loaded ei-
ther with a pituitous or a bilious humour,  a gentle vomit and
purge, if the patient be able to bear them,  will be of fervice.
If itarifes from flatulencies, the carminative medicines, di^
reaed for the heart-bum, mufl; be ufed.
  When ..he hiccup proves very obftinate, recourfe muft be
had to the moft powerful aromatic and  antifpafmodic medi-
cims.   The principal of thefe is mufk;  fifteen or twenty
grains of which may be made into a bcdus, and repeated oc-
cafionally.  Opiates are likewife of fervice; but they muft be
ufed with caution.^  A bit of fugar dipped  in compound fpi-
rits of  lavender,  or the  volatile aromatic  tinaure, may  be
taken frequently.   External applications are  fometimes alfo
beneficial;  as  the ftomach plafter; or a cataplafm of the Ve-
nice treacle of the Edinburgh  or  London difpenfatory, ap-
plied to the region of the ftomach.
  I lately attended a patient who had almoft a conftant hic-
cup for above  nine weeks.  It  was frequently ftopped by the
ufe of mufk, opium, wine, and other cordial  and antifpaf-
modic medicines, but always  returned.  Nothing however
gave the patient fo much eafe as brifk fmall beer.   By drink-
ing freely of this, the hiccup was often kept off for feveral
days,  which was more than could be done by the moft  pow-
erful medicines.   The patient was at length feized with a vo->
miting of blood,  which foon put an end to his life.   Upon
opening the body, a large fcirrhus tumour was found  near-
the pylorus or  right orifece of the  ftomach.

    CRAMP  OF   THE   STOMACH,

  This difeafe often feizes people fuddenly, is very danger
rous,  and requiies immediate affiftance.  It is moft incident
to perfons in the deeline of life, efpecially the nervous, gott-
ty,  hyftcric, and hypochondriac.
  If the patient has any inclination to vomit,  he ought to
take fome  draughts of warm water, or weak camomile tea,
to clean his ftomach.  After this,  if he has been coftive, a
laxative clyfter may be given.   He ought then to take lauda-
num.   The beft way  of adminiftering It, is  in a clyfter.
Sixty or feventy drops of liquid laudanum may be given in  a
clyfter of warm  water.  This is  much  more certain than
laudanum given by the raouth, which is often vomited, and
in fome cafes increafes the pain and fpafms  m the ftomach.
  If the pain  and cramps return with  great violence, after
the effeas of the anodyne clyfter are over, another, with an
                                                   equal 
    CRAMP  OF  THE  STOMACH.    337

equal or larger quantity of opium, may be given ;  and eve-
ry four or five hours a bolus with ten or twelve grains of mufk
and half a dram uf the Venice treacle.
  In the mean time, the ftomach ought to be fomented with
cloths dipped in warm water ; of bladders filled  with warm
milk and water, fhould be conftantly applied to it.   I have
often  feen thefe produce the moft happy  effeas.  The ano-
dyne balfam may alfo be rubbed on the part affeaed ; and  art
anti-hyfteric plafter worn upon it, for fome time after the
cramps are removed,  to prevent their return.
   In  very violent and lafting pains  of the  ftomach,  fome
blood ought to be let, unlefs the weaknefs of the patient for-
bids it.   When the pain or cramps proceed from a fuppreffi-
on of the menfes,  bleeding is of ufe.   If they  be  owing to
the gout,  recourfe muft  be had to fpirits*  or  fome of the
warm cordial waters.  Bliftering-plafters ought likewife, in
this cafe,  to be applied to the ancles.   I have often feen  vi-
olent cramps and pains of the ftomach removed by covering
it with a large plafter of Venice treacle.

         OF  THE   NIGHT-MARE.

   In this difeafe  the patient, in time of fleep, imagines  he
 feels an uncommon oppreffion or weight about his breaft or
 ftomach,  which he can  by no means  fhake off.  He groans,
 and fometimes cries out,  though oftener he attempts to fpeak
 in vain.  Sometimes he imagines himfelf engaged with an
 enemy, and, in danger of being killed, attemps to run away,
 but finds he cannot.   Sometimes he fancies himfelf in a houffc
 that is on fire, or that he is in danger of being drowned  in a
 fiver.  He often  thinks he is falling over  a precipice,  and
 the dread of  being dafhed to  pieces fuddenly awakes him.
   This diforder has been fuppofed to proceed from too much
 blood; from a ftagnation of  blood in the brain, lungs,  &c.
 But  it is  rather a nervous affeaion,  and arifes chiefly from
 indigeftion.   Hence we find  that perfons of weak nerves,
 who lead a fedentary life,  and live full, are moft commonly
  affliaed with the night-mare.  Nothing tends more to  pro-
 duce it than heavy "fuppers,  efpecially when ate late, or the
 patient goes to bed foon after.   Wind is likewife a very fre-
  quent caufe  of this  difeafe;  for which reafon  thofe who are
 affliaed  with it ought to  avoid all flatulent food. Deep
 thought,  anxiety,  or  any  thing that oppreffes the mind,
  ought alfo to be avoided. 
 3$       OF  THE  NIGHT-MARE.

   As perfons affliaed with the night-mare generally moarr,
 or make fome noife in the fit,  they fhould be waked, or fpo-
 ken to by fuch as hear them, as the uneafinefs generally goes
 off as foon as the patient is awake.  Dr. Whytt fays, he ge-
 nerally found a dram of brandy, taken at bed-time, prevent
 this difeafe.   That, however, is a bad cuftom, and, in time,
 lofes its effea.  We would rather have the patient depend
 upon the  ufe of food of eafy digeftion, cheerfulnefs, exercife
 through the day, and a light fupper taken  early, than to  ac-
 cuftom himfelf to drams.  A  glafs of peppermint-water will
 often promote digeftion as much as a  glafs of brandy, and is
 much fafer.   After a perfon of weak digeftion  however  has
 ate flatulent food, a dram may be neceffary ; in this cafe  we
 would recommend it as the moft proper medicine.
   Perfons who are young,  and  full of blood,  if troubled
 with the  night-mare,  ought to take a purge frequently, and
 ufe a fpatediet.

            OF    SWOONINGS,

   People of weak nerves or delicate conftitutions are liable
 to fwoonings or fainting fits.   Thefe indeed are feldom dan-
 gerous when duly attended to  ; but when wholly neglefted,
 or improperly treated, they often prove hurtful, and fome-
 times fatal.
   The general caufes of fwoonings  are fudden tranfitions
 from cold to heat;  breathing air that  is  deprived of its pro-
 per fpring or elafticity ;  great  fatigue; exceffive weaknefs;
 lofs of blood; long  falling;  fear, grief,  and other violent
 paffions or affeaions of the mind.
   It is well known, that perfons who  have been long expofed
 to cold, often faint or fall into a fwoon, upon  coming into
 the houfe, efpecially if they drink hot  liquor,  or fit  near a
 large fire.  This might eafily  be prevented by people taking
 care not to go into a warm room immediately after they have
 been expofed  to the cold air, to approach the fire gradually,
 and not to eat or drink any thing hot, till the body  has been
 gradually  brought into a warm temperature.
   When  any one,  in confequence of negleaing thefe pre-
 cautions,  falls into a fwoon, he ought immediately to be  re-
 moved to a  cooler apartment,  to   have ligatures  applied
 above his  knees and elbows, and  to have his hands  and face
fprinkled with vinegar or cold water.   He fhould likewife be
 made to fmell to vinegar, and fhould have a  fpoonful or two
                                                      of 
OF    S W O O N I N G  S.
339
of water,  if he can fwallow, with about a third part of vi-
negar mixed with it, poured into his mouth.  If thefe fhould
not remove the complaint,  it will be neceffary to bleed  the
patient, and afterwards to give him a clyfter.
  As air that  is breathed frequently,  lofes its elafticity  or
fpring, it is no wonder if perfons who refpire in it often fall
into a fwoon or fainting fit.   They are, in this cafe, depriv-
ed of the very principle of life.   Hence it is that fainting fits
are fo  frequent  in all crowded affemblies, efpecially in  hot
feafons.  Such fits however muft be confidered as a kind  of
temporary death ;  and,  to the weak and delicate, they fome-
times prove fatal.  They ought therefore with the utmoft care
to be guarded  againft.   The method of doing this  is  obvi-
ous.   Let affembly-rooms, and all other places of public re-
fort, be large  and well ventilated ;  and let the weak  and de-
licate avoid fuch places, particularly  in warm feafons.
   A perfon who faints, in fuch a fituation, ought  immedi-
ately to be carried into the open air ;  his temples fhould  be
rubbed with ftrong vinegar or brandy,  and volatile  fpirits or
falts held to his nofe. Heihould be laid upon his back with his
head low, and have a little wine, or fome other cordial, poured
into his mouth, as foon as he i^ able to fwallow it. If the per-
fon  has been fubjea to hyfteric  fits,   caftor or  afafoetida,
 fhould be applied to the nofe, or, burnt feathers,  horn, or lea-
 ther, &c.
   When fainting fits proceed from mere weaknefs or exhaus-
 tion, which is often the cafe after great fatigue,  long fafting,
 lofs of blood,  or the like, the patient muft be fupported with
 generous cordials; as jellies, wines, fpirituous liquors, &c.
 Thefe however muft be given at firft in very fmall quantities,
 and increafed  gradually  as  the patient is  able to bear them.
 He ought to be  allowed to lie quite ftill  and eafy upon  his
 back,  with his head low, and  fhould have frefh air admitted
 into his  chamber.   His food fhould  confift of nourifhing
 broths, fago-gruel with wine,  new  milk, and  other  things
 of a light and cordial nature.  Thefe things are to  be given
 out of the fit.  All that can be done in the fit is, to let him
 fmell to a bottle of Hungary-water, eau de luce,  or fpirits of
 hartfhorn, and to rub his temples with warm brandy, or  to
 lay a comprefs dipped in it to the pit of the ftomach.
   In fainting fits that proceed  from fear,  grief,  or other Vio-
 lent paflions or affeaions of the mind, the patient muft  be
 very cautioufly managed.   He fhould be fuffered to remain
 at reft, and only made  to fmell to fome vinegar.   After he is.
                                                     come 
34©          OF   S  W O  O  N  I  N  G S.
come to himfelf he may drink freely of warm lemonade, or
balm-tea,  with fome orange or  lemon-peel  in  it.   It  will
likewife be proper, if the fainting fits have been long and
fevere, to  clean the bowels by throwing in an emollient clyf-
ter.
   It is common in fainting fits, from  whatever caufe they
proceed, to bleed  the patient.   This praaice may be very
proper in  ftrong perfons  of a full  habit; but in thofe who
are weak  and delicate, or fubjea to nervous diforders, it is
dangerous.  The proper method with  fuch  people is to ex-
pofe them to the free air,  and to ufe cordial  and ftimulating
medicines, as volatile falts, Hungary-water, fpirits of laven*
der, tinaure of caftor, and the like.

   OF  FLATULENCIES,  OR   WIND.

   All nervous  patients,  without exception, are affliaed
with wind or flatulencies in the  ftomach and bowels, which
arifes chiefly  from the want of tone or  vigour in thefe or-
gans.   Crude flatulent aliment, as  dried flefh,  beans, cole-
worts, cabbages, and fuch like, may increafe this complaint;
but ftrong and healthy people are feldom troubled with wind,
unlefs they either overload their ftomachs, or drink  liquors
that are in a fermenting ftate, and confequently full of elaftic
air.   Wbile therefore the matter of flatulence proceeds from
our aliments,  the caufe which makes air feparate from them
in fuch quantity as to occafion complaints is almoft always a
fault of the bowels themfelves,  which are too weak either to
prevent the production of elaftic air, or to expel  it after it is
produced.
   To relieve this  complaint,  fuch medicines ought to be
ufed as have a tendency to expel wind, and,  by ftrengthen-
ing the alimentary canal, to prevent its  being produced there.
   The lift of medicine? for expelling wind is very numerous;
they often however difappoint the expeaations of both the
phyfician  and his patient.  The moft  celebrated among the
clafs of carminatives are, juniper berries ; the roots of ginger
and zedoary; the feeds of anife,  caraway,   and coriander;
gum afafoetida and opium ; the warm waters, tindures, and
fpirits, as  the aromatic water, the tinaure of wood-foot, the
volatile aromatic fpirit, aether, &c.
   Dr. Whytt fays, he found  no medicines  more efficacious
in expelling wind than aether and laudanum.  He generally
gave  the laudanum in a mixture with peppermint-water and
                                                 tinaure 
OF   FLATULENCIES,   OR  WIND.
tinaure of caftor,  or fweet fpirits of nitre.  Sometimes, in
place of this, he gave opium in pills with afafoetida.  He ob-
ferves, that the good effeas of opiates are equally conspicu-
ous,  whether the flatulence be contained in  the ftomach or
inteftines ; whereas thefe warm medicines, commonly called
carminatives, do not often give immediate relief, except when
the wind  is in the ftomach.
  With regard to aether, the Doaor fays, he has often feen
very  good effeas from it in flatulent complaints, where other
medicines failed.   The dofe  is  a tea-fpoonful mixed   with
two table-fpoonfuls of water *.   In gouty cafes he obferves,
that aether, a dram  of French brandy, or of the aromatic wa-
ter, or  ginger either taken in fubftance or infufed  in boiling
water,  are among the beft medicines for expelling wind.
   When the cafe of flatulent patients is fuch as makes it im-
proper  to give them warm medicines  inwardly, the Doaor
recommends external applications, which are fometimes of
advantage.   Equal  parts of the  anti-hyfteric and ftomach
plafter  may be fpread upon a piece of  foft leather, of  fuch
fize as  to cover the greater part ofthe belly.   This fhould be
kept en for a confiderable time, provided the  patient be  able
to bear it; if it fhould give great uneafinefs, it may be taken
off, and the following liniment ufed in  its ftead.
   Take of Bate's anodyne balfam an ounce;  of theexpreffed
oil of  mace half an ounce ;  oil  of mint two drams.  Let
thefe ingredients be mixed together, and about a table-fpoon-
ful well rubbed on  the parts at bed-time.
   For  ftrengthening the  ftomach and bowels,  and  confe-
quently for leffening the produaion of flatulence, the Doc-
tor recommends the Peruvian bark, bitters, chalybeates, and
exercife,   In flatulent cafes, he thinks fome  nutmeg or gin-
ger  fhould be added to the tinaure of the bark and bitters,
and  that the  aromatic powder fhould be joined with the
filings of iron.
   When  windy complaints  are attended with  coftivenefs,
which  is often the  cafe, few things will  be found to anfwer
better  than four  or five  of  the following pills taken every
night at bed-time.
   Take of afafoetida two drams ; facotrine aloes, fait of iron,
and powdered ginger,  of each one dram ; as  much of the e-
lixir proprietatis as will be fufficient to form them into pills.
                                                     On
  * Though the patient may begin with this quantity, it will be
neceflary to increafe the dofe gradually as the ftomach can bear it.
ALther  is now given in  confiderably greater dofce than it was iu
pr. Whytt's time. 
342     OF  FLATULENCIES,  OR  WIND.

  On the other hand, when the body is too open,  twelve or
fifteen grains of rhubarb, with half a dram or two fcruples of
the Japonic confeaion, given every other evening, will have
very good effeas.
  In thofe flatulent complaints which come on about the time
the menfes ceafe, repeated fmall bleedings often give more re-
lief than any other remedy.
  With regard to diet, the Doaor obferves,  that tea and all
flatulent aliments  are to be avoided ;  and that for drink, wa-
ter  with a little brandy or rum is not only preferable to malt
liquor, but,  in moft cafes, alfo to wine.
  As Dr. Whytt has paid great attention to this fubjea, and
and as his fentiments upon it in a great meafure agree with
mine, I  have taken the liberty to  adopt them ; and fhall only
add to his obfervations, that exercife is, in my opinion, fupe-
rior to all medicine, both for preventing the production, and
likewife for  expelling of flatulencies.  Thefe trfedis,  how-
ever, are not to be expeaed from fauntering about, or lolling
in a carriage;  but from labour, or fuch aaive amufements as
give exercife to every part of the body.

          OF    LOW   SPIRITS.

  All  who have weak nerves are fubjea to low fpirits in a
greater or lefs degree.  Generous diet,  the cold bath,  exer-
cife and amufements, are the moft  likely means  to remove
this complaint.   It  is greatly  increafed by folitude and in-
dulging gloomy ideas; but may often be relieved by cheerful
company and fprightly amufements.
   When low fpirits are owing to a weak relaxed ftate ofthe
ftomach and bowels,  an  infufion  of  the Peruvian bark with
cinnamon or nutmeg will be proper.   Steel joined with aro-
matics may likewife in this cafe be ufed with advantage ; but
riding, and a proper diet, are moft to be depended on.
  When they arife from a foulnefs ofthe ftomach and intef-
tines, or obftruaions in  the hypochondriac vifcera,  aloetic
purges will  be proper.   I  have fometimes known the Har-
rowgate fulphur-water of fervice in this cafe.
   When low fpirits  proceed from a fuppreffion of the men-
ftrual or of the haemorrhoidal flux, thefe evacuations may ei-
ther be reftored, or fome others fubftituted in their place, as
iffues, fetons, or the like.  Dr. Whytt obferves, that nothing
has fuch fudden good effeas in this cafe as bleeding.
   When low  fpirits have been brought on by long-continued
grief, anxiety, or other diftrefs of mind, agreeable company,
                                                  variety 
O^F   LOW   SPIRITS.
?43
variety of amufements, and change of place,  efpecially tra-
velling into foreign countries, will afford the moft certain re-
lief.
  Perfons affliaed with low fpirits fhould avoid  all kind of
excefs, efpecially of venery and  ftrong liquors.  The mode-
rate ufe of  wine and other ftrong liquors is  by no means
hurtful, but when taken to excefs they weaken the ftomach,
vitiate the humours, and deprefs the fpirits.  This caution is
the more neceffary,  as the unfortunate and melancholy often
fly to ftrong liquors for relief,  by which means they neves
fail to precipitate their own deftruaion.

   OF  HYSTERIC   AFFECTIONS.

   These likewife belong to the numerous tribe of  nervous
difeafes, which may be juftly reckoned the reproach of medi-
cine.   Women  of a  delicate habit, whofe ftomach  and in-
 teftines are relaxed,  and whofe nervous fyftem is extremely
fenfible, are moft fubjea to hyfteric complaints. In fuch per-
fons a hyfteric fit, as  it is called, may be brought on by an
irritation of the nerves ofthe ftomach or inteftines, by wind,
acrid humour, or the like.  A fudden fuppreffion of the menfes
often gives rife to hyfteric fits.   They may likewife be excit-
ed by violent paffions or affeaions of the mind, as fear, grief,
 anger,  or  great difappointments.
   Sometimes the hyfteric fit refembles a fwoon or faintingfit,
 during which the patient lies as in afleep, only the breathing
 is fo low as fcarce to be perceived.   At other times the pati-
 ent is affeaed with catchings and ftrong convulfions.  The
 fymptoms  which precede hyfteric fits are likewife various in
 different perfons.  Sometimes the fits come on with  coldnefs
 ofthe extremities, yawning and ftretching, lownefs of fpirits,
 oppreffion and anxiety.  At other times  the approach ofthe
 fit is foretold by a feeling as if there were a ball at the lower
 part of the belly, which gradually  rifes towards the ftomach,
 where it occafions inflation,  ficknefs,  and fometimes vomit-
 ing ; afterwards it rifes into the gullet, and  occafions a de-
 <rree'of fuffocation,  to which quick breathing, palpitation of
 foe heart, giddinefs of the head, dimnefs of the fight, lofs of
 hearing, with convulfive motions of the extremities and other
 parts of the body, fucceed.
   Our aim in the treatment of this difeafe muft be to lhorten
 the fit or paroxyfm  when  prefent,  and to prevent its return.
 The lonner the fits continue,  and the moie frequently  they
         fa                                          return, 
344   OF  HYSTERIC  AFFECTIONS.

return,  the difeafe  becomes  the more obftinate.   Theif
ftrength  is increafed  by habit, and  they induce fo great a
relaxation of  the fyftem, that it is with difficulty removed.
  It is  cuftomary, during the hyfteric  fit or paroxyfm, to
bleed the patient.   In ftrong perfons of a plethoric habit*
and  where the pulfe is full, this may  be proper ; but in weak
and delicate conftitutions,  or  where the difeafe has been of
long ftanding, or arifes from inanition,  it is not fafe.  The
beft courfe in fuch  cafes  is to roufe the patient  by ftrong
fmells, as burnt feathers, afafoetida,  or fpirits  of  hartfhorn,
held to the nofe.   Hot bricks may alfo be applied to the foles
of the  feet,  and  the legs, arms  and belly may be ftrongly
rubbed  with  a  warm cloth.  But the beft application is to
put the  feet and  legs  into warm water.  This is peculiar!/
proper when the fits precede the flow of the menfes.  In cafe
of coftivenefs, a laxative clyfter with afafoetida will be pro-
per ; and, as foon as the patient can  fwallow,  two table-
fpoonfuls of a folution of afafoetida, or of fome cordial julep,
may be given.
  The radical cure of this diforder will be beft attempted at
a time when the patient is moft  free from the fits.  It will
be greatly  promoted by a proper attention  to  diet.   A milk
and vegetable diet, when duly perfifted in, will often perform
a cure.   If, however,  the patient has been accuftomed to a
more generous diet, it will not be fafe to leave it  off all at
once, but by  degrees.   The moft proper drink is water with
a fmall quantity of fpirits.   A cool dry air is the beft.  Cold
bathing and every thing that braces the nerves, and invigo-
rates the fyftem,  is beneficial;  but lying too long in bed, or
whatever relaxes  the body,  is hurtful.   It is of the greateft
importance to have the mind kept conftantly eafy and cheer-
ful, and, if poffible, to have it always engaged  in fome agree-
able and interefting purfuit.
  The proper medicines are thofe which ftrengthen the ali-
mentary canal and the whole nervous fyftem, as the prepara-
tions of iron, the Peruvian bark, and  other bitters.   Twenty
drops ofthe elixir of vitriol in  a cup of the infufion of the
bark may be taken twice or thrice a-day. The bark and iron
may likewife be taken in fubftance,  provided the ftomach
can bear them ;  but they are generally given  in too  fmall
dofes to have any effea.   The chalybeate waters generally
prove beneficial in this diforder.
  If the ftomach be loaded with phlegm, vomits  will be of
ufe j but they fhould  not be too  ftrong, nor frequently re-
                                                  peated, 
   Of  HYSTERIC  AFFECTIONS,    345

 peated, as  they tend to relax and weaken the ftomach.  If
 there be a tendency to coftivenefs,  it muft be removed either
 by diet, or  by taking an opening pill as often as  it fhall be
 found neceffary.
   To leffert the irritability of  the fyftem, antifpafmodic me-
 dicines will be of ufe.  The beft antifpafmodic medicines are
 rhufk, opium,  and caftor.  When opium difagrees with the
 ftomach, it may either be applied externally* or given in clyf*
 ters.   It Is often  fuccefsful in removing thefe  periodical
 head-achs  to which hyfteric and hypochondriac patients are
 fubjea.  Caftor has in fome cafes been found to procure fleep
 where opium failed; for which reafon  Dr. Whytt advifes,
 that  they  fhould be joined together.   He likewife recom-
 mends the  anti-hyfteric plafter  to be applied to tbe abdomen**
   Hyfteric women are often affliaed with cramps  in various)
 parts ofthe body, Which are moft apt to feize them  in bed, or
 when afleep.  The moft efficacious medicines in this cafe are
 opium, bliftering-plafters,  and warm bathing or fomentati-
 ons.   When the cramp or fpafm is very violent,   opium is
 the remedy moft to  be depended  on.   In milder cafes im-*
 rherfing the feet and legs in warm water, or applying a blif-
 tering-plafter to the part affeaed,  will often be fufficient to
 remove the complaint.  In patients whofe nerves are un-
 commonly  delicate and fenfible, it will be better to omit the
 bliftering-plafter,  and to attempt the cure by opiates, mufk*
 camphire, and the warm bath.
   Cramps are often prevented or cured by compreffion. Thus
 cramps in the legs are prevented, and fometimes removed by
 tight  bandages ; and when convulfions arife from a flatulent
 diftention of the inteftines, or  from fpafms beginning  in
 them, they  may be often lefiened or cured by making a pret-
 ty ftrong compreffion upon  the abdomen by means of a broad
 belt.   A roll  of brimftone held  in the hand is frequently
 ufed as a remedy for cramps : Though this feems  to owe it's
 effea chiefly to imagination; yet,  as it fomes fucceeds, it
 merits a trial f.   When fpafms  or convulfive motions arife
 from fharp humours in the ftomach and inteftines,  no lafline
                         S s                       relief

  * Thoueh  antifpafmodics and anodyneB are umverfally recom-
 mended in this dffeafe, yet all the extraordinary cures that I ever
 knew  in hyfteric cafes were performed by means  of  tonic  and

 CTtretiperiio1i:sdia1fnfded  with cramps pretend to reap great be.
At from fmall bundles of  rofemary usd all wght about thus
feet, ancles, and knees. 
346    OF   HYSTERIC   AFFECTIONS.

relief can be procured till thefe are either correaed or expel-
led.  The Peruvian bark has fometimes cured periodic con-
vulfions after other medicines had failed.

     OF  HYPOCHONDRIAC  AFFECTIONS.

  This difeafe generally attacks the indolent, the luxurious,
the unfortunate,  and  the ftudious.   It becomes daily more
common in this country, owing, no doubt, to the increafe of
luxury and fedentary employments.  It has fo near a refem-
blance  to  the immediately preceding, that many authors
confider them as the fame difeafe, and treat them according-
ly.   They require however a  very different regimen; and
the fymptoms of the latter, though lefs violent, are more per-
manent than thofe ofthe former.
  Men of a melancholy temperament,  whofe minds  are ca-
pable  of great attention, and whofe paflions are not eafily
moved, are in the advanced  periods of life, moft liable to this
difeafe.  It is ufually  brought  on by long  and ferious at-
tention to abftrufe fubjeas, grief, the fuppreffion of cuftom-
ary evacuations, excefs of venery,  the repulfion of cutaneous
eruptions, long-continued evacuations,  obftruaions in fome
of the vifcera, as the liver, fpleen, &c.
   Hypochondriac perfons ought never to fall long,  and their
food fhould be folid  and  nourifhing.  All acefcent and
windy  vegetables are  to be avoided.   Flefh  meats agree
beft with them, and their drink fhould be old claret, or good
Madeira.  Should  thefe difagree with the  ftomach, water
with a Jittle brandy or  rum in it may be drunk.
   Cheerfulnefs and ferenity of  mind are by all means to be
cultivated.   Exercife of every kind is ufeful.  The cold bath
is likewife beneficial ;  and,  where it does not agree with the
patient, friaions with  the flefh-brufh or  a coarfe cloth may
be tried.  If  the patient has it in his power,  he ought to
travel  either by fea or  land.  A voyage or  a long journey,
efpecially towards a warmer  climate, will be of more fervice
than any medicine.
   Tbe general intentions  of  cure  in this difeafe  are to
ftrengthen  the alimentary canal, and  to promote the fecre-
tions.   Thefe intentions will be beft anfwered by the  differ-
ent preparations of iron and  the  Peruvian bark,  which after
proper evacuations, may be  taken in the fame manner as  di-
reaed in the preceding difeafe.
  If the patient be coftive,  it will be neceffary to make  ufe
of fome gentle opening medicine, as pills compofed of equal
                                                   parts 
OF  HYPOCHONDRIAC  AFFECTIONS.    347
parts of aloes, rhubarb, and afafcetida,  with as much of the
elixir proprietatis as is neceffary to form the ingredients into
pills.   Two, three, or four of thefe may be taken as often as
it fhall be found needful, to keep the body gently open. Such
as cannot bear the afafcetida may fubftitute Spanifh foap in its
place.
  Though a cheerful glafs may have good effeas in this dif-
eafe, yet all manner of excefs is hurtful.   Intenfe  ftudy, and
every thing that depreffes the fpirits, are likewife pernicious.
  Though  the general  fymptoms and treatment of nervous
diforders  were pointed out in  the beginning of this chapter ;
yet, for the behoof of the unhappy perfons affliaed with thofe
obftinate and complicated maladies, I have treated feveral of
their capital fymptoms under diftina or feparate heads. Thefe
however are not to he  confidered as different difeafes, but
as various modifications of  the fame difeafe.   They all arife
from  the fame  general caufes,  and require nearly the fame
method of treatment.  There  are many other  fymptoms that
merit particular attention, which the nature of my plan will
not permit  me to  treat at full  length.  I lhall therefore omit
them altogether, and conclude this chapter with a few gene-
ral remarks on the moft obvious means of  preventing or a-
voiding nervous diforders.
   In all perfons affliaed with  nervous diforders,  there is a
 great delicacy and fenfibility of  the whole nervous fyftem, and
 an uncommon degree of  weaknefs of the organs of digeftion.
 Thefe may be either natural  or acquired.  When owing to
 a defea in the conftitution, they are hardly to be removed ;
 but may be mitigated  by proper care.  When  induced  by
difeafes, as long or repeated fevers,  profufe haemorrhages, or
 the like, they prove alfo very obftinate,  and will yield only
 to acoarfe of regimen calculated to reftore and invigorate the
 habit.
   But nervous  affeaions arife more frequently  from caufes
 which it is, in a great meafure, in our own power to avoid,
 than from  difeafes, or  an original fault in the conftitution,
 &c.   Exceffive grief,  intenfe ftudy, improper diet, and ne-
 gfea of exercife, are the great  fources of this extenfive clafs
 of difeafes.                     *
   It has been  already obferved, that grief indulged deftroys
 the appetite and  digeftion, depreffes the  fpirits,  and  induces
 an univerfal relaxation and debility ofthe whole fyftem. In-
 ftances of this are daily to be feen.  The lofs of a near rela-
 tion, or any other misfortune in life, is often  fufficient to oc-
           1                                       cafion 
348    OF  HYPOCHONDRIAC AFFECTIONS.

cafion the moft complicated feries of nervous fymptoms. Such
misfortunes indeed are not to be avoided, but furely their ef-
feas, by a vigorous and proper exertion of the mind, might
be rendered lefs hurtful.  For direaions  in  this matter we
muft refer  the reader to the article  Grief in  the chapter on
thePaffians.
  The effeas of intenfe ftudy are pretty fimilar to thofe oc-
cafioned  by grief.   It preys upon the animal fpirits,  and de-
ftroys the appetite and digeftion.   To prevent  thefe effeas,
ftudious perfons ought,, according  to  the Poet, to toy with
their books *.  They fhould never ftudy too long at  a time;
nor attend long  to one particular fubjea, efpecially if it be
of a ferious nature.  They ought likewife to be attentive to
their pofture,  and  fhould take care frequently to  unbend
their  minds by mufic, diverfions,  and going  into agreeable
company.
  With  regard  to  diet, I fhall only obferve, that  nervous
difeafes may be induced either by excefs or inanition.  Both
of thefe  extremes  hurt  digeftion,  and  vitiate the humours.
When Nature is oppreffed with frefh loads of food, before
flie has had  time to digeft and affimilate the former meal, her
powers are weakened, and the veffels are filled with crude hu-
mours.   On the other hand, when the food is not fuflicient-
ly nourifhing, or is taken too feldom, the bowels are inflated
with wind,  and the humours, for want of regular frefh fup-
plies of wholefome chyle, are vitiated.  Thefe extremes are
therefore with equal care  to  be avoided.   They both tend to
induce a  relaxation and debility of the nervous fyftem, with
all its dreadful train of confequences.
  But the moft general  caufe of  nervous diforders  is indc
hnce.   Tbe aaive  and laborious  are feldom  troubled with
them.  They are  referved for the children of eafe and af-
fluence, who generally feel their keeneft force.   All we fhajl
fay to fuch perfons is, that the means of prevention and cure
are both  in their own power.  If  the conftitution of human
nature be fuch, that man muft either labour  or fuffer difeaf-
es,  furely no individual has  any right to ex,pea an exemption
from the general rule.
  Thofe, however,  who are willing to  take  exercife., but
whofe occupations confine them to the houfe, and perhaps to
an unfavourable pofture, really deferve our pity.  We have
in a former part of the book endeavoured to lay down rules
for their condua;  and fhall only add,  that where thefe can-
                                                    not
         * Armftrong on  Health, 
   QF  HYPOCHONDRIAC  AFFECTIONS.    349

not be complied with, their place may, in fome meafure, be
fupplied by the ufe of bracing and ftrengthening medicines ;
as the Peruvian bark, with other bitters;  the preparations of
fteel; the elixir of vitriol, he.
                            1  -  1 "1— ~ 1-----      —*-- r..... ~itm

               CHAP.     XLIV.

   DISORDERS   OF   THE  SENSES.

        WE do not mean to treat of the nature of our fenfati-
         ons, or to give a  minute defcription of the various
organs by which they are performed; but to point out fome of
the difeafes to which thefe organs are moft liable, and to fhew
how they may be prevented  and remedied,

               OF  THE    EYE,

  No organ of the body is fubjea to more difeafes  than the
eye ; nor is there any one of which the difeafes are more dif-
ficult to cure.  Though more  ignorant perfons pretend to
cure thefe than any other  clafs of difeafes ; yet a very  fuper-
ficial acquaintance with the ftruaure of the eye,  and the na-
ture of vifion, will  be fufficient to convince any one  of the
danger of trufting to them.  Thefe difeafes often exceed the
fkill of the moft learned phyfician ; hence we may eafily infer
the dangerof trufting them to ignorantquacks, who, withoutall
peradventure, put out more eyes than they cure.  But, though
the difeafes of the eye can feldom be cured, they might often,
by due care,  be prevented ;  and, even where the fight  is to-
tally loft, many things might be  done, which are generally
negfeaed, to render the unhappy perfon both more  ufeful to
himfelf and to fociety *,
                                                    The

  * It is pity thofe who have the misfortune to be born blind, or
who lofe their fight when young, lhould be fuffered to remain in
ignorance, or to beg.   This is both cruelty and want of ceconomy.
There are many employments of which blind perfons are very
capable,  as  knitting, carding,  turning a wheel, teaching lan-
guages, &c.  Nor  are inftances wanting of perfons who have ar-
rived to  the higheft  pitch of learning, without having the leaft
idea of light.   Witnefs the late famous Nicholas Saunderfon, of
Cambridge, and  the no lefs famous Dr. Thomas Blacklock of
Edinburgh.  The  former was one  of the firft mathematicians of
his age,  and the latter, befides being a good poet and philofopher,
is mafter of all the learned languages,  and a  very confiderable
adept in the liberal arts. 
35©          OF    THE    EYE.

   The eyfes are hurt by viewing bright or luminous objea$« ^
keeping the head too long in a hanging pofture; violent head-
achs ;  exceffive venery ; the long  ufe  of bitters ; the  efflu-
via from acrid or volatile fubftances ;  various difeafes; as the
fmall-pox, meafles, &c. but, above all,  from night-watch-
ing, and candle-light ftudies.   Long fafting is likewife hurt-
ful to the eyes : and frequent heats and colds are no lefs per-
nicious.  The  eyes are often  hurt by the ftoppage of cu-
ftomary evacuations ; as  morning fweats; fweating  of the
feet; the menfes in women;  and  the bleeding piles in men.
All kinds of excefs are likewife hurtful to the fight, parti-
cularly the immoderate ufe of ardent fpirits and other ftrong
liquors.
   In all  difeafes of the eyes, efpecially thofe attended with
inflammation, the cool regimen ought to be obferved.  The
patient muft abftain from all fpirituous liquors.   The fmoke
of tobacco, fmoky rooms,  the  vapours  of onions and gar-
lic, and all vivid lights and glaring colours, are carefully to be
avoided.  The drink may be water,  whey, or fmall  beer;
and the aliment muft be light and  of eafy digeftion.
   For preventing diforders of the eyes,  iffues and fetons are
of  prime ufe.  Every perfon whofe eyes are tender ought to
have one or more of thefe in fome part of the body.  It will
likewife be of ufe to keep the body gently open, and either
to bleed-or purge every fpring and fall.  All excefs and night-
ftudies are to be avoided.  Such as do not chufe a feton or an
iffue, will find benefit from wearing a fmall Burgundy-pitch
plafter between their fhoulders.
   A gutta ferena, or amaurofis,  is an  abolition  of the  fight
without any apparent caufe or fault in the eyes.   When it is
owing  to a decay or wafting of the optic nerve,  it does not
admit of a cure ;  but when it proceeds from a compreffion of
the nerves by redundant  humours, thefe may in fome mea-
fure be drained off, and the patient relieved.  For this pur-
pofe, the body muft be kept open with the laxative mercurial
pills.  If the patient  be young  and of a fanguine habit, he
may be bled.   Cupping, with fcarifications on the back part
of the head, will likewife be of ufe.  A running at the nofe
may be promoted by volatile falts,  flimulating powders, &c
But the moft likely means for relieving the patient are iffues
or blifters kept open for a long  time on  the back part of the
head, behind the ears, or on the neck.   1 have known thefe
reftore fight, even  after it had been for  a  confiderable time
loft.
                                                 Should 
OF    THE    EYE.
  Should thefe fail, recourfe muft be had to a mercurial fali-
vation ;  or, what will perhaps anfwer  the purpofe better,
twelve grains of the  corrofive fublimate of mercury  may be
diffolved in an Englifh pint and half of brandy, and  a table-
fpoonful of it taken twice a-day, drinking half a pint of the
decoaion of farfaparilla after it.
  A cataracl is an obftruaion of the pupil, by the interpofi-
 tion of fome  opaque fubftance which either  diminifhes  or
totally extinguifhes the fight.   It  is generally an opacity  of
 the chryftalline humour.  In a recent or beginning cataraa,
the fame medicines are to be ufed as in the gutta ferena ; and
 they will fometimes  fucceed.   But when this does not hap-
 pen,  and the cataraa becomes firm,  it muft be couched,  or
 rather extraaed.  I have refolved a recent cataraa by giving
the patient frequent  purges with calomel,  keeping a  poultice
of frefh hemlock conftantly upon the eye, and a perpetual blif-
 ter on the neck.
   The  myopia, or  Jhort-fightednefs,  and  the prefbyopia,  or
feeing only at too great a diftance, are diforders which depend
 on the  original ftruaure or figure of the eye, therefore ad-
 mit of no cure.  The  inconveniencies  arifing from  them
 may however be, in fome meafure, remedied by the help of
 proper glaffes.   The former requires the aid of a concave,
 and the latter of a convex glafs.
   A ftrabifmus, or fquinting depends upon an irregular con-
 traaion of the mufcles of the  eye from a fpafm,  palfy, epi-
 lepfy, or an ill habit.  Children often contraa this  diforder
 by having their eyes unequally expofed to the light.  They
 may likewife acquire it by imitation from a fquinting  nurfe
 or  play-fellow, &c.  As this diforder can hardly be cured,
 parents ought to be  careful to prevent it.   Almoft the only
 thing which can be done for it  is,  to contrive a mafk for the
 child to wear,  which will only permit him to fee in a ftraight
 direaion.
   Spots or fpecks on the eyes are  generally the effea  of  in-
 flammation,  and often  appear  after the fmall-pox, the mea-
 fles,  or violent ophthalmias.   They are very difficult to cure,
 and often occafion total blindnefs.  If the fpecks are foft and
 thin, they may fometimes be  taken off by gentle  cauftics
 and  difcutients ;  as vitriol, the juice  of  celandine,  he.
 When thefe do not fucceed, a furgical operation may be tri-
 ed : The fuccefs of  this however is always very doubtful.
   The blood-Jhot eye may be cccafioned  by a ftroke, a fall,
 retching, vomiting, violent coughing, &c.  i have frequent- 
  35*         OF    THE     EYE.

  ly known  it happen to children In the hooping-cough,  ft
  appears at firft like a bit of fcarlet, and  Is  afterwards  of a
  livid or blackifh  colour.   This  diforder generally goes off
  without  medicine.  Should it prove obftinate, the  patient
  may be bled,  and have his eyes fomented with a decoaion of
  comphry roots and elder flowers.  A  foft  poultice may be
  applied to  the eyes ; and the body fhould  be kept open by
  gentle purgatives.
   The watery, or weeping eye, is generally occafioned by a
  relaxation or weaknefs of  the glandular parts  of that organ.
  Thefe may be  braced and ftrengthened by bathing the  eye
  with  brandy and water,  Hungary-water,  rofe-water with
  white  vitriol diffolved in  it, &c.   Medicines which make a
 revulfion are likewife proper;  as mild purgatives, perpetual
 blifters on the neck, bathing the feet frequently in lukewarm
 water, he.
   When  this  difeafe proceeds  from  an obftruaion of the
 lachrymal dua, or natural paffage of  the  tears, it is called
 a fiflula lachrymalis, and can only  be cured  by a furgical
 operation.

            OF    THE     EAR.

   The funaions of the ear may be injured  by wounds, ul-
 cers, or any thing that hurts its fabric.  The hearing may
 likewife be hurt by exceffive noife ;  violent colds in the head;
 fever;  hard wax, or other fubftances fticking in the cavity of
 the ear ; too great a degree of moifture or drynefs of the ear.
 Deafnefs is  very often the effea of old age, and is incident to
 moft people in the decline of life.   Sometimes  it is owing to
 an original fault in the ftruaure or formation of the ear itfelf.
 When  this  is the cafe,  it admits of  no cure; and the un-
 happy perfon not only continues deaf,  but generally likewife
 dumb,  for life **
                                                    When

  * Though  thofe who have! the misfortune to be born deaf are
 generally fuffered to continue dumb,  and  confequently  are in a
 great meafure loft to fociety, yet nothing is more certain than that
fuch perfon^may be taught, not only to read and write, but alfo to
fpeak, and to underftand what others fay to them.  Teaching the
dumb to fpeak will appear paradoxical to thofe who do notconfidet
that the formation of founds  is merely mechanical, and may be
taught without the  affiftance of the ear.  This is not only capable
of demonftration, but is actually reduced to practice by the inge-
nious Mr. Thomas  Braidwood of Edinburgh*   This gentleman 
         O   F    T   H  E    £   A   R.          253

  When deafnefs is the effea  of wounds  or  ulcers of the
cars, or of  old age, it is not eafily removed.   When it pro-
ceeds from  cold of the head,  the patient muft be careful to»
keep his head warm,  efpecially in the night;  he fhould like-
wife take fome gentle  purges,  and keep-his feet  warm, and
bathe them frequently in lukewarm water at bed-time. When
deafnefs is  the  effea  of a foyer, it generally goes  off after
the patient recovers.   If it proceeds  from dry wax fticking
in the ears, it may be foftened by dropping  oil into them;
afterwards  they muft be fyringed with warm milk and water.
  If deafnefs proceeds from drynefs of the ears, which may
be known by looking into  them, half an  ounce of the  oil
flf fweet almonds, and the fame quantity of liquid apodel-
doch,  or tinaure of afafcetida, may be mixed together, and
a few  drops  of it put into the  ear every night at bed-time,
flopping them afterwards with a little wool or cotton.  Some,
inflead of oil, put a fmall  flice of the fat of  bacon into each
ear, which is faid to anfwer the purpofe very well.  When the
ears abound with moifture, it may be drained off by an iffue
or feton, which fhould  be  made as near tbe affeaed parts as
poffible.
   Some, for the cure of deafnefs* recommend the gall of an
eel mixed with  fpirit of wine,  to be dropped  into the ear;
ethers,  equal  parts of  Hungary-water and  fpirit  of laven-
der.  Etmuler extols  amber  and mufk; and Brookes faysj
he has often known hardnefs of hearing cured by  putting  a
grain  ot two of mufk into the ear with cotton-wool.  But
thefe  and other applications muft be varied according to the
caufe of  the diforder.
                            T t                  Though

has, by the mere force of genius and application', brought the
teaching  of dumb perfons to fuch a degree of perfection, that his
fcholars are generally more forward in their education thin thofe
of  the fame age who  enjoy all their faculties.   They not only
read and write with the utmoft readinefs, but likewife fpeak, and
are capable of holding converfation with any perfon in the light.
What a  pity  any of the  human fpecies fliould remain in a ftate of
itliotifm,  who are capsule of being rendered as ufeful  and intel-
ligent as others !  Wc  mention this not only from humanity to
thofe who have the misfortune to be born deaf,  but alio in  juitice
to  Mr.  Braidwood, whofe  fuccefs has far exceeded all  former
attempts  this way;  and indeed it exceeds imagination itfelf fo far,
that no perfon who has not feen  and examined his pupils can be-
lieve what  they are capable of.---As this gentleman,  however
willing  is  only able  to teach  a few, and  as the fir greater part
of thofe  who are born deaf  cannot afford to attend him, it would
be an  aft of ^reat humanity, as well a.S' of public utUitv, to ersct
an academy for their o shoot". 
354         O  F    T   H   E    E  A  R.

   Though  fuch applications may fometimes  be of fervice,
yet  they  much oftenef  fail, and frequently  they do hurt.
Neither the eyes nor ears ought to be tampered with ;  they
are  tender organs, and require a very delicate touch.  For
this reafon,  what we would chiefly recommend in  deafnefr,
is to keep the head warm.   From  whatever caufe the difor-
der proceeds, this is always proper ; and I have known more
benefit from it alone, in the moft obftinate cafes of deafnefsr
than from all the medicines I ever ufed.

   OF  THE   TASTE  AND  SMELL.

   Though thefe fenfes are not of fo great importance  to a
nian in a ftate of fociety, as the fight and hearing, yet, as
the lofs of them is attended with fome inconveniency,  they
deferve cur  notice.  They are  feldom to  be reftored when
loft, which  ought to make us very attentive to their preferva-
tion, by carefully avoiding whatever  may  in the leaft prove
injurious to them.  As there is a very great affinity betwixt
the organs of tailing and fmelling, whatever  hurts the  one
generally affeas the other.
   Luxury is highly injurious to thefe organs.  When the
nofe and palate are frequently ftimulated by fragrant  and
poignant difhes, they  foon  lofe the power of  diftinguifhing
taftes and odours with any degree of nicety.  Man, in a ftate
of nature,  may perhaps have thefe faculties as acute  as any
other animal.
   The fenfe of fmelling may be diminifhed or deftroyed by
difeafes ; as, the moifture,  drynefs, inflammation or fuppu-
ration of that membrane  which lines  the infide of  the nofe,
commonly called the olfaaory  membrane; the compreffion
of the nerves which fupply this membrane, or fome fault in
the brain itfelf at their origin.   A defea, or too great a de-
gree of folidity, of  the fmall fpungy bones  of the upper jaw,
the  caverns of the forehead, he. may likewife impair the
fenfe of fmelling.   It may alfo be injured  by a colfeaion of
foetid matter in thofe caverns,  which keeps conftantly ex-
haling from  them.   Few things  are more hurtful to  the fenfe
of fmell im: than taking great quantities of  fnuff.
   When the nofe  abounds with moifture,  after gentle  eva-
cuations, fuch things as tend to take off irritation,  and coa-
gulate the thin fharp ferum, maybe  applied;  as the oil of
anife mixed with fine flour;  camphire diffolved  in  oil of al-
monds,'"&c.  The vapours of  amber, frankincenfe, gum-
                                                 maftic, 
OF  THE  TASTE  AND  SMELL.       355
maftic, and  benjamin,  may  likewife be  received into the
nofe and mouth.
  For moiftening the mucus when it is too dry, fome recom-
mend fnuff made of the leaves of margoram, mixed with the
oil of  amber, marjoram, and anifeed ; or  a  fternutatory of
calcined white vitriol; twelve grains of which may be mixed
with two  ounces of maijoram-water, and  filtrated.  The
fleam  or vapour  of  vinegar upon hot iron received  up the
noftrils  is likewife of ufe  for foftening the mucus,  opening
obftruaions, &c.
  If there be an ulcer  in the nofe,  it  ought to be drelied
with fome emollient ointment, to which,  if the pain be very
great, a little laudanum may be added.   If  it be a veneral
ulcer, it is not to be cured without mercury.  In that cafe,
the folution of the corrofive fublimate in brandy may be tak-
en, as direaed in the gutta ferena.   The ulcer ought  like-
wife to  be wafhed with it; and  the fumes of cinnabar may
be received up the noftrils.
   If there be reafon to fufpea that the nerves which fupply
the organs of fmelling  are  inert, or want ftimulating, vo-
latile falts, ftrong fnuffs, and other things  which occafion
freezing,  may  be applied  to the nofe.   The forehead may
likewife be anointed with balfam of Peru, to which may be
added a  little of  the oil of amber.
   The  tajle may be  diminifhed  by emits, filth, mucus,
 aphtha?, pellicles, warts, &c. covering the tongue : It may
 be depraved by a fault of the faliva,  which,  being difcharged
 into the mouth,  gives the fame fenfation as if the  food  which
 the perfon takes had really a bad tafte ; or it  may be entire-
 ly deftroyed by injuries done to the nerves of the tongue and
 palate.   Few things prove more hurtful either to the fenfe of
 tailing  and fmelling than  obftinate colds,  efpecially thofe
 which affea the head.
   When the tafte. is diminifhed by filth, mucus, &c. the
 tongue  ought to  be fcraped  and frequently wafhed  with a
 mixture of  water* vinegar,  and honey, or fome  other deter-
 gent.   When the faliva is vitiated, which  feldom  happens,
 unlefs  in fevers or other difeafes, the curing of the difo.der
 is the cure of this fymptom.  To relieve it  however  in the
 mean time, the following things may be  of  ufe; If there be
 a bitter tafte, it may be taken  away by vomits,  purges, and
 other things which evacuate bile : What  is called a nidorous
 tafte, arifing from  putrid humours,  is corded  by the juice
 of citrons, oranges,  and other acids: A fait tafte is™£* ty 
 3$6       OF  THE  TASTE  AND   SMELL.

 plentiful dilution with watery liquors :  An acid tafte  is  de-
 ftroyed by abforbents and alkaline falts ; as powder of oyfter-
 fhells, fait of wormwood, &c.
   When the fenfibility of the nerves which fupply the or-
 gans of tafte  is diminifhed, the chewing  of horfe-radifh,
 pr other ftimulating fubftances will help to recover it.

         OF    THE    TOUCH.

   TpE fenfe of touching may be hurt by any thing that ob-
 ftruas the nervous influence, or prevents its being regularly
 conveyed to the organs  of  touching;  as  prefluic,  extreme
 cold, &c.  It may likewife be hurt  by too great a degree of
 fenfibility, when the nerve is not fufficiently  covered by  the
 cuticle or fkarf-fkin,  or where there is too great a tenfion of
 it, or it is too delicate,   Whatever diforders  the funaions of
 the  brain and nerves, hurts the fenfe of touching.  Hence it
 appears to proceed from the fame general caufes as palfy and
 apoplexy,  and requires nearly the  fame method of treatment.
   In aflupor, or defea of touching, which  arifes from anob-
 flrudtion of the cutaneous nerves,  the patient  muft firft  be
 purged ; afterwards fuch  medicines as excite the aaion of
 the  nerves,  or  ftimulate  the fyftem, may be ufed.  For this
 purpofe, the fpirit of hartfhorn, fal volatile oleofum, horfe-ra-
 difh, &c.  may be taken inwardly;  the difordered parts, at
 the  fame time, may be frequently rubbed with frefh nettles or
 fpirit offal ammoniac.  Bliftering-plafters  and  finapifms ap-
 plied to the parts will likewife be of ufe, as alfo warm bath-
 ing, efpecially in the natural hot baths.

 i  ■    'tit   j  .  •       ■ i      11.      iii   ——   .■

                 CHAP.    XLV.

   OF   A  SCIRRHUS  AND  CANCER.

  A   SCIRRHUS  is a hard  indolent  tumour feated in
 Jt\.  f°me °f tnc g'ands» as the breafts, the arm-pits, &c.
 If the tumour becomes large, unequal, of a livid, blackifh or
 leaden colour, and is attended with violent pain, it gets  the
 name of an occult cancer.  When the fkin  is broken, and  a
fanies or ichorous matter of an abominably  foetid fmell is dif-
 charged from the fore, it is called an open or ulcerated cancer.
 Perfons after the age of 45,  particularly women, and thofe
 who lead an indolent fedentary life, are molt fubjea to this
 difeafe.
                                           CAUSES. 
OF  A  SCIRRHUS  AND  CANCER.
  CAUSE S.-      .This difeafe is often  owing to fup-
 preffed evacuations; hence it  proves  fo  frequently fatal  to
 women of a grofs habit, particularly old maids and widows,
 about the time when the menftrual flux ceafes.   It may like-
 wife be occafioned by  exceffive  grief,  fear,  anger,  religious
 melancholy, or any  of the depreffing paflions.  Hence the
 unfortunate, the  choleric,  and thofe perfons who devote
 themfelves to a religious life in convents or monafteries, are
 often affliaed with it.  It may alfo be occafioned by the long-
 continued ufe of food that is too hard of digeftion, or of an
 acrid  nature;  by  barrennefs;  celibacy; indolence;  cold j
 blows ; friaion ;  preffure; or  the like.  Women often fuf-
 fer from  the laft  of  thefe by means  of  their  flays, which'
 fqueeze and comprefs  their breaft fo as to occafion great  mif-
 chief.  Sometimes the difeafe is owing to an hereditary difpo-
 fition.
  SYMPTOM S.-----.This diforder feems often  very
 trifling at the beginning.  A  hard tumour about the fize of
 a hazel-nut, or perhaps fmaller, is generally the firft fymptom.
 This will often continue for a long time without feeming to
 increafe, or giving the patient great uneafinefs ; but if the
 conftitution be hurt,  or the tumour irritated by preffure, or
 improper treatment of any kind, it  begins to extend itfelf to-
 wards the neighbouring parts, by pufhing out a kind of roots
 or limbs.  It then gets  the name of cancer, from a fancied
 refemblance betwixt thefe limbs, and the claws of a crab.
 The colour ofthe fkin begins to change,  which is firft red,
 afterwards purple, then bluifh, livid, and at laft black.   The
 patient complains of heat, with a burning, gnawing, fhooting
 pain.   The tumour is very hard, rough,  and unequal,  with
 a protuberance,  or rifing,  in the middle;  its fize increafes
 daily,  and the neighbouring veins become thick, knotty,  and
 of a blackifh colour.
  The fkin at length gives way, and a thin, fharp ichor be-
 gins to flow, which corrodes  the neighbouring parts  till  it
 forms a large unfightly ulcer.  More occult cancers arife» and
 communicate with the neighbouring glands.   The pain and
 ftench  become  intolerable; the appetite fails  ; the ftrength
 isexhaufted by a continual heaic fever; at laft, a violent hae-
morrhage, or difcharge of blood, from fome part of the bo-
 dy,  with faintings, or convulfion fits, generally put an end to
the  miferable patient's-life.
  REGIME  N.-------The diet ought to be light,  but
nourifhing. All ftrong liquors,  snd high-feafoned or falted
                                              pcovifionst 
 35*      OF  A  SCIRRHUS  AND  CANCER.

 provifions, are to be avoided.  The patient may take as much
 exercife as he can eafily bear ; and  fhould ufe every method
 to divert thought, and amufe his fancy.  All kinds of  exter-
 nal injury are carefully to be guarded againft, particularly of
 the affeaed part, which ought to be defended from all preft
 fure, and even from the external air, by covering  it with fur
 or foft flannel.
   M E D I C 1 N E.------This  is  one of thofe difeafes
 for  which no  certain remedy is yet known.  Its progrefs
 however may fometimes be retarded, and fome of its moft dif-
 agreeable fymptoms mitigated by proper applications.   One
 misfortune attending the difeafe is,  that the unhappy patient
 often conceals it too long.   Were proper means ufed in due
 time,  a  cancer might often be cured ;  but after the diforder
 has arrived at a certain height, it generally fets all medicine
 at defiance.
   When a  fcirrhus  tumour is firft difcovered,  the patient
 ought to obferve a proper regimen, and to take twice or thrice
 a-week a dofe of the common purging mercurial pill.  Some
 blood may alfo be  let,  and the part affeaed  may be gently
 rubbed twice a-day with a little of  the mercurial ointment,
 and  kept warm with fur or flannel.  The food muft be light,
 and  an Englifh pint ofthe decoaion of woods or  farfaparilla
 may  be  drank daily.   I have fometimes difcuffed hard tu-
 mours, which had the appearance of beginning cancers, by a
 courfe of this kind.
   Should the tumour however not  yield to this  treatment,
 but, on  the  contrary, become larger and harder, it will be
 proper to extirpate it,  either by the knife or cauftic. Indeed,
 whenever this can be done with fafety,  the fooner it is done
 the better. It  can anfwer no purpofe to extirpate a cancer
 after the conftitution is ruined, or the whole mafs of hu-
 mours corrupted by it.  This however  is the common way,
 which makes the operation fo feldom fucceed.   Few people
 will  fubmit to the extirpation,  till death flares them  in the
 face; whereas, if it were done early,  the patient would be in
 no danger of lofing his life by the operation, and it would
 generally prove a radical cure.
   When the cancer is fo  fituated that  it cannot  be cut off,
 or if the patient will not  fubmit to the operation,  fuch  medi-
cines' as will mitigate or relieve the  moft urgent  fymptoms
 may  be ufed.   Dr. Home fays,  thaJhalf a grain of the cor-
 rofive fublimate of mercury, diffobred in a proper quantity of
 brandy,  and  taken night and rnCrning,  will often be offer-
                                                    vice 
OF  A  SCIRRHUS  AND  CANCER.
vice in cancers of  the  face and nofe.   He likewife recom-
mends an infufion of the folanum,  or night-fhade, in cancers
of the bi calls.
  But the medicine moft in repute at prefent for this difeafe
is hemlock.  Dr. Stork, phyfician at Vienna,  has of late re-
commended the extraa  of this plant  as very efficacious in
cancers of every kind.  The Doaor fays, he has given fome
hunuf -1 weights of  it without ever hurting any body,  and
ofien vvi-n manifeft advantage.  He advifes the patient how-
ever  to begin with  very fmall dofes, as two or three grains,
and to increafe the dofe gradually till  fome good effea be
perceived, and there to reft without further increafe.  From
two or three grains at firft, the Doaor fays he has increafed
the  lofe to two,  three, or four drams a-day,  and finds that
fuch dofes may be  continued for feveral weeks  without any
bad confequences.
  The  regimen  which the Doaor recommends during the
ufe of the medicine,  is  to  avoid farinaceous fubftances not
fermented, and too acrid aromatics.  He fays, good wine will
not be hurtful to thofe who are accuftomed  to it, nor a mo-
derate ufe of acids;  and adds, that the patient fhould live in
a pure free air,  and keep his mind as quiet and  cheerful as
poffible.
  The  Doaor does not pretend to  fix the time in which a
cancer may be refolved by the  ufe of hemlock,  but fays he
has given it  for above two years  in large dofes without any
apparent benefit;  neverthelefs the patient has been cured hf
perfifting in the ufe of  it for half a year longer.  This is at
leaft encouragement  to give it a fair trial.  Though we are
far from thinking the hemlock  merits  thofe extravagant en-
comiums which the Doaor has beftowed upon ir,  yet,  in  a
difeafe which has fo long baffled the boafted powers of medi-
cine, we think it ought always to be tried.
   The  powder of  hemlock is by fome preferred to the ex-
traa.  They are both  made ofthe frefh leaves, and may be
ufed nearly in the fame manner.   Dr. Nicholfon of Berwick
fays, he gradually increafed the  dofe of the powder from a
few grains to half a dram,  and gave near four drams of it  in
the day with remarkably good effedls.  The hemlock may al-
fo be ufed externally either as a poultice or fomentation. The
fo<-e may li ice wife be kept clean by injeaing daily a  ftrong-
ec  >ction ofthe tops and leaves into it.
     ;v things contrioute more to the healing of foul  fordid
l'     if any kind, than keeping them thoroughly clean. This
                                                  ought 
36(J      OF  A  SCIRRHUS   AND  CANCER".

ought never to be negfeaed.   The bfeft application for this
purpofe feems  to  be the carrot  poultice.  The root of the
common carrot may be  grated, and moiftened With as much
Water as will bring it to the confiftence of a poultice or cata-
plafm.  This muft be applied  to the fore, and renewed twice
a-day.  It generally cleans the fore; eafes  the pain, and takes
away the  difagreeable fmell,  which  are  objects of  no fmall
importance in fuch a dreadful diforder *.
  Wort,  or an infufion of malt, has been recommended not
only as a proper drink, but a3 a powerful medicine in this
difeafe.  It  muft be frequently  made frefh,  and the patient
may take it  at pleafure.   Two, three, or even  four Englifh
pirvts of it may be drank every  day for a confiderable time.
No benefit can be expeaed from any medicine in this difeafe,
unlefs  it be perfifted in for a longtime.  It is of too obftinate
a nature to be foon removed ; and,  when it admits of a cure
at all,  it muft be brought about by inducing an  almoft total
change of the habit,  which muft always be a work of time.
Setons or  iffues  in the neighbourhood of the cancer have fome-
times good eftedls.
  When all other  medicines fail,  recourfe muft be had  to
Opium, as a kind of  folace.   This will not indeed cure  the
difeafe, but it will eafe the patient's agony, and  render  life
more tollerable  while it continues.
  To avoid this dreadful diforder, people ought to ufe whole-
fome food ;  to  take fufficient exercife  in the  open air; to be
as eafy and cheerful as poffible ; and carefully  to guard againft
all  blows, bruifes, and  every  kind  of  preffure upon  the
breafts or other glandular parts f.


                CHAP.    XLVI.

           OF     POISONS.

     EVERY perfon ought,  in  fome meafure, to be  ac-
      quainted  with the nature and  cure of poifons.  They
are  generally taken unawares, and their effedls are often fo
                                                  fudden

          * London Medical Effays.
  f As hemlock is  the principal  medicine recommended in  this
difeafe, we would have given fome directions for the gathering and
preparing  of that plant; but as its different preparations are now
kept in the fhops, we  think it much  fafer for people to get theifr
there, with proper directions for ufing them. 
OF     POISONS.          361
 fudden and violent, as not to admit of delay, or allow time
 fo procure the affiftance of phyficians.  Happily no great de-
 gree of medical  knowledge is  here  neceffary ;  the remedies
 for moft poifons being generally at hand, or eafily obtained,
 and nothing but common prudence needful in the application
 of  them.
   The vulgar notion,  that every poifon is  cured by  fome
 counter-poifon,  as a fpecific, has done much hurt.   People
 believe they can do nothing for  the patient,  unlefs they know
 the particular antidote to that kind of poifon which  he has
 taken.  Whereas the cure of all poifons taken  into the fto-
 mach, without  exception, depends  chiefly  on  discharging
 them as foon as poffible.
   There  is no cafe wherein the indications of cure are more?
 obvious than this.  Poifon is feldom long in the ftomach be-
 fore it occafions ficknefs, with an indication to vomit.  This
 fhews plainly what ought to be done.    Indeed common fenfe
 diaates to every one, that, if any thing has been taken into
 the ftomach which endangers life, it  ought immediately to be
 difcharged.    Were this  duly regarded, the  danger  arifing
 from  poifons might generally be avoided.   The method  of
 prevention is obvious, and the means  are in the hands of eve-
 ry man.
   We fhall not take up the reader's time with a detail of the
 ridiculous notions which  have prevailed among ignorant peo-
 ple in different ages with regard to poifons;  neither fhall we?
. mention the boafted antidotes,  which have been recommend-
 ed  either  for preventing or obviating their effeas; but fhall
 content ourfelves with pointing out  the poifons  moft  com-
 mon in this country, and the means of avoiding their danger-
 ous confequences.
   Poifons either belong  to  the mineral, the vegetable, or
 the animal kingdom.
   Mineral poifons  are commonly of an acrid or corrofive
 quality; as arfenic,  cobalt, the corrofive fublimate of mer-
 cury, &c.
   Thofe  of the vegetable kind ar^  generally of a narcotic,
 or ftuptfaaive quality ; as poppy, hemlock, henbane, ber-
 ries of the deadly night-fhadc,  he.
  Poifonous animals communicate their infeaion either  by
 tbe bite or fling.  This poifon  is very different from  the for-
 mer,  and  only produces its effeas when received into the bo-
 dy  by a wound.
  y  y                    U u               MINERAL 
 361         OF    POISONS.

   MINERAL   POISON S.------Arfenic is the
 moft common  of this clafs ; and, as the whole of them are
 pretty fimilar both in their effeas and method of cure,  what
 is faid with refpea to it,  will be  applicable to every  other
 fpecies of  corrofive poifon.
   When  a perfon has taken  arfenic, he  foon  perceives  a
 burning heat,  and a violent pricking pain in his ftomach and
 bowels, with an intolerable thirft, and an inclination to vo-
 mit.  The  tongue and throat feel rough and dry; and,  if
 proper help be not  foon  adminiftered, the patient  is feized
 with great anxiety, hiccuping, faintings, and coldnefs of the
 extremities.   To thefe fucoeed black vomits, foetid ftools,
 with a mortification of the ftomach and inteftines, which are
 the immediate forerunners of death.
   On the firft  appearance  of thefe  fymptoms  the patient
 fhould drink large quantities of new milk and falad oil till he
 vomits; or  he may drink warm water mixed with oil.   Fat
 broths are likewife proper,  provided they can be got ready in
 time.   Where no oil is to be had, frefh butter may be melt-
 ed and*  mixed  with the milk or water.  Thefe things are to
 be drank as long as the inclination to vomit continues.  Some
 have drank eight or ten  Englifh quarts before the vomiting
 ceafed;  and it  is never fafe to leave off drinking while one
 particle of the poifon remains in the ftomach.
   Thefe  oily or fat fubftances not only provoke vomiting,
 but likewife blunt the acrimony of the  poifon, and  prevent
 its wounding the bowels ; but if they fhould not make the
 perfon vomit,  half a dram or two fcruples  of the powder of
 ipecacuanha muft be given, or a few fpoonfuls of the oxymel
. or vinegar of fquills  may be mixed with the water which he
 drinks.   Vomiting may  likewife be excited by tickling the
 wifide of the throat with a feather.   Should thefe  methods
 however fail, half a dram of white vitriol, or five ut fix graiai
 of emetic  tartar, muft be adminiftered.
   If tormenting pains are felt in the lower belly, and there is
 reafon to fear that the poifon has  got down to the inteftines,
 clyfters  of milk  and oil  muft be very frequently thrown up;
 and the patient  muft drink emollient decoaions of barley,
 oatmeal, marfh-mallows, and fuch like.  He muft  likewife
 fake an  infufion  of fenna and manna,  a folution of Glauber's
 falts, or fome  other purgative.
   After the poifon has been evacuated, the patient ought, for
 fome time, to live upon fuch  things as are  of a healing  and
 tooling  quality;  to abftain  from flefh and all ftrong  liquors,
                                                      and 
         OF    POISONS,          363

and to live  upon  milk,  broth, gruel,  light puddings,  and
other  fpoon-meats of eafy digeftion.  His drink fhould be
barley-water, linfeed-tea, or infufions  of any  of  the  mild
mucilaginous vegetables.
  VEGETABLE   POISONS,  befides  heat
and pain of the ftomach,  commonly occafion  fome  degree of
giddinefs, and  often  a  kind of ftupidity or  folly   Perfons
who have taken thefe poifons  muft  be  treated  in  the fame
manner as for the mineral or corrofive.
  Though the vegetable poifons, when allowed  to remain in
the ftomach, often prove  fatal;  yet the danger  ,s  generally
over as foon  as they are difcharged.  Not bein^ of foch  a
cauftic or corrofive nature, they are lefs apt to wiund or inT
flame the bowels than mineral  fubftances; no time, howe-
vc, ought to be loft  in having them difcharged.
  Opium, being frequently taken  by miftake,  merits parti-
cular attention.   It is ufed as a medicine both in a  folid  and
liquid form, which latter commonly goes by the  name of
laudanum.   It is indeed a valuable medicine when taken in
proper quantity, but  as an over-dofe proves a ftrong poifon;
we  fhall point out its common effeas, together with the me-
thod of  cure.
  Too  great a quantity of opium  generally occafions great
drowfinefs,  with   flupor and other apopfeaic fymptoms.
Sometimes the perfon  has fo great an inclination  to  fleepi
that it is almoft impoffible to keep him awake.  Every method
muft,  however, be tried  for this  purpofe.   He fhould be
toffed, fluked, and moved about.   Sharp bliftering-plafters
fhould be applied  to his legs or arms, and ftimulating medi-
cines, as falts of hartfhorn, he.  held  under his  nofe.   It
will alfo be proper to let blood.   At the fame time every  me-
thod muft be taken to make him difcharge the poifon.  This
may be done in the manner direaed above, viz. by the ufe
of ftrong vomits,  drinking plenty of warm water with  oil,
he.
  Mead, befides vomits,  in this cafe, recommends acid  me-
dicines  with lixivial  falts.  He fays, that he has often giv-
en fait of worm-wood mixed with juice  of lemon in repeated
dofes with great fuccefs.
  If the body fhould remain weak and languid after the poi-
fon has been difcharged, nourifhing diet and cordials will be
proper;  but when there is reafon to fear that the ftomach or
bowels are inflamed,  the greateft circumfpeaion is neceffary
both with regard to food and medicine. 
r   3*4-3
  OF  THE  BITES  OF  POISONOUS  ANIMALS.

   We fhall begin with the bite of a mad dog, as it is both tha
 moft common and dangerous animal-poifon in this country.
   The creatures naturally  liable to contraa this difeafe are,
 as far aswe yet know,  all ofthe dog kind, viz. foxes,  dogs^
 wolves.  Hence it is called the rabies canina,  or dog  mad-
 nefs.  Of the laft we have none in this ifland ; and it fo fel-
 dom happens that any  perfon is bit by the  firft,  that  they
 fcarce deferve to be taken notice  of.   If fuch a thing fhould
 happen, the method of treatment is  precifely the  fame as for
 the bite of a  mad dog.
   The fymptoms of madnefs in a dog are as follow : At firft
 he looks dull,  fhews an averfion to food and company : He
 does not bark as ufual, but feems to murmur, is peevifh, and
 apt to bite ftrangers :  His ears and  tail droop more than ufu-
 al, and he appears drowfy : Afterwards he begins to loll out
 his tongue,  and froth  at the mouth,  his eyes  feeming heavy
 and watery :  He now,  if not confined, takes off, runs pant-
 ing along with a kind of  dejeaed  air, and endeavours to bite
 every one he meets.  Other dogs are faid to  fly from him.
 Some think this a certain fign ot  madnefs, fuppofing that they
 know him by the fmell; but it is not to be depended on.  If
 he efcapes being killed, he feldom  runs above two or three
 days,  till he  dies exhaufted with  heat, hunger, and fatigue.
    This difeafe is moft frequent  after long dry, hot feafons;
 and fuch dogs  as live  upon putrid  ftinking carrion, without
 having enough of frefh water, are  moft liable to it.
    When  any  perfon  is bit by a  dog,  the ftriaeft inquiry
 pught to be made, whether  the animal be  really mad.  Many
* difagreeable  confequences arife from negfeaing to afcertain
 this point.  Some people have lived  in continual anxiety for
  many years, becaufe they  had been bit by a dog which they
 believed to be mad ; but, as he had  been killed on the fpot, it
  was impoffible to afcertain the foa.   This fhould induce us,
  jnftead  of killing a dog the moment he has bit  any perfon,  to
  do all in our power tQ keep him alive, at leaft till we can  be
  certain whether he be  mad or not.
    Many  circumftances  may contribute to make people ima-
  gine a dog mad.  He  lofes his mafter, runs about in queft of
  him,  is fet upon by other dogs,  and perhaps by  men.  The
  creature thus frightened, beat, and abufed,  looks wild, and
  lolls out his  tongue as he runs along.  Immediately a crowd
  h alter  him ; while he., finding himfelf clofely purfued, and
                                                   raking 
     BITES   OF  POISONOUS  ANIMALS.     365

taking every one he meets for an, enemy, naturally attempts
to bite  him in  felf-defence.   He foon gets knocked on the
head, and it paffes  currently  that he was mad, as it is then
impoffible to prove the contrary.
  This being the true hiftory  of, by far, the greater part of
thofe dogs which pafs for mad, is  it any wonder that num-
berlefs whimfical medicines have been extolled for preventing
the effea6 of their bite ?  This  readily accounts for the great
Variety of infallible remedies for the bite of a mad dog, which
are to be  met with in almoft every family.  Though not one
in a thoufand has any claim to merit,  yet they are all fup-
ported by numberlefs vouchers.  No wonder that imaginary
difeafes fhould be cured by imaginary remedies.  In this way
credulous people firft impofe upon themfelves, and then de-
ceive others.  The  fame medicine which  was fuppofed  to
prevent the effeas of the bite, when the dog was not mad,
is recommended to a perfon who has had the misfortune  to
be bit by a dog  that was really mad.  He takes it, trufts  to
it, and is  undone.
  To thefe miftakes we muft impute the frequent ill fuccefs
of the medicines ufed for preventing the effeas of the bite  of
a mad dog.  It is not owing fo much to a defea  in medicine,
as to wrong applications.  I am perfuaded,  if proper medi*
cines were adminiftered  immediately after the bke is received,
and continued  for a  fufficient length of time, we fhould not
lofe one in a thoufand of thofe who have tbe misfortune to
be bit by a mad dog.                               .  ,
  This poifon is generally communicated by a wound, which,
neverthelefs, heals as foon as  a common wound  :  But afterr
wards it  begins to feel  painful, and as the  pain fpreads to-
wards the neighbouring parts,  the perfon becomes heavy and
liftlefs.   His fleep is unquiet with frightful dreams;  he
fighs, looks dull,  and  loves folitude.   Thefe are the fore-
runners,  or rather the firft fymptoms, of that dreadful dif-
eafe occafioned by the bite of a mad dog.   But as we do not
propofe to treat the difeafe itfelf, but to point out the method
of preventing it, we fhall not take up time in fhewing  its
progrefs from the firft invafion to its commonly fatal end.
  The common notion, that this poifon may lie in the body
for many years, and afterwards prove  fatal,  is both hurtful
and ridiculous.  It muft render fuch perfons as have had the
misfortune to be bit  very unhappy, and  can have no good ef-
feas.  If the perfon takes proper medicines for forty days af-
ter the time of  his being bit, and  feels no fymptoms of the
difeafe, there is reafon to believe him out of danger.
                                                  Th« 
366     BITES  OF  POISONOUS  ANIMALS.

  The medicines recommended for preventing the effeas of
the bite of a mad dog, are chiefly fuch as promote the differ-
ent fecretions, and antifpafmodics.
  Dr. Mead recommends a preventative medicine, which he
fays he never knew fail, though in the fpace of thirty years
he had ufed it a thoufand times.
  The Doa^'s prefcription is as follows :
  "  Take afh-coloured ground  liver-wort, cleaned, dried,
and  powdered,  half an ounce ; of black pepper powdered,
a quarter of an ounce.   Mix thefe well together,  and divide
the powder into four dofes ;  one of which muft be taken eve-
ry morning fafting,  for four  mornings fucceffively, in half
an Englifh pint of cows milk warm.
  After thefe four dofes are taken, the patient muft go into
the cold bath, or a cold fpring  or river every morning fafting,
for a month; he rauft  be dipped  all  over,  but not flay in
(with his head above water)  longer than half a minute, if the
water be very cold.  After this he muft go in three times a-
week for a fortnight longer.
  The perfon  muft be bled before he begins to ufe the me-
dicine."
  We fhall next mention the  famous Eaft India fpecific, as
it is called.  This  medicine is compofed of  cinnabar  and
mufk.   it is efteemed a great antifpafmodic ;  and, by many,
extolled as an infallible remedy for preventing the effea« of
the bite of a mad dog.
   " Take native and  foaitious  cinnabar, of each twenty-'
four grains, mufic fixteen grains.   Let thefe  be  made into a
fine powder, and taken  in a glafs of arrack or  brandy."
  This fingle dofe is faid to  fecure the perfon  for thirty days,
at the end of which it muft be repeated ; but  if he has any
fymptoms  of the difeafe, it muft be repeated in three hours.
   The following is likewife reckoned a good antifpafmodic
medicine:
   Take of Virginian   fnake-root in powder,  half a dram,
gum afafcetida twelve grains,  gum camphire  feven grains;
make thefe into a bolus with a little fyrup of faffron.
  Camphire may alfo be given in the following manner :
  Take purified nitre half  an ounce,  Virginian fnake-root
in powder two drams,   camphire one dram ; rub them toge-
ther  in a mortar, and divide the whole into ten dofes.
  Mercury is another medicine of great efficacy, both in the
prevention and cure of this kind of madnefs.   When ufed as
a preventative, it will be fufficient to rub daily a dram of the
ointment into the parts about  the w^ound.
                                               Vinegar 
     BITES  OF  POISONOUS  ANIMALS.     367

  Vinegar is likewife of confiderable fervice, and fhould be
taken fretfly, either in the patient's food or drink.
  Thefe are the principal medicines recommended for pre-
venting the effeas of the bite of a mad  dog.  We would not
however advife people to truft to any one of them ; but from
a proper  combination of their different  powers, there is  the
greateft reafon to hope for fuccefs.
  The great error in the ufe of thefe medicines lies, in not
taking them for a fufficient length of time.  They are ufed
more like cnarms, than medicines intended to produce any
change in the body.   To this, and not to the insufficiency of
the medicines,muft we impute their frequent want of fuccefs.
  Dr. Mead  fays, that the virtue of his medicine confifts in
promoting urine.  But how  a poifon fhould be expelled by
urine, with only three or four dofes  of any medicine,  howe-
ver powerful, is not eafy to conceive.  More time is certain-
ly neceffary  ; even though the medicine were more powerful
than that which the Doaor prefcribes.
  The Eaft-India fpecific  is ftill more exceptionable on this
account.
  As thefe and moft other medicines, taken fingly, have fre-
quently been found  to fail, we fhall recommend the following
courfe:
  If a perfon  be  bit in a flefhy  part,  where there is no ha-
zard of hurting any  large blood-veflel,  the parts adjacent to
the wound  may be cut away.  But if  this be not done foon
after the bite has been received, it will be better to omit it.
   The  wound may be wafhed with  fait and water, or a
pickle made of vinegar and fait, and afterwards dreffed twice
a-day with yellow bafilicon mixed with the red precipitate of
mercury.
   The patient fhould begin to ufe either Dr. Mead's  medi-
cine, or fome of the others mentioned above.  If he takes
Mead's medicine, he may ufe  it as the Doaor direas, for
four days fucceffively. Let him then omit it for two or three
days, and again repeat the fame number of dofes as before.
   During this courfe, he muft rub into the parts about the
wound, daily, one  dram of  the mercurial ointment.  This
may be done for ten or twelve days atleafr.
   When this courfe is over, he may take a purge or two,
and wait a few days  till the effea of the mercury begone off.
He muft then begin to ufe the cold bath, into which he may
go  everv morning for five or fix weeks.  If he fhould  feel
colu ind chilly for a long time after coming out of the cold
                                                  bath, 
 368     BITES  b?  POISONOUS  ANIMALS.

 bath, if will be better to ufe a tepid one, or to have the watef
 a little warmed.
   In the mean time, we would advife hrm notto leave off all
 internal medicines,  but to take either one of the bolufes of
 fnake-root, afafcetida and camphire; or one of the powders
 of  nitre,  camphire,  and fnake-root,  twice  a-day.   Thefe
 may be ufed during the whole time he  is bathing.
   During the ufe of the mercurial ointment, the patient muft
 keep within doors,  and take nothing cold.
   A  proper regimen muft be obferved throughout  fhe whole
 Courfe.   The patient fhould abftain from flefh', and all falted
 and high-feafoned provifions.  He muft avoid ftrong liquors^
 and live moftly upon a light and rather fpare diet.  His mind
 fhould  be  kept as eafy and cheerful as poffible, and all ex-i
 Ceffive heat and violent paflions avoided with the ufmoft care.
   I have never feen this courfe of medicine, with proper re-
 gimen,  fail to prevent  the  hydrophobia, and cannot help
 again obferving, that the  want of fuccefs  muft generally be
 Owing either to the application of improper medicines, or not
 ufing proper ones for a fufficient length of time.
   Mankind are extremely fond of every thing that promifes
 a fudden or miraculous cure.  By trufting to thefe they of-
 ten lofe their lives,  when  a regular courfe  of medicine would
 have rendered them abfolutely fafe.  This holds remarkably
 in the prefent cafe :  Numbers of people, for example, believe
 if they or their cattle be once dipped in the fea, it is   fuffi-
 cient ; as if the fait  water were  a charm  againft the effeas
 of the bite.  This, and fuch like whims, have proved fatal
 to many.
  It is a common notion, if a perfon be bit by a dog which
 is not mad,  that,  if he fhould go mad afterwards, the perfori
 Would be  affeaed  with the diforder at the  fame time; but
 this notion is too ridiculous to deferve a ferious confideration.
 It is a good rule,  however, to avoid dogs as much as poffible,
 as the difeafe is often upon them for fome time before its vio-
 lent fymptoms appear.   The hydrophobia has been  occafion-
ed by the bite of a dog which fhewed no other fymptoms of
the difeafe but liftleflhefs and" a fullen difpofition *.
                                                Though

  *  It is fomewhat furprifing,  that no proper enquiry has ever"
 been made into the truth of  the common opinion,  that  a dog
Which had been wormed cannot  bite after he goes mad.   If the
 faft could be afcertained, and the  practice rendered general, it
would fave both the lives and properties of many. 
      BITES  OF  POISONOUS  ANIMALS.     369

   Though we  do not mean fo treat fully  of the cure of the
 hydrophobia, yet we are far  from reckoning it incurable.
 The notion that this difeafe  could not be cured, has  been
 produaive of the moft horrid confequences.   It was  ufual
 either to abandon the unhappy perfons, as foon as they were
 feized with the difeafe,  to their fate, to bleed them to death,
 or to  fuffocate  them between mattraffes or feather-beds, &c.
 This  condua certainly deferred the fevereft  punifhment!
 We hope, for  the  honour of human nature, it will never
 again  be heard of.
   I have never had an  opportunity of treating this difeafe,
 and therefore can  fay  nothing of  it  from my own experi-
 ence ; but the learned Dr. Tiflot fays,  it may be cured in the
 following manner :
   1. The patient muft be bled to a confiderable quantity  ; and
 this may be repeated twice, or thrice,  or even a fourth time,
 if circumftances require it.
   2. The patient  fhould  be put, if  poffible, into  a warm
 bath ; and this fhould be ufed twice a-day.
   3. He fhould every day receive two, or even three emol-
 lient clyfters.
   4. 1  he wound,  and the parts adjoining to it, fhould be
 rubbed with the mercurial ointment twice a-day.
   5. The  whole limb  which contains the wound fhould be
 rubbed with oil, and be wrapped up in an oily flannel.  •   ^
   6. Every  three hours, a dofe of Cob's powder fhould be
 taken in a cup of the infufion of lime-tree and elder-flowers.
 This powder is  made,  by rubbing together in a mortar, to a
 very fine  powder, of native and foaitious  cinnabar,  each
 twenty-four grains; of mufk,  fixteen grains.
   7. The following bolus is to be given every  night, and to
 be repeated in the morning, if  the patient is not eafy, wafh-
 ing it down  with the infufion mentioned above :  Take  one
 dram of Virginian  fnake-root in powder ;  of camphire  and
 afafcetida ten grains each ; of opium,  one grain ;  and,  with
 a fufficient  quantity  of conferve,  or  rob  of elder,, make  a
 bolus.
   8. If  there be a great naufea at the  ftomach, with  a bitter-
 nefs in the mouth, thirty-five or forty grains of ipecacuanha,
 in powder, may be taken for  a  vomit.
   9. The patient's food, if he takes  any, muft  be light;
as panado,  foups made of farinaceous or  mealy vegetables,
he.
                           X x                   10.  If 
37*     BITES  OF  POISONOUS   ANIMALS.

   10.  If the patient fhould long continue  weak, and fub-
jea to  terrors,  he may take half a dram of the Peruvian
bark thrice a-day.
   The next poifonous animal which we fhall mention is the
VIPER. The greafe of thjs animal rubbed into the wound
is faid to cure the bite.  Though that is all the viper-catchers
generally do when bit,  we fhould not think it fufficient for
the bite of an enraged viper..  It  would furely be more fafe
to  have the wound  well fucked *, and  afterwards rubbed
with  warm falad-oil.  A poultice  of bread and milk, foft-
ened with falad-oil, fhould likewife be applied to the  wound;
and the patient ought to  drink freely of vinegar-whey,  or
water-gruel  with vinegar in it, to make  him fweat.   Vine-?  <
gar is  one  of the beft  medicines which can he ufed in any
kind  of poifon, and ought to be taken  very  liberally.   If
the patient be fick, he may take a vomit.   This  courfe will
be fufficient to cure the bite of  any of the  poifonous animals
of this country.
   With regard  to poifonous infeas, as the bee,  the wafp,
the hornet, &c. their flings  are feldom attended with danger,
unlefs  when a perfon happens to be flung by a great number
of them at the  fame time ;  in which  cafe  fomething  fhould
be done to abate the inflammation and  fwelling.  Some, for
this purpofe, apply honey ; others lay pounded parfley to the
part.   A mixture of  vinegar and Venice-treacle is likewife
recommended ; but 1 have always found  rubbing the part
with  warm  falad-oil  fucceed very well.    Indeed, when the
flings are fo numerous as to endanger the patient's life, which
 is  fometimes the  cafe,  he muft not only have oily poultices
applied to the part, but  muft likewife be bled, and take fome
cooling medicines; as nitre, or cream  of tartar, and fhould
 drink plentifully  of diluting liquors.
    It is the happinefs  of this ifland to have very few poifonr
 ous animals, and thofe which we have are by no means ofthe
                                                     moft

   * The practice of fucking out poifons is very  ancient;  and in-
 deed nothing can  be more rational.   Where the bite cannot be
 cut out,  this is the  moft likely way for extracting the poifon.
 There  can be no  danger in  performing this office, as the poifon
 does  no harm unlefs  it be taken into the body by a wound.  The
 perfon who fucks the wound ought however to warn his mouth
 frequently  with  falad-oil, which will fecure  him from  even the
 l^aft  inconveniency.  The Pfylli in Africa, and the Merfi in Italy,
 were famed for curing the bites  of poifonous animals by fucking
the wound; and we are told, that the Indians in North  America
practife the fame at this day. 
BITES  OF  POISONOUS  ANIMALS.
moft virulent kind.  Nine-tenths of the effeas attributed to
poifon  or venom in this country, are really other difeafes,
and proceed from quite different caufes.
  We  cannot  however make the fame obfervation with re-
gard to poifonous vegetables.  Thefe abound  every  where,
and prove often fatal to the ignorant and unwary.   This in-
deed is chiefly owing  to careleffnefs.   Children ought early
to be cautioned againft eating any kind of fruit, roots, or
or berries, which they do not know; and all poifonous plants
to which they  can have accefs, ought, as far as poffible, to
to be deftroyed.  This would not be fo difficult a talk as fome
people imagine.
   Poifonous plants have no doubt their ufe,  and they ought
to be propagated in proper places ;  but, as they prove often
deftruaive to cattle, they fhould be rooted out of all pafture-
grounds.    They ought likewife for the  fafety  of the human
fpecies, to be deftroyed in the neighbourhood of all towns
and villages ;  which,  by the by, are the places  where  they
moft commonly abound.   I  have feen  the  poifonous hem-
lock, henbane, wolfsbane, and deadly night-fhade, all grow-
ing within the environs of a fmall town, where, though feve-
 ral  perfons, within  the  memory  of  thofe living in it, had
loft their lives  by one  or other of thefe plants ; yet  no me-
thod, that I could hear of, had ever been taken to root them
out; though this might be done at a very trifling expence.
   Seldom  a year paffes but we have accounts  of feveral per-
 fons poifoned  by eating hemlock-roots  inftead of parfnips,
 or fome kinds  of fungus which they  had gathered for mufh-
 rooms.   Thefe examples ought  to  put  people  upon  their
 guard with refpea to  the former, and to put the latter entire-
 ly out of ufe.   Mufhrooms  may be a delicate difh, but they
 are a dangerous one,  as they are generally gathered  by per-
 fons who  do  not know one  kind  of fungus  from  another,
 and take every thing  for a mufhroom which has that appear-
 ance.
    We might  here mention many other plants and animals of
 a poifonous nature which are found in foreign countries; but,
 as our obfervations are chiefly  intended for  this ifland, we
 fhall pafs thefe over.  It may not however be amifs to obferve,
 for the behoof of fuch of our countrymen  as goto  America,
 that an effeaual remedy is now faid to be found for  the bite
 ofthe rattle-fnake.     —The  prescription is  as follows:
  Take of  the roots of plantain and  horehound, in fummer,
 roots and branches  together, a  fufficient  quantity;  bruife
                                                    then 
 37*     BITES  OF  POISONOUS  ANIMALS.

 them in a mortar,, and fqueeze out the juice, of which give,
 as foon as poffible, one large fpoonful; if the patient be fwell-
 ed,  you muft force it down his  throat.  This generally will
 cure; but, if he finds no relief in an hour after, you  may
 give  another fpoonful, which never fails.—-----If the roots
 are  dried, they  muft be moiftened with a little water.  To
 the wound may be applied a leaf of good tobacco moiftened
 with rum.
   We give this upon the faith of Dr. Brookes, who fays it
 was the invention of a negro; for the difcovery  of which
 he had his  freedom purchafed,  and a hundred pounds per
 annum fettled upon him during life, by the General Affembly
 of Carolina.
   It is poffible there may be in nature fpecific remedies for
 every kind of poifon; but as we have very little faith in any
 of thofe which have yet been pretended to be difcovered, we
 fhall beg leave again to recommend the moft flria attention
 to the following rules, viz. That when any poifonous fub-
 ftance has been  taken into the ftomach, it ought, as foon as
 poffible, to  be  difcharged by vomits, clyfters, and purges;
 and, when  poifon has been  received into  the body by a
 wound,  that it be expelled by medicines which promote the
 different fecretions, efpecially thofe of fweat, urine, and in-
 fenfible perfpiration ; to which  may be joined atifpafmodics,
 or fuch medicines as take off tenfion, and irritation ;  the
 chief of which are opium, mufk camphire,  and afafcetida.


                CHAP.     XLVII.

     OF   THE  VENEREAL  DISEASE.

   IN a former edition of this book the  venereal difeafe was
    omitted.   The reafons however  which at that time in-
 duced me to leave it out, have upon more mature confidera-
 tion  vaniflied.  Bad confequences, no  doubt,  may arife from
 ignorant perfons  tampering with medicine in this diforder ;
 but the danger from that quarter feems to  be more  than  ba-
 lanced by the great and folid advantages, which muft arife to
 the patient from an early knowledge of his  cafe,  and  an at-
 tention to a plan of regimen, which,  if it  does not cure the
 difeafe, will be fure to render it  more mild, and lefs hurtful
 to the conftitution.
   It  is peculiarly unfortunate.for the unhappy perfons who
contraa this difeafe, that it lies under a fort of difgrace. This
                                                renders 
OF  THE  VENEREAL  DISEASE.
  renders difguife neceffary, and makes the patient either con-
  ceal his diforder altogether,  or apply to thofe who promife a
  fudden and feciet cure;  but  who  in faa only  remove the
  fymptoms for a time,  while they fix the difeafe deeper in the
  habit.  By this means a flight infeaion, which  might have
  been eafily removed, is often converted into an obftinate, and
  fometimes incurable malady.
     Another unfavourable circumftance attending this difeafe
  is, that it affumes a variety of different fhapes,  and may with
  more propriety be called an affemblage >of  difeafes, than a
  fingle one.  No two difeafes can  require a more  different
* method of treatment than this does in its  different ftages.
v Hence the folly and danger of trufting to any particular nof-
  trum for  the cure of it.  Such noftrums are however general-
  ly adminiftered in  the  fame manner to all  who apply for
  them, without the leaft regard to the ftate of the difeafe, the
  conftitution of the  patient,  the degree of  infeaion, and a
  thoufand other circumftances of the utmoft importance.
     Though  the venereal difeafe is generally the fruit of un-
  lawful embraces, yet it may  be communicated to the inno-
  cent as well as the guilty.   Infants, nurfes,  midwives, and
  married women whofe hufbands lead diffolute lives, are often
  affeaed with it, and frequently lofe their lives by not being
  aware of their danger in due time.   The unhappy condition
  of fuch perfons will certainly plead our excufe, if any excufe
   be neceffary, for endeavouring to point out the fymptoms and
  cure of this too common difeafe.
     To enumerate all its different fymptoms,  however,  and to
   trace the difeafe minutely through its  various ftages,  would
   require a much larger fpace than falls to this part of my fub-
  jea ; I fhall therefore confine my obfervations chiefly to cir-
   cumftances of importance, omitting fuch as are either trifling,
   or which occur but feldom.  1 fhall  likewife pafs  over the
   hiftory of the difeafe, with the different methods of treatment
   which it  has undergone fince it was firft introduced  into Eu-
   rope, and many other circumftances of a fimilar nature ; all
  of which, though they might tend to amufe the reader, yet
   could afford him little or no ufeful knowledge.

     OF THE VIRULENT GONORRHOEA.

     The  virulent gonorrhoea is an involuntary difcharge of in-
  feaious matter from the parts of generation in either fex.  It
  generally makes its appearance within  eight or ten days after 
374    OF  THE VIRULENT GONORRHOEA.

the infeaion has been received ; fometimes indeed it appears
in two ojr three days, and at other times not before the end of
four or five weeks.  Previous to the difcharge, the patient feels
an itching with a fmall degree of pain in the genitals. After-
wards  a thin glary  matter  begins  to diftil  from  the urinary
paffage,,which ftains the linen, and occafions a fmall degree
of titillation, particularly in the time  of making water;  this,
gradually increafing, arifes at length to a degree of heat and
pain, which arc chiefly perceived about the extremity of the
urinary paffage, where a flight degree of rednefs  and inflam-
mation likewife begin to appear.
   As the diforder advances, the pain, heat of urine, and run-
ning increafe,  while  frefh fymptoms daily  enfue.  In men
the ereaions become painful and involuntary, and are more
frequent and lafting  than when natural.   This fymptom is
moft troublefome when the patient  is  warm  in bed.   The
pain which was at firft only perceived towards  the extremity,
now begins to reach all up the urinary paffage,  and is  moft
intenfe juft after the patient has done  making water.   The
running gradually recedes from the  colour  of feed, grows
yellow, and at length puts on the appearance of matter.
   When the diforder has  arrived at its height, all the fymp-
toms are more intenfe ; the heat of the urine is fo great, that
 the patient dreads the making of it,  and  though he feels a
conftant inclination this way,  yet it  is rendered with the
 greateft difficulty, and often only by drops : the involuntary
ereaions now become extremely painful and frequent ;  there
 is alfo a pain,  heat, and fenfe of fulnefs about the feat, and
 the running is plentiful and fharp, of a brown, greenifh, and
 fometimes of a bloody colour.
    By a proper treatment the violence of the fymptoms gra-
 dually abates; the heat of  the urine goes off; the involun-
 tary and painful ereaions, and the heat and pain about the
 feat  become eafier; the  running alfo gradually decreafes,
 grows whiter and  thicker, till at laft it entirely difappears.
    By attending to thefe fymptoms,  the gonorrhoea may be
 pretty readily diftinguifhed from any  other difeafe. There are
 however fome few diforders for  which  it may be miftaken,
 as an ulcer in the kidnies or bladder, thenar albus or whites
 in women, he. But in the former of thefe, the matter comes
 away only with the urine, or when the fphinaer of theblad-
 per is open; whereas in a gonorrhoea,  the difcharge is con-
 ftant.  The latter is more difficult  to diftinguifh,  and muft
 be known chiefly from its effeas, as pain, communicating the
 infeaion,  &c.
                                        REGIMEN. 
OF  THE VIRULENT GONORRHOEA.    375
  REGIME N.------When a perfon has reafon to fuf-
pea that he has caught the venereal infeaion, he ought moft
ftriaiy to obferve a cobling regimen,  to avoid every thing of
a heating nature,  as  wines,  fpirituous liquors, rich fauces,
fpiced, falted, high-feafoned, andfmoke-dried provifions, &c.
as alfo all aromatic and  ftimulating  vegetables, as onions,
garlic, fhallot, nutmeg, muftard, cinnamon, mace,  ginger,
and fuch like.  His food ought chiefly to confift of  mild ve-
getables, milk, broths,  light puddings,  panado, gruels, he.
His drink may be barley-water,  milk and water, decoaions
of marfhmallows  and liquorice,  linfeed tea, or clear whey.
Of thefe he ought to -drink plentifully.   Violent exercife of
all kinds, efpecially riding on horfeback,  and venereal plea*
fores, are to be avoided.  The patient muft beware of cold,
and when the inflammation is violent, he ought to keep his
bed.
  M  E  D  I C 1 N E.———A virulent gonorrhoea can fel-
dom  be cured fpeedily  and  effeaually at the  fame time.
The patient ought therefore not to expea, nor the phyfician
to promife it.  It will often continue for two or three months,
and fometimes for five or fix, even where the treatment has
 been  very proper.
  Sometimes indeed  a flight infeaion may be carried off in  a
 few days by bathing the parts in warm milk and water, and
 injeaing frequently up the urethra a little fweet oil or linfeed
 tea about the warmth of new milk.  Should thefe not fuc-
 ceed in  carrying off the infeaion,  they will at leaft  have  a
 tendency toleffen its virulence.  Aftringent injeaions how-
 ever  are always  to be ufed with caution.  When the difeafe
 is flight and quite recent, they may remove it ; but when  it
 is violent, or has  continued fo long as to  taint  the humours,
 they  will only tend to retard the cure, and to  render the dif-
 eafe more dangerous.
   It  is  now a common praaice  indeed to flop a gonorrhoea
 by aftringent injeaions.  Where this can be done with fafe-
 ty, it is no doubt proper; but it fhould only be attempted by
 perfons of fkill and experience in the treatment of the diforder.
 An aftringent injeaion may be  prepared by diffolving half a
 dram of the fugar of lead in fix or feven ounces of rofe-water.
 Where this is proper, a fmall  fyringefull of it, a little warm,
 may  be injeaed up the urethra five or fix  times a-day,  and
 continued till the running flops.
   Whether injeaions be ufed or not, cooling purges are al-
 ways proper in the gonorrhoea.  They ought not however  to
                                                       be 
 376    OF THE VIRULENT GONORRHOEA.

 be of the ftrong or draftic kind.  Whatever raifes a violent
 commotion in the body  increafes the danger,  and tends to
 drive the  difeafe deeper into the habit.  Procuring two or
 three ftools every fecond  or  third day for the firft fortnight,
 and the fame number every fourth or fifth day for the fecond,
 will generally be fufficient to remove the inflammatory fymp-
 toms, todiminifh the running,  and to change the  colour and
 confiftence ofthe matter, which gradually becomes more clear
 and ropy as the virulence abates *.
   When the inflammatory fymptoms run high, bleeding is
 always neceffary at the beginning.  This operation, as in o-
 ther  topical inflammations, muft be repeated according to the
 ftrength and conftitution of the patient, and the  vehemence
 and urgency of the fymptoms.
   Medicines which promote the fecretion of urine, are  like-
 wife  proper in  this ftage of  the diforder.  For  this purpofe,
 an ounce of nitre and two ounces of gum arabic, pounded to-
 gether, may be divided into twenty-four dofes,  one of which
 may  be taken frequently, in  a cup of the patient's drink.   If
 thefe fhould make him pafs his  urine  fo often as to become
 troublefome to him, he may either take them lefs frequently,
 or leave out the nitre altogether, and  take eqdal parts of gum
 arabic, and cream of tartar.   Thefe  may be pounded toge-
 ther, and a tea-fpoonful taken in a cup of the patient's drink
 four or five times a-day.  I have generally found this anfwer
                                                 extremely

  * If the patient can fwallow a folution of falts and  manna, he
 may take fix drams, or, if his conftitution requires it, an ounce of
 the former, with half an  ounce of the latter.  Thefe may be dif-
 folved in an  Engliih pint of boiling water,  whey, or thin water-
 gruel, and taken early in  the morning.
  If an infufion of fenna and tamarinds  be more agreeable, two
 drams of the former, and an ounce of the latter, may  be infufed all
 night in an  Englifh pint of boiling water.  The infufion  may be
 ftrained next morning, and half an ounce of Glauber's falts dif-
 folved in it.   A tea-cupful of this infufion may be taken every
 half-hour till it operates.
  Should the patient prefer an  electuary, the following  will  be
 found to  anfwer very well. Take of the lenitive elecfoary four
 ounces, cream of tartar  two ounces, jalap in powder two drains^
rhubarb  one dram,  and as  much of the fyrup of pale rofes as will
ferve to  make up the whole into a foft  eleduary.   Two or three
tea-fpoonfuls of this may be taken over night, and about the fame
 quantity next morning,  every day  that the patient chufes to take
 a purge.
  The dofes of the above medicines may  be increafed or diminifh-
ed according as the patient finds it neceffary.  We  have ordered
the falts to  be diffolved  in a large quantity of water, becaufe it
renders their operation more mild. 
     OF THE VIRULENT  GONORRHOEA.     377

extremely well both as a diuretic, and for keeping the body
gently open.
  Whe^n the pain and inflammation are  feated high towards
the neck of  the  bladder,  it will be  proper  frequently to
throw up an emollient clyfter,  which, befides the benefit of
procuring ftools* will ferve as a fomentation to the inflamed
parts.
  Soft poultices, when they can conveniently be applied to
the parts, are of great fervice.   They may be made  of the
flower of linfeed,  or of wheat bread and  milk, foftened with
frefh butter or fweet oil.  When poultices cannot be con-
veniently ufed, cloths wrung out of warm  water, or blad-
ders filled with warm milk and water, may be  applied.  I
have often known the moft excruciating pains, during the
inflammatory ftate of the gonorrhoea, relieved by one or other
of thefe applications.
  Few things'tend more to keep off inflammation in the fper-
matic veffels, than a proper trufs for the  fcrotum.  It ought
to be fo contrived  as to fupport the tefticles, and fhould be
worn from the firft appearance of the difeafe till it has ceafed
fome weeks.
  The above treatment will fometimes remove  the gonorr-
hoea fo quickly, that tbe perfon will be in doubt whether he
really laboured under that difeafe.  This, however, is too
favourable a turn  to be often expeaed.   Ir  more frequently
happens that  we are able only to  procure an  abatement or re-
miffion  of  the inflammatory fymptoms,  fo far as to make it
fafe to have recourfe to the great antidote  mercury.
   Many people, on the firft appearance of a gonorrhoea, fly
to the ufe of  mercury.   This is.a bad plan.   Mercury is of-
ten not at all neceffary in a gonorrhoea ;  and when taken too
early, it does mifchief.   It may be neceffary to complete the
cure, but can never be proper at the commencement of it.
   When bleeding, purging, fomentations,  and  the other
things recommended above have  eafed the pain,  foftened  the
 pulfe,  relieved the heat of urine, and  rendered  the involun-
 tary ereaions  lefs frequent, the patient may begin  to ufe
 mercury in any form that is leaft difagreeable to him.
   if he takes the common mercurial pill,  two at night and
 one in the morning will be a fufficient dofe at firft.   Should
 they affea the mouth too much, the dofe muft be leffsned ;
if not at all,  it may be gradually increafed  to five or fix pills
 in the day.   If calomel be thought preferable,  two or  three
 grains of it,  formed into a bolus with a little of the conferve 
378     OF THE  VIRULENT GONORRHOEA.

of hips, may be taken at bed-time, and the dofe  gradually
increafed to eight or ten grains.   One of  the moft |commoH
preparations of mercury now in ufe is the corrofive fublimate.
This may  be  taken in the manner afterwards  recommended
Under the confirmed lues or pox.  I have always found it one
of the  moft  fafe and  efficacious medicines when properly
ufed.
   The above medicines may  either be taken every day, or
every other day, as the patient is able to  bear them.  They
ought never to be taken in fuch quantity as to raife a falivati-
©n,  unlefs in a very flight degree.  The difeafe may be more
fafely, and as certainly cured without a falivation  as with it.
When the  mercury runs off by the  mouth, it is not fo fuc-
cefsful in carrying off the difeafe, as when it continues longer
in the body, and is difcharged gradually.
   Should  the patient be purged or griped  in the night by the
mercury, he muft  take an infufion of fenna,  or  fome  other
purgative,  and drink freely of water gruel to prevent bloody
ftools, which are very apt to happen fhould the patient catch
cold, or if the mercury has not been duly prepared.  When
the bowels are weak, and  the mercury is apt to gripe or purge,
thefe difagreeable  confequences may be prevented by taking
with the above  pills or bolus half a dram or two fcruples of
diafoordium,  or of the Japonic confeaion.
   To prevent  the difagreeable circumftances of  the mercu-
ry's affeaing the mouth too much, or bringing on a falivati-
on,  it may be combined  with purgatives.   With this  view
the laxative mercurial  pill has been contrived, the ufual dofe
of which is half a dram,  or  three pills, night and morning,
to be repeated every other day ;  but the fafer way is for the
patient to begin with two  or even with one pill, gradually m-
creafing the dofe.
   To fuch perfons as can neither fwallow a bolus nor a pill,
mercury may be given in a liquid form, as it can  befufpend-
ed even in a watery  vehicle,  by  means of gum-arabic;
which not  only ferves this purpofe, but likewife prevents the
mercury from affeaing the mouth, and renders it in  many
refpeas a better medicine *.                             It

  * Take quickfilver one dram, gum-arabic reduced to a mucilage
two drams; let the  quickfilver be rubbed with the mucilage, in a
marble mortar, until the globules  of mercury entirely difappear:
afterwards add gradually, ftill continuing the trituration, half an
ounce of balfamic fyrup, and eight ounces  of fimple cinnamon
water. Two table-fpoonfuls of this folution  may be  taken night
and morning.   Some reckon thia the beft form in which quickfilver
tan be exhibited for the cure of a gonorrhoea. 
    OF  THE VIRULENT GONORRHOEA.     37c>

  It happens very fortunately for thofe who cannot be brought
to take mercury inwardly, and likewife for perfons  whole
bowels are too tender to bear it, that an external application
of it will anfwer equally well,  and, in fome refpeas,  better.
It muft be acknowledged, that mercury taken  inwardly  for
any length of time,  greatly weakens and  diforders the bow-
els ;  for  which reafon, when  a  plentiful ufe of it becomes
neceffary, we would prefer rubbing to any other mode of  ap-
plication  whatever.   The common mercurial,  or blue oint-
ment, will anfwer very well.    Of that which  is made by
rubbing  together equal quantities of hog's lard  and  quick-
filver, about a dram may be ufed at a time. The beft time
for rubbing it on is at night,  and the moft proper place the
inner fide of the thighs.  The patient fhould Hand before the
fire when he rubs, and fhould  wear flannel drawers next his
fkin  all the time he is  ufing the ointment.  If  ointment of a
weaker or ftronger kind be  ufed,  the quantity muft  be  in-
creafed or diminifhed in proportion.
   If, during the ufe  of  the ointment, the inflammation of
the  genital  parts, together with  the  heat and feverifhnefs,
fhould return, or if the mouth fhould grow fore, the gums
tender,  and the breath become offenfive, a dofe or two of
Glauber's falts, or fome other cooling purge, may be taken,
and the rubbing intermitted for a few days.   As foon, how-
ever, as the figns of  fpitting are gone off,  if the virulency be
not quite correaed, the ointment muft  be repeated, but in
fmaller  quantities,  and  at longer  intervals,  than  before.
Whatever way mercury is  adminiftered,  its  ufe  muft be
perfifted  in as long  as  any  virulency  is fufpeaed to re-

   During this, which may be called the fecond ftage of the
diforder, though fo ftria a regimen is not neceffary as in the
firft or inflammatory ftate, yet intemperance of every kind
muft be  avoided.  The food muft be light, plain, and of eafy
cjigeftion; and the greateft indulgence that may be allowed
with refpea to drink is, a little wine diluted with a fufficient
quantity of water.   Spirituous liquors are to be avoided  in
every fhape.   I  have often known the  inflammatory fymp-
toms renewed  and  heightened, the running increafed, and
the cure rendered extremely difficult and tedious, by one  fit
of exceffive drinking.
   When the above  treatment  has removed  the heat of urine,
and forenefs of the  genital parts; when the quantity  of  run-
                                                    ning 
380     OF THE VIRULENT GONORRHOEA,

ning is confiderably leffened, without any  pain or  fwelling
in the groin or tefticle fopervening ; when the patient is free
from involuntary ereaions; and  laftly,  when  the  running
becomes pale,  whitifh, thick, void of ill fmell, and tenaci-
ous or  ropy ; when all or  moft of thefe  fymptoms appear,
the gonorrhoea is arrived  at its laft ftage, and we may gra-
dually proceed to the ufe of gentle aftringent, or agglutina-
ting medicines.  Thefe, however, ought always to be ufed
with caution.  When the  contagion is expelled, the running
will generally flop of itfelf;  and when  it does not, there is
ftill reafon  to fear, that the virulency is net completely fub-
dued.  But this will foon appear;  for if the contagion be
not  removed, upon flopping the running, fwelled  tefticles,
a fore throat, buboes, or fome other  fymptom of the  pox,
will enfue.   When  this happens,  the running eiuft be again
promoted by purges, and more mercury muft be ufed.
   That we may proceed with caution, and not give too fud-
den a check to the difcharge,  gentle aftringents may be mix*-
ed  with  purgative medicines, and taken in  the following
manner : To two ounces of the lenitive eleauary, add cream
of tartar and  powdered  rhubarb, of each halt an  ounce;
balfam of Capivi, an ounce and a half.   Let  thefe  be made
into an eleauary, with the fyrup of pale  rofes, and about
the bulk of a large  nutmeg taken evening and morning for
a dofe.
   If no bad fymptoms enfue  from ufing the above,  ftronger
aftringents, if neceflary, may be adminiftered, as the Venice
turpentine, the Peruvian balfam,  balfam  of Gilead, &c.  If
thefe balfams fhould,occafion naufea or  ficknefs, the patient,
inftead of them,  may take  fifteen or twenty drops of the acid
elixir of vitriol, in a glafs of red wine or  a cup of the infufion
cf the bark, twice or thrice a-day.
   Should the running,  notwithftanding the ufe of thefe me-
dicines, ftill continue, but without any figns of virulency, re-
courfe muft be had to aftringent  injeaions.  For  this pur-
pofe a little gum arabic may be diffolved in three or four
ounces of rofe-water, to which ten or twelve grains of the fu-
gar of lead  may  be added.   Two  or three drams of this may
be daily injedted up the urethra with afmall fyringe. It fhould
be ufed a little warm, and may be made ftronger as the cafe
requires.
   During  this courfe, a proper regimen is likewife to be ob-
ferved. The patient ought to take gentle exercife in the open
air, but fhould avoid great heat and fatigue.  His diet ought
                                                      to 
OF  THE VIRULENT GONORRHOEA.     $t
to be drying and agglutinating, as bifcuit, rice, millet, jellie*
of hartfhorn, and other things of a ftrengthening nature. His
drink may be Briftol water, claret, or red port, with the ad-
dition of a little water.   All excefs is carefully to be avoided,
and whatever may have a tendency to weaken or relax the
habit.
  If all thefe means  fhould prove ineffeaual,  and notwith-
ftanding the virulency is perfectly cured, a running fhould ftill
remain, the diforder is  then denominated a gleet;  the proper
treatment whereof we fhall next proceed to fhew.

            OF      GLEETS.

  A gonorrhoea frequently repeated, or improperly treat-
ed, often ends in a gleet, which may eithef proceed from re-
laxation, or from latent ulcers in fome of the parts which had
been the feat of the gonorrhoea.  It is, however, ofthe great-
eft importance in the cure of the gleet, to know from which
of thefe caufes it proceeds.  When  the difcharge proves very
obftinate, and receives little or no check from aftringent re-
medies, there is ground to fufpea that it is owing to ulcers :
but if the drain is inconftant, and is chiefly obfervable when
the patient isftimulated by lafcivious ideas, or upon ftraining
to go to ftool, we may reafonably conclude that  it is chiefly
owing to relaxation.
   In the cure of a gleet proceeding from relaxation, the prin-
cipal defign is to brace, and reftore a proper  degree of tenfion
to the debilitated and relaxed veffels.  For this purpofe, be-
fides the medicines recommended in the laft ftage of the go-
norrhoea, the patient may have recourfe to ftronger and more
powerful aftringents, as the Peruvian bark *, alum, vitriol,
galls, tormentil, biftort, balauftines, tinaure of gum kina, he.
   While the patient is taking thefe medicines, the cure may
 be promoted by aftringent injeaions, fuch as are recommend-
ed in the laft ftage of the gonorrhoea, to which a few grains
of alum, or white vitriol, may occafionally  be added.
                                                     The

  *  The Peruvian bark may be combined with other aftringents,
 and  prepared in the following manner:
  Take of Peruvian bark bruifed fix drams, of frefh  galls  bruifed
 two  drams; boil them in a pound and a half of water to a poiind :
 to the ftrained liquor add three ounces of the fimple tinaure of the
 bark.  A fmall tea-cupful of this may be taken three tires a-day,
 adding  to each cup fifteen or twenty drops of the acid elixir oj
vitriol'.                                                  ♦ 
382          OF     GLEETS.
   The laft remedy which we  fhall  mention  in this cafe 1*9
the cold bath, than which there is not perhaps a more pow-
erful bracer in the whole compafs of medicine.  It ought ne-
ver to  be omitted in this  fpecies of gleet,  unlefs there be
fomething in the conftitution  of  the patient  which renders
the ufe of it un fafe.   The  chief objeaions to the ufe of the
rold bath are, a  full habit, and an unfound ftate ofthe vifce-
la.  The danger from the former may always be leffened, if
not removed  by  purging and bleeding ; but the latter is an
infurmountable  obftacle, as the preffure of the water, and the
fudden contraaion  of the external  veffels, by throwing the
blood with too much force upon the internal  parts, are apt
to occafion ruptures ofthe veffels, or a flux of humours upon
the difeafed  organs.  But where  no  objeaion of this kind
prevails, the  patient ought to plunge over head in water every
morning fafting, for three or four weeks together.  He fhould
not, however, ftay long in the water, and  fhould take care to
have his fkin dried as foon as he comes out.
   The regimen  proper in this cafe is the fame as was menti-
oned  in the  laft ftage of the gonorrhoea : the diet muft be
drying and aftringent, and the drink Spa,  Pyrmont, or Brif-
tol waters, with which a little claret or red wine  may fome-
times be mixed.  Any perfon may now afford to drink thefe
craters, as they can be every where prepared at almoft no ex-
pence, by a mixture of common chalk and oil of vitriol.
   When the gleet  does  not in the  fmalleft degree yield to
thefe medicines, there is reafon to fufpea that it proceeds
from ulcers.   In this cafe recourfe muft be had to mercury,
and fuch medicines as tend to correa any  predominant acri-
mony  with which the juices may be affeaed, as thedecoaion
of china, farfaparilla, faffafrafs, or the like.
   Mr. Fordyce fays, he has feen many obftinate gleets of two,
three,  or four years ftanding, effeaually cured by a mercurial
inunaion, when almoft every other medicine has  been tried
in vain.  Dr. Chapman feems to be of the  fame opinion ;
but fays, he has  always found the mercury  fucceed beft in this
-cafe when joined with terebinthinate and other agglutinating
medicines.   For which reafon the Doaor recommends pills
made of calomel and Venice turpentine * ; and defires  that
                                                    their

  * Take Venice  turpentine, boiled to a fufficient degree of hard-
pefs, half an ounce, calomel half a dram.   Let thefe be mixed and
jformed into fixty pills, of which five orhxmay betaken night and
morning.  If, during the ufe of thefe pills, the mouth fhould grow
fore, or the breath become offenfive, they muft be difeontinued till
thefe fyniptoms difappear. 
          OF    GLEETS.          3S3

their ufe may be accompanied with a decoaion of gUaiacurrl
or farfaparilla.
  The laft kind of remedy which we  fhall mention for the
Cure of  ulcers in the urinary  paffage,  are  the fuppurating
candles or bougies ; as  thefe are prepared various ways, and
are generally to be bought ready made, it is needlefs to  fpend
time in  enumerating the different ingredients of  which they
are compofed, or teaching the manner of preparing them :
Before a bougie be introduced into the urethra,  however, it
fhould be fmeared all over with fweet oil, to prevent it from
ftimulating too fuddenly ;  it may be fuffered to  continue in
from one to feven or eight  hours,  according as  the patient
can bear it.   Obftinate ulcers are not only often healed,  but
tumours and excrefcences in the urinary paffages taken away,
and an obftruaion of urine removed, by means of bougies.

    OF   THE  SWELLED  TESTICLE.

  The  fwelled tefticle may either proceed  from infeaion
lately contraaed, or from the venereal  poifon lurking  in the
blood :  The latter indeed is not very common, but the for-
mer frequently happens both  in the firft and fecond ftages of
a gonorrhoea; particularly when the running is unfeafonably
checked, by cold, hard drinking, ftrong draftic purges, vio-
lent exercife, the too early ufe of aftringent medicines,  or th*
like.
  In the  inflammatory ftage bleeding is neceffary,  which
muft be repeated according to the urgency of the fymptoms*.
The food  muft be light, and the drink diluting.   High-fea-
foned food, flefh, wines, and every thing of a heating nature,
are to be avoided. Fomentations are of lingular fervice.  Poul-
tices of bread and milk, foftened with  frefh butter or oil, are?
likewife very proper, and ought conftantly to be applied when
the  patient is in bed : when he is up,  the tefticle fhould  be
kept warm,  and fupported by a bag or trufs,  which majp
eafily be contrived in fuch  a manner as to prevent the weight
ofthe tefticle from having any effea.
  If it fhould be found impraaicable to clear the tefticle by
the cooling regimen now pointed out,  and extended accord-
ing to circumftances,  it will be neceffary to lead the patient*
through fuch  a complete antivenereal courfe,  as  fliall enfure
                                                    him

  * I have been of ufe for fome time part, to apply leeches to in-
flamed tefticles, which practice hag always been followed with th?
noft happy effecl*. 
 3«4      OF THE  SWELLED  TESTICLE.

 him againft any future uneafinefs.   For this purpofe,  befides
 rubbing the mercurial ointment on the part, if free from pain,
 or on the thighs, as direaed in the gonorrhoea,  the patient
 muft be confined to bed,  if neceffary,  for five or fix weeks,
 fofpending the tefticle all the while with a bag or trufs,  and
 plying him inwardly with ftrong decoaions of farfaparilla.
   When thefe means do not fucceed, and there is reafon to
 fufpea  a fcrophulous or cancerous  habit, either of which may
 fupport a fcirrhus induration, after the venereal poifon is cor-
 reaed,  the parts fhould be fomented daily with a decoaion of
 hemlock, the bruifed leaves of which may likewife be added
 to the  poultice, and the extraa  at the fame time taken in-
 wardly*.   This  praaice  is ftrongly  recommended by Dr.
 Stork in fcirrhus and cancerous cafes; and Mr. Fordyce af-
 fures  us,  that this method  has  cured difeafed  . tefticles of
 two or three years ftanding,  even  when ulcerated, and when
 the fcirrhus had begun.to be affeaed with pricking and lane*
 ing pains.

           OF     BUBOES.

  Venereal buboes are hard tumours feated  in the groin,
 occafioned by the venereal  poifon lodged in this part.  They
 are of two kinds, viz. fuch as proceed from a recent infeaion,
 and fuch as accompany a confirmed lues.
  The  cure of recent buboes, that is fuch  as appear foon af-
 ter impure coition, may be firft attempted by difperfion, and,
 if that fhould not fucceed,  by fuppuration.   To promote  the
 difperfion of a buboe, the fame regimen muft be obferved as
 was direaed in the firft ftage of a  gonorrhoea.  The patient
 muft likewife be bled, and  take fome cooling purges, as the
 decoaion  of tamarinds and fenna, Glauber's falts, and  the
 like.  If,  by this courfe, the fwelling and other inflammato-
 ry fymptoms abate, we may fafely  proceed to the ufe of mer-
 cury, which muft be continued till the venereal virus is quite
fubdued +.
  But if the buboe fhould,  from the beginning,  be attended
 with great heat, pain, and puliation, it will  be proper to pro-
mote its fuppuration.  For this purpofe the patient may be
                                                allowed

  *  The extract of hemlock may be made into pills, and taken
in the manner directed under the article Cancer.
  f For  the difperfion of a buboe, a number of leeches applied t9
the part  afTefted will be,found  equally  efficacious as in  the in-
flamed tefticle. 
OF    BUBOES.          385
allowed to ufe his ordinary diet, and to take now and then a
glafs of wine.   Emollient cataplafms, confifting of  bread
and milk foftened with oil or frefh butter,  may be applied to
the part; and, in cold conftitutions, where the tumour  ad-
vances  flowly, white-lily roots boiled, or diced onions raw,
and a fufficient quantity of yellow bafilicon, may be added to
the poultice.
  When the tumour is ripe, which  may be  known by  its
conical figure, the foftnefs of the fkin, and a fluauation of
matter  plainly to  be felt under the finger,  it  may be opened
either by cauftic or a lancet, and afterwards dreffed with di-
geftive ointment.
   It fometimes,  however, happens  that buboes  can neither
be difperfed nor brought to a  fuppuration, but remain hard,
indolent tumours.  In this cafe the indurated  glands muft be
confumed by cauftic; if they fhould  become  fcirrhus, they
muft be diflblved by the  application of hemlock both exter-
nally and internally,  as direaed in the fcirrhus tefticle,

        OF    CHANCRES.

   Chancres are fuperficial, callous, eating ulcers; which
may happen either with or without a gonorrhoea.   They are
commonly feated about the glans, and make their appearance
in the  following  manner :  Firft a  little  red  pimple arifes,
which foon becomes pointed at top,  and is filled with a whit-
 ifh matter inclining to yellow.   This pimple is hot, and itch-
 es generally before it  breaks ; afterwards it degenerates  into
 an obftinate ulcer, the bottom of which is  ufually covered
 with a vifcid mucus,  and whofe edges gradually become hard
 and callous.  Sometimes the firft appearance refembles a fim-
 ple excoriation of the cuticle ; which, however,  if the caufe
 be venereal, foon becomes a true chancre.
   A chancre is fometimes a primary affeaion, but it is much
 oftener  fymptomatic, and is the mark of a confirmed  lues.
 Primary chancres difcover themfelves foon after impure coi-
 tion, and  are generally feated in parts covered with a thin cu-
 ticle ; as the lips, the nipples of women, the glans  penis  of
 men,  &c. *                                       .„,
                          Z z                     When

   * When venereal ulcers are  feated in the lips,   the  infection
 may be communicated by killing.  I  have feen very obftinate ve-
 nereal ulcers in the  lips, which I had all the reafon in  the world
 to believe wer« occaifou*J fofely by ki/fing au infected perfciK 
 386        OF    CHANCRES.

   When a  chancre appears  foon after  impure coition, its
 treatment  is in every refpea fimilar to that of the  virulent
 gonorrhoea.  The patient muft obferve the cooling regimen,
 lofe a little blood,  and  take  fome gentle dofes of falts and
 manna.   The  parts affeaed ought frequently to  be bathed,
 or  rather foaked,  in warm milk and water, and,  if the  in-
 flammation be great,  an emollient poultice orcataplafm may
 be applied to them.  This courfe will, in moft cafes, be fuf-
 ficient to abate the inflammation, and prepare the patient for
 the ufe of mercury.
   Symptomatic chancres are commonly  accompanied with
 ulcers in the throat, noaurnal pains, fcurfy  eruptions about
 the  roots of the  hair,  and other fymptoms of a confirmed
 lues.  Though they  may be feated in any of the parts men-
 tioned above, they commonly appear upon the private parts
 or the infideof the thigh.  They are alfo lefs painful,  but fre-
 quently  much larger and  harder than  primary chancres.
 As their cure muft depend upon  that of the pox, of which
 they are  only a  fymptom, we fhall take no further notice  of
 them, till we come to treat of a  confirmed lues.
   Thus we have  related moft of the fymptoms which ac-
 company or fucceed to  a virulent gonorrhoea, and have alfo
 given a  fhort view  of their  proper treatment; there are,
 however, feveral  others which  fometimes attend this difeafe,
 as a ftrangury or  obftruaion of urine, a phymofis, paraphy-
 mofls, he.
  A ftrangury may be occafioned either by a fpafmodic con-
 flriaion, or an inflammation of the urethra  and parts about
 the neck of the bladder.   In  the former cafe, the patient
 begins to voidriis  urine with tolerable eafe; but, as foonasit
 touches the galled or inflamed urethra, a fudden conftriaion
 takes place, and the urineis voided by fpurts, and fometimes by
 drops only.   When the ftrangury is owing  to an  inflam-
 mation about the  neck  of  the bladder,  there is a conftant
 heat and uneafinefs  about this part, a perpetual defire  to make
 water, while the patient can only render a few drops, and a
troublefome tenefmus, or conftant inclination to go to ftool.
  When the ftrangury is owing to fpafm,  fuch medicines
as tend to dilute and blunt the falts of the urine will be pro-
                                                    per.

  Nurfes  ought to beware of fuckling infefted children, or hav-
ing  their  breafts drawn by perfons tainted with the venereal dif-
eafe..  This caution  is peculiarly neceffary for nurfes who rcfidc
in the neighbourhood of great towns. 
          OF    CHANCRES.        387

  per.  For this purpofe, befides the common diluting liquors,
  foft and cooling emulfions, fweetened with the fyrup of pop-
  pies,  may  be ufed.   Should thefe  not have the defired ef-
  fea,  bleeding, and emollient fomentations, will be  necef-
  fary.
    When the complaint is evidently owing to an  inflammati-
  on about the neck of the bladder, bleeding muft be  more li-
  berally performed, and repeated according to the urgency of
  the fymptoms.  After bleeding,  if the ftrangury ftill  conti-
  nues, foft clyfters,  with  a proper  quantity  of laudanum in
  them, may  be adminiftered, and  emollient fomentations ap-
  plied  to the region of the bladder.  At the fame time, the
  patient may take every four hours a tea-cupful of barley-wa-
  ter, to an Englifh pint of which fix ounces of the  fyrup  of
  marfh-mallows, four  ounces  of the oil  of fweet  almonds,
  and half an  ounce of nitre, may be added.  If thefe  reme-
  dies fhould not relieve the complaint, and a total fuppreffion
  of urine fhould come on, bleeding muft be repeated, and the
  patient fet in a warm bath up to the middle.  It will be pro-
  per, in this cafe, to difcontinue the diuretics,  and  to draw
  off the water  with  a catheter ;  but as the patient is feldom
  able  to  bear  its being introduced, we would rather recom-
  mend  the  ufe of  mild bougies.   Thefe often  lubricate the
  paflage, and greatly facilitate the difcharge of urine.  When-
  ever they begin to flimulate or give any uneafinefs, they may
  be withdrawn.
    The phymofis is fuch a conftriaion of the prepuce over the
 .glans, as hinders it from being drawn backwards; the para-
  pbymofis,  on the contrary, is fuch a conftriaion of the pre-
  puce behind the glans,  as hinders it from being  brought for-
  ward.
    The treatment of thefe fymptoms is fo nearly the fame with
  that of the virulent gonorrhoea, that we have no occafion to
  enlarge upon it.  In general, bleeding, purging, poultices,
*and emollient  fomentations are fufficient.   Should  thefe,
  however, fail  of removing the  ftriaure, and the   parts be
  threatened with a mortification,  twenty or  thirty grains  of
  ipecacuanha, and one  grain of emetic tartar,  may  be given
  for a vomit, and may be worked off with warm water or thin
  gruel.
    It fometimes  happens, that, in fptte of all endeavours to
  the contrary, the inflammation goes  on, and fymptoms  of
  a beginning mortification appear.  When  this is the cafe,
  the prepuce  muft be fcarified with a lancet, and  if neceffary,
                                                  divided. 
388         OF    CHANCRES.

divided, in order to prevent a ftrangulation, and fet the in>
prifoned glans at liberty.  We fhall  not defcribe the manner
of performing  this operation, as it ought always to be  done
by a forgeon.   When  a mortification has  aaually taken
place,  it will be neceflary, befides performing the above ope-
rations, to foment the  parts frequently with cloths wrung
©ut of  a ftrong decoaion of  camomile flowers and bark,  and
to give the patient a dram of the  bark in powder every  two
or three hours.
   With regard to thepriapifm,  chordee,  and other diftortions
of the penis, their treatment is  no way different from that of
the gonorrhoea.    When they prove very  troublefome, the
patient may take  a  few drops of laudanum  at night, efpe-
cially after the operation of  a purgative through the day.

     OF  A  CONFIRMED  LUES  OR  POX.

   We have hitherto treated of  thofe affeaions in which the
venereal poifon is fuppofed to be confined chiefly to the parti-
cular  part by which it  was received, and  fhall next take a
view of the lues in its confirmed ftate, that is, when the poi-
fon is  aaually received into  the blood,  and, circulating with
it through every part of the body, mixes with the feveral fe-
cretions,  and renders  the whole habit tainted.
   The fymptoms of a confirmed lues are,  buboes in the
groin,  pains  of the  head and  joints,  which are peculiarly
troublefome in the night, or  when the patient  is warm in bed;
fcabs and fcurfs  in various  parts of the body, efpecially on
the head,  of a yellowifh colour, refembling honey-comb;
corroding  ulcers  in various  parts of the body, which gene-
rally begin about the throat, from whence they creep gradu-
ally, by the palate, towards the cartilage of the nofe, which
They deftroy ;  excrefcences or exoftofes arife in the middle of
the bones, and  their fpongy ends become brittle,  and break
upon the leaft accident; at other times,  they are foft, and
bend like wax  ; the conglobate glands become hard and  cal-
lous,  and form, in the neck, arm-pits, groin, and mefente-
ry, hard moveable tumours,  like the king's evil; tumours of
different kinds are likewife formed in the lymphatic veffels,
tendons, ligaments, and nerves,  as  the gummata, ganglia,
nodes,  uphs, he.  the  eyes are  affeaed  with  itching, pain,
rednefs, and  fometimes  with total blindnefs, and the  ears
with'a finging  noife,  pain,  and deafnefs, whilft their inter-
nal fubftance is exulcerated  and rendered carious;  at length 
      OF A CONFIRMED LUES OR POX.*     389

 all the  animal,  vital, and  natural funaions are depraved;
 the face becomes pale and livid ; the body emaciated and un-
 fit for motion, and the miferable patient falls into an atrophy
 or wafting confumption.
  Women have fymptoms peculiar to the fex;  as cancers of
 tbe breaft;  a fuppreffion or overflowing of the menfes -,  the
 whites; hyfteric affeaions ;  an inflammation, abfcefs, fcirr-
 hus, gangrene, cancer,  or ulcer of the womb ; they are ge-
 nerally either barren or fubjea to abortion ; or,  if they bring
 children  into the  world, they have  an  univerfal eryfipelas,
 are half rotten, and covered with  ulcers.
  Such is the catalogue  of fymptoms  attending this dreadful
 difeafe in its confirmed  ftate.   Indeed they are feldom all to
 be met with in the fame perfon, or at the fame time ; fo  ma-
 ny of them,  however, are generally prefent as  are fufficient
 to alarm the patient;  and if he has reafon to fufpea the in-
 feaion is lurking in his body, he ought immediately to fet
 about the expulfion of it, otherwife the moft tragical  confe-
 quences will enfue.
  The only certain remedy hitherto  known in Europe, for
 the cure of this difeafe,  is mercury, which may be ufed  in a
 great variety of forms, with nearly the fame fuccefs.  Some
 time ago it was reckoned impoffible to cure a confirmed lues
 without a  falivation; this method is now,  however,  pretty
 generally laid afide, and mercury is found  to be as efficaci-
 ous,  or rather more fo, in  expelling the venereal  poifon,
 when adminiftered  in fuch a manner as not to runoff  by the
 falivary glands.
  Various preparations of mercury have been extolled  at dif-
 ferent times, by different authors, for the cure of the venereal
 difeafe;  but  after all, it has  been found, that the moft  fimple
 forms in which it can be  introduced into the fyftem, general-
 ly fucceed as  well as the moft elaborate chemical  preparations.
 Thus, an ointment or pill prepared by triturating common
 quickfilver with greafe, refin, or mucilage, will, if ufed for a
 fufficient length of  time,  remove the moft obftinate venereal
 fymptoms, unlefs where  the conftitution is fo far deftroyed as
 to render a cure impoffible.
  Thefe may be ufed in  the fame  manner as for the virulent
 gonorrhoea;  and if any fymptoms  of a falivation fhould  ap-
 pear^ they muft be difcontinued for fome days, and a purge or
 two taken.  It is impoffible to afcertain either the exact  quan-
 tity of thefe  medicines that muft be taken, or the time they
ought to be continued in order to perform a cure.   Thefe 
fto      OF A CONFIRMED LUES OR POX.

will ever vary according to the  conftitution of the patient,
the feafon of the year, the degree of infeaion, the time it has
lodged in the body, he. But though it is difficult, as Aftruc
obferves, to determine, a priori, what quantity of mercury
will, in the whole,  be neceffary to cure this diftemper com-
pletely ;  yet it may be  judged  of a pojleriori, from the abate-
ment and ceafing of the fymptoms.  The fame author adds,
That commonly not lefs than two ounces of the ftrong mer-
curial ointment is fufficient, and not more than three or four
ounces neceffary.
   The only chemical preparation of mercury which we fhall
take notice of, is the corrofive fublimate. This was fome time
ago brought into ufe for the venereal  difeafe,  in Germany,
by the illuftrious Baron Van Swieten ; and was foon after in-
troduced into Britain by the learned Sir John Pringle, at that
time phyfician to the army.  The method of giving it is as
follows : One grain of corrofive fublimate is diffolved in two
ounces of French brandy or malt fpirits; and of this folution,
an ordinary table-fpoonful, or the quantity of half an ounce,
is to be taken twice a-day, and to  be continued as long as
any fymptoms of the diforder remain.   To thofe whofe fto-
mach cannot bear the folution,  the fublimate  may  be  given
in form of pill *.
   Several roots, woods, and barks, have been recommended
for curing  the venereal difeafe ; but none of them have been
found, upon  experience, to  anfwer  the high  encomiums
which had been beftowed upon them.  Though no one of
thefe  is to be depended upon alone, yet, when joined with
mercury, fome of them are found to be very beneficial in pro-
moting a cure.  One ofthe beft we know yet  is farfaparilla^
which may be prepared and taken according to the direaions
in the Appendix f.
   The mezereon-root is likewife  found to be a powerful af-
fiftant to the fublimate, or any other mercurial. It may either
be ufed along with the  farfaparilla, as direaed in the Appen-
dix,  or by itfelf.   Thofe  who chufe to ufe  the mezereon by
itfelf,  may boil an ounce  of the frefh bark, taken from the
root,  in  twelve Englifh pints of water to eight,  adding to-
                                                   wards

  * The  fublimate may be  diffolved in water, or any other li-
quor that the patient chufes.  I  commonly order ten grains to
be diffolved in an ounce of water, for the conveniency of  car-
riage, and  let the patient take twenty or thirty drops of it nigbt
and morning in half" a glafs of brandy or other fpiriti.
    f See Appendix, Decoction of Sarfaparilla. 
OF  A  CONFIRMED LUES OR  POX.
wards the end an ounce of liquorice.   The dofe of this is the
fame as of the decoaion of farfaparilla.
  We have been told that the natives of America cure the
venereal difeafe in every ftage by a  decoaion  of the root of
a plant  called the Lobelia.  It is ufed either frefh or dried ;
but we have no certain  accounts with regard to the propor-
tion.  Sometimes they mix other roots with it, as thofe ofthe
ranunculus, theceanothus, &c. but whether thefe are defign-
ed to difguife or affift it,  is  doubtful.  The patient takes a
large draught of the decoaion early in the morning, and con*
tinues to ufe it for his ordinary drink  through the day*.
  Many other  roots and  woods might be mentioned which
have been extolled for curing the venereal difeafe, as the chi-
na-root, the roots of foap-wort, burdock, &c. as alfo the
wood of guaiacum and faffafrafs ;  but as none of thefe have
been  found to poffefs virtues fuperior to thofe already men-
tioned,  we fhall, for the fake of brevity,  pafr them over, and
fhall conclude our obfervations on this difeafe with a few ge-
neral remarks concerning the proper  management of the pa-
tient, and the nature of the infeaion.

  GENERAL  OBSERVATIONS.

  The  condition of the patient ought always to be confider-
 ed previous to his entering upon a courfe of mercury in any
 form.   It would be equally rafh and  dangerous  to adminifter
 mercury to a perfon labouring under any violent  acute dif»
 eafe, as a putrid fever,  pleurify,  peripneumony, or the like.
 It would likewife  be dangerous in  fome chronic cafes ;  as  <t
                                                     flow

  * Though we are ftill  very  much in  the dark with regard  to
 the method of curing this difeafe among the natives of America,
yet nothing is more certain  than that they  do cure it with fpeed,
 fafety, and fuccefs, and that without the leaft knowledge of mer-
 cury. Hence it becomes an objeft of confiderable  importance to
 difcover their method of eure.   This  might  furely be done  by
 making  trials  of  the various  plants  which  are found in thofe
parts, and particularly of fuch as the natives are known to make
 ufe of.   All people in a rude ftate take their medicines chiefly
 from the vegetable kingdom, and are often poffeffed of valuable
fecrets with regard to the virtues of plants,  of which more en-
 lightened nations are ignorant.   Indeed we make no doubt hut
fome plants of our own  growth,  were  proper pains taken to dif-
cover them would be found as efficacious  in curing the venereal
difeafe as thofe of America.  It muft  however be remembered*
that what will cure the venereal difeafe in one country, will not
always be found to have equal fuccefs in another. 
OF A CONFIRMED LUES OR POX.
flow heaic fever, or the laft ftage of a confumption.  Some-
times, however, thefe difeafes proceed from a confirmed lues;
in which cafe, it will be neceffary to give mercury. In chronic
difeafes of a lefs dangerous nature, as the afthma, the gravel,
and fuch like, mercury, if neceflary, may be fafely admini-
ftered.   If the patient's ftrength has been  greatly  exhaufted
by ficknefs, labour,  abftinence,  or any other caufe, the ufe
of mercury muft be poftponed, till by time,  reft, and a nou-
rifhing diet, it can be fufficiently reftored.
   Mercury ought not  to be adminiftered  to women during
the menftrual flux, or when the period is near at hand.  Nei-
ther fhould it be given in the laft ftage  of pregnancy.  If,
however, the woman be  not near the time of her delivery,
and circumftances render it neceffary, mercury may be given,
but in fmaller dofes, and at greater interyals than ufual: with
thefe precautions, both the mother and child  may be cured
at the fame time; if not,  the diforder will at leaft be kept
from growing worfe, till the woman be brought to bed,  and
fufficiently recovered, when a more effeaual method  may be
purfued, which,  if fhe fuckles her child, will in all probabi-
lity be fufficient for the cure of both.
   Mercury ought always  to be adminiftered to infants with
the greateft caution.   Their tender  condition unfits them for
fupporting a  falivation, and makes  it neceffary to  adminifter
even the mildeft preparations of mercury to them with afpar-
ing hand.  A fimilar condua  is  recommended in the treat-
ment of old  perfons, who have the  misfortune to labour un-
der a confirmed lues.   No doubt the infirmities of age muft
render people lefs able to undergo the fatigues of a  falivation;
but this, as was formerly  obferved,  is feldom neceffary ; be-
fides, we have generally found,  that mercury  had much lefs
effea upon very old perfons than an  thofe who were younger.
   Hyfteric and hypochondriac  perfons,  and fuch as are  fub-
jea to an habitual diarrhoea or dyfentery, or to frequent and
violent  attacks ofthe epilepfy, or who are affliaed with the
fcrophula, or the fcurvy,  ought  to be cautious in  the ufe  of
mercury. Where anv one of thefe diforders prevails, it ought
either, if poffible, to be cured, or at leaft palliated, before the
patient enters upon a courfe of mercury.   When this cannot
be done, the  mercury muft be adminiftered in  fmaller  dofes,
and at longer intervals than ufual.
   The  moft  proper  feafons  for entering upon  a courfe of
 mercury, are the fpring and autumn, when the air  is of a mo-
                                                   derate 
OF  A CONFIRMED  LUES OR  POX.
derate warmth ;  if the circumftances of the  cafe,  however,
will not admit of delay,  we muft  not defer  the cure on ac-
count ofthe feafon, but muft adminifter the  mercury $ tak-
ing care, at the fame time,  to  keep the  patient's chamber
warmer or  cooler, according as the feafon of  the  year re-
quires.
  The next thing to be confidered  is the  preparation necef-
fary to be obferved before we proceed to adminifter a courfe
of mercury.  Some lay great ftrefs  upon this circumftance,
obferving, that by previoufly relaxing the veffels, and correa-
ing any diforder which  may  happen to  prevail  in the blood,
not only the mercury will be difpofed to aa more kindly, but
many other inconveniencies will be prevented.
   We have already recommended bleeding and gentle purges,
previous  to the adminiftration  of  mercury,  and fhall  only
now add, that thefe are always to  be  repeated according to
the age,  ftrength, conftitution, and other circumftances of
the patient.   Afterwards, if it can  be conveniently  done, the
patient ought to bathe once or twice a-day, for a few days,
in lukewarm water. His diet in the mean time muft be light,
moift, and cooling. Wine, and all  heating liquors, alfo vio-
lent  bodily exercife, and all great exertions of the mind, are
carefully to be avoided.
   A proper regimen is  likewife to be obferved by fuch as are
under a courfe of mercury.  Inattention to this not only en-
dangers the patient's life, but often alfo difappoints him of a
cure.  A much fmaller quantity of mercury will be fufficient
for the cure of a perfon who lives  low, keeps  warm, and ar
voids all manner of excefs, than of one who cannot endure to
put the fmalleft  reftraint upon his appetites : indeed it but
rarely happens that fuch are thoroughly cured.
   There is hardly any thing of more importance,  either for
preventing  or removing venereal infeaion, than cleanlinefs.
By an early attention to this, the  infeaion  might often be
prevented from entering the  body;  and, where it has already
taken place, its effeas  may be greatly mitigated.   The mo-
ment any perfon has reafon to fufpea  that he has received
the infeaion, he ought to wafh the parts with water and fpi-
rits, fweet  oil, or milk and water ; a fmall quantity of the
laft may likewife be injeaed up the urethra,  if it can  be con-
veniently  done.   Whether this difeafe at  firft took its rife
from dirtinefs is hard to fay; but wherever that prevails, the
infeaion is found in its  greateft degree of virulence,  which
                      A a a                        gives 
394     OF A CONFIRMED LUES OR POX.

gives ground to believe that a ftria attention  to cleanlinefs
would go far towards extirpating it  altogether *.
   When the venereal difeafe has been negfeaed,  or impro-
perly treated, it often becomes a diforder of the habit.  In this
cafe the cure muft be attempted by reftoratives, as a milk diet,
the decoaion of farfaparilla, and  fuch like,  to which mercu-
ry may be occafionally  added.   It is a common praaice in
North-Britain, to fend  fuch patients to drink  goat-whey.
This is a very  proper plan,  provided  the infeaion  has been
totally eradicated before-hand ; but when that is not  the cafe,
and the  patient trufts to the whey for finifhing his cure,  he
will often be difappointed.   I have  frequently known thedif-
eafe return  with all its virulence after a courfe of goat-whey,
even when  that courfe had been  thought quite fufficiejit  for
completing the Gure.
   One of the  moft unfortunate circumftances attending pa-
tients in this difeafe, is the neceflity they are often laid under
of  being foon  well.   This induces them  to take medicine
too faft, and to leave it  off too foon.   A few grains more of
medicine, or a few days longer confinement, would often  be
fufficient to perfea the  cure ; whereas, by  negfea of thefe,
                                                    a fmall

  * I have not  only often feen a recent infection carried off in a
few days by  means of cleanlinefs,  v\i. bathing, fomentations,  in-
jections,  &c. but have likewife found it of the greateft advantage
in the more  advanced ftages of the difeafe.  Of this I had lately a
very remarkable inftance,  in a man whofe penis  was almoft wholly
confumed by venereal ulcers: the matter had been allowed to
continue on the fores,  without  any care having been taken.to
clean them,  till, notwithftanding the ufe of mercury and other
medicines,  it had produced the effefts above mentioned.   I  or-
dered warm milk and water to be injefted three or four times
a day into all the finuous ulcers, in order to wafh out the matter;
after which  they were fluffed with dry  lint to  abforb  the frefh
matter as it was generated.   The patient at the fame time took
every day half  a grain of  the corrofive fublimate of  mercury,
diffolved in  an  ounce of brandy, and drank an  Englifh quart of
the  decoction of farfaparilla.  By this  treatment,  in  about fix
weeks, he was  perfectly cured ; and,  what was very remarkable,
a part of the penis was actually regenerated.
  Doctor Gilchrift has given an account  of a fpecies of the lues
venerea which prevails in the weft of Scotland, to which the  na-
tives give the name of Sibbins or Sivvins. The Doctor obferves,
that the fpreading of this difeafe  is chiefly owing to a negleft of
cleanlinefs,  and feems to think, that by due attention to that  vir-
tue it might  be  extirpated.  The treatment of this difeafe ii fimilar
to that of a  confirmed lues  or pox.  The yaws, a difeafe which
is now very common both in America and the. Weft India iflands,
may alfo be  cured in the  fame manner. 
OF A CONFIRMED  LUES OR  POX.
a fmall degree of virulence is ftill left in the humours,  which
gradually vitiates, and at length contaminates the whole mafs.
To avoid this,  we would advife, that the patient fhould ne-
ver leave off  taking medicine immediately upon the  difap-
pearing  of the fymptoms, but continue it for fome time
after, gradually  leffening the quantity,  till there is fuffi-
cient ground to believe,  that the difeafe is entirely eradi-
cated.
   It is  not only difficult, but abfolutely impoffible,  to af-
certain the exaa degree of virulence that may attend the dif-
eafe; for which reafon it will always be a much fafer  rule to
continue the ufe of medicine too  long, than to leave it off
too foon.  This feems to be the leading maxim of a modern
praaitioner of fome note for the venereal difeafe, who al-
ways oiders his patient to perform a quarantine of at leaft for-
ty days, during which time he takes forty bottles of,  I fup-
 pofe, a ftrong decoaion of farfaparilla,  or fome other anti-
 venereal fimple.   Whoever takes this method, and adds a
 fufficient quantity  of corrofive fublimate, or fome other ac-
 tive preparation of mercury to the decoaion, will feldom fail
 to cure a confirmed lues.
   It is  peculiarly unfortunate for the cure of this  difeafe,
 that not one in ten of thofe who contraa it, are  either able
 or willing  to fubmit to a proper plan of regimen.  The pati-
 ent is willing to take medicine ; but he muft follow  his bu-
 finefs, and,  to prevent fufpicions,  muft eat and drink like the
 reft of the family-  This is the true fource of nine-tenths of
 all  the mifchief arifing from the venereal difeafe.   I never
 knew the cure attended with any great difficulty or danger
 where  the patient ftriaiy followed the  phyfician's  advice:
 But a volume would not be fufficient to point out the dreadful
 confequences  which  proceed  from  an  oppofite  condua.
 Scirrhus tefticles, ulcerous  fore throats, confumptions,  ca-
 rious bones, and a rotten progeny, are a few of the bleffings
 derived from this fource.
    There is  a fpecies of falfe reafoning, with regard  to  this
 difeafe, which proves fatal to many.   A perfon of a found
 conftitution contraas a flight degree of the dilorder.   He geti
 well without taking any great care, or ufing much medicine,
 and hence concludes that this will always be the  cafe.   I he
 next time the  difeafe occurs, though ten times more virulent,
 hepurfues the fame courfe, and  his conftitution is turned.
 Indeed, tne different degrees  of virulence in the fmall-pox
 are not greater than in this  difeafe, though,  as the learned
         6                                      Sydenham 
396      OF A  CONFIRMED LUES OR POX.

Sydenham obferves,  in fome cafes the moft fkilful phyficians
cannot  cure, and  in  others, the moft ignorant old  woman
cannot kill the patient in that diforder.   Though a good con-
ftitution is always in favour ofthe patient, yet too great ftrefs
may be laid  upon it.   It does not appear from obfervation,
that the moft robuft conftitution is able to overcome the vi-
rulence of the venereal contagion, after it has got into the
habit.   In this cafe a proper courfe of medicine is always in-
difpenfably neceffary.
   Although it is impoffible, on account of the different de-
grees of virulence,  &c. to lay down fixed and certain rules
for  the cure of this difeafe,  yet the following general  plan
will always be found fafe, and often fuccefsful, viz.  to bleed
and adminifter  gentle purges with diuretics during the in-
flammatory ftate, and as foon as  the fymptoms of inflamma-
tion are abated,  to adminifter mercury, in any form that may
be moft agreeable to the patient.   The fame medicine, afiift-
ed by the decoaion of farfaparilla and a proper regimen, will
not  only fecure the  conftitution againft the  further progrefs
of a confirmed pox, but will generally perform  a complete
cure.


              CHAP.    XLVIII.

      DISEASES    OF   WOMEN.

         OMEN,   in all civilized nations, have the ma-
          nagement of domeftic affairs;  and it is very proper
they fhould,  as Nature has made them lefs fit for the  more
aaive and laborious employments.   This indulgence, how-
ever, is generally  carried too  far; and females, inftead of
being  benefited by it, are greatly injured, from  the want of
exercife and free air.   To be fatisfied of this, one need on-
ly compare the frefh and ruddy looks of a  milk-maid,  with
the pale complexion  of thofe females  whofe whole time is
fpent within doors.  Though Nature has  made an evident
diftinaion between the male and female with regard to  bodi-
ly ftrength and vigour,  yet fhe certainly never meant, either
that the one fhould be always without, or the other always
within doors.
   The confinement of females,  befides hurting  their figure
and complexion, relaxes their folids, weakens their minds,
and diforders all the funaions of the body.   Hence proceed
                                            obftruaions,
w 
DISEASES   OF  WOMEN.
39T
obftruaions,  indigeftion,  flatulence,  abortions,  and ' the
whole train of nervous diforders.   Thefe not only unfit wo-
men for being mothers and nurfes, but often  render  them
whimfical and ridiculous.   A  found mind depends fo much
upon a healthy  body, that where  the latter is wanting,  the
former is rarely  to be found.
  I have always obferved  that  women who were chiefly  em-
ployed without  doors, in  the  different branches of hufban-
dry, gardening, and the like,  were almoft as hardy as  their
hufbands,  and  that  their children were likewife ftrong and
healthy.   But as the bad effeas of  confinement and inaaivi-
ty upon both fexes have been  already fhown, we  fhall pro-
ceed to point out thefe circumftances in the ftruaure and  de-
fign of females, which fubjea them to peculiar difeafes ;.  th«  *
chief  of which are,  their monthly evacuations, pregnancy, and
child-bearing.   Thefe indeed cannot properly  be called dif-
eafes, but from the delicacy of the fex, and their being  of-
ten improperly  managed  in fuch fituations,  they become trie
fource of numerous calamities.

      OF  THE  MENSTRUAL DISCHARGE.

  Females generally begin to menftruate  about the age of
fifteen,  and leave it off about  fifty, which renders  thefe two
periods  the moft critical of their lives.  About the firft ap-
pearance of this difcharge, the conftitution undergoes a very
confiderable change,  generally,  indeed,   for  the better,
though fometimes for the  worfe.   The greateft care is now
neceffary, as  the  future  health  and happinefs of the female
depends, in a great meafure, upon her condua at this  pe-
riod *.
  If a girl about this time of  life be confined to the  houfe,
kept conftantly  fitting, and neither allowed  to romp about,
nor employed in any aaive bufinefs, which gives exercife to
                                                      the

  * It is the duty of mothers and thofe who are entrufted with the
education of girls, to inftruft them early in tbe conduft and  ma-
nagement of themfelves at this critical period of their lives.  Falfe
modefty, inattention, and ignorance of what is beneficial or hurt-
ful at  this time, are the fources  of many difeafes and misfortunes
in life, which a few  fenfible leffons  from an experienced matron
might have prevented.  Nor is  care  lefs neceffary in the fubfe-
quent  returns  of this  difcharge.   Taking improper food, violent
affeftions of the mind,  or  catching cold  at this period, is often
fufficient to ruin the health, or  to render the female ever afcer ia-.
capable of procreation. 
398    OF  THE MENSTRUAL DISCHARGE.

the whole  body, fhe  becomes weak, relaxed, and  puny ;
her blood not being duly prepared, fhe looks pale  and wan;
her health, fpirits, and vigour decline,  and fhe finks into a
valetudinary for life.   Such  is the fate of numbers of thofe
unhappy females, who, either from too much indulgence, or
their own narrow circumftances, are,  at  this critical period,
denied the benefit of exercife and  free air.
  A lazy indolent difpofition proves  likewife  very hurtful to
girls at this period.  One feldom meets with complaints from
obftruaions amongft the more aaive and induftnous part of
the fex;  whereas the indolent and lazy are feldom free from
them.   Thefe are, in a manner, eat up by the chlorofis, or
green-ficknefs and other difeafes  of this nature.  We would
therefore recommend it to all who wifh to efcape thefe ca-
lamities, to avoid indolence and inaaivity,  as their great-
eft enemies, and to be as much abroad in the open air as pof-
fible.
  Another thing  which proves  very hurtful to girls  about
this period  of life, is unwholefome food.   Fond of all man-
ner of trafh,  they often  indulge in  it, till their  whole  hu-
mours are quite viriated.   Hence enfue indigeftions, want of
appetite, and a numerous train of evils.   If the fluids be not
duly prepared, it is utterly impoffible that the fecretions fhould
go properly on : Accordingly we find, that fuch girls as  lead
an indolent life, and eat great quantities of trafh, are not on-
ly fubjea to obftruaions of tbe menfes, but likewife to glan-
dular obftruaions; as the fcrophula or king's evil, &e.
   A  dull dilpofition is alfo very  hurtful to girls at this peri-
od.   It is a rare thing to fee  a fprightly girl who does not en-
joy good health, while the grave, moping, melancholy crea-
ture, proves  the very  prey of vapours and hyfterics.  Youth
is the feafon for mirth and cheerfulnefs.  Let it therefore be
indulged.  It is  an  abfolute duty.   To lay in a flock of
health in time of youth,  is  as neceffary a piece of prudence
as to make provifion againft the decays of old age.   While
therefore wife nature prompts  the  happy  youth to join in
fprightly amufements, let not the fevere diaates of hoary age
forbid the ufeful impulfe, nor damp  with ferious gloom the
feafon deftined to mirth and innocent feftivity.
   Another thing very hurtful to females about this period of
life is ftrait clothes. The) are fond of a fine fhape, and  fool-
ifhly imagine, that this can  be acquired by lacing themfelves
tight.  Hence,  by fqueezing the ftomach and bowels,  they
 hurt the digeftion, and  occafion many incurable maladies.
                                                     This 
OF THE MENSTRUAL DISCHARGE.
  This error is not indeed fo common as it has been ;  but,  as
  fafhions change, it may come about again : we therefore think
  it not improper to mention it.  I know many females who,
  to this day, feel  the direful effeas of that wretched cuftom
  which prevailed fome years  ago,  of fqueezing every girl into
  as fmall a fize in the middle as poffible.   Human invention
  could not poffibly have devifed a praaice more deftruaive to
  health.
    After a female has arrived at that period  of  life when the
  menfes ufually begin to flow, and they do not appear, but,  on
  the contrary, her health and fpirits begin to decline, we would
  advife, inftead of fhutting the poor girl up i